The number of Virginia behavioral health calls to 911 that received a behavioral health response, rather than solely law enforcement, is increasing, albeit slowly — up from 10% in 2022 to 22% of calls in 2024.
But four years after Virginia’s Marcus Alert system took effect, limitations in funding and a staggered rollout of the system across the state means only about a third of localities have the system in place. That’s according to a new report from the Behavioral Health Commission.
In 2020, the General Assembly passed the Marcus-David Peters Act, so named for the Black biology teacher who was fatally shot by Richmond police in 2018 while experiencing a mental health crisis. The legislation created the Marcus Alert system, designed to dispatch behavioral health clinicians and other experts to people in crisis, instead of or at least in addition to law enforcement.
The report found that there’s a ways to go to achieve the goals of the legislation.
Implementation
At the local level, the Marcus Alert System is administered by community services boards (CSBs), which can encompass multiple localities and local agencies.
Thus far, 17 out of 40 CSBs, covering a third of Virginia localities, have implemented the system. An additional 10 CSBs have plans to launch the system in July 2026. In Hampton Roads, the Virginia Beach CSB and Hampton-Newport News CSB have Marcus Alert Systems up and running. The Western Tidewater CSB, which covers Suffolk, Southampton, Franklin and Isle of Wight, has also implemented the system.
The deadline for all localities to have Marcus Alerts in place is July 2028.
“Full state funding is necessary in this biennial budget to meet the 2028 deadline with all CSB coverage areas funded,” said Claire Mairead, associate policy analysist at the Behavioral Health Commission, in a presentation to the commission Tuesday in Richmond.
Funding
The CSBs adopt the Marcus Alert System in set phases, with each implementing CSB receiving a fixed allocation of $600,000 the year before the system goes into effect.
“Dickinson County has a a population of 17,000 people, and it is a CSB unto itself,” Sen. Creigh Deeds, D-Charlottesville and chair of the commission, said at Tuesday’s meeting. “They get the same $600,0000 as Fairfax County does with more than a million people. We’ve got some major flaws in the way this thing’s put together and the way it’s implemented, and we have to figure that out.”
The report proposed that the budget language could be amended to allow the Department of Behavioral Health and Developmental Services to distribute funds based on community needs.
Connie Vatsa, Marcus Alert Coordinator, sits for a portrait in the Crisis Response Team headquarters at the BJ Roberts Behavioral Health Center in Hampton on Friday, Sept. 12, 2025. (Kendall Warner/The Virginian-Pilot)
The current levels of funding are insufficient for some localities. The Hampton-Newport News CSB has a Marcus Alert team of clinicians, which has close to 24-hour coverage on weekdays and about 16 hours on weekends. Those clinicians respond and conduct evaluations for an average of 40 to 50 calls a month.
The Newport News region sees about 500 mobile crisis dispatches a month, to which a variety of agencies can respond.
“I would love to be able to consistently provide 24/7 coverage for a CSB or care clinician to respond to crises in the area,” said Connie Vatsa, Marcus Alert Coordinator at the Hampton-Newport News CSB. “I would probably need to at least double my clinicians.”
Effectiveness
There are other issues. There is no statewide training for CSBs, emergency dispatchers and law enforcement on the Marcus Alert System.
The legislation stipulates that when someone calls either 911 or 988, the state’s mental health crisis number, dispatchers use a triage framework to determine the appropriate level of response.
For level 1 calls, when a behavioral health intervention is appropriate but there’s no immediate danger to the person in crisis or anyone else, 911 operators must transfer those calls to 988. Calls with level 2 urgency, which prompt an in-person behavioral health response and may include cases of minor self injury, are also generally supposed to be transferred to 988.
Level 3 calls, when a person might be experiencing acute psychosis or could pose a significant threat to themselves or others, merit a response from a mobile crisis team and emergency services, including law enforcement. And level 4, when there is a direct and immediate threat to life, behavioral health takes a back seat to law enforcement, which must respond, and 988 calls must transfer to 911.
But call takers don’t always follow that format. Only 6% of low urgency calls were transferred to 988 in 2024.
“Many calls are from third parties, like a family member or a neighbor rather than the in-person crisis,” Mairead said. “When a third party calls 911, they usually want an in-person response like a welfare check, and 988 typically won’t dispatch mobile crisis teams for third-party calls. Sometimes when the person in crisis does call, they don’t want to be transferred, especially if they’re unfamiliar with 988 or have higher trust in their local 911 dispatchers.”
In localities that have implemented the system, 43,000 mental health calls came through 911.
And higher level calls rarely get a behavioral health response. Just 22% of the 10,281 level 3 calls in 2024 received a community care team response.
Jasmine Blow, mobile crisis clinician, and Jamel Royal, a medic/firefighter with Hampton Fire and Rescue, stand by their crisis response vehicle outside the BJ Roberts Behavioral Health Center in Hampton on Friday, Sept. 12, 2025. Blow and Royal are members of the Crisis Response Team for Hampton and Newport News. They respond with police and fire departments using the Marcus Alert System to community members suffering from mental health crises. (Kendall Warner/The Virginian-Pilot)
“Right now, the capacity of those community care teams is insufficient to meet the need,” Mairead said. “The existing capacity is being used for lower urgency calls, which further reduces capacity for level 3 and level 4 calls.”
And without statewide training, it’s not clear that 911 and 988 operators always know how to triage those calls, though Vatsa says that’s getting better.
“The system is increasing capacity,” she said. “People are becoming more aware of it. I think the 911 dispatchers are getting better at identifying Marcus Alert calls.”
The Marcus-David Peters Act also required all localities to establish a database where people with ongoing behavioral health concerns could let 911 and 988 dispatchers know relevant information, such as a family member to call in the event of a crisis. The statute required localities to implement that database by July 2023, but they are not often utilized by dispatchers, the report found.
A binder full of mental health resources is kept inside the crisis response vehicle outside the Crisis Response Team headquarters at the BJ Roberts Behavioral Health Center in Hampton on Friday, Sept. 12, 2025. (Kendall Warner/The Virginian-Pilot)
Some progress
The report found the percentage of behavioral health crises that receive a non-law enforcement response is on the rise. In Hampton and Newport News, that has resulted in fewer emergency custody orders — those allow law enforcement to take somebody into custody to be assessed for involuntary hospitalization. And, increasingly, the law enforcement that responds has received crisis intervention training.
“I can tell you, when my team goes out in the field, over 90% of the evaluations result in something other than an emergency custody order,” Vatsa said. “Before the Marcus Alert system and this mobile crisis capacity, if 911 dispatchers got a mental health call, their only option was to dispatch out a police officer, who then could determine whether or not the individual met the criteria to go to the hospital for the mental health assessment.”
Kate Seltzer, 757-713-7881, kate.seltzer@virginiamedia.com,