What Is a Psychiatric Hold? How Long Can You Be Held?

Key Takeaways

• A psychiatric hold is a legal mechanism that allows involuntary evaluation and treatment of a person who is a danger to themselves or others, or who cannot care for themselves due to mental illness
• New Jersey does not use the “5150” system (that is California law); NJ uses a screening certificate process under NJSA 30:4-27
• The initial screening period in NJ allows evaluation for up to 72 hours, after which temporary commitment can extend up to 20 days, and extended commitment requires a court hearing
• New Jersey has a separate civil commitment process specifically for substance use disorders under the Marchese Law
• Patients under psychiatric holds retain legal rights including the right to legal representation, the right to treatment in the least restrictive setting, and the right to a court hearing

Psychiatric Hold: A legal process by which a person can be involuntarily detained for psychiatric evaluation and treatment when they present an imminent danger to themselves or others, or when they are unable to care for themselves due to mental illness. The specific legal framework, terminology, and duration vary by state.

Psychiatric holds are among the most legally complex and emotionally difficult topics in behavioral health. For families of people struggling with addiction, understanding how involuntary evaluation works — particularly in New Jersey — can be critical during a crisis. This page explains what psychiatric holds are, how New Jersey’s system works, how long a person can be held, and how these processes intersect with substance use disorders.

What a Psychiatric Hold Is

Voluntary vs. Involuntary Commitment

Voluntary Admission: A psychiatric hospitalization that occurs with the patient’s informed consent. The patient agrees to treatment and generally retains the right to request discharge, though the facility may require a waiting period (typically 72 hours in NJ) before releasing a patient who clinicians believe still meets commitment criteria.

Involuntary Commitment: A legal process by which a person is detained for psychiatric evaluation or treatment without their consent, based on clinical and legal determinations that the person meets specific criteria related to dangerousness or inability to care for themselves.

Most psychiatric admissions in the United States are voluntary — the patient recognizes they need help and consents to evaluation and treatment. Involuntary commitment, by contrast, involves detaining a person against their will. This is a significant restriction of personal liberty and is therefore governed by detailed legal procedures designed to protect individual rights.

The legal threshold for involuntary commitment generally requires that the person:

• Is mentally ill (as defined by state law)
• Presents a danger to themselves (including suicidal behavior, self-harm, or inability to meet basic needs)
• Presents a danger to others
• Cannot be safely evaluated or treated in a less restrictive setting

When Psychiatric Holds Are Used

Psychiatric holds are most commonly initiated in the following circumstances:

• A person is actively suicidal or has made a suicide attempt
• A person is experiencing psychosis with dangerous behavior
• A person is in severe substance-induced crisis with co-occurring psychiatric symptoms
• A family member or clinician has observed behavior indicating the person cannot safely care for themselves
• Law enforcement encounters a person in public psychiatric crisis

The hold is intended to be a bridge to evaluation and appropriate care — not a punitive measure. The goal is to stabilize the person and determine whether continued treatment is necessary and, if so, at what level of care.

Psychiatric Hold Laws in New Jersey

NJ Screening and Commitment Process

Screening Certificate: A legal document in New Jersey, completed by a physician or psychiatrist, that authorizes the involuntary transport and evaluation of a person at a designated psychiatric screening center. The screening certificate initiates the formal commitment process under NJSA 30:4-27.

New Jersey’s involuntary commitment process is governed by NJSA 30:4-27 (the New Jersey Screening and Commitment Statute). The process unfolds in defined steps:

Step 1 — Initiation: A psychiatric hold can be initiated by:

• A physician, psychiatrist, or licensed mental health professional who completes a screening certificate
• A law enforcement officer who observes a person in psychiatric crisis and transports them to a screening center
• A family member or concerned person who contacts a screening center or files an application

Step 2 — Screening evaluation: The person is transported to one of New Jersey’s designated psychiatric screening centers. A psychiatrist conducts an evaluation to determine whether the person meets the criteria for involuntary commitment. This evaluation must occur promptly upon arrival.

Step 3 — Disposition: Based on the screening evaluation, the psychiatrist may:

• Release the person if they do not meet commitment criteria
• Refer the person for voluntary outpatient treatment
• Admit the person for involuntary inpatient evaluation (proceeding to temporary commitment)

How NJ Differs from Other States

A common point of confusion is the term “5150 hold,” which people frequently search for in connection with New Jersey. The 5150 hold is specific to California — it refers to Section 5150 of the California Welfare and Institutions Code. New Jersey has no equivalent numbered hold system.

5150 Hold (California): A California-specific legal provision that allows a qualified officer or clinician to involuntarily confine a person for up to 72 hours for psychiatric evaluation. While the term has entered popular culture, it has no legal applicability in New Jersey or most other states.

New Jersey’s system is functionally similar in that it allows involuntary evaluation, but the legal framework, terminology, and procedural steps are different. Every state has its own commitment statute with distinct provisions.

How Long Can You Be Held

Initial Screening Period

In New Jersey, the initial involuntary evaluation at a screening center can last up to 72 hours. During this period:

• The treatment team assesses the patient’s psychiatric condition
• The patient receives necessary acute treatment (including medication if clinically warranted)
• The clinical team determines whether continued involuntary treatment is necessary

If the clinical team determines the person no longer meets commitment criteria within the 72-hour window, they must be released or offered voluntary treatment.

