5150 Holds, LPS Conservatorship & Involuntary Commitment in California

By SoCal Addiction Centers Editorial Team | Last reviewed: | 8 min read Clinically Reviewed

Key Takeaways

  • 5150: 72-hour involuntary psychiatric detention under California Welfare and Institutions Code § 5150. Criteria: danger to self, danger to others, or gravely disabled.
  • 5250: 14-day certification for intensive treatment, initiated if the patient still meets criteria at the end of the 72-hour 5150.
  • 5270.15: Additional 30-day certification for intensive treatment, relatively rare, specific conditions apply.
  • LPS conservatorship: The Lanterman-Petris-Short Act framework for longer-term involuntary treatment of people who cannot provide for their basic needs due to mental illness or severe SUD.
  • SB 43 (2024): Expanded “gravely disabled” to include severe substance-use disorder independent of mental illness. Counties have discretion over implementation timing; most SoCal counties implemented in 2024–2025.
  • For addiction specifically: A 5150 for substance use alone was historically difficult to obtain under California law. SB 43 changes this meaningfully. The practical reality in 2026 varies by county.

5150 holds, 5250 certifications, LPS conservatorship — the California framework

California’s involuntary-commitment framework for mental health and severe substance-use conditions operates under the Lanterman-Petris-Short (LPS) Act, enacted in 1967 and codified at California Welfare and Institutions Code §§ 5000 et seq. This page answers the four most common questions about LPS — 5150 criteria, the difference between 5150 and 5250, consequences of 5250, and 5150 for drug use — from the perspective of families navigating the system and patients who have been or may be placed on a hold.

This is editorial guidance, not legal advice. For legal questions about a specific case, consult an attorney familiar with California behavioral-health law. The California Department of Health Care Services publishes the authoritative regulatory reference. Statute text is at leginfo.legislature.ca.gov.

What criteria does a 5150 hold have in California?

A 5150 hold in California requires a peace officer or qualified clinician to determine that a person is, as a result of a mental health disorder or — as of 2024 under SB 43 — a severe substance-use disorder, any one of the following:

  1. A danger to themselves (suicidal ideation with plan, intent, or means; self-harm; imminent risk)
  2. A danger to others (homicidal ideation; threats with means; recent violent acts connected to mental state)
  3. Gravely disabled — unable to provide for basic personal needs (food, clothing, or shelter) due to mental disorder or severe SUD

The criteria require present-tense danger or inability, not speculative future risk. A person with chronic mental illness or SUD who is currently stable and not presenting acute danger does not meet 5150 criteria, even if they have previously met criteria.

The 5150 authorizes 72 hours of involuntary detention in a designated psychiatric facility for evaluation and treatment. During the 72 hours, the facility’s clinical staff evaluate whether the person still meets criteria, stabilizes acute symptoms, and plans for either release or step-up to a 5250 certification.

A 5150 can be initiated by a peace officer (police, sheriff), a county-designated mental health professional, or in some counties by specific crisis-response teams. Family members cannot directly initiate a 5150 — they can request an evaluation through the county’s mobile crisis team or by calling law enforcement if there is imminent danger.

What is the difference between 5150 and 5250 in California?

The difference between 5150 and 5250 is duration and the legal process required:

5150 — 72-hour detention, initiated by a peace officer or qualified clinician, no pre-detention judicial review. The detention is evaluative: the facility assesses whether involuntary treatment is clinically necessary and whether the person still meets criteria.

5250 — 14-day certification for intensive treatment. A 5250 is initiated at or before the end of the 5150 if the facility’s clinical staff determine the person still meets LPS criteria and requires ongoing involuntary treatment. The 5250 requires a certification hearing — a due-process step — within four days of the certification. The patient has the right to legal representation (Patients’ Rights Advocate or attorney), to present evidence, and to contest the certification.

A 5250 is not automatic. If the hearing officer finds the person does not meet criteria, the certification is dismissed and the person is released. If the hearing officer upholds the certification, the person can be detained for up to 14 days from the start of the 5250 period.

After a 5250, further detention requires either:

  • 5270.15 — an additional 30-day certification for intensive treatment (relatively rare, narrow criteria)
  • LPS conservatorship — a longer-term judicial process for patients who remain gravely disabled

What are the consequences of a 5250?

Beyond the 14-day extended detention, a 5250 certification has several consequences:

Firearm prohibition. Under California Welfare and Institutions Code § 8103, a person placed on a 5250 is prohibited from owning, purchasing, or possessing firearms for five years. The prohibition applies to 5250 certifications, not standalone 5150 holds.

Reporting to federal NICS. California reports 5250 certifications to the federal National Instant Criminal Background Check System, which prevents the person from passing a federal firearms background check.

