A 5150 is a section of California law that allows someone experiencing a mental health crisis to be held in a psychiatric facility against their will for up to 72 hours. The term comes from Section 5150 of California’s Welfare and Institutions Code, part of the Lanterman-Petris-Short (LPS) Act passed in 1967. It’s become so widely known that “being 5150’d” is used colloquially across the country, even though the law only applies in California. Other states have their own versions of involuntary psychiatric holds, but the 5150 is the most culturally recognized.
The Three Criteria for a 5150 Hold
A 5150 hold can only be placed on someone who, as a result of a mental health disorder, meets at least one of three criteria: they are a danger to themselves, a danger to others, or “gravely disabled.” The person initiating the hold must have probable cause to believe one of these applies. It’s not enough for someone to be acting unusually or making poor decisions. The behavior has to connect directly to a mental health condition.
“Gravely disabled” has a specific legal meaning here. It refers to someone who is unable to provide for their own basic needs: food, clothing, and shelter. This criterion often applies when a person is so disoriented or disconnected from reality that they cannot feed themselves, find housing, or maintain the bare minimum of self-care. It does not mean someone is simply struggling financially or living in difficult conditions.
When the hold is initiated, the person receives a written notice explaining which of the three boxes was checked and the specific reasons the evaluator believes the criteria are met.
Who Can Place a 5150 Hold
Not just anyone can initiate a 5150. California law limits this authority to a specific list of people: peace officers (including police), the professional person in charge of a county-designated evaluation facility, attending staff at such a facility, members of a mobile crisis team, and other mental health professionals specifically designated by the county. A family member, friend, or employer cannot place a 5150 hold on someone, though they can call 911 or a crisis line if they believe someone is in danger.
Once the authorized person decides a hold is warranted, they must complete a written application describing the circumstances. Before someone is formally detained, the receiving facility’s staff is required to assess whether the person can be helped voluntarily. If voluntary treatment is possible, the facility should offer that option first. Detention is meant to be a last resort when someone cannot or will not accept care on their own.
What Happens During the 72 Hours
The 72-hour clock starts when the person is first placed on the hold, not when they arrive at the psychiatric facility. This distinction matters because emergency departments sometimes face long waits for available psychiatric beds, and those hours still count. During this window, clinicians evaluate the person’s mental state, determine a diagnosis if possible, and begin crisis intervention or stabilization.
A person on a 5150 hold is not in jail and has not been charged with a crime. They retain significant legal rights. California law guarantees the right to humane care, dignity, and privacy. Patients can see a patient’s rights advocate, someone independent from the clinical and administrative staff who can help them understand and exercise their rights. They also have the right to be free from unnecessary restraint, isolation, or excessive medication. Medication cannot be used as punishment or simply for staff convenience.
Patients also keep their rights to social activities, recreation, religious practice, and education programs. Treatment must be delivered in the least restrictive way possible, and the goal is to help the person regain the ability to function independently.
Involuntary Medication
Being on a 5150 hold does not automatically mean a person can be forced to take psychiatric medication. In California, involuntary medication requires a separate legal process. If a patient refuses medication and the treatment team believes it’s necessary, the facility must go through a court hearing (sometimes called a capacity hearing) to determine whether the person can make informed decisions about their own treatment. Only if the court finds the person lacks that capacity, and that going without medication poses serious risk, can involuntary medication be ordered. Even then, it must be administered with the minimum force necessary and only after all attempts at voluntary compliance have failed.
What Happens After 72 Hours
Three things can happen when the initial hold expires. The most common outcome is release: the person is discharged, often with referrals for outpatient treatment. Many people placed on 5150 holds are released well before the 72 hours are up once they’ve stabilized. The second possibility is that the person agrees to stay voluntarily for continued treatment.
The third and most serious outcome is an extension. Under Section 5250 of the same code, a person can be certified for up to 14 additional days of involuntary intensive treatment. This requires the professional staff to have evaluated the person and concluded that they still meet the original criteria (danger to self, danger to others, or gravely disabled) as a result of a mental health disorder. The person must also have been offered voluntary treatment and either refused or been unable to accept it. A certification review hearing is required during this extended hold, giving the patient a chance to contest the detention.
5150 Holds for Minors
California has a parallel provision for minors under Section 5585 of the Welfare and Institutions Code. The process is largely the same: the minor can be held for up to 72 hours for assessment and crisis intervention if they meet one of the three criteria. The key difference is in how “gravely disabled” is defined. For minors, the definition is specific to mental health disorders and does not include substance use disorders in the same way the adult definition can. Additionally, the process accounts for parental authority. Clinicians must identify who has the legal right to make medical decisions for the minor, whether that’s a parent, legal guardian, or conservator.
Costs and Financial Responsibility
A 5150 hold generates real medical bills, and this catches many people off guard. The person held (or their family) typically receives a bill for the psychiatric evaluation and any inpatient stay, just as they would for any other hospital visit. Health insurance, including Medi-Cal (California’s Medicaid program), generally covers involuntary psychiatric holds when they meet the standard of medical necessity. If the hold is deemed not medically necessary by the insurer, the patient could be responsible for the cost.
For uninsured individuals, county mental health systems often absorb some of the cost, but policies vary significantly by county. The financial burden of an involuntary hold is one of the more stressful aftereffects for patients and families, particularly when the person didn’t choose to be admitted in the first place.
Long-Term Implications of a 5150
A 5150 hold is not a criminal record, but it does have lasting consequences. Under California law, a person who has been detained on a 5150 hold is prohibited from purchasing or possessing firearms for five years. This restriction is automatic and does not require a separate court proceeding.
The hold also becomes part of a person’s mental health records, though these records are protected by strict confidentiality laws. They are not part of standard background checks for employment. However, certain government positions or security clearances may require disclosure of involuntary psychiatric holds, and the record can surface in future mental health evaluations or custody disputes. Some people choose to petition for the restoration of their firearm rights or to have certain records sealed, though the process and eligibility vary.