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The Lanterman–Petris–Short (LPS) Act (Cal. Welf & Inst. Code, sec. 5000 et seq.) concerns the involuntary civil commitment to a mental health institution in the State of California. The act set the precedent for modern mental health commitment procedures in the United States. The bi-partisan bill was co-authored by California State Assemblyman Frank D. Lanterman (R) and California State Senators Nicholas C. Petris (D) and Alan Short (D), and signed into law in 1967 by Governor Ronald Reagan. The Act went into full effect on July 1, 1972. It cited seven articles of intent:
- To end the inappropriate, indefinite, and involuntary commitment of mentally disordered persons, people with developmental disabilities, and persons impaired by chronic alcoholism, and to eliminate legal disabilities;
- To provide prompt evaluation and treatment of persons with serious mental disorders or impaired by chronic alcoholism;
- To guarantee and protect public safety;
- To safeguard individual rights through judicial review;
- To provide individualized treatment, supervision, and placement services by a conservatorship program for gravely disabled persons;
- To encourage the full use of all existing agencies, professional personnel and public funds to accomplish these objectives and to prevent duplication of services and unnecessary expenditures;
- To protect mentally disordered persons and developmentally disabled persons from criminal acts.
The Act in effect ended all hospital commitments by the judiciary system, except in the case of criminal sentencing, e.g., convicted sexual offenders, and those who were "gravely disabled", defined as unable to obtain food, clothing, or housing. It did not, however, impede the right of voluntary commitments. It expanded the evaluative power of psychiatrists and created provisions and criteria for holds.
Prior to 1987 it was assumed that the Act allowed involuntary treatment for those who were detained under an initial three day hold (for evaluation and treatment) and a subsequent fourteen day hospitalization (for those patients declared after the three-day hold to be dangerous to themselves or others or gravely disabled). However, in 1987 in Riese v. St. Mary’s Hospital and Medical Center the California State Court of Appeals declared that these patients had the right to exercise informed consent regarding the use of antipsychotic drugs, except in an emergency, and if they rejected medication "a judicial determination of their incapacity to make treatment decisions" was required before they could be involuntarily treated. This case was a class action suit brought in the name of patient Eleanor Riese by the California ACLU. Eleanor Riese's story is depicted in the movie 55 Steps.
Sections of LPS law
A 5150 is an involuntary 72-hour hold in a psychiatric facility, for evaluation. A peace officer, registered nurse, medical doctor, or certain other categories of people may place the hold. Three criteria apply to this section: a danger to themselves, a danger to others, or gravely disabled. A qualified officer, which includes any California peace officer, as well as any specifically-designated county clinician, can request the confinement after signing a written declaration stating the psychiatric diagnosis that the diagnosing medical professional believes to be the cause or reason why they believe the patient to be "a danger to themselves or others" or the psychiatric disorder that has rendered the patient incapable of making their own medical treatment decisions.
Most 5150 actions completely disregard the protections afforded by Section 5153. They are known to be effective at de-escalating the contact. This section was added in 1969 when the Section 5150 enacted in 1967 was determined to be inadequate at serving the needs of the mentally ill. For decades, Police and Sheriff's offices had seasoned detectives and others in plain clothes and unmarked car who were effective at de-escalating the contact and saving lives. Section 5153.
Whenever possible, officers charged with apprehension of persons pursuant to this article shall dress in plain clothes and travel in unmarked vehicles.
In informal usage, 5150 (pronounced "fifty-one-fifty") can refer to the person being confined (e.g., "I have a possible 5150 here"), the declaration, or the act of committing someone (as in "(Someone) was 5150ed").
- Largely because the production of many American movies and television programs are based in California, usage of the term "5150" has spread beyond its original location and user population. An album of the same name by the California hard rock band Van Halen was named directly for the code section, and derivative uses followed. It was also the title of rapper Eazy-E's 1992 EP 5150: Home 4 tha Sick.
- In 2016, Knott's Berry Farm opened a virtual reality attraction titled FearVR: 5150, in reference to the law, that was set inside of a mental hospital and received criticism from the mental health community, prompting its closure shortly after opening.
Section 5250 allows a qualified officer or clinician to involuntarily confine a person deemed to have certain mental disorders for up to 14 days, following being involuntarily held for 72 hours under a Section 5150 hold.
The hold is placed by psychiatric staff who determine a person deemed to have a mental disorder that makes them a danger to him or her self, and/or others and/or gravely disabled, and deemed to need more than a 72-hour hold for treatment. If the person is not a danger to him or her self or others, the person cannot be held if there are responsible family members, friends, or others who are voluntarily willing and able to care for the person.
Otherwise known as a T-Con (under W&I Code § 5352.1), may be initiated at any time while a patient is on hold, but usually occurs during the time in which a patient is on a 14-day hold for Grave Disability. Once the patient is on a T-Con, the patient is no longer legally on a "hold," but is temporarily conserved pending the actual conservatorship hearing. Although initially established for a 30-day period, T-Cons can be extended for up to one year as a general conservatorship. When a patient is detained on either a 5250 (14-day hold) or a 30-day hold, they are entitled to a Probable Cause Hearing in which a determination is made whether the hold meets legal criteria (if the hold is not legal, the patient may be discharged if he or she wishes.) Once a patient is on a T-Con or an actual conservatorship, the person is no longer on a 14-day or 30-day hold, and therefore, has no right to a Probable Cause Hearing. If the patient wishes, while on a T-Con, he or she may request a writ of habeas corpus. The individual will then be allowed to present a case in court, with the aid of a public defender, as to why he or she should not be on a T-Con and in the hospital.
- California Mental Health Services Act
- Lanterman Developmental Disabilities Act
- Community Mental Health Act (of 1963)
- Disability rights movement
- "5-1-5-0", a song by American country music artist Dierks Bentley about the policy
- Community Mental Health Act
- Emergency psychiatry
- Florida Mental Health Act (also known as the "Baker Act")
- Medically indigent adult
- Political abuse of psychiatry
- Section 135/136 of the Mental Health Act, a similar policy in England and Wales
- "Conservatorship of Susan T. (1994)". Justia Law. Retrieved 21 July 2018.
- "Involuntary medications: Riese v. St. Mary's Case Summary - Mental Illness Policy Org". Mentalillnesspolicy.org. 2018-09-20. Retrieved 2018-09-29.
- "Riese V. St. Mary'S Hospital Medical Center | Cal. Ct. App. | Judgment | Law". CaseMine. Retrieved 2018-09-29.
- "'55 Steps' Based on the True Story of Eleanor Riese". The Mighty. 2017-09-14. Retrieved 2018-09-29.
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- California Welfare and Institutions Code, Section 5150
- California Welfare and Institutions Code, Section 5008 (h) concerning gravely disabled
- California Welfare and Institutions Code, Section 5008 (m) emergency defined
- California Welfare and Institutions Code, Section 5256: Certification Review Hearing defined
- California Welfare and Institutions Code, Section 5332: Capacity Hearing defined, involuntary medication
- California Welfare and Institutions Code, Section 5325-5325.2: Patients' Rights
- American Psychiatric Association, Definition of Crisis Behavior & A Mental Disorder by DSM-IV (Diagnostic & Statistical Manual of APA), & Crisis Management
- California Code of Regulations (C.C.R.), Title 9 & Title 22, Licensed psychiatric hospitals in California are governed by CCR Title 22
- California Health & Safety Code, on seclusion and restraint