Legal detention

Completing the 5150

• probable
• grounds
• advisement
• signature
• date
• time
• documentation
• write an order changing the patient's legal status to

Write a brief note in the chart documenting your examination and reasons for placing the hold. Here is a link to the 5150 form.

★Patients sometimes come in from the outside and have been placed on 5150's by law enforcement officers. It is important to look at the three small boxes at the bottom of the form. If either of the last two boxes are checked, thus indicated that criminal charges might be pressed, you

Completing the 5250

A 14 day certification may written for a person who continues to meet LPS criteria of holdability upon the expiration of a 5150, meaning that they continue to present a danger to themselves or others or are gravely disabled.

The important elements here are largely the same as for a 5150, but with some additional work. You can download the 5250 form.

• probable
• grounds
• advisement
  • paperwork
  • copy the paperwork
  • give to patient
  • explain rights
• signature
• date
• time
• documentation
• notification of patient advocate

Probable cause is the reason why fourteen additional days are necessary. On the 5250 itself you should write "the specific facts which form the basis" for you decision to write the certification. Theoretically, you could write terms such as "suicidal", "wants to kill people", or "cannot provide shelter". More appropriately, you should generally provide additional information, such as "says he wants to blow his brains out", "wants to shoot the motherfucking ER doctor", or "cannot formulate a reasonable plan for food or shelter and has no funds."

Grounds for hold include the reason(s) why the person is being held. You must check at least one line.

Advisement is the notification a person receives after being placed on a 5250. Unlike a 5150, the person on the certification receives a copy of the certification itself. There are several elements to advising someone on a 5250

1. They
2. They must be told the reasons why the certification is being placed
3. They must be told that they have the write to a certification hearing on the inpatient unit with a patients' rights advocate and a hearing officer.
4. Regardless of their decision on #3, they have the write to a writ of habeas corpus, which is a judicial review in court.
5. You must sign, date, and time the 5250 at the bottom, under the advisement section.

★If the advisement is not completed or the patient does not receive a copy of the 5250, the certification will most likely be declared invalid and the patient will be released regardless of any circumstances.

Signatures are immensely important for 5250's. A physician or psychologist must sign one of the lines in the middle of the form AND a physician, psychologist, or nurse must sign the other line. ★It is imperative that there be TWO signatures.

Dates are extremely important and, unfortunately, easy to forget. Don't forget them. The expiration date on a 14-day certification is computed by adding 14 to the current date.

Documentation is very important, but relatively simple. You need to do two things after all of the above:

• write an order changing the patient's legal status to 5250.
• write a brief note in the chart documenting your examination and reasons for placing the hold.
• BOTH people who sign the 5250 MUST write a note.

Notification of

• the name of the patient
• hospital name and ward
• date

★You must phone in the information to the Mental Health Advocacy Project!

5260

The 5260 can only be instituted for danger to self. Patients who are gravely disabled should have a temporary conservatorship in place and those who continue to be a danger to others should be placed on a 180-day certification (or sent to jail). Patients who are placed on a 5260 have the write to a court trial and should be informed of this as stated on the 5260 form.

5270.15

• The 5270.15 takes its name from the corresponding section of the LPS Act. This section of the act provides for an additional 30 days of detainment on the grounds of grave disability following a 5250. The 5270.15 is placed in lieu of a temporary conservatorship.
• Why you haven't heard of it before...The 5270.15 sounds like a timesaving idea when compared to the rigors of a temporary conservatorship. It is. Importantly, the 5270.15 also includes the provision that a county must demonstrate that implementation of the 5270.15 would save money over temporary conservatorships.

Not every county permits the use of 5270.15, but LA county does.

Rights

Even if a patient is on a legal hold, he/she has certain rights. Some rights are immutable, some can be denied with just cause. They are listed here.