What actions can you take when someone in a mental health crisis – who is possibly a risk to themselves or others – refuses treatment?
In psychological emergencies and behavioral health crises, essential care and assistance, such as involuntary commitment, become crucial.
Involuntary commitment is a legal procedure that ensures you or a loved one receives necessary care, with or without consent. Involuntary commitment can be a difficult and emotional experience – but it can also help save lives.
If you’re concerned that you or someone you care about is experiencing a mental health crisis, Mission Connection’s licensed staff can guide you through California’s involuntary commitment laws. This article can also help by discussing:
- What involuntary commitment and psychiatric holds are
- What the laws for involuntary psychiatric holds in California are
- Legal protections for mentally ill patients
- Where to find support for involuntary commitments and psychiatric holds
Understanding Involuntary Commitment and Psychiatric Holds
Involuntary commitments and psychiatric holds can be stressful and frightening for everyone involved, yet they are also extremely important mental health and life-saving measures.
Let’s take a closer look at what involuntary and voluntary commitments and psychiatric holds are.
What Is Voluntary vs. Involuntary Commitment?
In mental health care, voluntary commitment means willingly admitting yourself to a treatment facility. In contrast, involuntary commitment involves someone taking legal action to admit you to a facility against your will.
Voluntary commitment allows you to seek mental assistance without pressure. It’s a good option when you understand your condition and are willing to seek help. You typically have the freedom to leave a treatment facility at any time, although certain procedures or notice periods might be necessary.
Involuntary commitment, on the other hand, is necessary when someone’s mental health leads them to become a personal or public risk. In these circumstances, this person likely needs admission to a treatment center, but they refuse it. it. The involuntary commitment procedure typically involves legal procedures such as a court order or police intervention.[1]
Unlike voluntary admissions, a psychiatric hold is imposed on people who:
- Refuse admission when they need it
- Are a threat to themselves or others
- Cannot make informed choices regarding their treatment
If you or someone you care about becomes a risk to your own safety, you may be held in a mental health care facility for 72 hours or up to three days before a hearing committee decides your involuntary commitment. In other words, you are held on psychiatric hold. [2]
The main purpose of a psychiatric hold is to provide a safe environment for initial evaluation and stabilization, which may include medication and crisis management.
Additionally, while on psychiatric hold, mental health experts assess the nature and severity of your issues so that they can develop a tailored treatment plan.
What Is the Law for Involuntary Psychiatric Holds in California?
In California, the law for involuntary psychiatric holds, outlined in California’s Welfare and Institutions Code, is the 5150 psychiatric hold. The duration of a 5150 hold is specifically 72 hours; however, it can extend through additional legal procedures.
The main purpose of a 5150 hold is to keep you safe and provide swift access to mental health care.[3] It is a temporary stay where mental health experts identify your condition, hospitalization requirements, and treatment needs. Mental health specialists or police officers have the authority to initiate the 5150 psychiatric hold.
While the 5150 hold might seem like an arrest because of the temporary restriction of movement, it is not a criminal procedure. You have specific rights under this code, such as the right to:
- Refuse any sort of medical treatment
- Have legal representation
- Make phone calls.
After 72 hours, there may be more involuntary holds based on the outcomes of continued medical treatment and assessments.
Criteria for Psychiatric Holds in California
Authorities use 5150 holds when the person suffering from mental health issues is a risk to themselves or others. The following are each criterion for a 5150 hold.[4] Someone may be held on psychiatric hold if they are a…
Are a Threat to Oneself
This means that the person shows actions or talks about having intentions to cause harm to themselves. For instance, this might include having thoughts about suicide or exhibiting self-harming behaviors.
Are a Threat to Others
Under this criterion, the person of concern has either threatened or tried to injure others, or there is a genuine concern that they may do so.
Have a Severe Disability
This condition applies when the person cannot fulfill their essential needs (such as for food, clothing, and shelter) because of a mental health issue. This criterion suggests they are not fit to care for themselves.
Legal Protections for Mentally Ill Patients
The Lanterman-Petris-Short Act (LPS Act) is a California law that controls involuntary commitment to mental health facilities.[5] It is a revolutionary act that changed psychiatric holds by ending indefinite and inappropriate detention of people with mental health disabilities. This act also created a program for mental health conservatorships in California for the severely disabled. Conservatorship is a legal procedure where the court assigns a person to make certain legal decisions for you.
Additionally, mental health facilities should meet the patients’ rights regulations outlined in the California Welfare & Institutions Code (WIC). Aside from California, the LPS has also become a blueprint for other states across the United States and has played a vital role in improving mental health care.
