Referrals and admissions are taken 24 hours a day, 7 days a week at Central State Hospital. Individuals must be between ages 18 to 65 and under a court order for in-patient mental health treatment to be accepted. Inquires regarding admission to Central State Hospital should consult with the appropriate contacts listed below. 

Monday through Friday from 8:00am – 5:00pm  

  • Civil – Contact the Social Work Director or their designee at (804) 712-2279 
  • Forensic – Contact the Chief Forensic Admission Officer or their designee at (804) 524-7543 

Monday through Friday from 5:00pm – 8:00am 

  • Contact the Administrator on Duty (AOD) at (804) 524-7151

Weekends and Holidays

  • Contact the Administrator on Duty (AOD) at (804) 524-7151

In both Civil and Maximum Security cases, Admissions Units receive all patients newly admitted to CSH. Their primary responsibility is to provide a thorough and accurate assessment of each patient, beginning on the day of admission during their admission interview with a psychiatric provider. Other clinical team members complete a discipline-specific assessment within seven days of admission. This time period allows the team to become more familiar with the patient’s particular strengths and individual needs, identifying discharge criteria and objectives that will continue to be assessed throughout the course of treatment.  

Adjudicated Not Guilty by Reason of Insanity (NGRI)

CSH serves individuals who have been adjudicated NGRI and committed to the custody of the Commissioner. Virginia follows a graduated release process where NGRI acquittees are granted an increasing level of autonomy and access to the community with demonstrated success at lower levels of privilege. Movement through the NGRI process is governed by the Internal Forensic Privileging Committee (IFPC) and/or the Forensic Review Panel (FRP). The IFPC is a hospital level committee appointed by the hospital CEO to review requests for NGRI patient privileges. Some levels of privilege also need to be approved by the Forensic Review Panel. FRP is a committee appointed by the DBHDS Commissioner to review and approve certain requests from treatment teams or patients to increase an NGRI acquittee’s level of privilege, including transfers to less restrictive hospitals, grounds privileges, and/or community privileges. 

Most NGRI acquittees in Virginia start their recovery process in our Maximum Security facility. From there, with demonstrated safety and psychiatric stability, transfer to a regional civil facility may be requested. Other privilege levels that may be included in the gradual release process are: escorted grounds accompanied by facility staff, unescorted grounds, community visits escorted by staff, unescorted community day visits, unescorted community overnight visits less than 48 hours, and trial visits of over 48 hours if needed. The final stage is conditional or unconditional release. A comprehensive release plan is developed between the patient, treatment team, and Community Services Board to then be approved by the IFPC, FRP, and finally the court. For each privilege request, the treatment team submits a request packet completed with the CSB and patient, to include an updated analysis of risk assessment and risk management plans.


Some individuals are committed to CSH prior to standing trial for an alleged criminal offense. Clinical programming and specialized evaluation services are offered to help the individual move forward in their process. Evaluations that may be conducted at CSH include ‘Mental Status at the Time of Offense’ evaluation or ‘Competency to Stand Trial’ evaluations. Hospitalization for these evaluations does not generally exceed 30 days, but this period can be extended if necessary.  

Individuals who are found Incompetent to Stand Trial may be committed to CSH for treatment. Individuals who are Incompetent to Stand Trial generally have a major mental illness or other condition that is severe enough to cause them to be unable to understand the legal proceedings against them, and/or cause serious impairment in the ability of the individual to work with their defense attorney.  

Treatment focuses on restoration of trial competency and acute psychiatric care. Competency restoration programming may include treatment planning, milieu, educational and legal issues groups, medication management, and individual psychoeducation. At any point during the treatment program, the patient may be evaluated to confirm they are competent to stand trial. Patients in the program are generally committed for 180 days at a time, but are returned to court sooner when possible. Treatment is sometimes extended when needed.  

Patients in the jail systems who are assessed as being mentally ill and “dangerous to self or others” may also stay at CSH briefly for emergency treatment facilitated by a court order or TDO. 


Release planning begins at admission, and involves collaboration between the individual, their loved ones, treatment team members, and community service boards throughout the state. Treatment teams discuss on a weekly or daily basis the discharge readiness status of all patients on their team, working with the patient and the Community Services Board to develop a robust discharge plan.

Each patient committed through the legal system is treated with a personalized treatment plan designed to help the individual prepare for what comes next after leaving our hospital. For some that will mean returning to jail and a criminal court to stand trial, while others will be released to the community through the gradual release program as they continue treatment.