California Mental Health Laws for Teens:
Psychiatric Holds, Legal Protections, and Your Rights
California teen mental health laws are some of the most diverse and ever-changing in the nation. From confidentiality laws to involuntary inpatient holds, teen mental health consent laws, and other legal issues, it can be confusing for both parents and children enrolling in mental health treatment.
A mental health professional can talk you through your mental health rights in California and help you make informed decisions for a teen in need of mental health treatment. This guide can also help, as it breaks down:
- The ins and outs of mental health care laws in California
- What 5150 holds for minors are
- The differences between voluntary vs. involuntary psychiatric hospitalization for teens
- Legal protections for teens in psychiatric care and how to advocate for these
- Parental rights and involvement in teen mental health treatment
- What to do in a teen mental health crisis
- Where to find support
Teen Mental Health Care in California: What Makes It Unique?
Laws Supporting Teen Mental Health Rights
To help improve rates of mental health treatment for teens, California has enacted several different laws that can help teens get access to vital mental health services. For instance, as of July 1, 2024, minors 12 years of age or older can consent to and receive outpatient mental health treatment or counseling. This includes outpatient treatment through state-funded insurance, without consent from a parent or guardian. A child’s therapist or mental health provider will need to determine if they are mature enough to be involved and participate in treatment, and decide if involving a parent wouldn’t be a good idea.
State law previously gave more parental rights in teen psychiatric care, since teens couldn’t consent to outpatient treatment unless they were a danger to themselves, others, or the victims of parental abuse. This change in California law has so many benefits for teens, including:
- Giving them more freedom to access outpatient treatment
- Ensuring teens don’t get billed for treatment that their parents don’t want to pay for
- Allowing teens to have more control over their own mental health care decisions
- Promoting open communication between teens and healthcare providers
This change in California law shows how the state is supporting teens in their mental health recovery. But, it’s important to know that it doesn’t necessarily mean parents don’t have other rights. In fact, parents continue to play a key role in their teen’s mental health treatment. Their support and involvement can still benefit the recovery process, especially when it comes to advocating for certain treatment options.
What Is a 5150 Hold for Minors?
While California does support teens who want more freedom in treatment, the state also has strict laws meant to protect minors and the public through psychiatric holds for teens. In emergency situations, a 5150 hold for minors might be issued to protect them from themselves and from others, or give them care if they are gravely disabled.
What is a 5150 Hold?
A 5150 hold in California is an involuntary psychiatric hold that allows someone with a mental health disorder to be placed in a locked treatment facility. These facilities are often hospitals or mental health clinics and can hold a teen for 72 hours or more.3 Like other emergency mental health holds nationwide, the goal of a 5150 hold is to protect people from endangering themselves, especially if they have thoughts of suicide, or hurting others.
It’s important to know that not just anyone can put someone on a 5150 hold. In California specifically, only certain people are authorized to initiate the hold, such as law enforcement officers, licensed clinicians, and designated county employees. This means that even if a parent believes their teen needs to be placed on a 5150 hold, they cannot do so by themselves.
Voluntary vs. Involuntary Psychiatric Hospitalization for Teens
Teen inpatient treatment laws ensure that they get adequate treatment whether they’re in a hospital voluntarily or involuntarily. During an involuntary stay after being placed on a 5150 hold, teens can expect certain treatment from hospital staff. This includes:
- Treatment with medications
- A thorough assessment of their mental health
- Individual and group therapy sessions
- Education on coping skills for managing their symptoms
Once the 5150 hold expires, teens may be released or transferred to a longer-term psychiatric facility. If they are released, it’s important that parents work closely with their teen’s treatment team to ensure they receive appropriate follow-up care.
Voluntary Residential Mental Health Treatment Centers
- Nature outings
- Experiential therapies (equine therapy, art therapy, music therapy)
- Meditation and yoga classes
- Fitness and nutrition guidance
- Group outings and activities
In addition to these amenities, inpatient treatment centers also offer a more relaxed and comfortable environment for people seeking mental health support. The focus is on healing and recovery rather than crisis intervention.
