The term “pink slip” in a hospital setting is an informal name for the legal document that authorizes the temporary involuntary detention of an individual for emergency psychiatric evaluation. This process is initiated when a person is believed to be experiencing a mental health crisis that poses a direct safety concern to themselves or others. While the specific name, color, and process of the form vary significantly by state across the U.S., the underlying function remains consistent: to provide immediate intervention and assessment in a secure environment.
What the Hospital Pink Slip Authorizes
The pink slip serves as a legal mechanism that overrides a person’s right to leave a medical facility, authorizing a temporary hold against their will. This document directs the transport and confinement of an individual to a designated psychiatric facility or hospital emergency department for immediate assessment.
Its primary purpose is to allow qualified mental health professionals time to conduct a thorough evaluation of the person’s current mental state and need for continued treatment. The issuance of this form legally mandates the facility to take the patient into custody and begin the assessment process without delay. The exact paper form may be called an “Application for Emergency Admission” or similar statutory name, but its function of legally justifying a short-term, non-consensual hold is universal.
Criteria for Involuntary Commitment
Stringent legal standards must be met before a pink slip can be issued to protect the individual’s civil liberties. The criteria center on the belief that the person has a mental illness and poses an imminent risk if not immediately evaluated. The most common standard involves a determination that the individual is a danger to themselves, typically through evidence of suicidal threats or serious self-inflicted bodily harm.
An individual may also meet the criteria if they pose a substantial risk of physical harm to others, manifested by recent violent acts or credible threats. A third criterion is “grave disability,” meaning the person is so impaired by their mental illness that they are unable to provide for their own basic human needs, such as food, clothing, or shelter.
The process can be initiated by various authorized individuals who have personally observed the concerning behavior. These include:
- Physicians
- Licensed clinical psychologists
- Designated mental health officers
- Law enforcement personnel
The initiating party must provide a written statement detailing the observed circumstances and the reasons for their belief that the person meets the legal criteria for emergency hospitalization.
The Initial Hold and Time Restrictions
Following the issuance of a pink slip and the person’s arrival, a period of observation and evaluation begins immediately. The law mandates strict time limits for this initial hold to protect the person’s rights during involuntary confinement. While often referred to as a “72-hour hold,” this period represents the maximum time allowed for the initial emergency assessment, not a guaranteed detention period.
Within the first 24 hours of arrival, the person must be examined by a qualified mental health professional, such as a psychiatrist or chief clinical officer. If the professional determines the criteria for emergency detention are not met, the person must be released immediately. If the criteria are confirmed, the hospital can detain the person for up to three court days following the examination to finalize a disposition and develop a treatment plan.
Outcomes Following the Evaluation
Once the initial hold period ends and the evaluation is complete, one of three primary resolutions determines the person’s next steps. The first and most common outcome is immediate release, which occurs if the chief clinical officer determines the person no longer meets the legal criteria for involuntary commitment. This release typically includes a discharge plan with referrals for outpatient treatment and support services.
A second outcome is voluntary admission, where the patient agrees to remain in the facility for continued treatment after their mental state has stabilized enough to provide informed consent. This grants the patient more rights and control over their treatment.
The third possibility is the pursuit of further involuntary commitment, which requires the hospital to file a formal affidavit with a probate court. This action initiates a judicial process, and a judge must issue a court order for any extended involuntary stay.