The term “51/50” is often heard in discussions surrounding mental health crises, yet its precise meaning can be unclear to many. This number refers to a specific type of temporary psychiatric hold, a legal provision designed to provide immediate intervention during acute mental health situations. This article aims to clarify the implications of a 51/50 hold and what it entails for individuals and their families.
Understanding the 51/50 Hold
A 51/50 hold is a legal authorization allowing for the involuntary detention of an individual for a mental health evaluation. This provision is specifically outlined in California’s Welfare and Institutions Code, Section 5150, and is part of the broader Lanterman-Petris-Short (LPS) Act. The LPS Act, which went into full effect in 1972, sought to establish due process protections and end indefinite involuntary commitments for mental health disorders.
For a 51/50 hold to be initiated, a professional must have probable cause to believe that, due to a mental health disorder, the individual meets one of three specific criteria. These criteria include being a danger to themselves, such as through suicidal ideation or attempts. It also applies if the person poses a danger to others, which could involve communicating a specific plan to inflict harm.
The third criterion is grave disability, meaning the individual is unable to provide for their basic personal needs like food, clothing, or shelter due to their mental condition. This temporary detention is not considered a criminal arrest; rather, it is a civil action focused on immediate assessment and intervention for individuals experiencing an acute mental health crisis.
The 51/50 Hold Process
Once the criteria for a 51/50 hold are met, the hold can be initiated by designated professionals, including peace officers, licensed members of a crisis team, or other mental health professionals authorized by their county. These individuals take the person into custody based on probable cause that one of the aforementioned conditions exists.
The individual is then transported to a designated facility for evaluation and treatment, such as a psychiatric emergency service or an approved hospital. The 72-hour timeframe for the hold begins the moment the person is first detained.
This 72-hour period includes weekends and holidays. During this time, mental health professionals conduct a thorough assessment of the individual’s condition. The facility does not have to hold the patient for the entire 72 hours if the professional determines the person no longer meets the criteria for continued evaluation or treatment. The primary purpose remains evaluation and stabilization, to determine if continued involuntary treatment is necessary or if the individual can be safely released.
Rights During a Hold and Release
Individuals placed under a 51/50 hold retain certain fundamental rights throughout their detention. They have the right to receive written notice of the hold and to communicate with an attorney. Patients also have the right to refuse certain medical treatments, including psychiatric medications, unless an emergency or court order dictates otherwise.
Following the 72-hour evaluation period, the individual may be released if mental health professionals determine they no longer meet the criteria for involuntary detention. Alternatively, they might agree to continue treatment on a voluntary basis. If the criteria for involuntary treatment persist, a further involuntary hold, such as a 14-day hold (often referred to as a 5250 hold), may be initiated, requiring additional justification.
Common Misconceptions and Specificity
A common misunderstanding about the 51/50 hold is that it constitutes a criminal charge. A 51/50 is a civil hold for mental health evaluation, not a criminal arrest, and therefore does not result in a criminal record. Another misconception is that being placed on a 51/50 hold is equivalent to receiving a formal psychiatric diagnosis; instead, it is a legal action based on observable behavior meeting specific criteria, not a clinical diagnosis.
The geographic specificity of the term “51/50” is important. This designation is unique to California law, originating from Section 5150 of the California Welfare and Institutions Code. While many other states have similar legal provisions for temporary involuntary psychiatric holds, they operate under different statutes and are known by various names and codes. These laws across states generally aim to address situations where individuals pose an imminent danger to themselves or others due to mental illness.