Everything You Need to Know About Involuntary Holds in Tennessee

In Tennessee, as in other states, individuals experiencing a mental health crisis may be placed on an involuntary psychiatric hold–a temporary but significant legal intervention. These holds allow authorities to detain someone without consent if they’re deemed an immediate danger, ensuring they receive evaluation and appropriate care. This guide outlines the process in Tennessee, including your rights and how you can offer support.

What Happens During an Involuntary Hold?

An involuntary psychiatric hold (also called an emergency detention or involuntary commitment) occurs when a physician, psychologist, crisis responder, or law enforcement officer determines that a person has a serious emotional disturbance or mental illness that poses a substantial risk of serious harm or causes the individual to be gravely disabled. Once criteria are met, the person can be detained initially for evaluation without a court order. The facility then evaluates whether further hold or commitment is necessary based on clinical assessments.

What Calls for an Involuntary Hold?

An individual exhibits behavior that poses an immediate and substantial likelihood of serious harm, such as:

• Actively suicidal thoughts or actions

• Suicidal self-harming behavior

• Threats of violence

An individual is unable to care for themselves due to a mental illness, for example:

• Unable to feed self

• Unable to clothe self

• Unable to bathe self

All less restrictive options are unsuitable.

Psychiatric Holds in Tennessee

In Tennessee, involuntary psychiatric holds are governed by Title 33 of the Tennessee Code Annotated (TCA), which outlines the procedures and legal framework for emergency detention and involuntary commitment. The process involves several legal stages designed to protect individual rights while allowing for necessary mental health intervention. 

• Under Tenn. Code Ann. § 33‑6‑401, an individual can be taken to a designated facility for emergency examination without a court order when a qualified professional determines that they meet the criteria for an emergency mental health hold. A Certificate of Need (CON) must be completed by a designated mental health professional or physician stating the basis for detention. 

• The person must then be transported to an approved facility for evaluation. Law enforcement often plays a role in transportation if public safety is a concern.

If continued detention is necessary, a second CON (usually within 24 hours) must confirm that the individual meets the criteria for further involuntary treatment. If treatment beyond 72 hours is deemed necessary, the facility must initiate court proceedings for Judicial Involuntary Commitment, which requires filing a petition in court under § 33-6-502.

Types of Mental Health Holds in Tennessee

• Voluntary admission: Individual consents and seeks treatment. May result in less restrictive policies and the opportunity for outpatient treatment.

• Emergency detention: Immediate hold by professionals for evaluation, lasting up to 72 hours. Law enforcement, doctors, and mental health crisis responders can detain someone under these circumstances without a court order.

• Emergency involuntary commitment: If danger continues, the court may permit a hold lasting up to 20 days. This includes an initial 5-day hold followed by another 15-day extension pending a probable cause hearing.

• Non-emergency (longer-term) involuntary commitment: Based on sworn petition, judicial order, and court-reviewed extension, this initial inpatient commitment may last a maximum of 6 months.

• An individual may be released before this time if the court decides they no longer pose a risk to themself or others. 

Know Your Rights

Even during involuntary detention, individuals retain key legal rights:

• Due process: Right to prompt judicial hearings (within 5 business days) with legal representation. If indigent, an attorney will be provided.

• Right to notice and appeal: Written notice of why you’re being held and grounds for commitment.

• Medical privacy and refusal rights: You can refuse medication if you have decision-making capacity, excluding emergency situations. Records must remain confidential except for limited disclosures necessary for treatment.

• Protection from unnecessary restraints or isolation. 

• Habeas corpus: This means you can petition to challenge your detention in court.

How You Can Help

• Stay informed: Understand the legal process and different types of holds.

• Advocate: Attend hearings, help secure legal representation, or consult a mental health attorney.

• Provide support: Offer transportation, accompany them to appointments, and connect them with crisis lines.

• Follow through: Help them engage with outpatient treatment plans, especially if court-mandated. This can include therapy and medication follow-up.

• Know crisis resources: In Tennessee, you can always call 911 and request a Crisis Intervention Team (CIT) officer in an emergency. You can also contact the National Alliance of Mental Illness (NAMI) Tennessee HelpLine at 800-467-3589*.

• *IMPORTANT NOTE: NAMI’s Tennessee HelpLine is NOT A CRISIS LINE. For the Suicide & Crisis Lifeline, call or text 988. You may also text “HOME” to 741741 for the national Crisis Text Line.

Conclusion

In Tennessee, involuntary psychiatric holds are designed to ensure safety and access to care during acute mental health crises, balanced with significant legal safeguards. Familiarizing yourself with the process, the law, and individual rights can better equip you to offer compassionate support. If you or a loved one faces an involuntary hold, always keep in mind: help is available and recovery is possible.