Many people don't realize that publicly-funded mental health services are available in their state. People looking for free or low-cost counseling often think their only options are counselors in private practice and don't know that publicly-funded providers in their communities may also offer counseling services.
While state-based programs are not for everyone, they are often a great place to start for people who face geographic or financial barriers to therapy. Intake specialists at community mental health programs can help people learn whether they qualify for state-funded services and can refer people who don't qualify to other low-cost programs that may be able to meet their needs.
When Should You Go to a State Mental Health Program?
Community services boards are one of the best places to go in Virginia if you're experiencing a mental health crisis and aren't sure whether you need inpatient or outpatient care. Each CSB is required to have trained staff who respond to mental health emergencies. If you are thinking of harming yourself or someone else, they will recommend and ensure that you obtain emergency inpatient services.
If you do not require inpatient care but require immediate access to outpatient services, a CSB is also the right place to go. In March 2019, Virginia Governor Ralph Northam announced that all 40 Virginia CSBs had achieved compliance with a 2017 state law requiring them to provide same-day access to services. This means any person needing a mental health assessment can receive one right away instead of waiting weeks for an appointment. People who are eligible for services are scheduled to begin treatment within seven to ten days.
The best way to know whether it's right to seek services at your local Virginia CSB is to call them. Not all CSBs provide individual therapy, so you should ask if they do over the phone before investing time and money in an in-person assessment. You should also ask if the CSB charges a fee for people who come in to meet with an intake counselor and find out they are not qualified for CSB services. If they don't charge people who don't qualify, talking to a counselor in person may be a good time investment. They will be able to help you clarify what you need and give you referral information if CSB services aren't right for you. If they do charge, you may be able to get some free referral information over the phone.
There are no income requirements to receive services at a CSB, but CSBs prioritize serving people who do not have the means to access mental health services in the private sector. If you have the ability to pay out-of-pocket for care or have a good insurance plan that includes mental health benefits, your needs may be better met by searching for a therapist on OpenCounseling or on your insurance company's website. Online therapy with BetterHelp (a sponsor of OpenCounseling) can be another great option, especially if the nearest therapist to you is a long commute away.
Thousands of people in Virginia are not getting the mental health care they need, in many cases because they don't know about the CSB system or other ways to access affordable care. Mental Health America ranks Virginia 40 out of 51 states (including the District of Columbia) for access to mental health care. Only about one third of Virginians with serious mental illness receive treatment at a CSB, even though far more than that qualify for services through one. So if you're not sure, call. You may find out that you qualify or that there is another affordable option nearby. In either case, the care you need may be closer than you think.
What Services Does a Community Services Board Provide?
Virginia state law requires every CSB to provide emergency and case management services for adults and children. Other services provided by CSBs can include inpatient, outpatient, day support, residential, prevention, and early intervention services. The type and extent of services offered depends on each specific CSB. Some CSBs serve more highly populated counties and cities and therefore have more funding to provide more services. Many CSBs offer outpatient counseling and therapy, though these departments are often small due to budget limitations.
Who Is Eligible for Public Mental Health Services in Virginia?
One of the most important requirements to receive services at a CSB is to be a resident of its service area. The number of counties and cities in a service area varies. Community service boards that administer services in rural areas that are more sparsely populated typically cover larger geographic areas.
Budget limitations require CSBs to regulate and restrict who can receive services through them. These restrictions vary by location and by the amount of funding each location receives. In general, CSBs focus on providing services to three client populations:
- People who are in need of emergency or crisis services
- People whose mental health conditions impact their ability to function
- People who belong to one or more special populations served by specific programs
Many CSBs receive specific grants to serve people in certain vulnerable groups and are required to serve certain groups by law. Depending on the CSB, these groups may include:
- Women who are pregnant and using opioid drugs
- People who are or who have recently been homeless
- People who qualify for disability due to a mental illness
- People with co-occurring mental health and substance use disorders
- People who have recently been discharged from an inpatient psychiatric facility
- People involved in the criminal justice system, including people on probation and parole
This does not mean the only people who can go to a CSB to inquire about counseling or therapy are people in one of these groups. The mission of a CSB is to help all people in the community access mental health services. Intake and assessment therapists help people determine whether they are eligible for CSB services and provide information and referrals for people who don't qualify. They often have lists of non-profit and low-cost counseling organizations that can serve people who lack insurance but don't qualify for therapy through a CSB.
