In California, the involuntary commitment of individuals in mental health facilities is governed by the Lanterman–Petris–Short (LPS) Act, enacted in 1972. This page describes the LPS involuntary treatment process (starting with the 72 Hour Hold), as well as the rights of persons evaluated and hospitalized under this law.
Content on this page:
Useful Links and Documents
What to expect when you call 911: Go to our Crisis Support page, and expand the “1. What to Expect When You Call 9-1-1” section
What to expect when you call 988: Go to our Crisis Support page, and expand the “2. What to Expect When You Call 9-8-8” section
Family input during 5150 crisis: A guide for families living in Santa Clara County created by NAMI family members.
LPS Hold Chart: This chart from LA county summarizes LPS Holds in California.
Involuntary Treatment Law Flowchart–Â A visual representation of LPS process
Rights of Individuals in California Mental Health Facilities – This excellent handbook by the California Department of Health Care Services summarizes the state’s involuntary mental health treatment laws, and people’s rights under those laws.
Commonly Used Terms
- Danger to Others – Words or actions which indicate a serious intent to cause bodily harm to another person, and which are due to a mental disorder.
- Danger to Self – Words or actions which indicate the intent to commit suicide or inflict serious bodily harm to oneself, or actions which place the person in serious physical danger, which are due to a mental disorder.
- Gravely Disabled – An adult who, as a result of a mental disorder (rather than a chosen lifestyle or lack of funds) is unable to provide for his or her basic needs for food. clothing or shelter.
- LPS Conservatorship – A mental health (LPS) conservatorship makes one adult (called the conservator) responsible for a mentally ill adult (called the conservatee). The LPS Conservator is responsible for both the Conservatee’s mental health treatment, as well as for their finances. This is in contrast to a “probate conservatorship,” which only gives the conservator rights over another dependent adult’s finances.
- Advocate – The person mandated by the state law to ensure that mental health patients maintain their statutory and constitutional rights.
Under California law, only designated professional personnel can place a person on a 72-hour hold (also called a “5150,” as it is authorized under Section 5150 of the Welfare and Institutions Code). These professionals can be police officers, licensed members of a crisis team, or other mental health professionals authorized by their county.
One of three conditions must be present for an individual to be placed on a 72-hour hold. The designated personnel believe there is probable cause that because of a mental disorder the person is:
- A danger to himself or herself;
- A danger to others; or
- Gravely disabled (unable to provide for his or her basic personal needs for food, clothing or shelter).
The person placed in a 72-hour hold must be advised of his/her rights. The authority or facility must complete paperwork stating the circumstances under which the person’s condition was called to the attention of the officer or professional; what probable cause there is to believe the person is a danger to others, a danger to himself or herself, or gravely disabled (due to a mental disorder); and the facts upon which this probable cause is based. Mere conclusions without supporting facts are not sufficient.
What happens during an involuntary 72-hour hold?
When an individual is detained for up to 72 hours, the emergency facility or hospital is required to do an evaluation of that person, taking into account his/her medical, psychological, educational, social, financial and legal situation. The hospital does not have to hold the patient for the complete 72 hours if the professional person in charge believes that the patient no longer requires evaluation or treatment.
By the end of the 72 hours, one of the following things must happen:
- The person may be released;
- The person may sign in as a voluntary patient;
- The person may be put on a 14-day “5250” involuntary hold (a “certification for intensive treatment”). For this extended hold, a court hearing will be automatically held to determine whether there is probable cause.
If a person is detained for 72 hours under the provisions of Section 5150 of the Welfare and Institutions Code and has received an evaluation, he or she may be certified for not more than 14 days of extended intensive treatment related to a mental disorder under the following conditions:
- The professional staff of the facility that provides evaluation services has analyzed the person’s condition and has found that the person is a danger to himself/herself or others or is gravely disabled.
- The person has been advised of the need for, but has not been willing or able to accept, treatment on a voluntary basis.
