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Is a Psychiatric Hold Necessary? Common Reasons Someone Could Experience a Psychiatric Hold

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Medically Reviewed Fact Checked

Last Updated on June 15, 2022 by Diane Ridaeus

Reasons Someone Could Experience a Psychiatric Hold

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

The words “psychiatric hold” often conjure images of psychiatric facilities from movies and TV, unless we’ve been there ourselves.  Doctors and nurses in white coats, scheduled drugging, padded cells, and limited time outside are features of standard, mainstream, inpatient psychiatric care as seen in films such as Girl, Interrupted, and the classic One Flew Over the Cuckoo’s Nest.

In an agitated state of psychosis, these can be safety measures for both the patient and the staff at a mental hospital.  In contrast, holistic inpatient programs are not able to accept patients with a current psychiatric hold placed on them. Holistic facilities are well-equipped after release from a psychiatric hold because a holistic facility is able to help a person regain a sense of stability after a mental health crisis or substance abuse issue, letting you feel in control of your life and your mind.

So, what is a psychiatric hold? How can arranging holistic treatment after release from a psychiatric hold be used to help better a person’s chances at improving their mental health?

What Is a Psychiatric Hold?

Commonly referred to as involuntary commitment, a psychiatric hold is a legally mandated stay at a psychiatric facility—in most states, 72 hours or less.1 The intent of such a hold is aimed at providing a safe space and professional care to those going through a mental health crisis. Holds occur both so individuals do not harm themselves or others as well as to help them recognize their own need for continued mental health care.

With standard mental health facilities, those sent into a psychiatric hold are quickly evaluated by doctors and given medication to ease their symptoms. However, in these cases, evaluations can be hastily performed, and the end goal may be sedation rather than determining the root of the issues presented. In such rushed and desperate circumstances, a hold may create more problems for the patient if effective, compassionate follow-up care is not provided.2

Once the person has stabilized, continuing treatment at a holistic facility can shift focus to the underlying medical and psychological reasons for the struggles faced by the individual. For that reason, a temporary hold can be beneficial for individuals in crisis, both for the person’s own security and that of the persons around them. Once released, they can begin to address mental and physical health holistically, under the supervision of trained medical and mental health professionals.

Is a 5150 Order the Same As a Psychiatric Hold?

A 5150 order and a psychiatric hold are two terms to describe the same legal process. As such, they both entail the same kind of treatment. Typically, a 5150 order is granted when an individual is deemed harmful to themselves, or others, or is unable to adequately handle their own issues.

Depending on the mental state of the individual, learning when to request a 5150 order or psychiatric hold is extremely important. Start by considering the well-being of the person involved and the potential danger they pose to themselves or others. For example, if a loved one is discussing suicide or concrete plans to harm another person around them due to a severe or untreated mental illness, they might need to be placed on a psychiatric hold. On the other hand, if a friend of yours makes a brief comment about feeling down in the dumps, it might be more beneficial to have a heart-to-heart conversation about what’s going on with them before turning to involuntary psychiatric care.

Warning Signs of Self Harm

One of the most frequent triggers for a psychiatric hold is a threat of self-harm. In such a negative state of mind, individuals may also threaten to hurt other people.3 Self-harm comes in various forms and can be a sign of unchecked mental health concerns. Harmful thoughts and plans for suicide are hard to think about, let alone talk about with your loved one. However, engaging in communication and practicing good observation are useful tools to ensure the well-being and safety of a loved one.

To keep yourself and others around you safe, look for these warning signs that may signal an approaching or immediate need for a 5150 order for an involuntary psychiatric hold:
  • Making frequent remarks about how life is meaningless or expressing feelings of hopelessness or extreme discontent with no possibility of things getting better, especially after trauma, heavy loss, or abuse.
  • Becoming completely disinterested in formerly beloved activities, seemingly out of the blue
  • Frequent and sudden mood changes, featuring either extremely positive or extremely negative emotions such as mania, rage, or uncontrolled crying spells
  • Uncharacteristically dangerous behavior, aggression, violence, or threats.
  • Very anxious behavior, paranoia, delusions
  • Isolation, cutting one’s self off from others, or acting cold and disconnected
  • Drug or substance addiction, especially if severely impacting the person’s finances, job, family, or health

Although these behaviors may indicate a potentially severe mental health crisis, one may want to assess the situation calmly and be sure of one’s observations before turning to a psychiatric hold. However, should the situation become critical, a psychiatric hold is preferable to the individual hurting themselves or others.