How Can You Find Out More About Local Programs in Virginia?
The best way to find out whether you qualify for counseling or other services at a Virginia CSB is to call your local program directly. In Virginia, each CSB is assigned to at least one county or city. Many CSBs serve several counties. Each CSB operates a crisis line that you can call when you are in crisis. These lines also often serve as general information lines for people seeking local mental health care. Some CSBs have dedicated information, access, or referral lines.
Virginia's Mental Health Clinics and Access Numbers
- Alexandria CSB: Serving the City of Alexandria
- (703) 746-5700 (main Human Services number)
- (703) 746-3535 (Mental Health Intake)
- (703) 746-3400 (Outpatient Mental Health Services)
- (703) 746-3400 or (703) 746-3401 (crisis line)
- Alleghany Highlands CSB: Serving the City of Covington and the County of Alleghany
- (540) 965-2135 (main number)
- (540) 965-6537 (daytime crisis line)
- (800) 446-0128 (after-hours crisis line)
- (540) 965-2100 (The Guinan Center for Mental Health and Substance Abuse Services)
- (540) 965-1770 (The Guinan Center After-Hours Emergency Line)
- Arlington County CSB: Serving the County of Arlington
- (703) 228-5150 (main number)
- (703) 228-5160 (crisis line)
- Blue Ridge Behavioral Healthcare: Serving the Cities of Roanoke and Salem and the Counties of Botetourt, Craig, and Roanoke
- (540) 343-3007 (Walk-In Clinic number)
- (540) 981-9351 (crisis line)
- (540) 266-9200 (The Burrell Center for Outpatient Services)
- Chesapeake Integrated Behavioral Healthcare: Serving the City of Chesapeake
- (757) 547-9334 (main number)
- (757) 548-7000 (crisis line)
- Chesterfield County CSB: Serving the County of Chesterfield
- (804) 748-1227 (main number)
- (804) 748-6356 (crisis line)
- Colonial Behavioral Health: Serving the Cities of Poquoson and Williamsburg and the Counties of James City and York
- (757) 220-3200 (main number)
- (757) 378-5555 (crisis line)
- (757) 220-3200 (Williamsburg Outpatient Counseling Office)
- (757) 898-7926 (York-Poquoson Outpatient Counseling Office)
- Crossroads CSB: Serving the Counties of Amelia, Buckingham, Charlotte, Cumberland, Lunenburg, Nottoway, and Prince Edward
- (434) 315-0370 or (866) 307-0370 (Assessment and Referral Services)
- (800) 548-1688 (Emergency Services and general crisis line)
- (804) 561-5057 (Amelia Center)
- (434) 542-5187 (Charlotte Center)
- (434) 392-3187 (Farmville Center)
- (434) 696-3747 (Lunenburg Center)
- Cumberland Mountain CSB: Serving the Counties of Buchanan, Russell, and Tazewell
- (276) 964-6702 (main number and daytime crisis line)
- (800) 286-0586 (after-hours crisis line)
- (276) 964-6702 (Cedar Bluff Outpatient Office)
- (276) 935-7154 (Buchanan County Satellite Office)
- (276) 889-3785 (Russell County Satellite Office)
- (276) 988-7961 (Tazewell County Satellite Office)
- Danville-Pittsylvania Community Services: Serving the City of Danville and the County of Pittsylvania
- (434) 799-0456 (main number)
- (434) 793-4922 (crisis line)
- (434) 793-4931 (Outpatient Counseling Services)
- Dickenson County Behavioral Health Services: Serving the County of Dickenson
- (276) 926-1680 (main number and daytime crisis line)
- (276) 926-1650 (after-hours crisis line)
- District 19 CSB: Serving the Cities of Colonial Heights, Emporia, Hopewell, and Petersburg, and the Counties of Dinwiddie, Greensville, Prince George, Surry, and Sussex
- (804) 862-8002 x3047 (Same-Day Access Intake Line)
- (804) 862-8000 or (866) 365-2130 (District 19 Crisis Line)