Within four days after the patient is placed on a 14-day involuntary hold (5250), there must be a certification review hearing (a “probable-cause hearing”). The hospital must present evidence as to why the patient needs further treatment. The patient, assisted by a patients’ rights advocate, can explain why he/she believes there is no need for further hospital stay. A hearing officer, court-appointed commissioner or referee will decide whether or not there is probable cause to keep the patient in the hospital against his/her will for a period not to exceed 14 days.
If the hearing officer decides there is not probable cause to hold the patient, the patient may request to remain in the hospital on a voluntary basis. If the hearing officer decides there is probable cause and the patient disagrees with the decision, he/she has the right to request a Writ of Habeas Corpus and have a hearing in the Superior Court of the county where the patient is being held.
For patients:Â What are my rights to contest a 14-Day Mental Health Involuntary Hold?
You may be represented at the Certification Hearing by a patients’ rights advocate or another person of your choice. You can also request to have family members or someone of your choice at the hearing to help explain your circumstances (Welfare and Institutions Code Section 5250). If you want your advocate or a facility staff member to telephone someone for you, make this request before the hearing.
If you are held beyond 72 hours, you have the right to remain in the hospital for voluntary treatment. If you do not wish to stay voluntarily, you will automatically be scheduled for a certification review hearing, which will occur at the facility where you are staying. By law, the Certification Review hearing shall be held within four days of the start of the extended hold. As soon as is practical, a Patients’ Rights Advocate meets with you to discuss the commitment process and assists you in preparing for the hearing. This advocate meeting normally takes place a day prior to the hearing and then again just before the hearing.
Re-certification for Intensive Treatment or “5260”
If during the 14-day certification period, a patient has attempted or threatened to take their own life and remains in imminent threat of taking their life, a doctor may request an additional 14-day hold, which is known as a re-certification.
For patients:Â What are my rights to contest a Re-certification?
You have the right to request a writ of habeas corpus. Contact your patients’ rights advocate or attorney for assistance. Please note that no hearing will take place for this hold (Welfare and Institutions Code Section 5260).
Riese Hearing (“Medication Capacity Hearing”)
A person on any LPS involuntary hold may refuse psychiatric medications, but then the treating doctor may petition the court for a Riese hearing, also known as a Medication Capacity Hearing. During a Riese hearing (usually held at the hospital), a hearing officer will decide whether the patient has substantial mental capacity to make medication decisions.
For patients:Â What are my rights regarding a Riese Hearing?
You have the right to a written copy of a notice that the petition requesting a Riese hearing has been filed with the Court. You must also be informed of your right to an attorney or advocate at the hearing. You may appeal a Reise hearing decision (decided against you) to the county Superior Court.Â
Does the person being held involuntarily have any rights?
Yes. A mental health patient being held involuntarily must be informed of the following rights in a language or manner he/she can understand. He/she is allowed:
- To keep and use his/her own personal possessions including toilet articles and clothing;
- To keep and be allowed to spend a reasonable sum of his/her own money (a conservator shall be appointed as required);
- To have access to individual storage space for private use;
- To see visitors each day;
- To have reasonable access to telephones;
- To have ready access to letter writing materials, including stamps and mail;
- To receive unopened mail;
- To refuse convulsive treatment;
- To refuse psychosurgery;
- To see a patients’ rights advocate;
- To be assisted by an attorney at the certification review hearing.
In addition, the patient has the right to be informed fully of the risks and benefits of the proposed treatment and give his/her informed consent. A patient has the right to refuse medication unless a capacity (Reise) hearing is held and a hearing officer or judge finds that the person does not have the capacity to consent to or refuse treatment. The patient may appeal this decision to the county Superior Court. A patient may also be forced to take medication without their consent if they are on LPS conservatorship, or there is an emergency where it is immediately necessary to give medication without prior consent for the preservation of life or the prevention of serious bodily harm.
For patients:Â Â What can I do if I feel my rights are being violated?
