A 5150 hold refers to a section of the California Welfare and Institutions Code (WIC) that allows for the involuntary psychiatric evaluation and temporary detention of individuals who are deemed to be a danger to themselves, to others, or are gravely disabled. It enables mental health professionals and law enforcement officers to place individuals under a 72-hour psychiatric hold, during which they are evaluated for their condition and potential avenues for treatment. 5150 holds aim to provide immediate assessment and potentially life-saving intervention for individuals experiencing acute mental health crisis, although it is important to note that these detainments are not arrests—though they do temporarily restrict elements of one’s liberty for a three-day period (and potentially longer).
Navigating the complexities of such crises often involves understanding the legal and ethical aspects surrounding involuntary psychiatric holds, and in today’s blog, Clear Behavioral Health will explore some of the considerations to be had around these procedures, along with the legal rights of those placed under a hold, the importance of ongoing care after the hold has expired, and potential treatment alternatives.
What is a 5150 Hold?
Under WIC 5150, an individual can be involuntarily placed in a locked psychiatric facility for an evaluation lasting up to 72 hours, initiated by any peace officer or specified individuals authorized by a county government. To qualify for a 5150 hold, the person in question must be assessed as a danger to themselves, others, or deemed “gravely disabled” (as defined by WIC 5008), indicating the person’s inability to provide for their basic necessities (such as their own food, clothing, or shelter). Law enforcement is often involved in placing someone on a 5150 hold, especially if the person struggling is highly symptomatic or causing disturbances in the community.
During the 72-hour hold period, the hospital or facility will assess the individual’s need for further psychiatric care for their condition. If the person’s condition improves, and they are no longer considered a threat to themselves/to others/unable to provide care for themselves, they are released. However, if the risks that brought them in continue to be an issue, the treatment facility may request a 5250 hold, extending the individual’s stay beyond the initial 72-hour limit of the 5150 hold.
How Does a 5150 Hold Differ From Other Kinds of Psychiatric Holds?
The number “5150” is often used informally to reference an involuntary hold, and each state typically has different laws governing similar procedures:
- 5150 Equivalent in Other States: Each state in the US has its own legal provisions for involuntary psychiatric holds, which may differ in duration, criteria, and terminology from one another. For instance, in New York, it is often referred to as a 9.39 hold, whereas in Florida it is known as the Baker Act. The specifics vary, but the general purpose—to protect individuals in acute mental health crises—is usually consistent.
- Other Types of Psychiatric Holds: Apart from the 5150 equivalent, there are longer-term involuntary psychiatric commitments in some states. For example, as referenced above, a 5250 hold in California can extend the involuntary treatment for up to 14 additional days for individuals who continue to meet the criteria (danger to self, to others, or grave disability). In many states, court orders are required for extended involuntary psychiatric treatment.
- Voluntary Admissions: In contrast to involuntary holds, individuals are able to voluntarily admit themselves to psychiatric facilities for evaluation and treatment. These voluntary admissions allow individuals to seek help for their mental illness without the legal compulsion of an involuntary 5150 hold.
Understanding the Decision to Impose a 5150 Hold
The decision to place someone under a 5150 hold is never to be taken lightly: it typically occurs when an individual is observed to show behaviors that are indicative of severe mental distress.
These behaviors might include:
- Exhibiting aggressive behavior
- Expressing suicidal thoughts
- Showing signs of severe psychosis
- Engaging in severe self-harm
- Displaying disorganized thinking or speech
- Exhibiting erratic or dangerous behavior
- Communicating a specific plan for self-harm or harming others
- Experiencing severe depressive episodes
- Having hallucinations or delusions
Who Can Impose a 5150 Hold?
In California, a 5150 hold can be initiated by licensed mental health professionals, such as psychiatrists, psychologists, and social workers, in addition to peace officers (such as police officers and law enforcement).
What Rights Does Someone Have Under a 5150 Hold?
Under a 5150 hold in California, individuals have several rights in place to safeguard their well-being and ensure fair treatment during their involuntary confinement:
- Legal Representation: Individuals have the right to legal representation during their hold. A lawyer can advocate for their rights and provide guidance through the legal processes.
- Hearing Before a Judge: Individuals also have the right to appear before a judge within a few days of the 5150 hold being put in place. During this certification review hearing, the necessity of their involuntary confinement is evaluated, and the individual can work with their attorney to present their case to be removed.
- Informed Consent: While a 5150 hold is involuntary, individuals must still provide their informed consent and agreement for any medications or treatments administered. The informed consent process ensures they understand the nature, risks, and benefits of any proposed treatments during their stay.
- Review of the Treatment Plan: Individuals placed on a hold have the right to review their treatment plan with the healthcare provider.
- Refusal of Treatment: Individuals have the right to refuse specific treatments, except in situations where immediate medical intervention is necessary to prevent harm to themselves or others.
- Protection from Abuse: Individuals under a 5150 hold have the right to be treated with dignity and respect. They should be protected from any form of abuse or mistreatment during their period of confinement.
- Breaking the Hold: By law, an individual must be released when the individual no longer meets the criteria for being held.
The Need For Ongoing Mental Health Treatment
While a 5150 hold provides immediate intervention, its effectiveness largely depends on what happens next. Once the 72-hour hold period concludes, it is often imperative to transition the individual to ongoing care to ensure they receive the proper long-term support. Linking them to comprehensive mental health providers and services, including therapy, support groups, and access to any prescribed medication, can be critical for their well-being once the hold has concluded.
Alternatives to Involuntary Hospitalization
While 5150 holds can be essential in psychiatric emergencies, they are not the only solution. Inpatient mental health treatment can provide a structured and supportive environment for individuals struggling with a severe mental health disorder. The viability of this option can be assessed by a mental health professional who will determine whether or not more intensive psychiatric treatment is necessary.
The Role of Mental Health Professionals
When it comes to mental illness, there is a wide range of disorders individuals may struggle with, and plenty of mental health services are available. Mental health staff are essentially the gatekeepers when it comes to determining the need for involuntary detention at a psychiatric hospital or if something else, such as residential treatment for mental illness, will suffice. This comes down to the overall severity of an individual’s condition, particularly as it relates to being gravely disabled and putting their own life, or someone else’s in life-threatening danger.
Benefits of Inpatient Mental Health Treatment
Inpatient treatment facilities for mental illness like the one offered at Clear Behavioral Health, provide a unique opportunity for individuals to receive proper evaluation and treatment outside of a hospital setting. With 24/7 supervision, therapy sessions, medication management, and a focus on stabilizing the individual’s condition, voluntary admission for mental health challenges can serve as a vital first step in the healing process.
Healing is Possible – and Help is Available For Mental Health and Substance Use Issues
The journey doesn’t end after a 5150 hold or even after voluntary admission to inpatient treatment. To foster lasting well-being, individuals need continuous support and a robust network of care on an ongoing basis. Family involvement and understanding play a pivotal role in the ongoing recovery process, creating a supportive environment where the individual can rebuild their life.
By recognizing the importance of immediate intervention, transitioning to ongoing care, and fostering a supportive environment, we can empower individuals on their journey toward mental wellness. If you or someone you know is struggling with mental health, remember that help is available, and every step taken toward seeking support is a courageous stride toward a better future. Call Clear Behavioral Health today to learn more about our mental health residential treatment and how we can support you in building a better tomorrow.