- (434) 634-2020 (Emporia Area Crisis Line)
- (804) 862-8002 x3047 (Petersburg Counseling Office)
- (434) 348-8900 (Emporia Counseling Office)
- (804) 541-8660 (Hopewell/Prince George Counseling Office)
- Eastern Shore CSB: Serving the Counties of Accomack and Northampton
- (757) 442-3636 (main number)
- (757) 442-7707 or (800) 764-4460 (crisis line)
- (757) 665-1260 (Eastern Shore Behavioral Healthcare Center)
- Fairfax-Falls Church CSB: Serving the Cities of Fairfax and Falls Church and the County of Fairfax
- (703) 383-8500 (Entry and Referral Line)
- (703) 573-5679 (crisis line)
- (703) 360-6910 (Gartlan Center)
- (703) 559-3000 (Merrifield Center)
- (703) 704-6355 (Outpatient Services at the Gerry Hyland Government Center)
- Goochland-Powhatan CSB: Serving the Counties of Goochland and Powhatan
- (804) 556-5400 (Goochland main number)
- (804) 556-3716 (Goochland crisis line)
- (804) 598-2200 (Powhatan main number)
- (804) 598-2697 (Powhatan crisis line)
- Hampton-Newport News CSB: Serving the Cities of Hampton and Newport News
- (757) 788-0300 (general inquiries)
- (757) 788-0011 (crisis line)
- (757) 788-0244 or (757) 788-0266 (Adult Comprehensive Outpatient Services)
- Hanover County CSB: Serving the County of Hanover
- (804) 365-4222 (main number)
- (804) 365-4200 (crisis line)
- (804) 365-4222 (Ashland Office)
- (804) 365-6760 (Mechanicsville/Bell Creek Office)
- Harrisonburg-Rockingham CSB: Serving the City of Harrisonburg and the County of Rockingham
- (540) 434-1941 (main number)
- (540) 434-1766 (crisis line)
- Henrico Area Mental Health and Developmental Services: Serving the Counties of Charles City, Henrico and New Kent
- (804) 727-8500 (main office number)
- (804) 727-8515 (intake and referral line)
- (804) 727-8484 (crisis line)
- (804) 727-8970 (Providence Forge Office)
- (804) 727-8100 (East Center Office)
- (804) 727-8920 (Richmond Medical Park/Henrico Office)
- (804) 727-8500 (Woodman Road Center/Glen Allen Office)
- Highlands CSB: Serving the City of Bristol (Virginia) and the County of Washington
- (276) 525-1550 or (855) 426-5263 (main number)
- (866) 589-0269 (after-hours crisis line)
- Horizon Behavioral Health: Serving the City of Lynchburg and the Counties of Amherst, Appomattox, Bedford, and Campbell
- (434) 477-5000 (main number and crisis line)
- (434) 522-8191 (after-hours crisis line)
- (434) 847-8035 (Horizon Wellness Center at Court Street, Lynchburg)
- (434) 946-2316 (Horizon Wellness Center at Amherst)
- (434) 352-8239 (Horizon Wellness Center at Appomattox)
- (434) 942-0370 (Horizon Wellness Center at Concord)
- (434) 847-8000 (Horizon Wellness Center at Landover, Lynchburg)
- (434) 948-4831 (Horizon Wellness Center at Langhorne, Lynchburg)
- (434) 332-5149 (Horizon Wellness Center at Campbell, Rustburg)
- (540) 586-5429 (Horizon Wellness Center at Bedford)
- Loudon County CSB: Serving the County of Loudoun
- (703) 771-5155 (information and appointments)
- (703) 777-0320 (crisis line)
- Middle Peninsula-Northern Neck CSB: Serving the Counties of Essex, Gloucester, King and Queen, King William, Lancaster, Matthews, Middlesex, Northumberland, Richmond and Westmoreland
- (804) 758-5314 (Mental Health Services)
- (800) 542-2673 (crisis line)
- (804) 333-3671 (Warsaw Counseling Center)
- (804) 693-5057 (Gloucester Counseling Center)
- Mount Rogers CSB: Serving the City of Galax and the Counties of Bland, Carroll, Grayson, and Smyth
- (276) 223-3200 (main number)
- (866) 589-0265 (after-hours crisis line)
- (276) 223-3202 (Wythe Counseling Center, Wytheville)
