A 5150 hold in California lets a peace officer or county-designated professional detain someone for up to 72 hours for assessment, evaluation, and crisis intervention. It applies when a mental health disorder makes a person a danger to themselves or others, or gravely disabled. It is a civil process, not a criminal arrest.
Key Takeaways
- 72 hours from first detention: The clock starts when the person is first detained. The hold can end sooner if they no longer meet the criteria.
- Three criteria: Danger to self, danger to others, or grave disability. Since SB 43, grave disability also covers severe substance use disorder and inability to provide for personal safety or necessary medical care.
- Not a criminal record: A 5150 is not an arrest, but some holds can trigger a temporary state firearm restriction.
- Three possible outcomes: Release, voluntary treatment, or certification for up to 14 more days (a 5250), with a hearing within four days.
- Plan the next step early: Book follow-up care and check your outpatient benefits before discharge so support continues without a gap.
Understanding the 5150 Hold: The Basics
Section 5150 is part of the Lanterman-Petris-Short (LPS) Act, the California law enacted in 1967 that governs involuntary mental health evaluation and treatment. The hold is meant for short-term safety and stabilization. When the crisis passes, many people continue care in a structured virtual outpatient program that fits around work and home.
Who Can Initiate a 5150 Hold?
Only people the law or the county authorizes can start a 5150. Under the statute, that includes:
- Peace officers
- Designated members of a mobile crisis team
- Professional persons designated by the county
- The professional person in charge of a county-designated evaluation and treatment facility
- Attending staff of a county-designated facility
Each must have probable cause, based on direct observation or credible information from others, that the person meets the criteria right now. Designation comes from the county and the facility, not from a professional license alone.
The Three Criteria for a 5150 Hold
A 5150 requires that a person meet at least one of three criteria as a result of a mental health disorder. For grave disability, a severe substance use disorder can also qualify under current law.
Danger to Self
This includes people who have attempted suicide, expressed serious suicidal intent with a plan, or engaged in self-harm that could cause serious injury or death. The assessment looks at current actions and how imminent the risk is.
Danger to Others
This applies when someone has made credible threats to harm others or has tried to cause harm. The focus is on actual threats or behavior that show a real risk to someone else’s safety.
Gravely Disabled
Being “gravely disabled” means a person cannot provide for basic personal needs because of a mental health disorder, a severe substance use disorder, or both. Since SB 43, those needs include food, clothing, shelter, personal safety, and necessary medical care.
An unconventional lifestyle is not grave disability. A person who can survive safely with help from a willing friend or family member would typically not be considered gravely disabled.
A 5150 cannot rest on mental health history alone. The criteria must be met in the present, although the person deciding must consider available information about the historical course of the person’s condition.
SB 43 and California’s Expanded Definition of Grave Disability
Senate Bill 43, signed in October 2023, is one of the most significant updates to the LPS Act since it was enacted. It took effect on January 1, 2024, but counties could vote to defer it. Every county had to implement it by January 1, 2026, so it now applies statewide.
What SB 43 Changed
- Broader basic needs: Grave disability now includes being unable to provide for personal safety or necessary medical care, not only food, clothing, and shelter.
- Severe substance use disorder: A severe substance use disorder, on its own or alongside a mental health condition, can now support a grave disability finding.
- Functional impairment over labels: The question is whether the condition prevents someone from meeting basic health and safety needs, not whether they use substances or live unconventionally.
Key SB 43 Terms, Explained
- Severe substance use disorder: A diagnosed substance-related disorder that meets the “severe” level in the current Diagnostic and Statistical Manual of Mental Disorders (DSM). A single episode of intoxication does not meet this standard.
- Personal safety: Whether the person can survive safely in the community without involuntary detention or treatment.
- Necessary medical care: Care a licensed health professional decides is needed to keep an existing physical condition from seriously worsening and likely causing serious bodily injury.
These definitions shape what clinicians document. They also explain why a hold may now be considered for someone whose untreated medical condition or unsafe living situation stems from their mental health or substance use.
What SB 43 Did Not Change
The 5150 is still a hold of up to 72 hours. The three criteria, the patient rights advisement, and the hearing rights for longer holds stay in place.
SB 43 also does not criminalize substance use. It is separate from CARE Court (the Community Assistance, Recovery, and Empowerment Act), which is a civil court program with its own process.
