Understanding Involuntary Psychiatric Holds in New Hampshire
Mental health crises can unfold rapidly and unpredictably. In New Hampshire, the law allows for certain interventions to protect individuals and those around them through a legal process which is known as involuntary commitment or a psychiatric hold. This guide explains what that process looks like in New Hampshire, when and how it’s used, and what patients and families need to know.
In the state of New Hampshire, a person may be placed under what is known as an involuntary hold/commitment/admission if they are believed to pose a serious risk to themselves or others due to a mental illness or are deemed unable to care for basic needs. It is also to be known that a person can be temporarily detained and evaluated for mental health concerns against their will.
Some scenarios that might lead to a hold include:
Active Suicidal behavior or threats
Severe psychosis, hallucinations, or delusions
Refusal of life-sustaining care due to mental illness
Hold Types & Criteria
Emergency Hold: Initiated when there’s immediate risk. Requires mental health professional or physician’s assessment
Extended Evaluation: May follow emergency hold if the individual remains a risk. Often requires court involvement
Involuntary Commitment: Long-term psychiatric care, only granted through a legal hearing with patient representation
How the Hold Process Begins
The process usually begins with a professional concern or report. Here's how it typically unfolds in New Hampshire:
Initiation: A physician, psychologist, peace officer, or family member completes legal paperwork to detain the individual.
Transport: The person is taken to a designated facility or hospital.
Admission & Evaluation: The person is medically cleared and evaluated for mental health risk.
Review or Hearing: If the facility seeks to extend the hold, a court review is scheduled.
What Happens During a Hold
While under an involuntary hold in New Hampshire, the person may:
Be confined to a secure unit meaning:
No access to leave without discharge
Monitored 24/7 by clinical staff
Visitors being allowed by typically limited and requiring permission
Receive psychiatric evaluation
Assessed by a court-appointed psychiatrist or psychologist
Be administered medications (sometimes involuntarily under specific conditions)
Important things to know during Involuntary Holds: Tips & Guidance
Rights of Individuals Under a Hold
The right to be informed of the reason for detention
Access to legal counsel
Right to refuse medication (unless overridden by court order)
Right to a hearing for extended holds
Patients can challenge their hold through legal counsel if they believe it is unjustified
Potential Outcomes
Release: If the person stabilizes and no longer meets criteria
Voluntary Admission: If the person agrees to stay for further care
Court-Ordered Commitment: For ongoing treatment under strict legal oversight
What families & Caregivers Can Do
Family members play a key role throughout the process — though they often feel sidelined
Stay Involved and communicate: Keep in touch with hospital staff and request a signed Release of Information (ROI) to receive updates about your loved one’s care. Keeping thorough documentation is also important as it is crucial to navigating the process
Advocate for Least Restrictive Alternatives: In New Hampshire, the law emphasizes the least restrictive environment for treatment
Understand the Legal Timeline: Once an involuntary hold is initiated, a hearing must occur within 15 business days in Probate Court
Conclusion
New Hampshire’s involuntary admission process is robust, structured, and centralized through the Probate Division, especially for non-emergency cases. It emphasizes medical input, legal oversight, and patient safeguards like counsel, review hearings, and renewals. The e-filing improvements streamlined access, but families must stay proactive—document behaviors, engage early, and push for comprehensive discharge planning