The person in charge of the facility in which you are receiving treatment is responsible for ensuring that all your rights are protected. You should be informed of your rights in a language and a manner that you can understand:
- On admission to a facility
- When there is a change in your legal status
- When you are transferred to another unit or facility
- At least once a year
If you believe that your rights may have been denied or violated, you can request to contact your patients’ rights advocate. If you have an attorney, you can request to contact them.
Santa Clara County Behavioral Health Services contracts with the Law Foundation of Silicon Valley to perform these functions. The County Patients’ Rights Advocate also monitors Santa Clara County inpatient facilities for compliance with the LPS commitment process. For assistance, contact:
Health/Mental Health Program, Law Foundation of Silicon Valley  Telephone: (408) 280-2420
4 North 2nd Street, Suite 1300, San Jose, CA 95113
If you are unable to reach your patients’ rights advocate, you may contact:
California Office of Patients’ Rights (Disability Rights California) Telephone: (800) 776-5746
– or –
Department of Health Care Services (DHCS) Mental Health Services Division Ombudsman  Telephone: 1 (888) 452-8609   Email: MMCDOmbudsmanOffice@dhcs.ca.gov
(Back to Top)
For Families and Friends of Patients:
What is an LPS conservatorship?
When an adult (over age 18) has a history of serious mental illness and cannot care for themselves, they may be considered “gravely disabled.” Gravely disabled means that, because of a mental disorder, the person cannot take care of his/her basic, personal needs for food, clothing, or shelter. If you or another adult are providing for the person’s food and shelter, the Court cannot find the person to be gravely disabled. Also, a person who chooses to be homeless, but can find their own food, clothing and shelter may not be considered gravely disabled. (Note: Some psychiatrists may decide that a person meets grave disability criteria when they have been hospitalized on a locked psychiatric unit multiple times over a short period of time.)
The LPS-authorized psychiatrist must certify on a conservatorship referral form that the person is gravely disabled. S/he will send the referral packet to the Office of the Public Guardian, who petitions the court for a temporary 30-day conservatorship (T-CON), to hold the person while the Public Defendant investigates and until a judge grants or denies the permanent conservatorship. A permanent conservatorship lasts one year, and can be renewed for another year if the Public Guardian and a judge agrees it is still needed.
Once authorized by a court, an LPS Conservatorship makes one adult (called the conservator) responsible for a mentally ill adult (called the conservatee). A conservator may be a public agency representative (in Santa Clara County, this is through the Office of the Public Guardian) or a conservator may be a private person, such as a family member or friend. The Public Guardian’s Office prefers to assign a family member if one is willing. If you or other relatives decide not to take on this role, they will probably assign a Public Guardian.
How is an LPS conservatorship started?
An LPS conservatorship request can only be initiated by a psychiatrist authorized by Santa Clara County to do LPS evaluations. The psychiatrist must be willing to document their belief that the person is gravely disabled to the point that they need to be conserved for their own safety and physical well-being. These psychiatrists are normally employed at an LPS Designated Psychiatric Facility (listed below). The referral is usually started after the individual has been hospitalized on an involuntary 72-hour hold (5150), and has been placed an additional 14-day hold (5250). Family members can request that the inpatient psychiatrist consider an LPS conservatorship (see below), but the psychiatrist must agree that one is appropriate.
LPS Designated Facilities in Santa Clara County:
- Santa Clara Valley Medical Center
- EPS (Emergency Psychiatric Services)
- Barbara Arons Pavilion Inpatient Hospital
- Stanford University Hospital
- El Camino Hospital, Mountain View
- VA Palo Alto
- Kaiser PHF, Santa Clara
- Crestwood PHF
- San Jose Behavioral Health
- Main Jail, Unit 8A
Can I request a conservatorship for my ill family member?
If your loved one over age 18 is hospitalized on an involuntary LPS hold, and you strongly believe their mental illness interferes with their basic need for food clothing or shelter, you can request that the psychiatrist consider an LPS Conservatorship referral. Use the AB1424 form to document grave disability, and add a cover letter stating you wish staff to consider conservatorship. Be sure to emphasize that you are not able to care for them yourself. Obtaining the cooperation of the hospital treatment team is the most important factor in successfully obtaining a conservatorship.
