Navigating What Happens After a 5150 Hold

By Jared Levenson - Reviewed on July 1, 2023
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In mental health care, few terms are as loaded as “5150,” a code that signifies an involuntary psychiatric hold.

For the uninitiated, a 5150 hold is a section of the California Welfare and Institutions Code (WIC) that allows a person with a mental illness to be involuntarily detained for a 72-hour intensive psychiatric treatment or hospitalization due to risk of harm to self or others, or an inability to provide self-care.

The Online Mental Health Reviews team comprises professionals with extensive experience and knowledge in the mental health industry, including clinicians and counselors. Our thorough research and firsthand experience with mental health cases, including 5150 holds, equip us to provide accurate and insightful commentary on these complex issues.

Immediate Steps Post-Hold

What Is 5150 Involuntary Hold?

Once a 5150 hold is placed, several immediate steps are taken to ensure the individual’s safety and commence treatment:

  1. Evaluation and Diagnosis: Licensed professionals conduct a comprehensive mental health assessment to ascertain the individual’s mental state and diagnose any mental health disorders.
  2. Medication: Based on the diagnosis, appropriate medications may be administered to manage the individual’s symptoms and stabilize their condition. These may be refused per the patient’s rights.
  3. Counseling and Psychiatric Care: The individual will receive counseling and psychiatric care tailored to their specific needs, including individual therapy, group therapy, or other therapeutic interventions.

Determinants of Continued Involuntary Hospitalization

While the initial hold lasts for 72 hours, certain factors may warrant a longer period of involuntary hospitalization:

  • The severity of Mental Health Condition: If the individual’s mental health condition remains severe and unable to function independently, extended hospitalization may be necessary.
  • Risk to Self or Others: If the individual poses a significant threat to themselves or others, the hold may be extended to ensure everyone’s safety.
  • Self-Care Capability: If the individual cannot perform basic self-care tasks, extended care might be required until they regain this ability.

Possible Outcomes Post-Hold

Once the individual is stable enough for the hold to be lifted, several outcomes can follow:

  • Follow-up Treatment: The individual will likely require ongoing psychological and psychiatric treatment, potentially including therapy and medication management.
  • Relapse Prevention Plan: The individual, in collaboration with their healthcare provider, will develop a plan to prevent relapse, which could involve regular check-ins, lifestyle modifications, and coping strategies.
  • Community Resources: The individual may be connected with community resources, such as support groups, outpatient programs, or housing services, to aid their recovery.

Understanding Mental Illness, Violence, and Suicide

After a 5150 hold, it’s crucial to understand the intersection of mental health professionals, illness, violence, and suicide.

The goal is to provide necessary treatment and resources, reduce potential violence, and prevent suicidal ideation or attempts.

  • Mental Illness: It’s a broad term that includes conditions like depression, anxiety disorders, and schizophrenia. People with mental health conditions are often misunderstood and stigmatized, making seeking help harder.
  • Violence: Contrary to popular belief, individuals with mental illness are not inherently violent. According to the American Psychological Association, only a small proportion of violence can be attributed to mental health conditions.
  • Suicide: Suicide is a tragic consequence of untreated or poorly managed mental illness. Individuals suffering from depression or bipolar disorder are at a higher risk of suicide.

What is a 5150 or 72-hour hold?

5150 or 72-hour hold: California law allows involuntary psychiatric evaluation and involuntary treatment for up to 72 hours.

  • Involuntary Detainment: This happens when someone’s mental condition makes them a danger to themselves or others or unable to provide for their basic needs.
  • Professional Evaluation: Mental health professionals evaluate the severity of the crisis and plan treatment during the 72-hour hold.
  • Potential Extension: If needed, the hold can be extended to a 5250, allowing up to 14 days of involuntary psychiatric hospitalization.
  • Immediate Intervention: A 5150 hold ensures safety during a serious mental health emergency or crisis.

What Criteria Must Be Met for a 5150 Hold in California to Be Initiated?

To initiate a 5150 hold in California, specific criteria must be met. These ensure the hold is used when necessary for safety:

  • Danger to Self: If a person poses a risk of harming themselves or others due to mental health, a 5150 hold can be initiated.
  • Danger to Others: The hold can also be initiated if a person threatens others due to mental health.
  • Grave Disability: If a person can’t meet basic needs due to mental health, it meets the third criterion.

Trained mental health professionals or law enforcement decide to initiate a 5150 hold.

Who Can Initiate a 5150 Hold in California?

These professionals ensure the safety of individuals in mental health crises and start the process for appropriate care and treatment.

  • Mental Health Professionals: They include psychiatrists, clinical social workers, psychiatric nurses, and other mental health providers and clinicians. They can initiate a 5150 hold if they believe the individual meets the criteria.
  • Law Enforcement Officers: Police and other law enforcement personnel can also initiate a 5150 hold if they believe the person poses a danger to themselves or others.
  • Designated Professionals: Certain professionals appointed by the county, such as psychologists and marriage and family therapists, can initiate a 5150 hold based on the county’s guidelines.

