A Guide to Navigating Involuntary Holds in Washington
Facing a mental health crisis can be overwhelming for both individuals and their loved ones. In some cases, a person may need to be placed on an involuntary psychiatric hold to ensure their safety and provide urgent treatment. This guide explains the process of involuntary holds in Washington State. It’s meant to help you understand your rights, what to expect, and how to support your loved one.
What is an Involuntary Psychiatric Hold?
An involuntary psychiatric hold means that a person is kept in a hospital or evaluation facility against their will for a limited time to address a mental health crisis. This can happen when someone poses a risk to themselves or others. The goal is not to punish, but to provide emergency evaluation, safety, and care. It does not lead to a criminal record, but each U.S. state has unique laws and guidelines to regulate these holds.
What is the Criteria for an Involuntary Hold?
In Washington State, a person may be held involuntarily if they meet any of the following criteria due to a mental health or substance use disorder:
Danger to self (e.g., active suicidal thoughts or actions)
Danger to others (e.g., threats or violent behavior)
Gravely disabled (unable to provide for basic needs like food and clothing)
A Designated Crisis Responder (DCR) makes this determination after evaluating the person. DCRs are licensed mental health professionals who specialize in mental health risk assessment. The Designated Crisis Responder program is unique to Washington, but many states have similar programs.
How are Holds Initiated?
There are several ways a hold can begin:
Emergency room: If someone goes to the ER during a crisis, staff may contact a DCR.
Police or first responders: They can take someone to an evaluation facility for assessment.
Mental health providers: Therapists, doctors, or social workers can request a DCR evaluation.
Family and Friends: You can contact your local crisis line to report a concern. In the case of an immediate emergency, call 911.
Washington’s Involuntary Hold Laws
Washington uses a law called the Involuntary Treatment Act (ITA). Here’s how it works:
Initial Hold: 72 hours (3 days)
A person can be held for up to 72 hours (excluding weekends and holidays) for emergency evaluation and treatment. In emergencies, this hold may last up to 120 hours (5 days) pending a court hearing.
14-Day Commitment
If the person still meets the criteria, the facility may petition the court for an additional 14-day hold. A court hearing is held, and the person has the right to legal representation.
Longer Commitments
Further commitments require additional court hearings and evidence that continued treatment is necessary. The court may choose to extend the hold by 90 or 180 days, depending on the circumstances.
Know Your Rights
If you or a loved one is placed on an involuntary hold, you still have rights:
Right to legal representation: A public defender will be appointed if needed.
Right to a hearing: You can challenge the hold in court.
Right to be informed: You have the right to know why you’re being held and for how long.
Right to medical care and dignity: You must be treated with courtesy and provided with appropriate care. Your medical privacy must be respected according to HIPAA guidelines.
Right to refuse medications: You may refuse medications during an involuntary hold unless the failure to administer medicine would result in a likelihood of serious harm. If administered involuntarily, this decision must be reviewed within 24 hours.
How You Can Help
Stay calm and compassionate: Your loved one may be scared or confused. Reassure them and remind them you care.
Communicate with staff: Share important history or concerns with the medical staff or the DCR.
Ask questions: Don’t hesitate to ask for updates or clarification from providers.
Respect confidentiality: Providers must follow privacy laws, but they can often accept information from you, even if they can’t share details.
Help plan for discharge: Ask about next steps, medications, safety planning, and follow-up care.
Conclusion
Involuntary psychiatric holds are used only when necessary to keep someone safe during a mental health crisis. While the process can be difficult, it’s designed to provide emergency help and a path toward stability and recovery. Understanding the system and knowing your rights can make the experience less frightening and more manageable for everyone involved. If you need immediate help, call the 988 lifeline or contact your local crisis center.