This makes facilities like Mission Prep a better option for long-term mental health treatment than an emergency psychiatric hospital. However, in more severe cases where people may harm themselves or others, emergency psychiatric care may be necessary before transitioning to a residential treatment center.
Court-Ordered Mental Health Treatment for Teens
Aside from severe psychiatric emergencies, teen mental health court orders might also lead to inpatient or other mental health treatment. In California, juvenile mental health courts each have their own eligibility requirements. There are currently 10 different juvenile courts across the state.5
Most of these courts accept teens with misdemeanors and felonies but not those with violent crime and sex offenses. Teens with mental health problems including schizophrenia, anxiety disorders, and personality disorders such as borderline and antisocial can all be accepted into treatment court.
During mental health treatment court, teens and their families will have a chance to work on their mental health and get treatment before their illness leads to bigger issues. These treatment courts offer help by:
- Offering probation supervision focused on accountability
- Mental health treatment monitoring
- Goal setting and incentives
- Drug treatment
- Education and employment opportunities
- Family counseling
- Crisis intervention
By addressing the underlying mental health issues that may contribute to delinquant behavior, these courts aim to break the cycle of repeat offenses and help teens lead more productive lives. Enrolling in court-mandated mental health intervention is also a great way for teens who might not know how to get help on their own to receive the support they need.
Legal Protections and Advocacy for Teens in Psychiatric Care
Just because you’re in a locked or involuntary inpatient mental health treatment doesn’t mean you don’t have rights. Here’s a look at some of the many inpatient teen psychiatric hospitalization rights parents and their children should know about.
Right to Refuse Medication (In Some Cases)
Right to Seek Legal Representation
Known as a “habeas corpus hearing,” someone being held against their will for mental health treatment has the right to seek legal representation and challenge the hold.7 This legal process allows someone to appear before a judge, who will determine if there is enough evidence to justify the hold. If not, the person can be released from involuntary commitment and receive proper care through other means, even if the 72 hours are not up.
Right to Dignified and Humane Treatment
The California Department of Healthcare Services Handbook also states that people on 5150 holds have a right to humane treatment. Any treatment given must be to help teens function independently. Treatment must also be provided in ways that are least restrictive, such as letting teens decide what therapy sessions to attend instead of forcing them to attend all of them.
Right to Privacy and Confidentiality
Both federal HIPAA laws and California laws determine who gets to view a teen’s medical records. In short, if a minor consents to care under state or other laws, then they also control who gets access to their health information. Remember, in California, teens aged 12 and older can consent to outpatient mental health treatment. This means that they can also authorize on whether their parents can access their medical records or not.
Right to Informed Consent
In California, minors aged 12 and above have the right to give informed consent for mental health treatment. This means that they must be provided with all relevant information about their treatment, including possible risks and alternatives, before making a decision. Understanding minor mental health consent in California is crucial for both teens and parents.
Parental Rights and Involvement in Teen Mental Health Treatment
- Treatment plans
- Medications
- Symptoms and diagnoses
- Progress notes (not therapy notes)
As a parent or legal guardian, you are an essential part of your child’s support system and play a vital role in their overall well-being. Here are some ways you can work with your teen and their treatment team to help in the mental health recovery journey:
- Be a part of California mental health advocacy and always protect your child’s rights. It can be overwhelming navigating the mental health system, but knowing your child’s rights and advocating for them can make a significant difference in their treatment.
- Encourage open communication with your child and their treatment team. This includes communicating any concerns or changes you notice in your child’s behavior or mental state.
- Educate yourself about your child’s specific mental health condition and its treatment options. This will not only help you understand what they are going through, but it also allows you to ask informed questions and make educated decisions about their treatment plan.
Staying informed and involved in your child’s mental health treatment helps you understand your child’s needs better, as well as improves the effectiveness of their treatment.
What to Do in a Teen Mental Health Crisis
Regular therapy and outpatient mental health treatment can only do so much for a teen experiencing a mental health crisis. What can you do if your teen is making threats about harming themselves, or is a danger to others? Here are some steps to follow.
