Mental observation holds, sometimes referred to as 5150 holds, permit mental health providers to hold a patient for 72 hours against his will if reasonable cause exists to believe the patient might be a danger to himself or others. Several laws mandate what is allowed in regards to 72 hour psychiatric holds. These laws are designed to balance the patient's constitutional rights with his own best interests and the best interests of society.
Cause to Hold
In order for a licensed psychiatrist or otherwise licensed mental health professional to hold a patient against his will for the purpose of psychiatric evaluation, a court order to do so must be obtained. While laws vary by state, a court will typically issue an order to hold a patient for observation if reasonable evidence exists to document that the patient is a threat to himself or others. Examples include threats of suicide on behalf of the patient, a threat to do harm to others or a demonstrated lack of ability to control his emotions or actions that are consistent with symptoms of mentally incapacitated person.
Temporary psychiatric holds are typically only enforceable in most states for a period of 72 hours or less, although laws relating to how long a patient may be held for observation vary by state. At the end of the designated period, one of three things must occur. The patient must be allowed to leave the facility voluntarily, the patient must be given the option to admit himself for further treatment on a voluntary basis, or the order to hold the patient for additional observation must be renewed.
Scope of Treatment
During the course of treatment, the patient cannot be forced to participate in any counseling or treatment sessions against his will. In addition, the patient must be made aware of his rights as recognized by state and federal law. However, the hospital or psychiatric facility in which the patient is held is required to evaluate the patient's mental health to the best of its ability, including documenting any threats of self-harm made by the patient and the actions and behavior of the patient while under the facility's care.
If, at the end of the time allotted by the state in which the order to hold was issued the treating physician feels that the patient poses a continued risk to himself or others, the patient can be held for an undetermined period of time through certification for intensive treatment. If the patient disagrees with this decision, he has the express right to appeal the decision through a writ of habeas corpus through the Court of Appeals in the state in which he is being held. The decision as to whether the patient will ultimately be held against his will can only be determined by the court in which the matter is heard.