After a 72-hour 5150 hold in California, one of three things happens: you are released, you stay voluntarily for continued treatment, or the facility certifies you for an extended involuntary hold of up to 14 additional days. The outcome depends on a clinical evaluation conducted before the 72 hours expire, which determines whether the original reasons for the hold still apply.
The Three Outcomes at 72 Hours
Near the end of a 5150 hold, the facility’s clinical team evaluates whether you still meet the legal criteria for detention: danger to yourself, danger to others, or grave disability. If you no longer meet any of those criteria, you’re discharged. The facility should provide a discharge plan that includes referrals to outpatient services, information about follow-up appointments, and enough medication to bridge the gap until you can see a provider.
If the treatment team believes you still need inpatient care but you’re willing to stay, you can convert to voluntary status. This gives you more control over your treatment and more flexibility to leave, though the facility can place a new hold if it believes discharge would be unsafe.
The third path is a 5250 certification, which authorizes up to 14 days of involuntary intensive treatment. For this to happen, two conditions must be met: the clinical staff must determine you remain a danger to yourself or others, or are gravely disabled, and you must have been offered voluntary treatment but were unwilling or unable to accept it.
What “Gravely Disabled” Means Now
California expanded its definition of “gravely disabled” through SB 43, which took effect January 1, 2024. Previously, grave disability meant being unable to provide for food, clothing, or shelter due to a mental health disorder. The new definition adds personal safety and necessary medical care to that list. It also broadens the qualifying conditions to include severe substance use disorders and co-occurring mental health and substance use disorders, not just mental illness or chronic alcoholism alone.
Some counties deferred adoption of the new definition until January 1, 2026, so the criteria applied to your case may depend on where you’re held.
Your Rights During an Extended Hold
If the facility certifies you under a 5250, you retain significant legal rights. California’s Lanterman-Petris-Short Act guarantees that certain rights can never be taken away, regardless of your status. These include the right to be free from unnecessary restraint, the right to not have medication used as punishment or for staff convenience, and the right to individualized treatment that is the least restrictive option available.
Other rights can only be denied if the facility demonstrates “good cause,” meaning the exercise of the right would be harmful to you, would seriously infringe on others’ rights, or would cause serious damage to the facility, and no less restrictive alternative exists. These include the right to daily visitors and reasonable access to telephones for confidential calls. Staff cannot deny rights as punishment or offer them as rewards for good behavior, and you’re entitled to an explanation every time a right is denied.
You also have the right to see a patients’ rights advocate at any point during your hold.
How to Challenge a 5250 Hold
You have two main options for contesting an extended hold. The first is a certification review hearing, which the facility must schedule within four days of the 5250 certification. At this hearing, a facility representative presents the evidence supporting your continued detention, and you have the right to be represented by an attorney or patients’ rights advocate. You can also request that family members attend to speak on your behalf, including by telephone if arranged in advance. The hearing can be postponed at your request or your attorney’s request.
The second option is filing a writ of habeas corpus, a formal legal petition asking a judge to review whether the facility has a lawful basis to hold you. You file this through the superior court using a standard form (HC-002). If granted, the facility director must bring you before the court and justify the detention. One important trade-off: filing a writ means giving up your right to the certification review hearing, so it’s worth discussing the choice with your advocate before deciding.
What Happens Beyond 14 Days
If you still meet criteria after a 5250 hold, California law allows further extensions, though each requires its own legal justification. A 5260 hold authorizes an additional 14 days, but only if you remain a danger to yourself. A 5270 hold authorizes 30 days and applies only to people found to be gravely disabled. For individuals considered a danger to others, a 5300 hold can last up to 180 days and is renewable. Each step narrows the qualifying criteria and raises the legal bar for continued detention.
At the far end of this spectrum, if a person remains gravely disabled after extended treatment, the county can petition for an LPS conservatorship under Section 5350, which lasts up to one year and is renewable. This is a court process with its own set of legal protections.
The Firearm Restriction
A 5150 hold triggers an automatic five-year prohibition on purchasing or possessing firearms in California, starting from the date you were taken into custody. This applies even if you were released at the end of 72 hours and never certified for extended treatment. If you are certified under a 5250, 5260, or 5270, the state restriction remains five years, but you may also face a lifetime prohibition under federal law.
Who Pays for the Hold
Billing for a 5150 or 5250 hold works similarly to other hospital stays. If you have Medi-Cal, the cost is covered through a combination of federal, state, and county funds. Beneficiaries with a share-of-cost obligation must meet that threshold before Medi-Cal reimburses the provider. If you have private insurance, the hold is typically billed as a psychiatric inpatient admission and subject to your plan’s coverage terms, including copays and deductibles. If you’re uninsured, the county generally absorbs the cost, though billing practices vary. You can receive a bill for an involuntary hold, which catches many people off guard.
After Discharge
California law requires facilities to create a discharge plan before releasing you. This should include an assessment of your ability to care for yourself, whether you have access to prescribed medications, and whether you can get to follow-up appointments. The plan should also identify early warning signs of relapse and connect you with community-based services.
In practice, the quality of discharge planning varies widely. Some facilities arrange outpatient appointments and provide a supply of medication. Others hand you paperwork and a list of phone numbers. If you have a family member or friend who can be involved in discharge planning, their presence can help ensure you leave with a concrete plan rather than a generic one. The patients’ rights advocate at the facility can also help you understand what services you’re entitled to before you walk out the door.