San Mateo County
Psychiatric Hold in San Mateo County: What Families Should Do First
A guide for the first 24 hours at Mills-Peninsula, El Camino, or other local facilities when your loved one is on a 5150 hold.
- Author
- Karina Marwan, RN, MSN, Family Mental Health Advocate
- Published
- Reading time
- 12 min read
On this page
A psychiatric hold can be a challenging, sometimes frightening and confusing time for families, especially if it is your first. If you have just been told that your adult loved one (adult child, spouse, sibling, or parent) is on a 5150 hold in San Mateo County, this guide outlines the critical steps to take immediately.
Understanding the 5150 Hold
California Welfare & Institutions Code §5150 allows designated peace officers or clinicians to detain a person for up to 72 hours if they appear to be a danger to themselves, a danger to others, or gravely disabled due to a mental health condition.
- The clock: The 72-hour period begins at the moment of detention, including time spent in an emergency department.
- Outcomes: After 72 hours, a patient may be discharged, admitted voluntarily, or certified for an additional 14 days (called a 5250 certification).
Action Plan: The First 24 Hours
1. Confirm location and details
Patients are often transferred between facilities. Common receiving locations in San Mateo County include:
- Mills-Peninsula Medical Center (Burlingame)
- El Camino Hospital (Mountain View)
- Sequoia Hospital (Redwood City)
Case details
Once you have the details, be sure to write them down in your notes app or somewhere easily accessible so you can remember.
- Facility
- Place
- Admission date/time
- Date
- Assigned social worker
- Person
2. Identify the unit social worker by name and write it down
If you do not know where they were taken, the San Mateo County BHRS Access Line at 800-686-0101 can usually help. The unit can confirm presence under HIPAA when there is a safety reason or with patient consent.
Information loss between shifts is the single biggest source of family frustration in a 5150 hold. You need one consistent point of contact whose name and shift you know.
Ask: "Who is the social worker assigned to this case, and when do they work?" If a social worker has not been assigned yet, ask which charge nurse or psychiatric provider is following the case. Write their names down. Use them every time you call.
3. Submit written family input
Verbal input often does not make it into the chart. Written input does. In the first 24 hours, fax or hand-deliver a one-page note covering:
- Your loved one's name and date of birth
- Your name and relationship to the patient
- Specific information you wish to share about past and recent concerning behaviors
- Medication history you can verify (names, doses, last taken if known), including info about effectiveness of this or past medications to help guide the treating clinicians
- Prior diagnoses, hospitalizations, and contact info of current mental health providers
- Any medical conditions they should be aware of
- Prior 5150s and 5250s
- Anyone in the household who is at risk
- Your contact info and the best way to reach you
Release of information and visiting
Ask them to ask your loved one to fill out a Release of Information (ROI) to allow you to speak to the care team there during the hold. Ask them to request this daily or until they sign. Get the name of the person you asked this of and follow up with them.
Ask when visiting hours are and write this down.
4. Track the timeline yourself
The unit may not proactively tell you when the 72 hours expires. Calculate it from the time of detention, which is on the 5150 form. If an ROI was signed, be sure to request a copy. Mark it on your calendar. Calls about discharge planning should start by hour 24, not hour 70.
Remember that if a facility knows your loved one has a place to go (like your home) they may sometimes discharge them earlier. Be sure to state that you can only take your loved one home once you are sure it is safe to do so.
5. Monitor medications and rights
If antipsychotic medication is administered against the patient's will, California law generally requires a Riese hearing to determine if they can legally refuse. Contact the facility's Patients' Rights Advocate if you have concerns about due process.
What to ask the providers
| Contact | Key questions to ask |
|---|---|
| Unit social worker | Who is the attending psychiatrist? What are the visiting policies? Is there a Patients' Rights Advocate contact? |
| Attending psychiatrist | What is the provisional diagnosis? What medications are being adjusted? What does "stable enough for discharge" mean for this patient? |
| The patient | Have you been given documents to sign? Do you understand them? Do you want an advocate involved? |
For the longer version of this script, see questions to ask before your loved one goes home .
Common pitfalls to avoid
- Excessive calling: Frequent calls can alienate the staff you need to collaborate with; aim for one thoughtful written communication instead.
- Waiting on discharge planning: Start discharge discussions by hour 24. Waiting until hour 70 often results in a plan that lacks family input.
- Misunderstanding HIPAA: Hospitals can often confirm a patient's presence for safety reasons and can always receive information from family members, even without a signed release.
San Mateo County resources
- 988 Suicide & Crisis Lifeline
Call or text 988
- StarVista Crisis Center
650-579-0350
- San Mateo County BHRS Access Line
800-686-0101
- NAMI San Mateo County (opens in new tab)
Support and education for families
When to call 988 or 911
Contact 911 only if there is an immediate, life-threatening situation where your loved one is actively attempting to cause harm and you cannot maintain safety. When speaking with dispatch, clearly state that this is a mental health emergency and request crisis-trained officers if they are available.
Contact 988 for suicidal ideation, emotional distress, or if you are uncertain whether 911 is necessary. The 988 lifeline can facilitate connections to local mobile crisis teams when that level of intervention is the appropriate response.
Within San Mateo County, mobile crisis teams may be able to respond in place of law enforcement; contact the BHRS Access Line or 988 to determine availability in your specific area.
The role of an advocate during a 5150
If engaged during a hold, my role involves: initiating contact with the unit social worker prior to shift changes, assistance obtaining signed release forms to allow you to speak to the care team, submitting formal written family input within the first 24 hours, and meticulously tracking the 72-hour timeline. I also coordinate directly with the attending psychiatrist regarding diagnosis and medication, request Riese hearings when necessary, and ensure a robust discharge plan is established with the outpatient team well before hour 72.
Navigating this system is complex; you do not have to manage these details or maintain these records alone.
Continue reading
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