California recently passed legislation that allows evaluations and assessments for involuntary psychiatric holds to be conducted using telehealth technology. California's Lanterman-Petris-Short Act authorizes the involuntary commitment and treatment of individuals with mental health disorders. If an individual is considered to be a danger to themselves or others as a result of a mental health disorder, the individual may be taken into custody for a period of up to 72 hours for assessment, evaluation, and crisis intervention. These 72 hour involuntary commitments are commonly referred to as "5150 holds," in reference to the Welfare & Institutions Code Section authorizing the process. Counties designate certain general acute care hospitals, psychiatric hospitals and other health care facilities that can evaluate and assess 5150 patients.
Prior to admitting a person to a health care facility for treatment and evaluation pursuant to Section 5150, a physician, psychiatrist, or other qualified professional must assess the individual to determine the appropriateness of the involuntary detention. Until recently, the professional needed to conduct the assessment "in person."
The new law provides that a 5150 assessment must be made "face-to-face," but can be conducted "either in person or by synchronous interaction through a mode of telehealth that utilizes both audio and visual components." The new law also clarifies that 5150 evaluations conducted using telehealth modalities are protected by existing laws that grant civil and criminal liability immunity to hospitals and licensed professionals in connection with 5150 evaluations.
The inclusion of telehealth technology as a way to evaluate and assess 5150 holds is indicative of the prevalence of telehealth technology as a modern form of health care delivery. The updates to the law will allow California hospitals to further integrate telehealth technology in their emergency departments, and may ease the burden on hospitals and professionals conducting these assessments. As this issue develops, other states may update their involuntary commitment laws to allow for the use of telehealth for similar psychiatric evaluations and assessments.
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