If your loved one is not currently hospitalized involuntarily, you may still be able to have them evaluated by Santa Clara County Behavioral Health for grave disability.
- If your loved one will cooperate, you can:
- Contact the Santa Clara County Behavioral Health Services Call Center at 800-704-0900 x2 to help you set up an appointment with a psychiatrist authorized to do LPS evaluations.
- Drive the mentally ill person to Emergency Psychiatric Services (EPS) for an evaluation.  Their phone is 408-885-6100, and their address is 820 Enborg Ct., San Jose (next to Valley Medical Center)
- If your loved one refuses to cooperate, you can check if they qualify for Assisted Outpatient Treatment (AOT)
* Note: Some people have heard that a private attorney can arrange for an LPS Conservatorship, but they can only facilitate the process described above. An authorized LPS psychiatrist must certify grave disability and request the LPS conservatorship.
For more details on the Conservatorship process, read the following section (“For Patients”). For more information on requesting mental health Conservatorships, visit the Santa Clara County Superior Court’s page on LPS Conservatorships.
What is a conservatorship, and how does it affect me?
LPS Conservatorship is a process in which the court appoints a person to make certain legal decisions for you. This person is called a conservator. Your conservator can make decisions like whether you can start or stop taking psychiatric medications, accept other medical treatment, manage your money and decide where to live. When you are on a conservatorship, the court may limit your right to vote, to enter into contracts, to drive or to own a firearm. The LPS conservatorship can last for a maximum of one year at a time, and can be renewed in court at the end of the year.
When would I be put on a conservatorship?
You can be put on a conservatorship if the court believes that you are “gravely disabled” which means having a mental disorder that keeps you from being able to provide food, clothing and shelter for yourself.
How does a conservatorship get started?
Conservatorship is usually set up while you are in a hospital receiving psychiatric treatment. If your doctor or person responsible for your care believes that you need to be put on conservatorship because you have a mental disorder that keeps you from being able to provide food, clothing and shelter for yourself, he or she may make a recommendation to the County agency that does conservatorship investigations. It is up to the investigator to decide whether or not to request the court to start a conservatorship.  Not everybody that meets the definition of “gravely disabled” is automatically put on conservatorship. You must be given a copy of the petition if one is filed, and told the time of the conservatorship hearing in court.
What are my rights to challenge being put on a conservatorship?
You have the right to:
1) Free legal representation
The court will appoint an attorney to represent you free of charge if you cannot afford to hire your own lawyer. You and your lawyer also have the right to “subpoena” witnesses, which means requiring people who might have something helpful to say to come to court and testify for you.
2) Jury trial
Most conservatorships begin with a hearing before a judge. However, if you want your case to be decided by a jury, you have that right. The law even gives you the right to have a hearing, and if you lose, then a jury trial. This jury trial is not automatic. You must request the jury trial within five days after the hearing. Discuss this with your lawyer.
3) Proof beyond reasonable doubt
This is the highest standard of proof the law has. It is the same standard of proof applied in criminal cases.
What is temporary conservatorship?
If the person in charge of the facility where you are staying believes that you may benefit from the services of a conservator because you remain gravely disabled, you may be placed on a temporary conservatorship (T-con) for up to 30 days. At the end of 30 days, a hearing will be held to determine whether you remain gravely disabled and whether a one-year conservatorship will be necessary. Your advocate or attorney can assist you with the conservatorship hearing process (Welfare and Institutions Code Section 5352.1).
 If I am put on a conservatorship, do I lose all my rights?
No. The law specifically states that if you are in the hospital under conservatorship, you have the same rights as other people to wear your own clothes, to make confidential phone calls, to receive unopened correspondence, to have visitors daily, to have individual storage space, to keep reasonable amounts of your own money for canteen expenses, and other rights. Your conservator does not have the power to restrict or limit these rights in any way. You also have the right to be involved in your treatment plan, and in placement decisions. If you feel you have been forced to live in a place that is too restrictive for your needs, or if the conservator has been given too much power over your life, you can ask for a special hearing in court to review these things.