Moreover, the LPS Act has contributed to easing the process of discharge from inpatient treatment, as it helps transition people with mental health problems from psychiatric institutions to community-based facilities.
The LPS Act also protects your mental health rights, even if you are undergoing involuntary treatment. For example:
- You can opt for a personalized treatment program that doesn’t hamper your freedom
- You can make phone calls and meet visitors
- You can expect adequate medical care and respectful treatment
Let’s further explain how this act protects your mental health rights.
Patient Rights Under the LPS Act
The LPS Act includes two categories of rights.5 The first category of rights – called “non-deniable” rights – applies to everyone, including voluntary and involuntary patients, and is not affected by conservatorship. Some of the rights in this category include:
- Treatment services and medical care that maintain your personal freedom
- Respect, privacy, compassionate care, physical exercise, social interactions, and recreational activities
- Freedom from extreme physical restraint, medication, isolation, or neglect
- Refusing dangerous procedures, such as brain surgery
The second category of rights – called “deniable rights” – includes wants or desires that might be refused when there is a “justifiable reason” to do so. However, they should be denied in a way that is least restrictive of your rights. The patient’s parent, guardian, or conservator cannot waive these rights on their behalf.
However, every denial of a want needs documentation in the patient’s treatment record. Some of these rights include:
- Wearing your own clothes and using personal belongings
- Keeping money and buying small things
- Having an individual storage area for private use
- Having daily visitors
Under certain safety protocols, using telephones for personal calls or writing, sending, and receiving letters can be denied. However, for the most part, patients in residential settings are encouraged to keep in reasonable contact with loved ones.
If a facility denies your right(s), it must have a valid and good reason for doing so. For instance, if you’re considered a safety risk to yourself, the facility staff, or others around you. If you’re concerned about your rights in mental health treatment, a mental health professional can explain these to you and how you can go about protecting them.
Our Approach at Mission Connection
Focusing only on mental health symptoms while neglecting interests and lifestyle choices can create resistance to therapy, less optimal outcomes, and an increased risk of relapse.
At Mission Connection, our treatment approach goes beyond just treating your symptoms and helps you attain the life you deserve. When you start your healing and recovery journey with us, you can be confident that you’ll join a community that truly aims to create long-lasting change.
Our clinical foundation is the basis of all our methods – from your initial appointment to the way we organize our treatment planning and assist your continued wellness. Additionally, our programs rely on combining the most up-to-date, evidence-based techniques with true empathy and personalized support.
Central to Mission Connection’s treatment programs is our dedication to a therapeutic method known as “Recovery-Oriented Cognitive Behavioral Therapy,” or CT-R. CT-R is a groundbreaking and evidence-based form of treatment that enables us to achieve the highly effective and enduring results our clients have come to know.
Our CT-R approach…
- Focuses on your strengths
- Helps you identify and achieve important personal goals
- Teaches you how to solve problems, manage your emotions, improve relationships, and practice self-growth
- Assists in changing unhealthy beliefs and creating new ones that are genuinely helpful in your recovery journey
Reach Out for Support Today
Involuntary commitment and psychiatric holds are important elements of mental health treatment when a person’s mental condition becomes a danger to themselves or others. Yet, these processes do not mean that you or a loved one will have no say in what happens during treatment. Legal protections have been developed to balance the need to care for those experiencing a mental health crisis with protecting their essential rights and independence.
Starting the path to mental health recovery may seem challenging, but at Mission Connection, you won’t have to embark on this journey by yourself. Our group of empathetic and well-trained experts will guarantee that you receive support and care at every stage of the process.
We provide flexible choices for in-person meetings and telehealth (virtual) appointments – so that you can fit sessions easily into your timetable.
Prepared to start your recovery journey with Mission Connection? Get in touch with us today at 866-338-4958 to arrange a consultation.
References
- Cleveland Clinic. (2025). Involuntary commitment. February 10. https://my.clevelandclinic.org/health/articles/involuntary-commitment
- Morris, N. P. (2021). Reasonable or random: 72-hour limits to psychiatric holds. Psychiatric Services, 72(2), 210–212. https://doi.org/10.1176/appi.ps.202000284
- Stallman, H. M., & Gupta, V. (2025). Involuntary commitment. StatPearls, StatPearls Publishing. January 20. https://www.ncbi.nlm.nih.gov/books/NBK557377/
- Sullivan, M., Scherban, B., & Bera, S. (2024). Involuntary commitment: a humanitarian treatment. Psychiatric Services, 75(12), 1281–1283. https://doi.org/10.1176/appi.ps.20240145
- Disability Rights California. (2018). Understanding the lanterman-petris-short (lps) act. January. https://www.disabilityrightsca.org/publications/understanding-the-lanterman-petris-short-lps-act