According to psychiatric research, 1 million 72-hour emergency psychiatric holds take place across the country each year.
What is a 72-hour emergency psychiatric hold? The term comes from the Lanterman-Petris-Short Act (LPS) that was signed as a California law in 1968 to put a stop to the indefinite involuntary commitment in practice at the time.
What Happens in a 72-Hour Hold?
The 72 hours of a psych hold, often known as a time for observation, mainly involve monitoring and evaluating the patient to determine if they need more long-term treatment for their mental illness.
The process is as follows:
- Upon arrival, the patient will answer questions about themselves and their symptoms.
- The hospital staff will provide the patient with new clothing.
- Patients are not permitted to talk to anyone outside the hospital, but are exceptions in certain cases.
- Patients will meet with a team of doctors and psychiatrists to determine the right course of treatment to treat symptoms. Physical restraints are rarely used and only in serious situations when the patient is not responding to treatment.
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What Are the Benefits of a 72-Hour Hold?
Untreated mental illness can be debilitating for individuals and loved ones. Suicide is the 12th leading cause of death in the United States, with 130 deaths each day.
Treatment for mental illness is not an easy, straightforward process and often lacks the funding, accessibility, and support it needs. However, with a 72-hour hold, violent acts and suicides are prevented. Hospitalization offers monitoring, treatment, and stabilization for high-risk patients.
In addition, holds can connect patients to psychiatrists, therapists, and other resources post-discharge.
What Happens if the Patient Still Needs Treatment After a 72-Hour Hold?
If, after the 72-hour hold, the patient continues to meet any of the three criteria for the original psychiatric hold, the attending medical staff will place the patient on a 5250 or 14-day hold for more intensive treatment.
If this involuntary hold is extended, patients will receive a physical copy of this certification. The 14-day time period is the maximum limit, with the possibility of being released before that time, based on the patient’s prognosis and symptoms.
Patients will also gain the right to a probable cause (PC) hearing, also known as a certification review hearing, when a patient rights advocate speaks on their behalf.
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How Is a 72-Hour Psych Hold Initiated in California?
In California, law enforcement officers or mental health professionals as evaluators can place someone on an involuntary emergency psych hold, or 5150, due to a mental illness. Three factors must be deemed about the patient:
- They are a danger to themselves and have threatened or indicated the intent to commit suicide or cause bodily harm to themselves.
- They are a danger to others, which is usually connected to someone with bipolar disorder or depression who demonstrates actions or threatens to inflict bodily harm to another person.
- They have a grave disability and are unable to provide for their basic needs (or a third party is unable to provide them), such as food, clothing, personal hygiene, and shelter.
The legal term “5150” comes from the number of the section of the Welfare and Institutions Code. The law requires that the evaluator ends the hold when the patient no longer meets these three criteria for involuntary hospitalization on a continual basis.
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What Happens During a Probable Cause Hearing in California?
Probable cause (PC) hearings held after a psychiatrist recommends a 14-day hold are usually informal. However, they are necessary to help the mental health facility evaluate whether there is a cause to keep the patient hospitalized. The final decision on whether to discharge the patient or continue their care is made by the hearing officer.
Here is what to expect:
- Before the hearing, the patient is assigned a patient’s rights representative from the county, who will meet with the patient to discuss their wishes moving forward: to contest the 14-day hold or not contest.
- Both patient and representative attend the PC hearing in the hospital, or the patient may choose not to attend.
- At the PC hearing, the hearing officer will hear testimony from the patient’s rights representative and the hospital representative (psychiatrist, nurse, or social worker).
- The patient’s family, who can also provide testimony or more information, may be present during the PC hearing with the patient’s permission.
- At the conclusion of the PC hearing, the hearing officer will determine if the patient continues to meet the hold criteria and upholds the 5250 or they do not and can either be discharged or remain hospitalized on a voluntary basis.
Can You Have an Attorney Represent You for a 72-Hour Hold?
If you or a loved one have been placed on a 72-hour hold and the mental health facility has determined you continue to meet the criteria for involuntary hospitalization for a longer hold, you can seek legal representation from a Los Angeles criminal law attorney to defend your case.
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