Taking away a person’s agency and freedom is an awful thing to do, but every social worker has seen situations where there is no real choice.
It happens with the boy deep in the autism spectrum disorder who lashes out and destroys walls, flips tables, breaks car windows, and can’t be calmed down. It happens with substance use disorder addicts in the throes of chemical dependency who can no longer care for even their own most basic needs like food and liquids. It happens when schizophrenia strikes once happy, successful professionals and they engage in self-harm and won’t consent to treatment.
In those moments, the California social services network has only one real alternative: the section 5150 of the Welfare and Institutions Code 72-hour involuntary hold for mental health. The current law, created by the Lanterman-Petris-Short Act (LPS) in 1967, outlines the circumstances and procedures for temporary involuntary commitments.
But this controversial section of state law may be getting an update, one that puts social workers right in the thick of things—and one that may spark even more controversy.
California Social Workers Today Rely on Peace Officers for 5150 Holds in Crisis Situations
Currently, certain designated mental health professionals, such as psychologists or psychiatrists, can initiate an emergency hold. But in most cases, the responsibility falls to law enforcement officers.
It’s no secret in the social work community how much danger that creates for people in crisis. Police, trained in managing threats and violent situations, lack the skills to talk down patients who are mentally ill. All too often, they perceive a threat and react with the tools they have. That leads to unnecessary injury and death.
There’s a litany of cases where families, fearing for themselves or their mentally disturbed relatives, have called for assistance only to watch, horrified, as police kill the individual rather than helping.
Yong Yang, a bipolar Korean American man experiencing an episode, was gunned down by LAPD officers when they arrived to find him holding a knife in his parents’ home in 2024. Prior to their arrival, Yang’s parents said he wanted to be alone, but that he had not been violent.
In 2013, a Los Banos man named Sonny Lam was killed by a police officer after his father called for assistance with his declining mental health.
Nationally, almost 20 percent of individuals killed by police are experiencing some sort of mental health crisis. A significant proportion of them, like Lam and Yang, are minorities.
This leaves many social workers reluctant to call for police assistance even when they have a patient who needs involuntary emergency commitment to be treated for a mental crisis. Yet in most California communities, there is no other real choice.
What if Social Workers Were Allowed To Make Temporary Holds Independently?
This is the thinking that lead Senator Aisha Wahab to introduce Senate Bill 402 in 2023. To Wahab, it seemed crazy that the people with the most training in dealing with individuals in crisis were less empowered than those with the least.
California’s social workers get the training to help overcome prejudice and bias through MSW programs required for licensure in the state. in addition to de-escalation and communications skills with people in altered states. There’s no way to rerun the past to know if they could have brought Lam or Yang into involuntary commitment without violence. But many people believe their odds would be better than those of police—including many police themselves.
The bill gained the support of the California Police Chiefs Association, which would also prefer to keep officers out of the process for individuals who do not currently pose a danger to themselves or others. There are also practical issues for the police. With shortages of officers in many California jurisdictions, it’s a real problem that processing a 5150 takes an officer off the street for four to five hours of their shift.
Social Workers Are Already Empowered To Make Involuntary Commitment Decisions in Other States
This wouldn’t be an entirely unprecedented move on California’s part; social workers in eight states already can initiate emergency commitments without additional requirements, and can start the process with a judicial review in six others. Psychiatric social workers with LA county’s Psychiatric Mobile Response Teams already perform crisis evaluations and fill out 5150 applications for involuntary holds.
As it stands, however, it’s only their designation as members of a mobile crisis team that allow that authority.
The proposed law would give any licensed clinical social worker in California that ability, as well as:
- Physicians
- Psychologists
- Licensed Marriage and Family Therapists
- Licensed Professional Clinical Counselors
Just like with peace officers, holds placed by social workers or other mental health professionals would be both temporary and subject to review by another healthcare professional. Additionally, county behavioral health directors would have the authority under the legislation to choose exactly which professionals could initiate a detention.
It’s that local touch that is crucial. Social workers dealing with local communities are in a far better position to make a call on whether someone genuinely needs involuntary commitment, whether it can be performed safely without law enforcement, or whether some alternative treatment option exists that might be a better choice. Both their experience and their education in mental health and community resources come into play making such judgement calls.
The Bill Failed, but the Idea Has Legs
SB 402 made it out of committee but never came up for a vote.
While police agencies supported the legislation, other groups that are traditionally allied with California’s social work community weren’t always in favor. Disability rights advocates testified that the state should be reducing paths to involuntary commitment, not expanding them. And they expressed concern that individuals in need of assistance might start to avoid social workers if they were aware it could lead to a temporary hold, rather than getting the help they need.
It’s a tough call for social workers, who have concern for both the dignity and freedom of each person, but also an understanding of the right of the community to safety and security. But ultimately, what is most important is that it’s a decision that is made with sensitivity and compassion. Ensuring people are treated with the respect and dignity everyone deserves is exactly why people get into social work in the first place. With those qualities and a first-rate education to back them up, there’s a stronger argument for why it makes sense for social workers to be entrusted with this authority.