Involuntary Rehab in California (Can You Force Someone into Treatment?)

What happens if a loved one refuses to get help for a life-threatening addiction or mental illness? Can you force someone into involuntary rehab in California?

Contact Bright Future Recovery today to learn more about addiction treatment in California.

Laws Governing Involuntary Rehab in California

In California, it is possible to have a person temporarily detained for an evaluation – and possibly treatment – if they pose a danger to themselves or others as a result of an mental illness or substance use disorder (addiction).

So the short answer to question at the heart of today’s post, “Can you force someone into involuntary rehab in California?” is “yes.”

But that short response doesn’t fully answer the question, because the standards and processes for involuntary admissions are governed by multiple pieces of legislation, including the Lanterman-Petris-Short (LPS) Act, Senate Bill 43, and Laura’s Law.

The Lanterman-Petris-Short Act

For more than 50 years, involuntary admissions into mental health facilities in California have been governed by the Lanterman-Petris-Short (LPS) Act. This act, which was signed into law by then-Gov. Ronald Reagan in 1967 and went into effect in July 1972, is enshrined in California law as Welfare and Institutions Code Sections 5000-5500.

As noted in the law’s introductory section, the goals of the LPS Act included:

• Ending the inappropriate, indefinite, and involuntary commitment of persons with mental health disorders, developmental disabilities, and chronic alcoholism
• Providing prompt evaluation and treatment of persons with mental health disorders or impaired by chronic alcoholism
• Guaranteeing and protecting public safety
• Safeguarding individual rights through judicial review
• Providing individualized treatment, supervision, and placement services by a conservatorship program for persons who are gravely disabled
• Establishing consistent standards for the protection of the personal rights of persons receiving services
• Providing services in the least restrictive setting appropriate to the needs of each person receiving services 
• Protecting persons with mental health disorders and developmental disabilities from criminal acts

Prior to the passage of the LPS Act, many people were held indefinitely in state-run psychiatric hospitals. As noted in a 1983 article in the journal Hospital and Community Psychiatry, the patient population of California’s state-run psychiatric hospitals dropped from 37,000 in 1955 to 2,500 by the early 80s.

5150 Holds

In California, involuntary holds due to mental illness are commonly referred to as 5150 holds. This is a reference to Section 5150 of the LPS Act, which addresses this topic.

According to that section, someone who poses a danger to themselves or someone else due to a mental health disorder, or who is “gravely disabled” by a mental illness, may be held for up to 72 hours “for assessment, evaluation, and crisis intervention, or placement for evaluation and treatment in a facility designated by the county.”

A 5150 hold can be initiated by one of the following individuals:

• Police officers
• Licensed mental health professionals
• Physicians
• Designated hospital staff

5150 holds fall under civil law, not criminal law. But they can apply to people who have been accused of a crime. Section 5225 allows a judge to order an involuntary 72-hour hold for any criminal defendants who meet the 5150 criteria “as a result of chronic alcoholism or the use of narcotics or restricted dangerous drugs.”

If the professionals who evaluate a patient on a 5051 hold determine that they need additional care, and the patient refuses, they may be held for additional time as established in sections 5250 and 5270 of the LPS Act:

• Section 5250 allows a person to be held for up to 14 days to receive “intensive treatment.”
• Section 5270 permits a person to be held for 30 additional days after their 5250 hold timeline has expired, with the option to add another 30 days if the need exists

At any time in this process, a patient can agree to receive additional treatment, which negates the need for the involuntary holds.

Senate Bill 43

As noted earlier in today’s post, to be placed on a 5150, 5250, or 5750 hold, a person must meet at least one of the following criteria due to a mental illness:

• Poses a danger to themselves
• Poses a danger to others
• Is gravely disabled

The first two of these criteria are relatively clear, but what does “gravely disabled” mean? 

As defined in the LPS Act, a person is considered to be gravely disabled by a mental illness if their condition prevents them from providing their basic personal needs for food, clothing, and shelter.

Senate Bill (SB) 43, which was signed into law by Gov. Gavin Newsom in October 2023, expanded that definition to include people who are unable to provide the following for themselves: food, clothing, shelter, personal safety, or necessary medical care.

SB 43 also added “severe substance use disorder” to the justifiable causes of a 5150 hold. Prior to that change, a person had to have a mental illness to be involuntarily detained. They could also have a co-occurring substance use disorder, but a standalone addiction was not enough to qualify them for a 5150 hold until SB 43 changed the law.

Laura’s Law

Officially known as Assembly Bill 1421: Assisted Outpatient Treatment (AOT) Demonstration Project Act of 2002, Laura’s Law allows a person to be court-ordered to receive assisted outpatient treatment if a judge determines that they:

• Have a mental illness
• Are unlikely to survive in the community without supervision
• Have a lack of compliance with treatment
• Have symptoms that indicate their condition is “substantially deteriorating”
• Will benefit from assisted outpatient treatment

Laura’s Law was named in honor of Laura Wilcox, a college student who was killed in 2001 by a 40-year-old man who had previously refused mental health treatment.

According to the San Bernardino County Department of Behavioral Health, someone who is ordered to take part in assisted outpatient treatment under Laura’s Law may receive services such as:

• Intensive client-directed case management and treatment services, including evaluating the need for community residential housing
• Assessment of client needs
• Development of client plan
• Linkage with appropriate services as well as monitoring of follow-through with services
• Coordination of access to medications, psychiatric and psychological services, substance use services, supportive housing, vocational rehabilitation, and veterans’ services
• Advocacy
• Education/understanding and management of symptoms

Learn More About Addiction Rehab in California

You don’t have to wait until you have become gravely disabled or pose a danger to yourself or others to benefit from professional treatment for an addition or a mental illness.

Bright Future Recovery offers a full continuum of personalized care in a safe, welcoming, and highly supported environment.

Treatment options at our rehab in Northern California include detox, residential care, a partial hospitalization program (PHP), an intensive outpatient program (IOP), and a virtual (online) outpatient program.

To learn more about how we can help you or a loved one, or to schedule a free assessment, please visit our Contact page or call us today.