Crisis5150 Holds, CARE Court and Conservatorship in California: A Family Guide. What these terms mean, how they differ, and where Los Angeles families can turn when a loved one refuses help.

When an adult you love has a serious mental illness or a severe substance use problem and says no to every offer of help, you will hear these legal terms fast. This guide explains them in plain words. This guide is not legal advice. For your situation, talk with a California attorney.

A 5150 hold can happen when, because of a mental health disorder or a severe substance use disorder, a person is a danger to themselves, a danger to others, or gravely disabled. The hold is for assessment, evaluation and crisis intervention. It is not a punishment and it is not a criminal charge.

Families cannot place a hold themselves. Police and certain trained professionals authorized by the county make that call, and the person is evaluated at a facility. What families can do is give clear, honest information about what they have seen.

In 2024, a California law called SB 43 widened the meaning of gravely disabled. Under the updated definition, a person may be gravely disabled because of a mental health disorder, a severe substance use disorder, or both. This applies when they cannot provide for their basic needs for food, clothing, shelter, personal safety or necessary medical care. Counties could delay the change until January 1, 2026, and Los Angeles County began using it on that date.

If the treatment team believes the person still meets the legal criteria after the first hold, it can certify them for up to 14 more days of intensive treatment. This is often called a 5250. For people who remain gravely disabled, the law allows further short extensions in some cases, with proper approval.

Families are often surprised by how quickly a person can be released. A hold is meant to handle the crisis, not to fix the illness. That is why planning for the days after discharge matters so much. Ask the hospital team, with your loved one’s permission, about follow-up appointments and medication.

• Write down dates, events and anything the person said or did that worried you.
• Keep a list of current medications, doctors and past hospital stays.
• Ask whether your loved one will sign a release so staff can talk with you.

To qualify, a person must be 18 or older and have schizophrenia spectrum disorder, another listed psychotic disorder, or bipolar I disorder with psychotic features. A diagnosis based only on intoxication does not count. The person must also not be clinically stable in voluntary treatment and must meet other criteria about safety and deterioration.

Family members can file a petition. So can a person who lives with the respondent, certain treating professionals, hospital staff, first responders who have had repeated contact, and the person themselves. Filing is free. Los Angeles County is accepting petitions, and the county Department of Mental Health has a petitioner’s guide.

If the court finds the person eligible, the person and the county try to reach a voluntary CARE agreement. If they cannot agree, the court can order a CARE plan of community services. The court appoints a legal representative for the person, and the person can choose a supporter. Neither an agreement nor a plan can be used to force someone to take medication. Services can last up to one year and may be extended for up to one more year.

LPS stands for the Lanterman-Petris-Short Act, the California law that also covers 5150 holds. A conservatorship lasts up to one year and can be renewed by the court. Before one is set up, the county investigates.

Before recommending conservatorship, the county investigator must consider less restrictive options, including assisted outpatient treatment and CARE Court. Conservatorship is recommended only when no suitable alternative is available.

Because conservatorship removes some of a person’s rights, it is complex. If you think it may come up, talk with a California attorney about your situation.

• Immediate danger: call 911. Tell the dispatcher it is a mental health crisis and describe what is happening.
• 988: call or text 988 to reach the 988 Suicide and Crisis Lifeline. Families can call for advice too.
• LA County Department of Mental Health 24/7 Help Line: (800) 854-7771. This line offers support, resources and referrals, and is how you reach the county’s Psychiatric Mobile Response Team.

When you call, stay calm and be specific. Say what you see right now: not eating, threats, wandering at night, a medical problem being ignored. Mention weapons in the home. If your loved one uses alcohol or benzodiazepines heavily, tell the team; stopping either one suddenly can be medically dangerous, and a doctor should be involved.

Keep the door open. Short, calm conversations that avoid arguing often work better than big confrontations. Our guide on helping a loved one who won’t accept help covers this in more depth. When mental illness and substance use show up together, read about co-occurring disorders.

A planned intervention is a different path from a legal one. It brings family together with a professional to make a clear, caring request for treatment. Many families try this before, or alongside, the options above. See how to choose an interventionist. Ongoing case management can then help coordinate doctors, programs and follow-up. At Blackburn Recovery Services, case management can include advocacy in healthcare and legal settings, such as helping families prepare for a meeting with a treatment team. Blackburn does not give legal advice.

• Look after yourself. Family support groups help you stay steady for the long haul.
• Keep your notes up to date. They help in a crisis call, a hospital visit or a court petition.
• Set limits you can keep, and keep everyone in the home safe.

• LA County Department of Mental Health: CARE Court information and resources
• Judicial Branch of California: Information for petitioners about the CARE Act
• California Department of Health Care Services: SB 43 frequently asked questions
• LA County Department of Mental Health: SB 43, an expansion of grave disability
• LA County Department of Mental Health: 24/7 Help Line

If you are not sure what kind of help your family needs, see Where to start, or reach us at (888) 305-5422 or info@theblackburngroup.org. Blackburn Recovery Services also runs a free virtual family support group every two weeks, open to any family.

If someone is in crisis, call or text 988 to reach the 988 Suicide and Crisis Lifeline. In an emergency, call 911.

• How to Help a Loved One Who Won’t Accept Help
• How to Choose an Interventionist
• Co-Occurring Disorders

All guides →