I did a presentation on Colorado mental health law a few months ago and thought i share some of it as i think it pertains.
The truth is even if we place an individual on a hold, we may not find placement aka a bed in a mental health treatment facility. The hold eventually expires or is dropped and they are released. Bed availability is a HUGE barrier in Colorado. The average lengths of stay if a bed is availability is 3 - 5 days.
This is based on my experience only. The below was taken from the State of Colorado website (
Colorado's involuntary mental health treatment system explained | Colorado Department of Human Services)
Colorado Mental Health Law - System of care and treatment for mental health is established in Colorado statute (Title 27, Article 65, C.R.S., commonly referred to as "
27-65"), and further defined in OBH rule (Volume 2 CCR 502-1).
Colorado Law Requires - When any person appears to have a mental illness and, as a result of such mental illness, appears to be an
imminent danger to others or to self or appears to be gravely disabled, an intervening professional upon probable cause and with such assistance as may be required, may take the person into custody, or cause the person to be taken into custody.
Why do we need § 27-65-105?
- Civil commitment= severe infringement of public rights/freedoms
* Such restriction of liberties requires due process of law.
- 27-65 sets out procedural safeguards
* Maintain a person’s dignity and integrity;
* Be provided in a restrictive setting only when less restrictive setting are unavailable and when safety is endangered;
* Protect people’s privacy, dignity, and other rights;
* Encourage the use of voluntary services;
* Inform and encourage family involvement when appropriate; and,
* Facilitate the recovery and resiliency of each person
Some Important Definitions
- “Imminent” is key - Applies to the proximity in time of the dangerousness. More specifically, the term “imminent” applies to a determination of whether the danger to others or himself or herself is current; it does not apply to how soon in time a specific dangerous act may be undertaken.
- Danger to Self – The individual poses a substantial risk of physical harm to self as manifested by evidence of recent threats of or attempts at suicide or serious bodily harm to self.
- Danger to Others – With respect to other persons, that the individual poses a substantial risk of physical harm to another person or persons, as manifested by evidence of recent homicidal or other violent behavior by the person in question, or by evidence that others are placed in reasonable fear of violent behavior and serious physical harm to them, as evidenced by a recent overt act, attempt, or threat to do serious physical harm by the person in question.
- Gravely Disabled – A condition in which a person, as a result of a mental health disorder, is incapable of making informed decisions about or providing for his or her essential needs without significant supervision and assistance from other people. As a result of being incapable of making these informed decisions, a person who is gravely disabled is at risk of substantial bodily harm, dangerous worsening of any concomitant serious physical illness, significant psychiatric deterioration, or mismanagement of his or her essential needs that could result in substantial bodily harm. A person of any age may be “gravely disabled”, but such term does not include a person whose decision-making capabilities are limited solely by his or her developmental disability.
Who can initiate a 72-hour mental health hold?
- A Certified peace officer.
- A Physician or Licensed Psychologist with a license in the state of Colorado.
- An APRN with psychiatric/mental health training.
- A Licensed marriage and family therapist, licensed professional counselor, or licensed addiction counselor who by reason of postgraduate education and additional preparation has gained knowledge, judgment, and skill in psychiatric or clinical mental health therapy, forensic psychotherapy, or the evaluation of mental disorders.
- A Licensed clinical social worker
Advisement of Rights
- The patient must be advised of the decision to place a mental health hold.
- Documentation of same must be entered into the medical record demonstrating that this was performed.
- Further, if the “professional” believes that the person is mentally ill and, as a result, is an imminent danger to self or others, or gravely disabled, …documentation produced in the case must state facts sufficient to establish the above conclutions.
- After seizure of the person for an M-1 hold – the 72 hour evaluate and treat program must begin as soon as possible after he or she is admitted.
What happens when the 72-hour hold expires
- Released if no longer found to meet certification criteria.
- Referred for further care and treatment on a voluntary basis.
- Certified for treatment pursuant to § 27-65-107 (short-term certification).
What is Certification?
- Short Term Certification (STC)
* § 27-65-107
* Done by petitioning the court.
* A person may be certified for not more than 3 months for short-term treatment if the person is found to have a mental health disorder and meets certification criteria and has not accepted voluntary treatment.
* A certification for short-term treatment may be extended once for a period not to exceed 3 months if the professional person in charge of the treatment believes that a period longer than three months is necessary for treatment of the person and the condition for short-term certification continue to be met (Extended certification).
- Long Term Certification (LTC)
* § 27-65-109
* Done by petitioning the court.
* Can file long-term certification for short-term certifications lasting more than 5 months.
* May order long-term care for up to 6 months.
* 27-65-109(3): Respondent may request a jury trial, which is to be held within 10 days.
* 27-65-109(5): If extension of LTC is sought, it must be done within 30 days of the expiration of the original order.
* If no hearing is requested, the court may proceed ex parte.
* Each extension shall be for no longer than 6 months.