Temporary and Extended Commitment

Temporary Commitment: If the screening evaluation determines that the patient continues to meet commitment criteria beyond the initial 72 hours, the facility may file for temporary commitment. Under NJ law, temporary commitment can last up to 20 days.

During temporary commitment:

• The patient receives continued inpatient psychiatric treatment
• The clinical team conducts ongoing assessment of the patient’s condition
• The patient has the right to legal representation
• A court hearing is scheduled if commitment beyond 20 days is sought

Extended Commitment: If the treatment team believes the patient needs continued involuntary treatment beyond the temporary commitment period, they must petition the court for extended commitment. This triggers a formal court hearing where:

• The patient is entitled to legal representation (a public defender is appointed if needed)
• The state must present evidence that the patient continues to meet commitment criteria
• The judge makes a determination based on the evidence presented
• If granted, extended commitment is for a defined period (typically up to 90 days in NJ), after which the process must be repeated

Your Right to a Court Hearing

Every person subject to involuntary commitment in New Jersey has the right to a court hearing. The hearing is adversarial — the patient has counsel who can cross-examine witnesses and present evidence. The standard of proof is “clear and convincing evidence,” which is a higher bar than the “preponderance of the evidence” used in most civil cases.

Patients or their families can also file a writ of habeas corpus at any time to challenge the legality of the commitment.

Psychiatric Holds and Substance Use Disorders

When Addiction Triggers Involuntary Evaluation

Substance use alone does not typically meet the criteria for involuntary psychiatric commitment. However, substance use frequently co-occurs with psychiatric crises that do meet commitment criteria:

• Suicidal ideation during intoxication or withdrawal — alcohol and opioid withdrawal can trigger severe depression and suicidal behavior
• Substance-induced psychosis — methamphetamine, cocaine, and high-dose cannabis can induce psychotic episodes with paranoia and aggressive behavior
• Inability to care for self — a person in severe active addiction who is unable to meet basic needs for food, shelter, and safety may meet commitment criteria

In these situations, the psychiatric hold addresses the immediate psychiatric emergency. The underlying substance use disorder may be addressed during the hospitalization or in discharge planning.

Marchese Law and Substance Abuse Commitment in NJ

Marchese Law (NJSA 26:2B-15.1): A New Jersey statute that provides a civil commitment pathway specifically for individuals with substance use disorders who are a danger to themselves or others as a result of their substance use. Named after a family who advocated for the law, it allows family members and others to petition the court for involuntary commitment to substance abuse treatment.

New Jersey is one of a limited number of states that has a specific civil commitment process for substance use disorders, separate from the general psychiatric commitment statute. Under the Marchese Law:

• A spouse, relative, guardian, or county counsel can file a complaint alleging that a person is an alcoholic or drug-dependent individual who is a danger to self, others, or property
• The court holds a hearing at which the respondent has the right to counsel
• If the court finds the criteria are met, it can order the person into treatment for up to 180 days
• The order can be for inpatient or outpatient treatment, depending on the clinical recommendation

This law provides an option for families who feel that their loved one’s addiction has reached a point of imminent danger but who cannot persuade the person to enter treatment voluntarily. It is a significant legal tool, but it carries complexities — including questions about the effectiveness of coerced treatment and the legal rights of the individual.

Patient Rights During a Psychiatric Hold

Legal Protections

Individuals under involuntary commitment in New Jersey retain significant legal rights:

Right to Legal Representation: Every person subject to commitment has the right to an attorney. If they cannot afford one, a public defender is appointed. The attorney’s role is to advocate for the patient’s interests, including challenging the commitment if appropriate.

Right to Treatment in the Least Restrictive Setting: New Jersey law requires that treatment be provided in the least restrictive environment consistent with patient safety. If a patient can be safely treated in an outpatient setting, inpatient commitment is not appropriate.

Right to Informed Consent for Treatment: Even under involuntary commitment, patients retain the right to refuse specific treatments (including medication) in most circumstances. A court order may be required to administer involuntary medication, and the patient has the right to a hearing on this issue.

Right to Communication: Patients under commitment retain the right to communicate with attorneys, family members, and advocacy organizations. Facilities may impose reasonable restrictions on communication timing but cannot prohibit it entirely.

How to Advocate for Yourself or a Loved One

For patients:

• Ask to speak with your assigned patient advocate — all NJ psychiatric facilities are required to have one
• Request contact information for legal aid organizations including the NJ Division of Mental Health Advocacy
• Document your treatment experience and keep records of all communications with staff

For families:

• Contact the facility’s social work department for updates on your loved one’s treatment plan and expected discharge
• If you believe commitment is no longer appropriate, communicate this to the patient’s attorney
• If you are the party who initiated commitment and believe continued treatment is necessary, communicate your concerns to the treatment team
• Familiarize yourself with the Marchese Law if the primary issue is substance use disorder rather than a psychiatric condition

---

This glossary entry is part of our Addiction Treatment Glossary. For related clinical frameworks, see Substance Use Disorder: NCP, Stages, and Clinical Frameworks and What Is the ASAM Criteria?. For NJ-specific guidance on getting help for someone who refuses treatment, read our pages on court-ordered rehab in New Jersey and getting mental health help for someone who refuses.