WHAT’S THE DIFFERENCE BETWEEN 5150 AND 5250?

What’s the Difference Between 5150 and 5250 Holds in California?

In California, 5150 and 5250 are legal codes that allow for the involuntary psychiatric commitment of individuals who are deemed a danger to themselves or others due to a mental health crisis. While they sound similar, there are some key differences between 5150 and 5250 holds that you need to understand.

What is a 5150 Hold?

A 5150 hold, officially known as Section 5150 of the California Welfare and Institutions Code, allows for the involuntary psychiatric commitment of an individual for up to 72 hours (3 days). This is often referred to as a 72-hour hold or a 3-day hold.

For a 5150 hold to be initiated, the individual must be evaluated by a qualified professional such as a psychiatrist, psychologist, social worker, or designated mental health clinician. The evaluator must determine that the individual is a current danger to themselves or others, or is “gravely disabled” as a result of a mental health disorder. This means they are unable to provide their own food, clothing, or shelter due to their condition.

If the evaluator determines the individual meets these criteria, they can be transported against their will to a designated psychiatric facility for further evaluation and treatment. Law enforcement often assists with the transportation process when necessary.

Key Facts About 5150 Holds:

• Can only last up to 72 hours
• Initiated by mental health professional or law enforcement
• Requires dangerousness to self, others, or grave disability
• Results in involuntary commitment to psychiatric facility

What Happens During a 5150 Hold?

During the 72-hour 5150 hold period, the individual is evaluated and treated by mental health professionals at the psychiatric facility. The main goals are to provide stabilization care, conduct an in-depth evaluation, initiate treatment, and determine if longer-term involuntary commitment is necessary.

At any time during the 72 hours, if the mental health professionals determine the individual no longer meets 5150 criteria, they must be released. If the 72-hour period is up and criteria are still met, the hold can be extended with a 5250.

What is a 5250 Hold?

A 5250 hold, officially known as Section 5250 of the California Welfare and Institutions Code, allows for an additional 14 days of involuntary psychiatric hold after the initial 72 hours of a 5150. This is often referred to as a 14-day hold or 2-week hold.

For a 5250 hold to be initiated, the psychiatric facility must conduct a certification review hearing while the individual is still on the 5150. They must provide evidence that the individual continues to be a danger to themselves or others, or gravely disabled due to a mental health disorder.

If the hearing officer agrees, the individual can be held for treatment up to 14 additional days. They must be informed of their rights and the reasons for the extended hold.

Key Facts About 5250 Holds:

• Extension of a 5150, up to 14 days
• Requires certification review hearing
• Continued dangerousness or grave disability must be shown
• Involuntary commitment continues at psychiatric facility

Why Are 5150 and 5250 Holds Used?

The purpose of 5150 and 5250 holds is to protect individuals experiencing a mental health crisis, as well as public safety, by allowing temporary involuntary psychiatric commitment. They provide a way to get severely mentally ill individuals off the streets and into treatment during an acute mental health episode when they are unable to recognize their need for care.

Without these involuntary holds, many individuals would never receive treatment. Their mental health conditions would likely deteriorate further, putting themselves and potentially others in danger. The holds provide a window to stabilize individuals and hopefully transition them to voluntary treatment.

Patients’ Rights During 5150/5250 Holds

While 5150 and 5250 holds allow involuntary commitment, patients still have the following rights during the hold period:

• Right to judicial review and habeas corpus
• Right to speak with an attorney
• Right to have personal rights explained
• Right to refuse medication in non-emergency situations
• Right to file grievances about care
• Right to interact with visitors

Mental health advocates can help ensure patients’ rights are protected during involuntary holds. Having a patient advocate or attorney can also be very helpful.

Contesting a 5150 or 5250 Hold

If you believe you have been wrongfully placed on a 5150 or 5250 hold, or kept longer than necessary, it is important to contest the hold and speak with an attorney about your options right away. An attorney can help you file a writ of habeas corpus demanding your release or request a judicial review of your case.

Proving the hold meets legal requirements often comes down to the opinion of the evaluating mental health professionals. But an experienced attorney can argue flaws in their assessments, present evidence of your current mental state, and fight for your release if the hold is unwarranted.

After a 5150/5250 Hold

After a 5150/5250 hold period ends, here are some possible next steps:

• Release back into the community
• Voluntary admission to inpatient psychiatric treatment
• Conservatorship – court-ordered mental health treatment in community
• Another 14-day hold if criteria still met (5250)
• 30-day hold (5260)
• 180-day hold (5300)

The best-case scenarios are being released or agreeing to voluntary treatment. Conservatorships result in the longest period of court-ordered mental health treatment, including forced medications, outside of the hospital.

When Are 5150/5250 Holds Misused?

While 5150 and 5250 holds serve an important purpose when used properly, they can also be misused or overused in some cases. Holds may be wrongfully initiated against individuals who do not actually meet legal requirements. Or individuals can be held longer than necessary once stabilized.

Reasons these involuntary holds may be misused include:

• Family members request hold out of convenience/control
• Law enforcement use as alternative to jail for nuisance behaviors
• Psychiatric facilities profit from longer stays
• Clinician disagreement on readiness for discharge
• Gaps in care/housing upon release

Advocating for yourself or a loved one and consulting an attorney at the first sign of unjustified detention are important. The hearing process tends to favor psychiatrists ordering the hold, so legal representation is essential.

Long-Term Impacts of 5150/5250 Holds

While intended to provide emergency mental health intervention, 5150/5250 holds can lead to trauma and long-lasting repercussions for patients. Potential long-term consequences include:

• Psychological trauma from forced treatment
• Physical side effects from medications
• Social stigma associated with involuntary commitment
• Loss of autonomy over treatment decisions
• Disruption to living situation, employment, relationships
• Legal restrictions on firearm ownership
• Difficulty obtaining professional licenses
• Limitations on travel visas
• Records that follow you and influence future commitments

Some argue the benefits of getting needed treatment outweigh these risks in cases of severe mental illness. But for anyone who questions the necessity of their hold or feels it was mishandled, seeking legal advice is important to protect your rights and prevent unjustified detention.

Takeaways

• 5150 holds allow involuntary psychiatric commitment for up to 72 hours.
• 5250 holds extend the involuntary commitment for up to 14 additional days.
• Holds require dangerousness to self/others or grave disability due to mental illness.
• Holds lead to evaluation and stabilization treatment in a psychiatric facility.
• Patients maintain rights during involuntary holds.
• Contesting a hold and consulting an attorney quickly are important.
• Misuse of holds or detaining patients longer than needed still occurs.
• Long-term impacts like trauma and loss of rights are possible.

Understanding the process and your rights is key if you or a loved one is placed on a psychiatric hold. Speaking with an attorney can help you determine if a hold meets requirements or if advocating for release is needed.