A psychiatric hold is a temporary legal intervention used when an individual is experiencing a severe mental health crisis. The primary goal is to provide immediate mental health assessment and treatment to ensure the safety of the individual and the community. This process is initiated by law enforcement or qualified mental health professionals, functioning not as a criminal action, but as a civil protective measure.
Criteria for Involuntary Commitment
For a psychiatric hold to be legally initiated, a person must meet specific statutory criteria showing they pose an immediate and substantial risk of harm due to a mental disorder. The first common standard is danger to self, meaning the person has shown an intent or recent act of suicide or serious self-harm. This includes overt threats, attempts, or behaviors that place the person in imminent physical danger.
The second criterion is danger to others, which applies when a person expresses a serious intent to cause bodily harm to another individual or has recently engaged in violent behavior. This determination focuses on the immediate threat posed by the individual’s mental state, not just general hostility or agitation. Both criteria require a direct link between the mental disorder and the expressed or actual dangerousness.
The third, and often more complex, criterion is grave disability, where a person, as a result of a mental disorder, is unable to provide for their own basic personal needs. These needs are legally defined as food, clothing, or shelter. A person might be considered gravely disabled if they are so severely disorganized by their illness that they cannot access or utilize available resources to ensure their survival and safety. This standard is generally not met if the person is merely choosing an unconventional lifestyle or is homeless but still able to care for themselves.
The Standard Initial Duration
The initial duration for an emergency psychiatric hold is typically a maximum of 72 hours across most U.S. jurisdictions. This timeframe allows medical professionals to conduct a thorough psychiatric assessment, perform stabilization, and formulate an initial treatment plan. The 72-hour clock begins upon the individual’s arrival and acceptance at the designated facility for evaluation.
The person must be released at any point within the 72 hours if the treating physician determines the criteria for the hold are no longer met. If the individual is stabilized and no longer poses an immediate risk of danger to self, others, or grave disability, they are discharged. The hold represents the maximum time allowed for emergency evaluation before a more formal legal process must be initiated to justify continued detention.
Legal Mechanisms for Extension and Release
If the treating psychiatrist determines that the individual still meets the criteria for involuntary commitment after the initial 72-hour hold, the facility must seek a legal extension through a formal certification process. These successive holds require increasingly stringent legal proof to justify the ongoing restriction of the person’s liberty.
14-Day Hold
The most common next step is a 14-day hold, which requires an administrative or judicial review to certify the continued need for detention. During this review, the patient has the right to legal representation and can challenge the facility’s decision to continue their confinement.
Temporary and Long-Term Commitments
Following the 14-day period, if the person remains a danger or gravely disabled, the facility may petition the court for a temporary commitment for longer periods (30, 90, or up to 180 days, depending on the state). These longer commitments mandate a formal court hearing where the facility must present clear and convincing evidence that the individual still meets the statutory criteria. The longest form of involuntary commitment is typically an LPS conservatorship or similar long-term order, which can last up to a year and is reserved for individuals deemed persistently and severely gravely disabled.
Release from any involuntary hold occurs when the treating physician determines the patient is no longer a danger to themselves or others, or is no longer gravely disabled. The commitment ends either by the expiration of the court-ordered time limit without a successful extension or by the clinical decision to discharge the patient.