The term “5150 hold” refers to a specific section of the California Welfare and Institutions Code (WIC) that authorizes the involuntary detention of an individual for temporary psychiatric evaluation and treatment. This legal tool is part of the state’s Lanterman-Petris-Short (LPS) Act, which governs involuntary commitment procedures for people experiencing a severe mental health crisis. The hold is not a criminal arrest, but a means of providing immediate assessment and crisis intervention. It allows authorized professionals to take a person into custody against their will for a limited time to ensure their safety and the safety of the public.
Understanding the Criteria for Emergency Detention
For a 5150 hold to be lawfully initiated, the person must meet one of three specific criteria defined within the California Welfare and Institutions Code. The hold requires probable cause, meaning the authorized professional must reasonably believe a mental health disorder is causing the individual to pose a threat or be unable to care for themselves. This determination must be based on observable behavior or recent statements, not solely on past mental health history.
The first criterion is being a danger to themselves, often evidenced by explicit threats of self-harm, a recent suicide attempt, or severe self-injurious behavior. A professional must assess the likelihood of immediate harm, considering factors like a specific plan or the means to carry out the self-harm.
The second ground for detention is being a danger to others, meaning the person poses a risk of physical harm to another individual. This is established through threats or actions indicating homicidal intent or a violent mental state. Probable cause must exist that the individual’s mental disorder is driving this dangerous behavior.
The third criterion is being “gravely disabled.” Grave disability means the individual is unable to provide for basic personal needs, including food, clothing, or shelter. This determination is made when a mental disorder prevents the person from securing these necessities. A person is not gravely disabled if a willing and responsible family member or friend can ensure their basic needs are met.
Initiating the Hold and Designated Facilities
The authority to initiate a 5150 hold is restricted to personnel designated and trained for this specific legal action. Peace officers, such as police or sheriff’s deputies, are frequently involved, especially when the crisis presents a public safety concern. County mental health designees, including members of mobile crisis teams or emergency psychiatric service workers, also have this authority.
Professional staff members at a designated facility, such as a physician or licensed clinician, may also authorize the hold once the person is brought to their attention. The professional initiating the hold must complete a written application detailing the specific facts and circumstances establishing probable cause for the detention. This documentation ensures a record of the evidence used to justify the involuntary custody.
Once the hold is initiated, the person must be transported to a county-designated facility for evaluation and treatment. These facilities are typically locked psychiatric hospitals or specialized units within a hospital emergency department. The facility must be approved by the State Department of Health Care Services to provide the mandated 72-hour assessment and crisis intervention services.
The Mandatory 72-Hour Evaluation Period
The 5150 hold permits a person to be held for up to 72 hours for evaluation, assessment, and crisis intervention. The 72-hour clock begins the moment the person is taken into custody by authorized personnel. The person must be released sooner if staff determines they no longer meet the criteria for involuntary detention.
During this period, the person receives an intensive evaluation by qualified mental health professionals, including psychiatrists, psychologists, and social workers. The goal is to assess the severity of the mental health disorder and determine if the person remains a danger to self, others, or is gravely disabled. Assessment involves reviewing the circumstances that led to the hold, a mental status examination, and consultation with family or friends if appropriate.
Crisis intervention and stabilization are also provided to address immediate symptoms of the mental health crisis. This may include medication management or therapeutic support aimed at reducing acute distress and restoring stability. The detention is specifically for evaluation and crisis management, not for long-term psychiatric treatment.
Patient Rights and Subsequent Steps
Despite the involuntary nature of the hold, individuals retain significant legal and civil rights under the LPS Act. They have the right to be informed of the reasons for their detention, both orally and in writing, in a language they can understand. Patients are entitled to the assistance of a Patients’ Rights Advocate, who explains their rights and helps them navigate the legal process.
A person also has the right to refuse non-emergency medical treatment, including psychiatric medications, unless a court order is obtained. They can make phone calls to notify family or friends of their location. If the facility determines the person needs to be held beyond the initial 72 hours, they have the right to a certification review hearing. An independent hearing officer determines if there is probable cause for continued detention during this review.
At the end of the 72-hour evaluation period, there are three primary outcomes:
- The individual is released if staff determines they no longer meet the criteria for being a danger to self, a danger to others, or gravely disabled.
- The individual agrees to remain in the facility for further treatment on a voluntary basis.
- If the person still meets the involuntary criteria and refuses voluntary admission, the facility may certify the individual for an additional, longer hold under WIC Section 5250, which authorizes a 14-day period of intensive treatment.