Why the Rollout Timing Mattered
San Francisco and San Luis Obispo counties began applying SB 43 in 2024, and some counties followed in 2025. Most, including Los Angeles, waited until January 2026. That staggered start explains why families saw different practices from one county to the next, and counties are still refining training and local procedures.
How SB 43 Plays Out in an Evaluation
- Assessment: Clinicians weigh observed behavior, recent safety events, medical needs, and whether the person can use the support around them.
- Documentation: Records may focus on a person’s inability to stay safe or get needed medical care, rather than on a diagnosis alone.
What Families Can Do Under SB 43
- Ask about local practice: Ask staff how your county applies the expanded definition and what information would help.
- Plan the handoff: If both conditions are present, ask before discharge about dual diagnosis treatment that addresses mental health and substance use together.
The 5150 Process at a Glance: From First Contact to Discharge or Certification
- Field contact and safety check: An authorized person decides whether current risk meets 5150 criteria and, if so, starts the hold.
- Advisement at custody: The person is told who is detaining them, that it is not a criminal arrest, and where they are going.
- Transport and medical clearance: Many people go first to an emergency department for medical clearance, then to a county-designated psychiatric facility.
- Pre-admission assessment: Facility staff assess the person face to face, in person or by video, to decide whether detention is needed or voluntary services will work.
- Rights advisement at admission: Staff explain the reasons for the hold, the person’s rights, the Patients’ Rights Advocate contact, and the date and time the 72 hours began.
- Evaluation and stabilization: Clinicians assess risk, diagnosis, substance use, and supports. Treatment, including medication, may be offered.
- Disposition: If criteria no longer apply, the person is released with referrals. Voluntary treatment is offered when care is still needed.
- Certification or handoff: If criteria persist and voluntary care is declined, the facility may certify a 5250 with a hearing within four days. Otherwise, the person leaves with a follow-up plan.
What Happens During a 5150 Hold?
A person on a 5150 is held in a county-designated facility approved by the state for evaluation and treatment. If they are first taken to a hospital that is not county-designated, that hospital may hold them for up to 24 hours while it arranges a transfer.
Throughout the hold, staff reassess the person on an ongoing basis. Crisis intervention and treatment, including medication, can be provided at the same time as the evaluation.
How the 72-Hour Clock Works
Under California Welfare and Institutions Code § 5150, the 72-hour period begins when the person is first detained, not when they reach a bed. The statute also requires staff to tell the person the date and time their hold began, which gives families a fixed reference point.
In most cases, weekends and holidays count toward the 72 hours. A facility may exclude them only if the state has certified that it cannot provide evaluation and treatment on those days. Staff must tell the person if that applies.
Not sure where to start? You can check what your insurance covers in a couple of minutes, with no obligation.
Patient Rights During a 5150 Hold
People on a 5150 keep most of their civil rights. The California Department of Health Care Services (DHCS) patients’ rights handbook lists protections that apply during involuntary detention. Facilities may limit some of them for documented good cause, which separates core legal rights from day-to-day safety rules.
| Area | Right | Common limits |
|---|---|---|
| Communication | Reasonable access to phones and daily visitors | Can be limited for documented good cause |
| Personal property | Wear own clothes; keep personal items and toiletries; storage space | Hazardous items may be secured |
| Money | Keep and spend a reasonable amount | Can be limited for documented good cause |
| Send and receive sealed mail | Can be limited for documented good cause | |
| Medication | Informed consent before antipsychotic medication | Emergencies, or after a capacity (Riese) hearing |
| ECT and psychosurgery | Right to refuse | The facility cannot deny these rights |
| Advocacy | Contact the county Patients’ Rights Advocate | Contact information given at admission |
The main right that is restricted during a 5150 is the ability to leave the facility.
Who Pays for a 5150 Hold in California?
A 5150 evaluation is emergency psychiatric care. Facilities typically bill it to the person’s health coverage like other emergency care, and costs such as deductibles or copays depend on the plan.
- If the person has health coverage: Emergency psychiatric services are generally billed to the plan. Ask the facility’s billing office what was submitted.
- If the person has public coverage: Public programs have pathways for emergency mental health care. Cost-sharing rules vary by program.
- If the person is uninsured: Ask the facility’s financial counselor about financial assistance and screening for coverage programs.
