If this is a psychiatric emergency, call 911
Additional Resources:
- 988 Suicide & Crisis Lifeline: Call or text 988 (24/7)
- StarVista Crisis Center (San Mateo County): 650-579-0350 (24/7)
- San Mateo County BHRS Access Line: 800-686-0101
Serving Colma, CA · San Mateo County
If your family needs support maneuvering through the behavioral health system for your adult loved one in Colma, you do not have to figure this out alone.
When you feel confused or uncertain when your family member is receiving care from Seton Medical Center or Kaiser South San Francisco, you can get practical advocacy and clear next steps.
Who you'll work with
Karina Marwan, RN, MSN
I'm Karina Marwan, RN, MSN. With over four decades in nursing, I have supported families through complex psychiatric decisions and care transitions. As your advocate, I help you prepare for calls and meetings, ask precise questions, document what matters, and represent your family's priorities with teams at Seton Medical Center, Kaiser South San Francisco, and county-linked programs.
A family advocate is not a therapist or attorney. I am a clinical guide and communication partner who helps you understand the system, protect your rights, and move from crisis confusion toward a practical care plan.
- RN
- MSN
- 40+ years clinical experience
- Family mental health advocacy
No obligation. We will confirm whether advocacy is the right fit for your situation.
How I help
I stay with you through the hospital piece, the county behavioral health piece, and the scary part when someone is heading home again. You were never meant to juggle all of that by yourself.
Hospital liaison
I help you talk with ER, inpatient, and social work staff in a way that keeps dignity on both sides. Family meetings, jargon unpacked into everyday words, and someone who remembers the thread when the shift changes and the story doesn't.
Rights protection
Consent forms, privacy rules, and grievance steps can feel like a wall. I walk through them with you so you know what you can ask for, what to write down, and what the facility is supposed to honor under its own policies and the law.
Discharge planning
We look for a plan you can live with: paperwork that matches reality, follow-up visits that are actually scheduled, medications that are accessible, and a real bridge to county or outpatient care. Ideally before anyone is hurrying your loved one toward the door.
FAQs
What happens when a 5150 ends in San Mateo County?
The next step is usually discharge, voluntary continuation, or transition to a 5250 process. Families should request the plan before hour 72 whenever possible.
What is the difference between a 5150 and a 5250?
A 5150 is an initial 72-hour hold used for assessment and immediate safety during a psychiatric crisis. A 5250 is a 14-day certification that extends that care for intensive treatment if stabilization isn't reached within the first three days.
Why is my loved one still in the Emergency Room at Seton Medical Center after 24 hours? Are they actually receiving treatment?
This is known as "psychiatric boarding," and it is a significant challenge in the Peninsula. While in the ER, care is often focused on safety rather than long-term stabilization. I help families maintain pressure on the "Bed Board" and social work teams to ensure your loved one is prioritized for a transfer to an appropriate psychiatric unit as soon as a spot opens.
The hospital says they can't speak to me without a release. Does that mean I have no say in the care plan?
Not at all. While HIPAA limits what clinicians can give you, it never prevents them from receiving information. I help families deliver "Dated Safety Concerns" and "Patient History Summaries" that the team is ethically and clinically required to review, regardless of a signed release.
What can we do if discharge feels unsafe?
I help you challenge unsafe transitions by translating your home-safety concerns into the specific clinical language that hospital administrators are required to review. We move from feeling powerless to having a documented seat at the discharge planning table.
Do you only work with Colma families?
Support extends throughout San Mateo County, with care plans adapted to each local hospital and referral pathway.
Where Colma families end up and what happens at each place
Colma families frequently rely on North County provider networks and benefit from strong crisis-to-follow-up coordination.
Local guide: Seton Medical Center
A common first touchpoint for Colma families in San Mateo County. Open the full map when you are ready—nothing loads until you choose.
Each link below goes to a different destination. Links open in a new browser tab.
Ready to talk through your situation?
Book a free 20-minute consultation. We will outline next steps for advocacy, documentation, and communication with your care teams.
Book a free 20-minute consultation