Professional licensing implications. Some professional licensing boards ask about involuntary commitment history on applications and renewals. A 5250 may trigger mandatory disclosure depending on the license.

Insurance and employment. Health insurance applications generally cannot use mental health history against an applicant under federal and state protections, but some employment contexts (military enlistment, federal security clearance) may consider involuntary commitment history.

Medical record. The 5250 becomes part of the person’s medical record and is reported to the California Department of Justice. The record is confidential under HIPAA and California medical privacy law but will appear in certain background checks.

Right to petition for removal of firearm prohibition. California provides a judicial process to petition for early restoration of firearm rights under certain circumstances.

Families considering requesting involuntary treatment for a loved one should understand that these consequences are lasting. They do not make 5250 inappropriate when clinically indicated — but they warrant informed family discussion.

What is a 5150 hold for drug use?

Until 2024, California’s 5150 statute applied to “mental health disorders” and did not clearly extend to substance-use disorder alone. A person intoxicated or withdrawing but not presenting an independent mental-health crisis often did not meet 5150 criteria under the pre-SB 43 framework, even if clinically in serious condition.

SB 43 (2024) — signed October 2023, implementation beginning 2024 with counties given discretion — changed this. SB 43 expands the “gravely disabled” criterion to include people who, due to severe substance-use disorder (or a co-occurring mental-health and SUD), are unable to provide for personal safety or necessary medical care. The statute explicitly recognizes severe SUD as a standalone basis for involuntary intervention.

In practice in 2026:

  • All six SoCal counties have implemented SB 43 as of 2025, though with varying clinical protocols and training rollouts.
  • The clinical bar is “severe SUD with inability to provide for basic needs / medical care” — not simply “actively using substances.” Active addiction without grave disability does not meet SB 43 criteria.
  • A person in acute opioid withdrawal requiring medical stabilization, or in severe alcohol withdrawal with delirium tremens risk, may meet criteria under SB 43’s grave-disability standard because the medical need for immediate care can’t be declined safely.
  • County Behavioral Health divisions and designated emergency psychiatric facilities operationalize SB 43 differently. Some counties have dedicated crisis triage protocols; others fold SB 43 evaluations into existing 5150 processes.

Families seeking involuntary treatment for a loved one with SUD should:

  1. Call the county Behavioral Health crisis line (see numbers below)
  2. Request a mobile crisis team evaluation if the person is in the community
  3. If the person is in acute medical crisis, call 911 — hospital ER evaluation is a distinct pathway
  4. Consult with the county Patients’ Rights Advocate about the legal process

SB 43 does not replace voluntary treatment. Voluntary treatment — through a county DMC-ODS referral or commercial insurance — remains clinically preferable when the patient is willing and able to engage. Involuntary intervention is a last-resort pathway when voluntary engagement is not possible.

This page focuses on 5150 and 5250. Related California statutes cover adjacent involuntary-treatment pathways:

Each of these is a distinct legal pathway. They are not interchangeable with 5150/5250 and serve different patient populations. Our dedicated pillars for each explain the specifics.

County crisis resources

For immediate psychiatric or SUD crisis — including situations where 5150 may be warranted:

  • LA County ACCESS Center: (800) 854-7771 — 24/7 psychiatric emergency and mobile crisis response
  • Orange County Crisis Assessment: (714) 517-6353 — OC mobile crisis
  • San Diego County Access & Crisis Line: (888) 724-7240
  • Riverside County Crisis: (951) 686-4357
  • San Bernardino County Crisis Response: (800) 451-2873
  • Ventura County Crisis Team: (866) 998-2243

988 Suicide & Crisis Lifeline: Dial 988 from any phone in California. Routes to the nearest crisis center.

911: For acute medical emergencies, including overdose, withdrawal seizure, or immediate physical danger.

Need guidance on involuntary treatment options?

Our editorial team can explain the specific statutes that apply to your family member’s situation, point you to the right county resources, and clarify the distinction between 5150, CARE Court, Laura’s Law, and Prop 36 pathways. We are not attorneys; for specific legal questions, consult a California behavioral-health law specialist.

Contact our editorial team →

For immediate crisis intervention, call your county crisis line above or 988. For editorial guidance on SoCal addiction treatment options, call (310) 596-1751.

Last reviewed: 2026-04-23. Statutory references reflect California law current at review. SB 43 implementation varies by county; confirm current county operational status through the county Behavioral Health division. This page is editorial content, not legal advice. For specific legal questions, consult a licensed attorney.

Looking for treatment options in your area? We can help point you in the right direction. (310) 596-1751 — or request a callback.