California Involuntary Psychiatric Holds Explained by Disability Rights by http://www.disabilityrightsca.org/Documents/ListofGrantsAndContracts.html.
In the state of California, there exists a law that grants police officers and select mental health professionals the authority to detain individuals whom they believe, due to a mental illness, pose a risk of causing harm to themselves or others. This provision, commonly known as a "5150 hold," derives its name from the corresponding regulation found in the Welfare and Institutions Code (WIC) § 5150.
72-Hour “5150” Holds At the beginning of a hold, you should be taken to a psychiatric hospital or other mental health facility where medical professionals can evaluate you. While in the hospital, staff will determine whether to request a longer hold for treatment, or whether you can be safely released. The hospital does not need to hold you for the full 72 hours. WIC § 5152. The hospital should release you sooner if they believe that you no longer require evaluation or treatment. By the end of the 72 hours, one of several things will happen:
Under this legislation, individuals meeting specific criteria can be held for a period of up to 72 hours. It is important to note that this detention is not considered a criminal arrest. Throughout this timeframe, mental health professionals will conduct assessments to determine whether the individual can be safely discharged, if voluntary services would be suitable, or if further treatment is necessary. Refer to WIC §§ 5151-5152 for more information.
In the event that a mental health professional concludes that additional treatment is required, and if the individual is deemed unwilling or unable to accept voluntary treatment, a further hold may be filed for an additional 14 days under WIC § 5250. This process is in place to ensure the safety and well-being of individuals experiencing mental health crises.
Criteria for a Psychiatric Hold
In accordance with WIC § 5150.05, individuals cannot be detained solely on the basis of having a mental illness. A police officer or mental health professional may only hold someone if there is a belief that the individual's mental illness poses a risk of harm. While mental health history may be considered, it cannot be the sole basis for a hold.
To be placed on a psychiatric hold, one must meet at least one of the following criteria due to a mental health disorder:
- Danger to Self (DTS):
Typically, this involves threats or attempts of self-harm or suicide.
- Danger to Others (DTO: This criterion is met through threats or actual attempts to harm others.
- Grave Disability: (GD) Being "gravely disabled" refers to the inability to provide for basic needs such as food, clothing, or shelter due to a mental health disorder (WIC § 5008(h)). For example, someone may be deemed gravely disabled if they are not eating enough to survive or are unable to maintain housing.
It is important to understand the criteria for a psychiatric hold to ensure that individuals are only detained when necessary for their safety and the safety of others.
Additional Information on Grave Disability
http://www.disabilityrightsca.org/Documents/ListofGrantsAndContracts.html.
Someone incapable of caring for herself, but who can survive safely with the help of a willing third party, would likely not be “gravely disabled.” § 5350(3). See also Conservatorship of Early, 35 Cal. 3d 244, 253, 673 P.2d 209 (1983) (citations omitted) “…imposition of a conservatorship should be made only in situations where it is truly necessary. To accomplish this purpose evidence of the availability of third party assistance must be considered;” and O'Connor v. Donaldson, 422 U.S. 563, 575, 95 S. Ct. 2486, 2493–94, 45 L. Ed. 2d 396 (1975) “…while the State may arguably confine a person to save him from harm, incarceration is rarely if ever a necessary condition for raising the living standards of those capable of surviving safely in freedom, on their own or with the help of family or friends.”
Being homeless, by itself, would likely not meet the “gravely disabled” criteria. However, someone who cannot or will not try to find food or shelter as a direct result of a mental illness would more likely be considered gravely disabled. See Conservatorship of Chambers, 71 Cal. App. 3d 277, 284, 139 Cal. Rptr. 357 (Ct. App. 1977) (“…the term [gravely disabled] is sufficiently precise to exclude unusual or nonconformist lifestyles. It connotes an inability or refusal on the part of the proposed conservatee to care for basic personal needs of food, clothing and shelter.”)
Also, though past acts may be considered, someone is not gravely disabled unless they are a present danger to themselves because of their inability to provide self-care. See Conservatorship of Benevuto, 180 Cal.App.3d 1030 (1986). The likelihood of future harm may also not be enough to meet commitment criteria. Id at 1034 n.2. (“If LPS conservatorship may be reestablished because of a perceived likelihood of future relapse, many conservatees who would not relapse will be deprived of liberty based on probabilistic pessimism. This cost is unwarranted in view of the statutory procedures available to rapidly invoke LPS conservatorship if required.”) Note: A similar law allows the police (or designated others) to take you into custody if they think you meet the above criteria due to chronic alcoholism. WIC § 5170.
If the treating facility wants to hold you for longer than 72 hours, you have the right to a Certification Review Hearing. At this time, you are entitled to written notice that you are being held. This notice must include the specific reasons for which you are being held. WIC § 5251. You are also entitled to assistance from a patients’ rights advocate. This is someone who will help you understand your rights and advocate for your interests. WIC § 5325(h).
This hearing must be held within four days of being certified for a 14-day hold, unless you or your advocate request a postponement. WIC § § 5250, 5254. You do not need to request this hearing, as it is automatically scheduled for you. At the hearing, a neutral party will review whether there is enough evidence (called “probable cause”) to continue to hold you against your will. This hearing is for your benefit, and the hospital has the burden of justifying holding you. You are not required to prove why you should not be held, but you are allowed to present evidence to show why the hospital should not hold you for any longer.
http://www.disabilityrightsca.org/Documents/ListofGrantsAndContracts.html.
If the party conducting the hearing determines there is not enough evidence that you need to be held, the hospital must release you. WIC § 5256.
Rights During a Certification Review Hearing You are granted certain rights and protections during a Certification Review Hearing.1 These include:
- The right to be assisted by an attorney or other advocate;
- The right to present evidence on your own behalf;