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What are the laws governing involuntary psychiatric holds (e.g., 5150) in my state or country?
Executive summary
Laws for involuntary psychiatric holds vary widely by jurisdiction but generally allow temporary detention for evaluation when a person is deemed a danger to themselves or others, or gravely disabled; many states use a roughly 48–72 hour emergency hold as the first step before longer civil commitment procedures (see summaries and reviews) [1][2]. Recent policy debate and legislative activity spotlight New York and California: New York’s governor has proposed expanding criteria and who may order commitments and renewing assisted outpatient orders (Kendra’s Law changes) [3][4][5]; California’s 5150 framework allows up to 72-hour holds and SB-43 (effective Jan. 1, 2025) broadened emergency transport and conservatorship pathways [6][7].
1. How emergency holds generally work: a shared skeleton across states
Most reporting and reviews describe a common pattern: an authorized person (police, clinicians, or designated responders) initiates an emergency detention, a clinical evaluation follows, and if criteria are met the person can be held for a short statutory period (often about 72 hours) while the need for longer commitment is assessed; this framework is what comparative studies and clinical summaries call “psychiatric emergency hold” laws [1][2].
2. Criteria that typically justify a hold: danger, grave disability, inability to meet basic needs
Across sources the core statutory triggers are consistent: imminent risk of harm to self (suicidal behavior) or others (homicidal), or “grave disability” — inability to care for basic needs such as food, shelter, or medical care. New York’s proposed changes would explicitly allow intervention when inability to meet basic needs creates substantial risk, reducing reliance on “imminent overt act” language [3][2].
3. Time limits and next steps: short holds then judicial review or extensions
Emergency holds are time-limited (72 hours is the common example cited for U.S. jurisdictions), after which hospitals, clinicians and courts determine whether to seek longer involuntary admission or initiate outpatient commitment processes; psychiatric review and a possible court hearing are typical next steps [2][8].
4. Who can initiate or authorize holds — shifting roles and debates
States differ on which professionals can authorize holds. New York’s 2025 proposals would expand the pool of licensed professionals (including psychiatric nurse practitioners) who can perform evaluations and admit or recommend involuntary treatment, a change proponents say improves access and opponents fear may reduce safeguards [4][3][9].
5. Recent state changes to watch: California (5150/SB-43) and New York reform efforts
California’s well-known “5150” process permits up to 72-hour holds under the Welfare & Institutions Code; reporting and county guidance note how 5150 is used and that extensions are possible [6]. California’s SB-43 (effective Jan. 1, 2025) broadened who can be transported for evaluation and may increase 72-hour detentions (San Diego County estimated ~1,500 more detentions) [7]. In New York, Governor Hochul’s 2025 proposals would expand involuntary commitment criteria, ease renewal of assisted outpatient treatment (Kendra’s Law) and authorize more clinicians to act — a package sparking support from some psychiatric groups and opposition from civil liberties advocates [3][4][5].
6. Rights and procedural protections: courts, hearings, medication limits
Sources emphasize due process safeguards: patients generally have rights to contest detention at hearings, and courts weigh continued detention or forced medication; mental-health advocacy groups and legal summaries stress procedural protections and limits on forced treatment absent judicial approval [2][10][11].
7. Research and controversy: effectiveness, civil liberties, and outcomes
Academic reviews document wide statutory variation and ongoing debate about whether involuntary and outpatient commitment reduce violence or improve outcomes; advocates warn expanded authority risks loss of liberty and mistaken assessments by non-clinical actors, while proponents argue reforms address gaps and bed shortages [1][5][9].
8. Practical next steps for readers seeking local law specifics
Available sources provide general patterns and examples (California’s 5150, New York proposals) and state compilations exist (e.g., comparative guides and state-by-state summaries), but for precise criteria, forms, time limits, and appeal procedures in your jurisdiction consult your state code or official health department pages — summaries and reviews underscore that statutes differ significantly across states [12][1].
Limitations: these sources cover U.S. states and recent 2024–2025 reforms; available sources do not mention the laws in countries outside the U.S. or provide a complete, authoritative text for every state statute — for binding legal advice or the exact statutory language, consult your state code or a licensed attorney [8][12].