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Posted by on Mar 8, 2011 in Legal, Legislation, Neuropsychiatry

The Road to Involuntary Commitment in California: Alas, We’ve Been Down It Before

The Road to Involuntary Commitment in California: Alas, We’ve Been Down It Before

Sheens_Korner_episode_3.jpg

The shockingly haggard appearance and increasingly pressured rants of unemployed actor Charlie Sheen in the latest episode of his homemade web show, “Sheen’s Korner,” beg the question, now more than ever:

What is the process for involuntarily commitment in the state of California?

Fortunately (or unfortunately), we’ve been down this road beforespecifically with Ms. Britney Spears, who was very publicly involuntarily committed twice for psychiatric evaluation in 2008. And the behaviors that led to Spears’s commitmentpublic head shaving, attacking a car with an umbrella, sobbing in publicdon’t seem any more disturbing than those of Mr. Sheen during the last 2 weeks. On the contrary, I would argue that Sheen’s recent behavior has been more troubling than that of Spears, given his allusions to extreme violence in his verbal tirades (eg, slitting throats) and yesterday’s bizarre wielding of a machete on the roof of the Live Nation office building in Beverly Hills.

In California, the process of involuntary commitment is performed under the state statute known as 5150, in which a designated clinician (prompted by family members), a public safety officer, or an EMT may initiate the process for a 72-hour hold. But the criteria for probable cause are relatively strict in California and dictate that a person must pose a danger to himself or others or is “gravely disabled.”

The latter term, according to the 5150 application, “means a condition in which a person, as a result of a mental disorder, is unable to provide for his or her basic personal needs for food, clothing and shelter.” It is a criterion that might be difficult to establish in Sheen’s case, unless it can be reasonably documented through photographs and film (and I think that it could be) that he has lost a considerable amount of weight in a brief period of time.

Nevertheless, according to Keith Valone, a clinical psychologist* who was quoted by the LA Times in 2008, “Getting a 5051 isn’t a very hard [process] to do. Families can either call a hospital, ask if they write holds and then just present at the hospital. Or if the patient is uncooperative, they can call the police.”

Here’s hoping that someone acts shortly. 

* Who wasn’t involved in Spears’s care.

Screen capture of episode 3 of “Sheen’s Korner.”

03/09/11 addendum: There are veiled and certainly not-so-veiled indications that Sheen might pose a danger to others. In addition to a current restraining order, granted on the basis of alleged physical threats toward his estranged wife, it has been reported that one of Sheen’s live-in girlfriends abruptly left his home late last week. Sheen’s own words (through Tweeting and the first episode of “Sheen’s Korner”) suggest that the woman escaped after being exposed to Sheen’s misdirected anger.

There also may be indications that Sheen is a danger to himself. According to Life & Style magazine, for what this source is worth, Sheen’s friends now fear that he is suicidal.

bmartin (1127 Posts)

A native East Tennessean, Barbara Martin is a formerly practicing, board-certified neurologist who received her BS (psychology, summa cum laude) and MD from Duke University before completing her postgraduate training (internship, residency, fellowship) at the Hospital of the University of Pennsylvania in Philadelphia. She has worked in academia, private practice, medical publishing, drug market research, and continuing medical education (CME). For the last 3 years, she has worked in a freelance capacity as a medical writer, analyst, and consultant. Follow Dr. Barbara Martin on and Twitter.