A “52/50 hold” is shorthand for Section 5250 of the California Welfare and Institutions Code (WIC), part of the state’s Lanterman-Petris-Short (LPS) Act. This legal mechanism authorizes the involuntary detention of an individual for intensive psychiatric treatment, extending beyond the initial 72-hour evaluation period. The hold provides a brief, structured period of care for people who are believed to be a danger to themselves, a danger to others, or gravely disabled due to a mental health disorder.
The Legal Criteria for Certification
Certification for a 14-day hold under WIC 5250 requires a finding that the person meets one of three specific legal criteria as a result of a mental health disorder or impairment by chronic alcoholism.
The first criterion is being a danger to self, which typically involves a recent suicide attempt or a credible, immediate threat of self-harm. This requires a demonstrable, substantial physical risk where the individual’s mental state is actively leading to life-threatening actions.
The second criterion is being a danger to others, usually met when a person has recently made a serious threat of substantial physical harm or has attempted or inflicted physical harm on another person. This standard focuses on protecting public safety from a specific, present threat. The third criterion is being “gravely disabled,” meaning the person is unable to provide for their basic personal needs for food, clothing, or shelter due to a mental disorder.
The definition of gravely disabled is complex and does not simply include homelessness or a non-conformist lifestyle. A person is not considered gravely disabled if they can survive safely with the help of responsible family or friends who are both willing and able to provide support. Unless those third parties specifically indicate their willingness and ability in writing, they cannot be considered for this purpose. This strict definition ensures the involuntary hold is used only when the individual cannot care for themselves and lacks an available support system.
The Procedural Steps and Duration
The 52/50 hold is a direct extension of the initial 72-hour involuntary psychiatric hold (WIC 5150). If, after the 72-hour evaluation, professional staff determines the person still meets the criteria for involuntary detention and refuses voluntary treatment, they may be certified for the 5250 hold, which allows for a maximum of 14 continuous days of intensive treatment.
The decision to certify the patient is made by the professional staff of the designated facility, often a psychiatrist or medical director, and must be thoroughly documented. This documentation must explicitly state the facts demonstrating the person continues to meet the criteria of being a danger to self, a danger to others, or gravely disabled. The patient must also have been advised of the need for treatment but must have been unwilling or unable to accept it voluntarily.
Patient Rights and the Review Hearing
A central safeguard for a patient placed on a 52/50 hold is the automatic right to a Certification Review Hearing, which must be held within four days of the certification date. This informal, facility-based proceeding, often called a probable cause hearing, determines if there is sufficient legal evidence to continue the involuntary detention for the remainder of the 14 days.
The hearing is typically conducted by a neutral hearing officer, and the patient has the right to assistance from a Patients’ Rights Advocate or an attorney. A representative from the treatment facility must present evidence to justify the continued hold. The patient or their advocate has the opportunity to present evidence for release. If the hearing officer finds there is no probable cause to continue the hold, the patient must be released from the involuntary status.
The patient also retains the right to refuse certain treatments, though this right can be overridden in an emergency situation or if a court order is obtained. If the patient disagrees with the hearing officer’s decision, they may request a petition for a Writ of Habeas Corpus, which is a judicial review of the detention’s legality by a Superior Court judge. Requesting a writ bypasses the Certification Review Hearing, as it serves as a higher-level legal challenge.
Following the 14-Day Hold
When the 14-day intensive treatment period concludes, the patient’s involuntary detention must be terminated unless specific legal actions are taken. The most common outcome is release, granted if the treating psychiatrist determines the patient no longer meets the criteria of being a danger to self, others, or gravely disabled. Upon release, the patient typically receives a discharge plan for follow-up care and support services.
A second possibility is that the patient agrees to remain in the facility for continued care on a voluntary basis, transitioning from an involuntary to a voluntary status. If the patient remains imminently suicidal, the facility may seek an additional 14-day hold under WIC 5260, which is specifically for patients who continue to be a danger to themselves. For patients who remain gravely disabled, the facility may seek a 30-day extended hold under WIC 5270.15.
If the patient remains gravely disabled and requires a longer-term plan, the facility may initiate proceedings for a conservatorship under WIC 5350. This process appoints a temporary or permanent conservator to make decisions regarding the patient’s psychiatric treatment, placement, and finances. This is considered the most restrictive and long-term form of involuntary supervision under the LPS Act.