Who Can Lift a (5150) Hold
Lake County

Any of Lake County’s designated 5150 staff can rescind a 5150 hold upon re-evaluation and determining the individual no longer meets 5150 criteria and after discussion with the crisis supervisor and receiving permission to rescind the 5150 hold. (Or in the case of a hold written by law enforcement, after the Behavioral Health staff’s initial evaluation deems the individual is not holdable).

If the ED physician believes that the psychiatric emergency has been resolved for a patient on a 5150 hold, he/she may request a reassessment of the patient by an LCBH crisis worker.

The Behavioral Health Director has also granted authority to doctors at the hospitals to rescind a 5150 hold if medically appropriate to do so because the condition deemed to be a mental illness by the peace officer either has turned out to be a medical condition, or the condition was passing in nature and is now fully ameliorated. Most common occurrence for this would be an individual is brought to the Emergency Department by law enforcement who voiced suicidal ideation while intoxicated, then once sober, the individual denies any suicidal ideation. In addition, ED physicians can also lift a 5150 hold if it is determined that the individual requires immediate medical treatment for a medical condition. In these circumstances the physician will have authority to rescind the 5150 hold without evaluation/consultation by Behavioral Health staff.

In these circumstances, the physician will make a note in the hospital record of the finding, providing the peace officer with documentation indicating the patient is cleared (medically &/or psychiatrically), and the invalid 5150 application shall become a part of the hospital’s records.

CRISIS EVALUATIONS: Lake County Behavioral Health Services will assess any person brought to the local hospital. All persons will receive a full crisis evaluation.

• If they meet 5150 criteria, appropriate placement at a designated Psychiatric Health Facility, designated Acute Psychiatric Hospital, or inpatient psychiatric unit in a General Acute Care Hospital bed, will be found for the individual. LCBH crisis worker will administer the 5150 advisement & application. If peace officer initiated the hold—that hold is revoked and a new 5150 application is initiated by LCBH crisis worker after their assessment is complete.

• (Copy of original 5150 application & completed request for transport will be left at ED for patient chart & transfer purposes). A copy of assessment paperwork is available upon request by the ED for inclusion in the client’s chart.

• If they do not meet 5150 criteria, and no medical requirement exists, they are referred to an appropriate level of service (Lake County Behavioral Health Services, primary care, private therapist/psychiatrist, etc.), a plan is generated and then ED staff will discharge the patient according to their usual procedures. Any existing peace officer 5150 application will be revoked. (A copy of assessment paperwork is available for the patient record, upon request by ED)
• If it’s determined that the patient has intensive needs such as medical needs, housing needs, etc., but does not meet the 5150 criteria, the LCBH crisis worker will communicate this fact to the ED team.
• The LCBH crisis worker is only responsible to determine if a client meets 5150 criteria or not.
• Discontinued 5150’s must contain a notation on the form indicating time, date and reason for the discontinuance.

EVALUATIONS & SAFETY: ED will provide a space where the LCBH crisis worker may conduct an assessment in a confidential setting, if possible.

• Safety of the patient, ED staff, and the LCBH crisis worker must be considered in finding an appropriate location.
• Safety factors to consider are having sufficient staff presence near patient to reduce risk of patient elopement and the removal or securing of sharp objects to prevent patient access.