- Reach out to emergency services including calling 911, or a California mental health crisis intervention team. For instance, in Los Angeles County, the PMRT, or Psychiatric Mobile Response Team, can provide psychiatric crisis intervention and de-escalation.9
- Try your own de-escalation skills, which involve staying calm, listening actively with empathy, and validating their feelings and thoughts. Avoid challenging them or giving ultimatums.
- If they have a mental health provider, contact them for guidance on how to handle the situation. They may also be able to refer you to additional resources such as inpatient treatment facilities or, if it’s not an immediate emergency, schedule a teen for an emergency session.
- Be ready in case your teen gets placed on a 5150 hold. Know where to store their personal items and ask questions about where your teen will be transported.
- Have a support system in place, such as someone to talk to during this difficult time.
As a parent, it can be scary coming face to face with a mental health crisis. But, reaching out for help and possibly having a 5150 hold placed on your child is better than having them hurt themselves during a crisis. Our article “What to Do if Your Child Is in a Mental Health Crisis” can also help during these difficult situations.
Getting Support: Mission Prep Can Help
It’s important to have a plan in place for after a 5150 hold is over. Your teen may need ongoing treatment or therapy, which Mission Prep can offer. Our mental health services provide a full continuum of care, ranging from inpatient to outpatient mental health treatment and telehealth services. We encourage family involvement every step of the way and provide a balance of care for teens while easing the concerns of worried family members.
Whether your teen is recovering after a mental health crisis or you want to use evidence-based treatment to get them started on a path to wellness, we can help. Call us today to schedule a tour of our therapeutic facilities in CA and VA, or for more information on how we can support you and your teen’s mental health recovery journey.
References
- Statista. (2024, July 5). U.S. population aged under 18 years 2021, by state. https://www.statista.com/statistics/301928/us-population-under-18-by-state/
- Puffer, M. (2021, December 17). Barriers and solutions discussed at Youth Mental Health Collaborative — The Los Angeles Trust for Children’s Health. The L.A. Trust for Children’s Health. https://www.thelatrust.org/articles/new-post-p4agn-th5zd-282r9-k8hn8-zdhgl-spnaz-k497t
- Mental Health Holds – BulletPoints project. (2022, May 5). BulletPoints Project. https://www.bulletpointsproject.org/mental-health-holds/
- NAMI Westside LA. (2024, July 12). Understanding California mental health holds: A guide – NAMI Westside Los Angeles. https://namiwla.org/find-support/psychiatric-holds-definitions-for-the-state-of-california/
- Judicial Council of California, Bacharach, A. J., Strobel, D., & Center for Families, Children & the Courts. (2023). Juvenile collaborative court models: Juvenile mental health court. Judicial Council of California. https://courts.ca.gov/system/files/2024-10/JCJC_Models_Juvenile_mental_health_court-Revised-11-2023.pdf
- California Department of Health Care Services. (n.d.). HANDBOOK rights for individuals in mental health facilities admitted under the Lanterman-Petris-Short Act. In California Department of Health Care Services. https://www.dhcs.ca.gov/services/Documents/DHCS_Handbook_English.pdf
- English, A., Gudeman, R., & National Center for Youth Law. (2024). Minor Consent and Confidentiality: A compendium of state and federal laws (By National Center for Youth Law). National Center for Youth Law. https://youthlaw.org/sites/default/files/2024-10/NCYLMinorConsentCompendium2024-California.pdf
- Rights, O. F. C. (2022c, December 28). 227-Does the HIPAA Privacy Rule allow parents the right to see their children’s medical records | HHS.gov. HHS.gov. https://www.hhs.gov/hipaa/for-professionals/faq/227/can-i-access-medical-record-if-i-have-power-of-attorney/index.html
- Psychiatric Mobile Response Teams (PMRT) – Department of Mental Health. (2022, April 2). Department of Mental Health. https://dmh.lacounty.gov/our-services/countywide-services/eotd/pmrt/
