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Assisted Outpatient Treatment as an alternative to 5250 involuntary hold.
Summary
In California, a family member who was not placed under a 72-hour involuntary detention under Welfare & Institutions Code section 5150 hold cannot directly prolong the stay of the other spouse in the psychiatric ward, because the decision to “hold” is based on the determination of the medical professionals treating the individual. Alternatives include Petitioning the Court for an Assisted Outpatient Treatment or some form of Conservatorship.
5150 Emergency of imminent risk of harm to self or others, determined by medical professionals
The legal authority for a 51/50 hold in California is found in Welfare and Institutions Code section .
These sections of the law allow for the involuntary detention of an individual for up to 72 hours. The standard for detaining the individual is if a medical professional determines that the individual is:
Non-medical professional cannot compel extension of 51/50 because they are based on medical necessity
A Welfare & Institutions Code section 5150 is a 72-hour involuntary detention.
It's based on the medical determination that the individual poses an imminent danger to themselves or others due to a mental disorder. Medical Professionals Make the Decision. The decision to extend a 51/50 hold beyond the initial 72 hours to a 14-day Welfare & Institutions section
hold rests with the medical professionals treating the individual. A family member may be able to influence an extension of 5150 to a 14-day 5250
A family member of the person who is being held can potentially influence the treatment plan of the person being held, as follows. The family member can provide relevant information to the medical team about the patient's history, current behavior, and any concerns they have regarding the patient's safety or well-being. This information can be crucial in the treatment planning process.
The family member can express their concerns to the medical team about the patient's condition and the potential for continued danger.
However, it's important to remember that the medical professionals will ultimately make the decisions based on their professional judgment and the patient's clinical condition.
If the medical team determines that continued treatment is necessary, the family member can play a crucial role in supporting the patient's recovery by: (i) participating in family therapy sessions, if recommended by the treatment team; (ii) following the treatment plan; (iii) assisting to ensure that the patient adheres to medication schedules, attends therapy appointments, and engages in self-care activities; (iv) creating a stable and understanding environment for the patient upon their release from the hospital.
California law emphasizes the importance of patient autonomy and the least restrictive environment. Court intervention in medical decision-making is generally limited unless there's evidence of gross negligence or a violation of the patient's rights.
Alternatives to a 5120 - (i) Assisted Outpatient Treatment; and (ii) Conservatorship
Outside of a 5150- 5250, two legal procedures that allow a family member to directly influence medical care received by a family member are: (i) Assisted Outpatient Treatment; or (ii) Conservatorship.
The topic of conservatorship is outside the scope of this blog, but, you can read about conservatorships at my blog on that subject - .
Assisted Outpatient Treatment is Court-Ordered community treatment
Assembly Bill 1421 established the Assisted Outpatient Treatment (AOT) Demonstration Project Act of 2002, known as Laura's Law. This law is codified at Welfare & Institutions Code section .
Assisted Outpatient Treatment (AOT) can provide court-ordered community treatment for individuals with a history of repeated hospitalization or incarceration, or a history of violent behavior to self or others. AOT permits California Counties to utilize courts, probation, and mental health systems to address the needs of individuals unable to participate in community mental health treatment programs without supervision.
Criteria for AOT - serious mental illness, unlikely to survive; non-compliance with treatment
AOT can be considered if the individual has a serious mental illness; is unlikely to survive safely in the community without supervision; has a history of non-compliance with treatment that has resulted in hospitalization or serious harm.
Process to Obtain Process:
Petition: A petition for AOT must be filed with the court. The petition must be filed by the County Medical Official. [WIC
(b)(1)] Only certain people may request that the County Medical Official file the petition. [WIC
(b)(2)]. After filing the petition, a court hearing will be held to determine if the individual meets the criteria for AOT.Court Order: If the court grants the petition, an AOT order is issued. This order may require the individual to comply with a treatment plan, which may include medication, therapy, and other services.
Important Considerations: AOT is a serious legal intervention that restricts an individual's autonomy. The court must find clear and convincing evidence that AOT is necessary. The individual's rights must be protected throughout the process.
Disclaimer: This is a very simplified explanation. AOT is a complex legal process with specific requirements and procedures. This information does not constitute legal advice. It iss crucial to consult with a qualified mental health professional and/or legal expert for specific guidance related to your situation.
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