Why Do People Go Into a Psychiatric Hold?

Psychiatric Hold

Individuals going through a crisis who are in need of psychiatric help are often in need of an intervention to help them seek the care they need. Any reasoning behind a 5150 order should always be intended to preserve the best interest of the individual involved. Ensuring that their best interests are maintained and protected during a psychiatric hold is of the utmost importance. The two most common reasons people are placed on a psychiatric hold include mental health issues and issues stemming from substance abuse.4

Mental Health Issues

Mental health issues are a diverse set of conditions, all requiring different amounts of care, unique treatment plans, and individual attention. The situation may be most difficult for those with co-occurring disorders. Many factors can exacerbate mental health conditions. External pressures can manifest in people as a mental health crisis.5 Violent outbursts, uncontrolled actions, and suicidal thoughts or actions may present that clearly require a psychiatric hold. In a psychiatric institution, those struggling with their mental health can have access to constant, supportive care in an environment that can keep the person safe until stabilized.  After release, an individual can be assisted to receive mental health help of a more long-term nature. 

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Issues Stemming from Substance Abuse

Substance abuse, especially the abuse of certain narcotics, can cause a variety of psychiatric outcomes that could warrant a 5150 order. Often, stimulants such as methamphetamines and phencyclidine (PCP) cause violent outbursts in their users. This can cause others to feel in danger. Psychiatric holds can be used to place a loved one struggling with substance abuse in a safe environment that can help them medically detox and come down from an aggressive high.

It is important to note that those using depressants such as barbiturates or opiates have more subdued actions when high. However, these drugs can trigger depressive episodes in users, which can further trigger any existing issues concerning self-harm or suicidal ideation. For these individuals, placement in a facility well-equipped to handle any issues spurring from depressants can help prevent the individual from committing acts of self-harm. In addition, a hold can mitigate the negative outcomes of their substance use and provide a comfortable environment for withdrawal and detox.

What Is Withdrawal?

Certain drugs cause dependence and addiction, resulting from neuroadaptation. Stopping active substance abuse, or detoxing from prescription drug use, causes withdrawal symptoms to emerge. Withdrawal can be extremely dangerous if handled improperly. If someone you know is going through severe substance withdrawal, a psychiatric hold might be the best way to ensure that they stay safe through such a difficult time.

What are the Symptoms of Withdrawal?

What are the Symptoms of Withdrawal?
Substance type plays a large role in the symptoms faced during substance withdrawal.6

The top four abused substances that have significant withdrawal symptoms include:
  • Benzodiazepines. These drugs are often used to control anxiety and depression. Typically, after around 1-4 days, heavy users start to begin the withdrawal cycle. Symptoms can include anxiety, an increase in body temperature, faster heart rate, irritability, muscle cramping, sensory disturbances, and nausea. Coming off benzodiazepines too quickly can mean that these symptoms could linger for several months or years after stopping. 
  • Heroin. Heroin is one of the most used substances across the country, with over 900,000 people in the United States actively using.7 Twelve hours after the last use, withdrawal symptoms begin. Common heroin withdrawal symptoms typically include tiredness, flu-like symptoms, chills, body aches, trouble sleeping, anxiousness, and overall irritability. These symptoms peak after 24-48 hours but can be felt for several months to a year after last use, without proper withdrawal assistance. 
  • Alcohol. Alcoholism, because of its effect on the central nervous system and internal organs, is a complex medical situation. If not handled properly, abrupt alcohol withdrawal can be life-threatening. Symptoms of alcohol withdrawal begin after 8 hours without alcohol and peak around 24-72 hours. Alcohol withdrawal symptoms can include seizures, delirium tremens, sweating, inability to sleep, stomach issues, and headache. Delirium tremens is a condition that puts the individual into a temporary state of psychosis that can be dangerous if not properly managed. Alcoholism is very hard to overcome without proper treatment, and it can take years to regain and maintain sobriety.
  • Cocaine. Cocaine has become increasingly popular for its energy-boosting properties, especially in party settings or nightclubs. A few hours after the last use, cocaine withdrawal can cause depression, lethargy, inability to sleep or oversleeping, and paranoid behavior. Users may experience extreme drug cravings that seem insatiable. The peak of these symptoms is within the first week without using cocaine, and withdrawal lasts anywhere from one week to 10 weeks.