Families can bring a photo of the insurance card, ask for itemized bills, and keep copies of discharge paperwork. Before scheduling follow-up care, you can verify your outpatient benefits to understand what your plan may cover.
What Happens After the 72-Hour Hold?
Outcomes depend on current risk and whether the person accepts care. Many people are released before or at the end of the 72 hours with referrals, others continue voluntarily, and some move to certification if criteria persist.
Release
If clinicians find the person no longer meets the criteria and can be safely released, they are discharged, ideally with a follow-up plan.
Voluntary Treatment
The person may choose to continue treatment voluntarily, either inpatient or outpatient. For people living with persistent depression symptoms, anxiety that disrupts daily life, or post-traumatic stress disorder (PTSD), ongoing care supports longer-term stability.
5250 Hold (14-Day Certification)
If the person still meets the criteria and will not or cannot accept voluntary care, the facility may certify up to 14 more days of intensive treatment. A certification review hearing must be held within four days. The person can be represented and present evidence.
Longer Holds and Conservatorship
Further holds exist for narrower situations, each with its own review process. Conservatorship is a separate court process in which a conservator is appointed to make treatment and placement decisions.
| Hold | Maximum length | When it applies | Review |
|---|---|---|---|
| 5150 | 72 hours from first detention | Danger to self or others, or grave disability | No hearing; rights advisement required |
| 5250 | 14 days | Criteria persist; voluntary care declined or not possible | Certification review hearing within 4 days; right to seek a court hearing (habeas corpus) |
| 5260 | Up to 14 more days | Imminent threat of suicide that continues after a 5250 | Right to judicial review (habeas corpus) |
| 5270 | 30 days | Still gravely disabled after a 5250 and unwilling or unable to accept voluntary care; only in counties whose board of supervisors has authorized it | Certification review hearing, unless judicial review is requested |
| 5300 | 180 days | Attempted, inflicted, or seriously threatened substantial physical harm to others, with a continuing demonstrated danger | Court petition; right to an attorney and a jury trial |
| LPS conservatorship | 1 year, renewable by court petition | Ongoing grave disability | Court process; right to a court or jury trial |
Understanding the Purpose: Crisis Intervention, Not Punishment
A 5150 is a mental health intervention for an acute crisis, not a form of punishment. Its goals are to:
- Protect the immediate safety of the person and the community
- Provide professional psychiatric evaluation during a crisis
- Connect people to appropriate mental health treatment
- Stabilize the person’s condition so they can transition to ongoing care
During a crisis, many people cannot recognize their need for treatment. The 5150 process creates a short window to assess the situation, stabilize, and ideally move toward voluntary care.
After a 5150: The Importance of Ongoing Care
A 5150 addresses the immediate emergency, but lasting stability usually depends on what happens next.
For many people, virtual mental health treatment is an accessible next step. Virtual intensive outpatient programs offer structured support while you keep up with daily routines, and they typically include:
- Individual therapy sessions with licensed clinicians
- Group therapy focused on skill building and peer support
- Evidence-based approaches such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT)
- Psychiatric medication management when appropriate
- Crisis planning and relapse prevention strategies
Virtual care can be especially helpful for people who need trauma-informed virtual IOP care. Many people find that getting care from the privacy of home lowers barriers and supports more consistent participation.
Ready to talk it through? Our team can walk you through your options and what virtual care could look like around your schedule.
Specialized Support for Unique Needs
Mental health recovery is not one-size-fits-all. People from marginalized communities may have faced discrimination or a lack of understanding in traditional treatment settings.
For LGBTQIA+ people dealing with identity-related stress, family rejection, or minority stress, affirming and supportive mental health care can help them feel safe and supported in treatment. People managing borderline personality disorder (BPD) or bipolar disorder often benefit from approaches built around their specific symptom patterns.
Recognizing When Someone Needs Help
Knowing the signs someone may need outpatient care can help families step in before a crisis reaches the point of a 5150. Common signs include:
- Significant changes in mood, behavior, or personality
- Withdrawal from relationships and activities they once enjoyed
- Expressing feelings of hopelessness or worthlessness
- Difficulty managing daily responsibilities
- Increased substance use as a coping mechanism
- Declining self-care and personal hygiene
Family Support and Advocacy During a 5150 Hold (AB 1424)
Assembly Bill 1424, in effect since 2002, requires people deciding on involuntary evaluation to consider relevant information about a person’s history, including information from family. Families can share what they know even when privacy laws prevent staff from sharing information back without the patient’s written consent.
