Northern Virginia Mental Health Institute (NVMHI) is one of Virginia’s eight adult state mental health hospitals and serves the rapidly growing Northern Virginia region from a nearly 60-yearold building on the Inova Fairfax Medical Campus. The 2025 Appropriations Act directed the Department of Behavioral Health and Developmental Services (DBHDS) to identify potential locations for a replacement facility that can meet current and future needs for this region.

As the Commonwealth continues modernizing its behavioral health infrastructure, the replacement of NVMHI aligns directly with the General Assembly’s right-sizing effort, initiated in Item 310 CC of the 2019 Appropriations Act. That framework envisions a regional hospital system in which facilities operate at an optimal size of 200 to 300 beds, supported by strong community-based services and a more balanced distribution of inpatient capacity. Based on Northern Virginia’s population growth, civil and forensic admission patterns, and statewide census pressures, the replacement NVMHI should be designed at approximately 250 beds. This bed count advances the long-term right-sizing strategy and helps stabilize capacity across all adult state hospitals, particularly given the reduced bed count at the new Central State Hospital.

DBHDS, working with the Department of General Services and a real estate broker, evaluated ten potential sites across Northern Virginia. Sites were assessed based on acreage suitable for a multi-story hospital, access to public transportation (particularly Metro), and proximity to a full-service hospital with an emergency department. Three sites emerged as the strongest options:

• Site 1: Willow Oaks Corporate Drive (Fairfax) – Located 0.7 miles from the current NVMHI and Inova Fairfax Hospital, with strong access to Metro, bus routes, and major roadways. This site best meets all core requirements, particularly proximity to emergency medical services.

• Site 2: Virginia State Police Property (Braddock Road, Fairfax) – Approximately six miles from the current NVMHI and near Inova Fairfax Hospital, with adequate buildable space. The property is currently in use by other state agencies.

• Site 3: Lorton Gateway (Lorton) – Approximately 16 miles from the current NVMHI, a large parcel with sufficient acreage for a modern facility and parking. Limited transit access and proximity to a former landfill make it a less optimal option than Sites 1 and 2.

Selecting a site is the first step. If the General Assembly chooses to move forward, funding will be required for land acquisition, planning, design, and construction.

A modern, 250-bed NVMHI is essential to meeting regional and statewide behavioral health needs and strengthening a safe, sustainable statewide hospital system. Given this increase in capacity for the region, the General Assembly may also wish to direct DBHDS to examine statewide adult psychiatric bed capacity to ensure alignment with regional demand and with the right-sizing framework previously endorsed by the legislature. Such an analysis could include options for redistribution of beds across state hospitals and would support a more coordinated approach to long-term capital planning and regional management of state-operated beds.