What Happens After a 5150 Hold in California?

  • Release: If the mental health professionals deem the individual safe, they may be released.
  • Voluntary Treatment: They can stay in the psychiatric facility if they agree with further treatment.
  • Extended Hold: If there’s still a risk, the hold may be extended to a 5250 hold, allowing for up to 14 more days of involuntary hospitalization.
  • Certification Review Hearing: A certification review hearing will occur within four days after a 5250 hold.
  • Outpatient Services: Sometimes, the individual might be referred for outpatient treatment services after being released.
  • Family Involvement: In most cases, the person will be released to their family after the 3-day hold and receive mental health services.

What happens on an emergency hold?

On an emergency hold:

  1. Individuals’ behavior is assessed for any immediate danger to themselves or others.
  2. They are placed in a treatment facility in a secure environment where their safety can be ensured.
  3. Evaluation and intervention plans are developed based on the severity of the situation.
  4. Treatment options, such as therapy and/or medication, may be discussed and recommended.
  5. Family members and loved ones are notified to provide support and involvement in recovery.

Please note that this is just a general overview, and specific procedures may vary depending on the jurisdiction and circumstances.

Involuntary Psychiatric Holds and Firearm Prohibitions in California

  • Firearm Prohibition: After a 5150 hold, an automatic five-year firearm prohibition exists. You cannot own, possess, purchase, receive, or attempt to purchase or receive a firearm for five years.
  • 5250 Hold: If a 5150 hold is extended to a 5250 hold (14 days), the firearm prohibition can be extended to life under federal law.
  • Relinquishment of Firearms: If you own firearms, they must be relinquished. They can be sold to a licensed gun dealer, transferred to a non-prohibited third party, or turned over to a law enforcement officer.
  • Restoration of Firearm Rights: It is possible to petition the court to restore firearm rights, but this requires legal representation and is not guaranteed.
  • Reporting to Database: Mental health facilities must report individuals subject to these holds to a database used for background checks when purchasing firearms.
  • Priority: These laws aim to keep the individual and the wider community safe. If dealing with serious mental illness or health issues, contact professionals for help.

What is law AB 1194?

California Assembly Bill 1194 (AB 1194) is an important law for the mental health field. It affects conservatorships and guardianships. Here’s what you need to know:

  • Compulsory Counsel: Appointed lawyers are mandatory in certain conservatorship proceedings.
  • Civil Penalties: Non-professional fiduciary conservators can face penalties of up to $1,000 for each instance of abuse.
  • Preference for Representation: If someone expresses an appreciation for a specific attorney, that choice should be respected.
  • Improved Oversight: The law introduces training in financial abuse and better oversight for conservators.
  • Empowering Conservatees: AB 1194 aims to empower conservatees and hold fiduciaries to higher accountability standards.

Disability Rights California explains the law about forced care in California and gives important information about the Lanterman-Petris-Short Act (LPS Act).

However, research has identified that many gaps remain in our understanding of 5150s and urges the need for further study to better understand the benefits and costs.

What Happens After A 5150 Hold Conclusion

The 5150 hold process, while crucial for ensuring immediate safety, is not without its criticisms.

Some argue it infringes on personal liberties, while others believe it fails to provide long-term solutions for chronic mental health issues.

However, providing immediate intervention during a crisis is critical to our whole mental health treatment system. As we continue to improve mental health care, we must consider these points and work towards a system that balances immediate safety with respect for individual rights and long-term care solutions.

For further reading, check out resources about 5150 holds, the impact of a 5150, 5150 costs, visiting, public records, 5150 rules, after-release, get out of a hold, background check, self-commitment, who pays, minors, and 5150 codes.

Remember, if you need to reach a lawyer or expert for urgent questions, Just Answer’s $5 trial is a reasonable option. Our team has bought and reviewed Just Answer, and we believe this service could be helpful when navigating the complexities of the healthcare industry.

Our team welcomes your involvement in our discussions on 51/50s. Please feel free to leave a comment if you have any questions about 5150 records or if there’s a mental health software product you’d like Online Mental Health Reviews to investigate next.

If You Are In Crisis

Waiting for an online therapy session may not be the safest option if you are in a severe crisis. Should you need immediate assistance, don’t hesitate to dial 911, especially if there’s a risk of self-harm or harm to others.

For those contemplating self-harm, the 988 Suicide and Crisis Lifeline is available around the clock. Just dial 988 to get the help you need at any time.

Another valuable resource is the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline. Available 24/7, every day of the year, you can reach them at 800-662-HELP (4357). This free, confidential service assists individuals struggling with mental health or substance abuse disorders by providing information and helping them locate treatment options.

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