The Importance of Ongoing Specialty Consultation in Writing WIC 5150 Involuntary Holds

For mental health clinicians and police officers, issuing a ?Welfare and Institutions Code (WIC) 5150 hold ?is one of the most powerful and complex responsibilities. This 72-hour involuntary hold allows the temporary detention of an individual who presents a danger to self, danger to others, or is gravely disabled due to ?behavioral symptoms of ?a mental disorder or ?illness.??

While it is a critical tool to prevent immediate harm, it carries significant legal, ethical, and professional risks if not applied correctly. Specialty consultation provides an essential layer of protection and support, helping clinicians navigate this nuanced process and avoid legal pitfalls.

In this post, we will explore the importance of ongoing specialty consultation, focusing on legal standards, the risks of disciplinary actions, potential civil liberties violations, and criminal liability for improperly issued 5150 holds.

Understanding the Legal Standard: Douglass vs. City of Los Angeles.?

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The California Supreme Court case ?Douglass v. City of Los Angeles, 5 Cal. 2d 123, ?highlights the need for probable cause ?when issuing a 5150 hold. The ruling clarified that a clinician ?or police officer must have ?"reasonable cause to believe" ?that the person poses a danger to themselves or others or is gravely disabled. ?

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Probable cause? has been identified as the following…

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“Probable cause under WIC 5150 ?exists when facts are known “that would lead a person of ordinary care and prudence to believe, or to entertain a strong suspicion, that the person detained is mentally disordered and is a danger to himself or herself. . .”?People v. Triplett, 144 Cal.App.3rd 283.288 (1983).? The 5150 Application for Admission to an Inpatient Psychiatric Hospital? ?“must be able to point to specific and articulable facts which, taken together with rational inferences from those facts, reasonably warrant his or her belief or suspicion.”??

Probable cause requires more than a hunch; it demands observable facts that point to a genuine mental health crisis necessitating involuntary detention.

Failure to meet this standard can have severe legal consequences. If a 5150 hold is improperly issued, it could:

1. Violate the individual’s civil liberties, leading to claims of unlawful detention.

2. ?Exposure ?to legal actions— malpractice suits, and criminal liability for false imprisonment.

3. Legal Ramifications of an Improper 5150 Hold - for Clinicians?

Professional Disciplinary Actions: The California Board of Behavioral Sciences (BBS) and the Medical Board of California have the authority to investigate clinicians who misuse 5150 holds.

? Sanctions may range from probation and fines to suspension or revocation of licensure. This can have career-damaging consequences, limiting the clinician’s ability to practice.?

4. ?Compromise the quality of care, as premature or unnecessary holds can erode trust between the patient and the mental health system.

In Douglass vs City of Los Angeles, Douglass, the Complaint brought forth causes of action for: (1) Unconstitutional Detention; (2) Excessive Force; (3) Retaliation; (4) Violation of Due Process; (5) Violation of the Americans with Disabilities Act; (6) Violation of the Bane Act; (7) Battery; (8) False Arrest & Imprisonment; (9) Negligence; and (10) Negligent Employment and Supervision.? Also, the Court stated that the legal requirements for immunity against legal action were not met because the standard for probable cause was not met. The outcome of Douglass, the Court " finds that no reasonable officer could believe that there was probable cause for detention."

Given these stakes, ?ongoing consultation with legal and regulatory experts in the area of Laws of Patient's Rights, LPS Act, and 5150 involuntary psychiatric civil detainment ?is crucial to ensure that the probable cause threshold is met consistently.

Note: Although this case and codes focus on California, every State has its own process for civil detainment in an inpatient psychiatric hospital.

DLH-Enterprises5150 specializes in California LPS Act and the Laws of Patient Rights.

DLH-Enterprises5150.com

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