- (276) 783-8185 (Smyth Counseling Center, Marion)
- (276) 238-9700 (Fernwood Counseling Center, Galax)
- New River Valley CSB: Serving the City of Radford and the Counties of Floyd, Giles, Montgomery, and Pulaski
- (540) 961-8300 (main number)
- (540) 961-8400 (crisis line)
- Norfolk CSB: Serving the City of Norfolk
- (757) 823-1600 (main number)
- (757) 664-7690 (crisis line)
- (757) 664-7699 (Boulevard Center)
- (757) 823-1600 (Olney Road Center)
- (757) 664-6670 (Tidewater Drive Center)
- Northwestern CSB: Serving the City of Winchester and the Counties of Clarke, Frederick, Page, Shenandoah, and Warren
- (540) 636-2931 (main office number)
- (540) 635-4804 or (800) 342-1462 (crisis line)
- (540) 743-4548 (Page County Clinic)
- (540) 459-5180 (Shenandoah County Clinic)
- (540) 636-2931 (Warren County Clinic)
- (540) 667-8888 (Winchester Area Clinic)
- (833) 626-1490 (Substance Use Confidential Warmline)
- (540) 743-3733 (volunteer-staffed Concern Hotline for Page County)
- (540) 459-4742 (volunteer-staffed Concern Hotline for Shenandoah County)
- (540) 635-4357 (volunteer-staffed Concern Hotline for Warren County)
- (540) 667-0145 (volunteer-staffed Concern Hotline for Frederick, Winchester, and Clarke Counties)
- Piedmont CSB: Serving the City of Martinsville and the Counties of Franklin, Henry, and Patrick
- (276) 632-7128 (Martinsville Office)
- (276) 694-4361 (Patrick County Office)
- (540) 483-0582 (Franklin County Office)
- (888) 819-1331 (Emergency Services)
- Planning District One Behavioral Health Services: Serving the City of Norton and the Counties of Lee, Scott, and Wise
- (276) 679-5751 (main number)
- (276) 346-3590 (Lee County Office and Crisis Line)
- (276) 225-0976 (Scott County Office and Crisis Line)
- (276) 253-8300 (Wise County and Norton City Office and Crisis Line)
- Portsmouth Department of Behavioral Healthcare Services: Serving the City of Portsmouth
- (757) 393-5357 or (757) 393-8618 (main number)
- (757) 393-8990 (Emergency Services)
- Prince William County CSB: Serving the Cities of Manassas and Manassas Park and the County of Prince William
- (703) 792-7373 (Woodbridge Access Intake Office)
- (703) 792-4900 (Woodbridge Crisis Line)
- (703) 792-5241 (Manassas Access Intake Office)
- (703) 792-7800 (Manassas Crisis Line)
- Rappahannock Area CSB: Serving the City of Fredericksburg and the Counties of Caroline, King George, Spotsylvania, and Stafford
- (540) 373-3223 (main number)
- (540) 373-6876 (Crisis Line for Fredericksburg and Stafford and Spotsylvania Counties)
- (540) 775-5064 (Crisis Line for King George County)
- (804) 633-4148 (Crisis Line for Caroline County)
- (540) 373-3223 (Fredericksburg Clinic)
- (540) 582-3980 (Spotsylvania County Clinic)
- (540) 659-2725 (Stafford County Clinic)
- (540) 775-9879 (King George County Clinic)
- (804) 633-9997 (Caroline County Clinic)
- Rappahannock-Rapidan CSB: Serving the Counties of Culpeper, Fauquier, Madison, Orange, and Rappahannock
- (540) 825-3100 (main number)
- (540) 825-5656 (crisis line)
- (540) 825-5656 (Culpeper Behavioral Health Clinic)
- (540) 347-7620 (Fauquier Behavioral Health Clinic)
- Region Ten CSB: Serving the City of Charlottesville and the Counties of Albemarle, Fluvanna, Greene, Louisa, and Nelson
- (434) 972-1800 or (866) 694-1605 (crisis line)
- (434) 985-5220 (Greene County Office)
- (434) 481-3890 (Greene Counseling Center)
- (434) 972-1800 (Peterson Counseling Center, Charlottesville)
- (434) 589-8276 (Fluvanna County Office and Counseling Center)
- (434) 263-4889 (Nelson County Office and Counseling Center)
