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Dealing with a Psychiatric Emergency

If you have a friend or family member who is struggling with mental illness, you are not alone.  Research shows that approximately one in five families are impacted by mental illness.  There are times when a mental illness becomes so severe that hospitalization is necessary.  As a friend or family member, you can play an important role in assuring the safety of the individual as well as others in the community.  Mental health emergencies can be unexpected and not easily detected by friends, family or even mental health professionals.  However, keeping in mind warning signs and knowing what to do in the case of a psychiatric emergency will better equip you for handling crisis when and if it occurs.

What is a “5150”?

When an individual becomes a danger to themselves, others or is gravely disabled (meaning they can not maintain their basic needs due to their mental health condition), this is considered a psychiatric emergency and may warrant a psychiatric hospitalization.  While ideally individuals will go to the hospital voluntarily, there are often times that this does not occur.  There are several reasons for involuntary hospitalization.  Sometimes, the person is in denial of the severity of the risk, even when it has been clearly stated.  The individual may not be able to assure a plan for safety.  In cases like this, a 72-hour involuntary psychiatric hold (also known as a “5150”), is written by the police or a designated mental health professional.  This hold can be extended or shortened once the individual is in the hospital.

What can I do to help?

Maintain contact with your friend or loved one.  Often times, individuals who struggle with mental illness tend to isolate themselves.  This makes it difficult for friends, family and mental health professionals to be aware of warning signs and risk factors.  The earlier the intervention takes place, the less likely it will be that a psychiatric emergency will occur.

When a suicidal threat or threat to harm another is made, it is important to seek help IMMEDIATELY. 
In the case of grave disability, it is also important to notify mental health professionals as soon as possible as the criteria for grave disability may be met one day but not the next. 

As a friend or family member, you can play a vital role in communicating past psychiatric history as well as other pertinent information regarding health issues or history of drugs and/or alcohol.  This can be very helpful in providing appropriate treatment.  Due to limits of confidentiality, mental health professionals are not able to disclose information about treatment unless the mental health professional is given permission by the client.  However, this does not mean that you cannot provide information or concerns to mental health professionals.

As a family member or friend you may or may not be successful in encouraging follow up after the crisis has resolved.  Outpatient psychiatric services are typically voluntary, as is the decision to take medication.  Understand that you can encourage them to follow up in the outpatient setting, but you cannot force your friend or family member to seek help.  In most cases, encouragement, limit setting, and showing genuine care and concern are the most helpful tactics.

Who should I contact?

In a time of crisis families or significant others often experience a sense of confusion and panic. 
If there is threat of harm to self or others involving a weapon you must immediately contact the police by dialing 9-1-1. 
In cases of extreme agitation or impulsive behavior, it is also recommended that you contact the police in order to restrain the individual from harming anyone, including themselves.  Always err on the side of caution. Emergency rooms are also available for psychiatric services.  If the individual is currently receiving services through the Orange County Health Care Agency’s Mental Health Clinic, please contact that clinic during business hours.  If the individual is not currently open with the clinic you would consider the following options depending on your location.

Centralized Assessment Team (C.A.T.) - Click here for C.A.T web page
1-866-830-6011  or  714-517-6353

This is a team designed to provide evaluations for involuntary hospitalizations (5150), assist police, fire and social service agencies in cases of psychiatric emergencies, provide linkage to appropriate services or provide information and referrals to family members or significant others for community resources.

Evaluation and Treatment Services (ETS)

Provides 24-hour crisis stabilization, hospital diversion, and referral access to ABC acute psychiatric inpatient services.

Orange County Health Care Agency (OCHCA)- Click here for OCHCA web site

Mental Health Clinics -  Click here for Mental Health Clinics
Available to provide emergency services during regular business hours from:
8 a.m. - 7 p.m., Monday through Thursday and 8 a.m. - 5 p.m. on Friday.


**Please be aware that police often assist Orange County Health Care Agency Mental Health
professionals to evaluate for involuntary hospitalizations to insure the safety of all involved.