A 5150 refers to an involuntary psychiatric hold in California, named after Section 5150 of the state’s Welfare and Institutions Code. It allows authorized individuals to place someone in a mental health facility for up to 72 hours if that person is considered a danger to themselves, a danger to others, or gravely disabled due to a mental health disorder. The term has become widely recognized shorthand for any involuntary psychiatric detention, though it technically applies only in California.
Where the Term Comes From
Section 5150 is part of the Lanterman-Petris-Short Act, a California law passed in 1967 that overhauled how the state handles involuntary mental health treatment. Before this law, people could be committed to psychiatric institutions indefinitely with little legal oversight. The act introduced time limits and specific criteria to protect individual rights while still allowing emergency intervention. The number “5150” is simply the section number in the legal code, but it became so commonly used in hospitals, police departments, and pop culture that it’s now understood far beyond California’s borders.
Other states have their own versions of involuntary hold laws. Florida calls its equivalent the Baker Act. Texas uses an Emergency Detention Order. New York has a provision under its Mental Hygiene Law. The rules vary by state, but “5150” has become a cultural catchall for the concept of being involuntarily placed in psychiatric care.
The Three Criteria for a 5150 Hold
A 5150 hold can only be initiated when someone meets at least one of three legal criteria, all tied to a mental health disorder:
- Danger to self: The person is at risk of harming or killing themselves.
- Danger to others: The person poses a credible threat of violence toward other people.
- Gravely disabled: The person is unable to provide for their own basic needs, including food, clothing, or shelter, because of a mental health condition. A 2024 update to California law expanded this category to also include grave disability caused by a severe substance use disorder.
The person initiating the hold must have probable cause to believe one of these criteria is met. A general concern about someone’s mental health, without evidence of immediate danger or inability to care for themselves, is not enough.
Who Can Place Someone on a 5150 Hold
Not just anyone can initiate a 5150. California law limits this authority to specific categories of people: police officers, the professional person in charge of a designated mental health facility, members of that facility’s attending staff, designated members of a mobile crisis team, or a mental health professional designated by the county. A family member, friend, or employer cannot place someone on a 5150 hold directly, though they can call law enforcement or a crisis team to request an evaluation.
What Happens During the 72 Hours
Once someone is placed on a 5150 hold, the 72-hour clock starts from the moment they are first detained, not from the time they arrive at the hospital. During this period, a psychiatric team evaluates the person, determines a diagnosis if possible, and decides whether they need continued treatment or can be safely released. Being placed on a 5150 does not guarantee you’ll be held the full 72 hours. If clinicians determine early on that you no longer meet the criteria, you can be released before the time is up.
If, at the end of 72 hours, the treatment team believes the person still meets the criteria for involuntary care, the hold can be extended under a different code section (5250) for an additional 14 days. This extension requires a formal certification and gives the patient the right to a hearing to challenge the continued detention.
Rights You Keep During a Hold
Being held involuntarily does not strip away all your legal rights. California law guarantees several protections for people on a 5150:
- Phone access: You have the right to make and receive confidential phone calls.
- Medication refusal: You can refuse treatment with antipsychotic medications unless a hearing officer or judge determines you lack the capacity to make that decision, or unless there’s a genuine medical emergency.
- Legal representation: You have the right to see a patient’s rights advocate who is independent from your treatment team. You also have the right to an attorney and can file a legal petition (called a writ of habeas corpus) to challenge your detention at any point.
- Visitor access: You can communicate privately with your advocate or attorney.
Firearm Restrictions After a Hold
A 5150 hold carries a legal consequence that outlasts the hospitalization itself. Under California law, anyone who is detained under Section 5150, evaluated, and admitted to a mental health facility is prohibited from owning or purchasing firearms for five years after their release. This restriction is automatic and does not require a separate court proceeding.
Who Pays for an Involuntary Hold
One of the most frustrating realities of a 5150 hold is the bill that can follow. Even though the person didn’t choose to be hospitalized, they can still be held financially responsible. As of 2016, the average cost of an inpatient psychiatric stay in the U.S. was roughly $7,100 over about six days, though the amounts hospitals actually charge patients can be significantly higher, ranging from around $8,400 to over $21,000 in some estimates.
Public programs like Medicaid and Medicare cover about 60% of inpatient psychiatric stays for people under 65. Private insurance picks up another 27%, and roughly 10% of stays are self-pay or uncompensated. But even with insurance, patients often face deductibles, copays, and coinsurance that can add up quickly. Courts have generally upheld that patients can be billed for involuntary care. In one Iowa case, a man was pursued by a collections agency for nearly $3,000 after an involuntary hospitalization, and the state’s Supreme Court ruled the hospital was entitled to recover the cost. In New Jersey, a man with schizophrenia and limited income received a bill exceeding $65,000, later reduced to about $6,700 because he was uninsured.
If you or a family member faces a bill after an involuntary hold, it’s worth contacting the hospital’s financial assistance office. Many facilities have charity care programs, and eligibility for Medicaid can sometimes be applied retroactively to cover the stay.