- (540) 967-2880 (Louisa County Office and Counseling Center)
- Richmond Behavioral Health Authority: Serving the City of Richmond
- (804) 819-4000 (main number)
- (804) 819-4100 (crisis line)
- Rockbridge Area CSB: Serving the Cities of Buena Vista and Lexington and the Counties of Bath and Rockbridge
- (540) 463-3141 or (877) 766-3105 (main number)
- (540) 463-3141 (main access line)
- (540) 839-3162 (Bath County access line)
- (855) 222-2046 (crisis line)
- Southside CSB: Serving the Counties of Brunswick, Halifax, and Mecklenburg
- (434) 572-6916 (main number)
- (833) 697-7272 (general information line)
- (833) 377-7272 (crisis line)
- (434) 848-4121 (Brunswick Behavioral Health Center, Lawrenceville)
- (434) 572-2936 (Halifax Behavioral Health Center, South Boston)
- (434) 738-0154 (Mecklenburg Behavioral Health Center, Boydton)
- Valley CSB: Serving the Cities of Staunton and Waynesboro and the Counties of Augusta and Highlands
- (540) 887-3200 or (540) 943-5515 (main number)
- (540) 943-1590 or (540) 885-0866 or (866) 274-7475 (crisis line)
- Virginia Beach CSB: Serving the City of Virginia Beach
- (757) 385-3200 (main number)
- (757) 385-0888 (crisis line)
- (757) 385-0511 (Pembroke Clinic)
- (757) 385-8222 (Magic Hollow Clinic)
- Western Tidewater CSB: Serving the City of Franklin and the Counties of Isle of Wight and Southampton
- (757) 966-2805 (main number)
- (757) 925-2484 (crisis line)
- (757) 942-1090 (Same Day Access information line)
- (757) 942-1069 (Suffolk Services Center)
- (757) 935-5160 (Saratoga Services Center)
- (757) 966-2805 (Harbour View Service Center)
- (757) 562-2208 (Franklin Services Center)
- (757) 357-7458 (Smithfield Services Center)
Each CSB's website includes additional information about the services they offer and who qualifies for them. Most also explain where their walk-in assessment centers are located. Many intake departments at CSBs can give you basic information over the phone, including alternative service providers to contact if you don't meet requirements for CSB services.
How Does Virginia's Public Mental Health System Work?
Community mental health programs (CMHPs) are publicly-funded organizations that provide essential mental health services to people who live in the city or county they serve. They are administered by state governments and funded by a range of public income sources including federal block grants.
Many CMHPs were founded after the federal government passed the Community Mental Health Act in 1963. This landmark law encouraged states to build community programs that would serve as alternatives to institutionalization for people with serious mental illness.
The main purposes of CMHPs are to function as a mental health safety net and to provide mental health services to people regardless of their ability to pay. Other important functions of CMHPs are to provide a single point of entry for mental health services and to enable people with serious mental health conditions to live in the least restrictive setting possible in the community.
A community services board (CSB) is a publicly-funded community mental health program in the state of Virginia. The CSB system was established in 1968 pursuant to Virginia Code 37.2-500. This law requires every county or city in Virginia to establish a public agency that serves "as the single point of entry into publicly funded mental health, developmental, and substance abuse services." Virginia CSBs are administered and overseen by the Virginia Department of Behavioral Health and Developmental Services (DBHDS).
