The terms “5150” and “5250” are shorthand for sections of the California Welfare and Institutions Code that outline procedures for temporary, involuntary psychiatric detention. These sections are part of the Lanterman-Petris-Short (LPS) Act, which governs the involuntary civil commitment of individuals with mental disorders in California. The purpose of these holds is to provide a brief period of evaluation and crisis stabilization in a secure facility. This measure is activated when an individual is experiencing an acute mental health crisis and is deemed to pose an immediate risk to themselves or others.
Legal Criteria for Involuntary Detention
An individual can only be detained involuntarily under the LPS Act if they meet one of three specific legal criteria, all resulting from a mental health disorder.
The first criterion is being a danger to self, which involves a credible threat or attempt to commit suicide or inflict serious bodily harm. The second condition is being a danger to others, met when a person has made threats or taken actions indicating a clear intention to cause physical harm to another person.
The third criterion is being “gravely disabled.” This designation applies to an adult who, because of a mental disorder, is unable to provide for their basic personal needs, such as securing food, clothing, or shelter. Meeting any one of these three conditions provides the legal foundation for initiating an involuntary hold.
The Initial 72-Hour Evaluation Hold
The 5150 hold is the initial involuntary detention phase, authorized for a maximum duration of 72 hours, beginning when the individual is taken into custody. This period is designed for psychiatric evaluation and crisis stabilization. Law enforcement officers and specific county-authorized mental health professionals have the authority to initiate this hold. They must have probable cause, meaning they must strongly suspect the individual meets one of the three legal criteria for detention.
Upon detention, the individual is transported to a designated facility, such as a psychiatric hospital, for assessment. During this timeframe, staff work to stabilize the person and conduct a comprehensive evaluation. The facility must release the individual sooner if they no longer meet the legal criteria. By the conclusion of the hold, staff must determine if the person can be safely released, agrees to voluntary treatment, or requires further intensive treatment.
Process for Extended Certification
If the treating professional determines that an individual continues to meet the criteria for involuntary detention and is unwilling or unable to accept voluntary treatment, they may initiate a 5250 hold. This certification for intensive treatment extends the involuntary hospitalization for a maximum of 14 additional days. The decision to extend the hold must be based on the same standard used for the initial detention. This extension shifts the focus from emergency evaluation to providing intensive psychiatric treatment.
A Certification Review Hearing (CRH) is automatically scheduled and must take place within four days of the 5250 certification. This hearing is held at the facility, overseen by an independent hearing officer, referee, or commissioner. The hospital staff must present evidence demonstrating why the individual continues to meet the legal criteria for confinement. The purpose of this review is to determine if there is sufficient probable cause to justify the continuation of the involuntary hold.
The patient is entitled to have a patient rights advocate present at the CRH to explain their rights and represent their perspective. The hearing officer reviews the case, including the medical evidence and the patient’s testimony, to decide whether the hold is legally justified. If the officer finds insufficient evidence, the individual must be released. If the hold is upheld, the patient remains in the facility for the remainder of the 14-day period, unless they are released earlier by the treatment team.
Patient Rights and Post-Hold Outcomes
Individuals placed on an involuntary hold retain rights protected under the LPS Act. They have the right to be informed of the reasons for their detention and to have access to a patient rights advocate. Patients also maintain the right to refuse treatments, including psychotropic medications, unless a court or hearing officer determines they lack the capacity to make that decision or in cases of an immediate emergency. They can challenge the legality of their detention at any time by filing a petition for a writ of habeas corpus.
Once the 14-day 5250 hold concludes, there are several possible outcomes for the patient. The individual may be discharged if treating professionals determine they are no longer a risk. A patient may also choose to convert their involuntary status to a voluntary admission to continue receiving care. If the person is still determined to be gravely disabled after the 14-day period, the facility may petition the court to establish an LPS conservatorship, a legal proceeding for longer-term management of care.