How do I get off conservatorship?
1) Rehearing:
Even if you lose your conservatorship hearing or trial, there are things you can do. First, you may apply for a “rehearing” to try to show the judge that you are no longer “gravely disabled.” However, once you have had one rehearing, you may not request another one for another six months
2) Writ of habeas corpus:
The United States Constitution allows anyone who believes they are being held illegally by the government (including by a conservator) to file a “writ of habeas corpus” to challenge the confinement. There is also a special law in California that allows any state hospital patient to file a writ. Ask your lawyer or advocate for assistance.
3) Challenge reestablishment:
If you have been on a conservatorship for a whole year, the county must decide whether to drop the conservatorship or ask the court to “reestablish” it. If the county decides to reestablish your conservatorship, you may challenge it and ask for a trial again before a judge or a jury.
If you have any questions, contact your county Patients’ Rights Advocate:
Health/Mental Health Program, Law Foundation of Silicon Valley  Telephone: 1 (408) 280-2420
4 North 2nd Street, Suite 1300, San Jose, CA 95113
Involuntary Treatment Law Flowchart
See this flowchart for a visual overview of the involuntary treatment process.
California’s Assisted Outpatient Treatment (AOT) Demonstration Project Act of 2002 (also known as Laura’s Law) provides court-ordered temporary outpatient care for individuals with severe mental illness for whom the inability to accept voluntary mental health treatment (see Anosognosia) may put them or others at risk of harm. Santa Clara County offers Assisted Outpatient Treatment (AOT) Services.
Who qualifies for AOT?
- An individual 18 years or older and a resident of Santa Clara County with a serious mental illness that causes them to be unlikely to survive safely in the community without supervision. Or, they need AOT to prevent deterioration that can result in grave disability or serious harm to themselves or others. Additionally, the person’s mental health must have resulted in one of the following:
- Psychiatric hospitalization or incarceration two or more times in the past 36 months
- Threats or acts of violent behavior towards themselves or others in the past 48 months
- Failure to engage in treatment when offered
What services are provided in an AOT?
Services include:
- Intensive case management
- Psychiatry and medication management
- Benefit and housing support
- Life skill development
- Guidance and support to help people reach recovery goals
Who should I contact if I think someone needs assistance through AOT?
If you think your loved one may qualify for AOT, call the Behavioral Health Call Center at (800) 704-0900 and select option #3 to speak with AOT team member or fill out the AOT Referral Form and email to AOT@hhs.sccgov.org. For more information, go to Assisted Outpatient Treatment (AOT) – Behavioral Health Services – County of Santa Clara
California has recently enacted new legislation that increases mandated treatment of persons with serious mental health illnesses: CARE Court and SB 43. These two new laws are being phased in by California counties, and their Santa Clara County effective dates are listed below.
**NEW** CARE Court (SB1338) also known as Care ACT (2022). Santa Clara County started CARE Court on December 1, 2024.
CARE Court is a new civil court process that offers individuals living with untreated schizophrenia spectrum or other psychotic disorders a new pathway to access community-based (outpatient) behavioral health services. The goal of the CARE Act is to prevent conservatorship, institutionalization or incarceration for individuals who meet qualifying criteria by engaging them in outpatient services (similar to those offered by Assisted Outpatient Treatment – AOT). For more information on the program from Santa Clara County Behavioral Health Services, see Community Assistance, Recovery, and Empowerment (CARE) Act. This web page includes Care Court Brochure, Care Court Powerpoint Presentation, and Care Court Referral Form.
Who Qualifies for CARE Act Services?
