A 5150 hold is the temporary, involuntary detention of an individual for a mental health evaluation under California law. Named after the section of the Welfare and Institutions Code (WIC) that authorizes it, this process allows a person to be held for up to 72 hours if they are deemed a danger to themselves or others, or are gravely disabled due to a mental health disorder. The purpose of this initial hold is to provide a safe environment for evaluation and crisis intervention. After the initial 72 hours conclude, legal and clinical pathways determine the individual’s next steps, ranging from immediate release to extended involuntary treatment. These processes ensure that any continued detention is medically justified and legally compliant.
The Initial 72-Hour Review and Release Criteria
During the 72-hour period, professional staff at the designated facility conduct a clinical assessment of the individual’s condition. The goal is to determine if the person still meets the criteria that necessitated the initial hold: danger to self, danger to others, or grave disability. The facility does not need to hold the person for the full 72 hours if the treating psychiatrist determines they no longer require evaluation or treatment.
The person is released back into the community if the treating professional concludes they are stabilized and the crisis has passed. This release includes mandated care coordination planning, which outlines follow-up care and resources. Developed with the individual, the county behavioral health department, and the health care payer, this plan aims to ensure a smooth transition to voluntary, ongoing mental health services. The person may also choose to sign in voluntarily for continued care.
If the individual is released, the facility notifies the peace officer who initiated the hold, provided the officer requested notification and certified that the circumstances could support a criminal complaint. This notification is limited to the person’s name, address, and dates of admission and release. If the individual is not released or does not sign in voluntarily, the facility determines if the person still meets the criteria for involuntary treatment, initiating the next formal step under California law.
Certification for Extended Treatment
When the 72-hour hold ends, if professional staff determines the person still meets the criteria for danger or grave disability and is unwilling or unable to accept voluntary treatment, they can be certified for an additional 14 days of intensive treatment. This extended hold, formally called “certification for intensive treatment” (or a “5250 hold”), requires the person to be transferred to a facility designated by the county to provide this intensive treatment.
The certification requires a professional analysis finding the person is a danger to themselves, a danger to others, or gravely disabled due to a mental health disorder. Grave disability means the person is unable to provide for basic personal needs, such as food, clothing, or shelter. However, a person is not considered gravely disabled if responsible family or friends are willing and able to help provide for those basic needs.
The facility must issue a formal notice of certification, which legally justifies the additional 14 days of involuntary detention. This notice and the documentation must clearly articulate the facts and reasons why the person continues to meet the statutory criteria. The person must also have been advised of the need for treatment but declined it or lacked the capacity to consent.
Patient Rights and Certification Review Hearings
Once certified for the 14-day hold, a person is immediately entitled to due process rights to challenge the continued detention. The facility must inform the person of their right to a certification review hearing, which is automatically scheduled. This hearing must take place within four days of the date the person was certified for intensive treatment.
The Certification Review Hearing is conducted by a neutral party, such as a court-appointed commissioner, a referee, or a certification review hearing officer, who is not an employee of the county mental health program. The purpose is to determine whether probable cause exists to detain the person for the remainder of the 14 days. The facility carries the burden of justifying the continued hold by presenting evidence that the person still meets the criteria (danger to self, danger to others, or gravely disabled).
The certified person has the right to legal counsel; an attorney or a county Patients’ Rights Advocate meets with them to prepare for the hearing and discuss the commitment process. If the hearing officer finds a lack of probable cause, the person is immediately released from the involuntary hold. If the finding favors the facility, detention continues, but the person retains the right to file a writ of habeas corpus to have a judge review the legality of the hold.
Pathways to Long-Term Care
If the person’s condition has not stabilized by the end of the 14-day hold, further involuntary holds are possible, though they are less common and more restrictive. If the person was held for being a danger to themselves, they may be certified for an additional 14-day hold specifically for suicidal individuals. If the person was held for being gravely disabled, they may be placed on a 30-day hold for additional intensive treatment, depending on county utilization.
The mechanism for court-ordered, long-term involuntary treatment is the initiation of a Lanterman-Petris-Short (LPS) Conservatorship. This process is pursued when a person is determined to be persistently and severely gravely disabled, requiring treatment beyond the short-term holds. The process begins with a referral to the public conservator’s office, which investigates the person’s situation.
If the investigation supports the need, a petition for conservatorship is filed with the Superior Court. A temporary conservatorship (T-Con) may be granted while the full investigation proceeds, typically lasting up to 30 days.
An LPS Conservatorship, if granted by the court, typically remains in effect for one year and can be renewed annually if the person remains gravely disabled. This conservatorship allows for placement in a locked facility and the management of a person’s treatment and basic needs.