July 15, 2021

Guide to Involuntary Treatment (LPS) Holds

(Graphic created with information from Placer County’s website.)

5150 Holds

A 5150 is a 72-hour long involuntary treatment hold in a hospital or mental health facility (this is called a 5585 for minors). To be subject to a 5150 hold, at least one of the following criteria must be met (as a result of a mental health disorder):

  • Danger to self: someone has threatened or attempted self-harm or suicide;  
  • Danger to others: someone has made threats or actual attempts to harm others;
  • Grave disability: Someone is unable to provide for their own food, clothing, or shelter. 

If a peer (individual living with mental health conditions) was subject to a 5150 hold, after the 72-hour period has elapsed, there are several possible outcomes:

  • The peer will be released, or;
  • The peer will accept voluntary treatment, or;
  • The peer’s hold will be extended to another 14-day involuntary hold (5250, also called “certification for intensive treatment”), or;
  • The peer will be referred to the Office of the Public Guardian for a conservatorship (5352).

5250 Holds

A 5250 is a 14-day long involuntary treatment hold in a hospital or mental health facility and an extension of a 5150. If the treating facility wants to extend a 5150 to a 5250, the peer has the right to a Certification Review Hearing. At this time, the peer is entitled to a written notice that they are being held. This notice must  include an explanation of specific reasons why the peer is being held. The peer is entitled to assistance from a patients’ rights advocate, who will help them understand their rights and advocate for their interests. At the hearing, a neutral party will review whether there is enough evidence (called “probable cause”) to continue to hold the peer against their will. This hearing is for the peer’s benefit, and the hospital has the burden of justifying holding them. 

If a peer was subject to a 5250 hold, there are several possible outcomes:

  • The peer may be released before 14 days. They may be released by staff, or at a certification review hearing, or at a habeas corpus hearing (this is a hearing where the peer asks a judge to review the legality of their hold. For instance, a judge may decide to release them if their rights were violated during the process leading to a hold), or; 
  • The peer will sign as a voluntary patient, or;  
  • If the person treating the peer determines that they need more treatment, they may be placed on another involuntary hold (5260, 5300, or 5270) 
  • The peer will be referred to the Office of the Public Guardian for a conservatorship (5352).

FAQs for Peers

1. How can I be released from an involuntary hold?

During a 5150 hold, the treatment facility should release you before 72 hours has elapsed if they believe that you no longer require mental health evaluation or treatment.

If you are not released during or after the 72 hours of a 5150 hold and the treatment facility wishes to extend your hold, you are automatically entitled to a Certification Review Hearing. During this hearing, the treatment facility will attempt to prove that there is “probable cause” to hold you longer, and your patient’s rights advocate or attorney can help you make a case for your release.

If you are still being held after your Certification Review Hearing, you may file a writ of Habeas Corpus through your patient’s rights advocate or attorney. This will grant you a formal court hearing to challenge your hold.

2. How do I avoid a longer hold?

It is important to show that the reason for which you were first placed on hold is no longer a concern:

  • If you are held for being a danger to yourself,  try not to harm yourself or make threats to do so during your hold and after your release. 
  • If you are held for being a danger to others, try not to be belligerent or argumentative with those around you. Try not to touch anyone unless instructed to do so by staff. 
  • If you are held for being gravely disabled, try to show that you can take care of yourself at the treatment facility. Try to eat, sleep, and clean yourself regularly. Let staff know that you have access or know how to access food, clothing, and shelter.

It may also be helpful to contact someone who can help you with treatment or basic needs, such as a friend or a family member. They should submit a letter to the court indicating that they are willing and able to help you; the letter must be in writing to be considered. Generally, try to be respectful to everyone you interact with at the treatment facility.

3. Who can advocate for me?

Beyond a 72 hour hold, you are legally entitled to private assistance from a patients’ rights advocate or attorney, who will help you understand your rights and advocate for your interests.

4. What if I am a minor?

For a minor, a 72-hour involuntary treatment hold is called a 5585. A 5585 is analogous to a 5150 in most ways, but they differ in that minors may only be held on a 5585 when authorization for voluntary treatment by a parent or guardian is not available or agreed to. Therefore, a minor can avoid involuntary treatment if their parent or guardian consents to voluntary inpatient treatment. Additionally, the definition of a gravely disabled minor has been modified to state that the minor must be “unable to use the elements of life which are essential to health, safety and development, including food, clothing, shelter, even though provided to the minor by others,” as a result of a mental health disorder. After a minor’s release from a 5585, an aftercare plan is required to support their needs.

After a 5585 hold, it is possible for a minor’s hold to be extended into a 5250, and then a 5260, 5300, or 5270. The process for this is the same as it is for adults.

5. Will this hold be on my permanent record?

Each denial of your rights will be documented in your record. You are entitled to know the content of each notation and an explanation for each denial of rights.

Although an involuntary hold will be in your medical record, it is not a criminal arrest and thus will not be reflected in your criminal record.

6. What are my rights during an involuntary hold?

  • These are your rights that cannot be denied:
    • The Right to Humane Care
    • The Right to Be Free from Abuse or Neglect
    • The Right to Social Activities and Recreation  
    • The Right to Education
    • The Right to Religious Freedom and Practice
    • The Right to Be Free from Discrimination
  • You have rights that may be denied for good reason. Good cause for denying any of the rights means that the professional person in charge has a good reason to believe that allowing a specific right would cause: Injury to that person or others; or a serious infringement on the rights of others; or serious damage to the facility; and there is no less restrictive way to protect against these occurrences.  
    • Wearing your own clothing
    • Possessing money
    • See visitors
    • Access storage space
    • Keep and use personal possessions
    • Use a telephone
    • Receive mail
    • Have writing materials