An individual 18 years old or older with a diagnosis of schizophrenia spectrum or other psychotic disorder, who meets ALL of the following:
- Currently experiencing a mental illness that is severe in degree and persistent in duration, which may cause behavioral functioning which interferes substantially with the primary activities of daily living, and which may result in an inability to maintain stable adjustment and independent functioning without treatment, support, and rehabilitation for a long or indefinite period of time
- Not currently clinically stabilized in an ongoing voluntary treatment program
- Meet one of the following:
- The person is unlikely to survive safely in the community without supervision and the person’s condition is substantially deteriorating.
- The person is in need of services and supports in order to prevent a relapse or deterioration that would likely result in grave disability or serious harm to the person or others, as defined in Section 5150
- CARE would be the least restrictive alternative to ensure the person’s recovery and stability
- Be likely to benefit from participation in CARE
Who Does NOT Qualify? Certain conditions and disorders are excluded, including:
- Serious mental illnesses outside of psychotic disorder class, including bipolar disorder, major depression, and post-trauma stress disorder
- Psychotic disorders due to medical conditions, such as traumatic brain injury, autism, dementia, or other physical health or neurological conditions
- Substance use disorder that does not otherwise meet the definition of a psychotic disorder
Who Can File a CARE Act Petition?
To be a petitioner, individual must be 18 years of age or older, can be related to the respondent, be living with the respondent, or be part of an agency that has had frequent contact with the respondent due to their mental health disorder. Petitioners may include:
- Family members
- Behavioral health providers
- First responders with a history of engagement with the individual
- The respondent themselves
How Do I File a CARE Act Petition?
In the County of Santa Clara, a family member, clinician, first responder, or another qualified petitioner can:
- (Recommended*) Request a CARE outreach referral to Behavioral Health Services to provide their loved one an opportunity to engage in services and avoid the court process. If the referred person meets CARE Act criteria, the CARE Outreach and Engagement Team will make every effort to engage them in services and avoid CARE court proceedings. They provide intensive assertive outreach and offers referrals to same services that would be accessed via CARE court. * This can be a good first step, as it gives the individual a chance to avoid the court process, and the referral can be kept confidential. If outreach is unsuccessful, the CARE Outreach and Engagement Team can file the CARE Act petition, using supporting information gathered during CARE Outreach process.
To contact the CARE Outreach Team.
Call: 1 (800) 704-0900 option #3 or email: CAREoutreach@hhs.sccgov.org
or
- File a CARE Act petition directly with the court. The Care Court Referral Form can be downloaded from the County’s website Community Assistance, Recovery, and Empowerment (CARE) Act. The form can be filed in person or via mail at: Probate Clerk’s Office Downtown Superior Courthouse 191 N. First Street, San Jose, CA 95110
What Happens in CARE Court?
The goal in CARE Court is to connect qualifying individuals with a court-ordered CARE Plan for up to 12 months, with the possibility to extend for an additional 12 months. The petitioned individual has a right to:
- Legal counsel
- Actively participate in the development of the CARE Plan
- Choose a voluntary Supporter (can be a friend, family member, faith leader, mentor, person with lived experience, behavioral health staff, etc.).The Supporter is appointed by the court to help them understand, communicate, express preferences, and make self-directed choices regarding the CARE Plan.
The petitioned individual, judge, behavioral health clinical team, attorney and Supporter work in partnership to create the CARE Plan, which can include mental health services, stabilization medications, housing, and social services support. The County Behavioral Health CARE Outreach and Engagement Team coordinates CARE Plan services and provides reports for regular Court status meetings.
What if the Petitioned Individual Refuses to Engage in the CARE Plan?
Often participants will cooperate with a CARE Plan because it has been ordered by a judge, and they’ve had a hand in its creation. Even if an individual consistently refuses services, the CARE Outreach and Engagement Team continues their outreach and engagement efforts and will also try alternative referrals such as Assisted Outpatient Treatment (AOT). Ultimately though, failure to engage in the CARE Plan could be considered evidence that no suitable alternatives to conservatorship are available.
Senate Bill (SB) 43Â (2023) expands the definition of Grave Disability, one of the criteria used to place people with disabilities on involuntary holds and the only criteria for mental health conservatorships. Santa Clara County must implement SB43 by January 1, 2026.