Regardless of symptoms, withdrawal is not an easy process and can be hard to handle if important symptoms are not taken seriously or if the person is not given treatment to address issues of substance abuse. Inpatient services and psychiatric holds allow for signs of withdrawal to be evaluated and handled by trained medical doctors and mental health professionals. Individuals are supported by a setting that helps keep them safe and comfortable throughout a very confusing time.

Can You Voluntarily Surrender Yourself for a Psychiatric Hold?

Yes and no. A 5150 order is court-mandated, so submission of an entrance into a psychiatric hold is not voluntary. Because you are legally deemed in need of a psychiatric hold, you can willingly comply with the 5150 order, but you cannot technically submit a 5150 order against yourself. You can, however, check yourself into a psychiatric facility if you feel the need to be under psychiatric care.

In some instances, a long-term order may be necessary to place an individual deemed a threat to themselves or others on a 14-day psychiatric hold. This order gives the individual the opportunity to receive a hearing to determine whether they are deemed in need of a psychiatric hold. Similar to a 5150, this order is court-mandated and non-negotiable. However, the inclusion of a hearing concerning the actions of the individual helps create a broader picture of the incident, helping the court determine the best method of care to help the individual improve.8

Alternatives to Prescription Treatment Plans

Alternatives to Prescription Treatment Plans

Healing isn’t all about medication or compounding diagnoses—instead, it stems from the nourishment, which includes nourishment of the soul. Alternative to Meds focuses on creating a treatment plan best suited for the patient’s needs without pushing pharmaceuticals as a cure-all. Our lovely inpatient center is equipped with a plethora of treatment options aimed at helping those struggling with addiction or mental health concerns to live an organic human life beyond their diagnosis.


1. Hedman, L.C., Petrila, J., Fisher, W., Swanson, J., Dingman, D., Burris, S. (2016). State laws on emergency holds for mental health stabilization. Psychiatric Services, 67:5, 529-535

2. Saya, A., Brugnoli, C., Piazzi, G., Liberato, D., Di Ciaccia, G., Niolu, C., & Siracusano, A. (2019). Criteria, Procedures, and Future Prospects of Involuntary Treatment in Psychiatry Around the World: A Narrative Review. Frontiers in psychiatry, 10, 271.

3. Walker, S., Mackay, E., Barnett, P., Sheridan Rains, L., Leverton, M., Dalton-Locke, C., Trevillion, K., Lloyd-Evans, B., & Johnson, S. (2019). Clinical and social factors associated with increased risk for involuntary psychiatric hospitalisation: a systematic review, meta-analysis, and narrative synthesis. The lancet. Psychiatry, 6(12), 1039–1053.

4. Penzenstadler, L., Gentil, L., Grenier, G. et al. (2020). Risk factors of hospitalization for any medical condition among patients with prior emergency department visits for mental health conditions. BMC Psychiatry 20, 431.

5. Baldaçara, L., da Silva, A. G., Pereira, L. A., Malloy-Diniz, L., & Tung, T. C. (2021). The Management of Psychiatric Emergencies in Situations of Public Calamity. Frontiers in psychiatry, 12, 556792.

6. Marsden, J., White, M., Annand, F., Burkinshaw, P., Carville, S., Eastwood, B., et al. (2019). Medicines associated with dependence or withdrawal: a mixed-methods public health review and national database study in England. The lancet. Psychiatry, 6-11, 935-950.

7. NIDA. 2022, January 26. What is the scope of heroin use in the United States? Retrieved from on 2022, February 18

8. NAMI, 2012. Arizona involuntary treatment process. Retrieved from on 2022, February 18

This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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Is a Psychiatric Hold Necessary? Common Reasons Someone Could Experience a Psychiatric Hold
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