Understanding Criteria for Involuntary Psychiatric Holds

Involuntary psychiatric holds, also known as involuntary commitments, are a necessary intervention when individuals pose a risk to themselves or others due to their mental health condition. These holds have been subject to misrepresentation in popular media, often depicted as cruel and unjust. However, in reality, medical providers must navigate several legal and ethical hurdles before forcing a patient into medical custody.

This article will explore the criteria for involuntary psychiatric holds, the history behind them, the reasons why individuals may be involuntarily committed, and the legal limitations associated with these holds. It is important to understand that involuntary psychiatric holds are not arbitrary punishments but are performed with the best interests of the patient in mind.

History of Involuntary Medical Confinement

Forcing patients into psychiatric care has a long and complex history in the United States. In the 1800s and early 1900s, psychiatric hospitals served as holding grounds for individuals who were deemed deviant by societal standards rather than medical criteria. However, in the middle of the twentieth century, activists began advocating against unnecessary psychiatric hospitalization, leading to stricter legal standards for involuntary medical holds.

This movement also aimed to reduce the number of psychiatric hospitals and transition patients into community-oriented settings. These changes were driven by the recognition that mental health conditions should be treated with care and compassion, rather than confinement and isolation.

Police Powers

One of the most common reasons for an involuntary psychiatric commitment is to protect the general society. When individuals exhibit violent or erratic behavior that may harm others, police or medical officials may determine that it is necessary to force them into psychiatric care. It is essential to recognize that such behavior can often stem from undiagnosed or poorly managed mental health conditions.

In these cases, imprisoning the individual would not be a helpful long-term solution, as mentally ill individuals do not choose to act against societal norms. Instead, they require proper treatment and support. By coercing the person into receiving mental health care, law enforcement aims to protect society and ensure the well-being of both the individual and those around them.

Parens Patriae

Another criterion for involuntary psychiatric holds is to protect the individual themselves. When someone expresses threats of self-harm or suicide, police are legally allowed to intervene and force them into medical care. This principle, known as parens patriae, is often applied when dealing with children or mentally disabled individuals.

However, when it comes to adults, the use of parens patriae as a justification for involuntary commitment can raise civil rights concerns. Police and attorneys must carefully consider the individual’s rights and the potential impact of their involuntary confinement. Balancing the need for safety with respect for individual autonomy is crucial in these situations.

The 72-Hour Rule

In most states, an involuntary psychiatric commitment cannot extend beyond 72 hours without a formal hearing. During this initial 3-day period, patients receive basic medical treatment, allowing them to recover from any acute episodes and gain a better understanding of the need for further assistance.

After the 72-hour period, patients have the right to refuse further medical treatment. At this point, medical providers must decide whether to release the patient or seek a mental health hearing to persuade a judge that continued treatment is necessary to prevent self-harm or harm to others.

It is important to note that laws regarding involuntary commitments vary by state, and it is crucial to research and understand the specific rules and regulations in your jurisdiction. For example, the California Lanterman-Petris-Short (LPS) Act includes additional provisions for extended commitments beyond the initial 72 hours.


Involuntary psychiatric holds are not arbitrary actions but rather interventions aimed at protecting individuals and society. These holds have evolved over time, with stricter legal standards and a focus on community-oriented care. Police powers and parens patriae are two criteria that can justify involuntary commitments, but they must be approached with caution and respect for individual rights.

Understanding the criteria for involuntary psychiatric holds is essential for individuals with mental health conditions and their loved ones. It helps dispel misconceptions and provides clarity about the circumstances under which someone may be involuntarily committed. By acknowledging the best interests of the patient and the importance of proper treatment, we can support those who require assistance in their journey toward mental well-being. Call us today at 833-820-2922.