The most useful information is short and factual:
- Safety history: Recent suicide attempts, threats, or severe self-neglect
- Treatment history: Medications that helped or caused problems, and past hospitalizations
- Daily functioning: Ability to get food, shelter, safety, and needed medical care
- Supports: Who can safely help after discharge
Many counties provide an AB 1424 family information form to organize this input; ask staff where to submit it. Submitting the form does not guarantee specific requests will be followed, but it gives decision-makers context only family can provide.
The Importance of Prevention and Early Intervention
Early, voluntary care is generally preferable to waiting for a crisis that may require involuntary intervention. Prevention includes:
- Seeking treatment early when symptoms first appear
- Staying consistently engaged with mental health care
- Building a support system of family, friends, and professionals
- Developing coping skills and crisis management strategies
- Understanding your own mental health patterns and early warning signs
Common Questions About 5150 Holds
How long is someone held on a 5150?
Up to 72 hours, starting when the person is first detained. If the person is certified for a 5250, the stay can extend up to 14 more days.
Is a 5150 hold a criminal record?
No. A 5150 is a civil process and does not create a criminal record.
California law does set a five-year firearm prohibition when a person held as a danger to self or others is admitted to a designated facility. The person can request a court hearing to lift it, and a California attorney can advise on firearm or licensing questions.
Can someone be released before 72 hours?
Yes. If clinicians find at any point that the person no longer meets the criteria, they should be released. The 72 hours is a maximum, not a requirement.
Can a person on a 5150 refuse medical treatment?
People keep the right to give or refuse informed consent for most treatment, including antipsychotic medication. Medication can be given without consent in an emergency or after a capacity hearing. The right to refuse electroconvulsive therapy (ECT) and psychosurgery remains.
What if someone disagrees with a 5150?
During a 5150, the person can contact the county Patients’ Rights Advocate. If the hold becomes a 5250, a certification review hearing follows within four days. The person can be represented, present evidence, and ask for a court hearing.
Is 5150 only in California?
Yes. “5150” refers to a section of California’s Welfare and Institutions Code. Other states have their own emergency evaluation laws with different names, criteria, and timelines.
Moving Forward: From Crisis to Recovery
A 5150 can be one of the hardest moments in a person’s mental health journey, and often in their family’s experience too. The process can feel frightening, but it exists to protect people and connect them to care during a dangerous crisis.
Recovery is possible. Whether through in-person services or online therapy for anxiety and depression, the right fit of care and support can help people build lives defined by stability, connection, and hope.
What to Do After a 5150 Hold: Practical Next Steps
The days after discharge matter. These steps can help you or your loved one keep momentum:
- Get your discharge paperwork: Ask for discharge instructions, diagnoses, current medications, and follow-up recommendations, and keep copies for your next providers.
- Book follow-up care within about a week: Many discharge plans aim for a psychiatry or therapy appointment within seven days.
- Check your benefits first: Call the number on your insurance card, or use the verification link above, to understand costs before you book.
- Choose enough structure: If weekly therapy is not enough, a virtual intensive outpatient program (IOP) offers several hours of live group and individual therapy each week from home.
- Build a written safety plan: List warning signs, coping steps, trusted contacts, and crisis numbers, including 988. Learn how outpatient care supports suicide prevention.
- Line up practical help: Identify who can help with rides, medication pickups, and appointment reminders for the next 30 days.
- Track how you are doing: Use a simple daily check of sleep, mood, stress, and medications taken, and bring it to your first follow-up.
Getting Help: Resources and Next Steps
If you or someone you love is in a mental health crisis:
- Immediate danger: Call 911 or go to the nearest emergency room
- 988 Suicide and Crisis Lifeline: Call or text 988 for immediate support
- Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline: 1-800-662-HELP (4357) for treatment referrals and information
Virtual outpatient care is not emergency care. For ongoing support once you are safe, programs with flexible evening IOP sessions can work around your schedule without disrupting work or family commitments.
Mental health challenges do not define you, and asking for help is a sign of strength. If you want to talk through options after a 5150, contact the Higher Purpose Recovery team or call (949) 844-3813.
This article provides general information about California law and mental health care. It is not legal or medical advice.
