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LA County to Train ER Doctors to Initiate Mental Health Holds, Freeing Up Crisis Teams

UCI Health in Lakewood Among Five Hospitals Selected for Pilot Program

By LCCN Staff Report

LOS ANGELES — Los Angeles County will train emergency room physicians at five private hospitals, including UCI Health in Lakewood, to initiate 5150 psychiatric holds in an effort to free County mental health crisis teams to respond to emergencies in the community.

The Los Angeles County Board of Supervisors approved the pilot program Tuesday through a motion by Supervisor Janice Hahn, co-authored by Supervisor Lindsey P. Horvath.

The program is designed to address a significant demand on the County’s Psychiatric Mobile Response Teams, which currently spend an average of 1,100 hours each month responding to private hospitals to conduct 5150 evaluations.

A 5150 hold allows an authorized professional to involuntarily detain a person for psychiatric evaluation for up to 72 hours when the individual meets certain legal criteria, including posing a danger to themselves or others.

County hospitals have long had personnel authorized to initiate the holds. However, many private hospitals have had to call County crisis teams and wait for them to conduct the evaluation.

At least 35 private hospitals in Los Angeles County currently do not have physicians authorized under the Lanterman-Petris-Short Act to initiate 5150 holds.

A state law enacted in 2025, Assembly Bill 416, opened the door for emergency room physicians at private hospitals to become
LPS-authorized and conduct the evaluations themselves.

“Every hour our crisis teams spend inside an emergency room is an hour they aren’t out in the community responding to someone who is having a mental health emergency in their home or on the street,” Hahn said.

“We have built up a strong alternative crisis response system, and now we need to make sure we are using those resources as effectively as possible,” Hahn said. “If a patient is already in an emergency room, we should empower trained ER doctors to evaluate them and initiate a 5150 hold, rather than making them wait for a County crisis team to arrive.”

The pilot will begin at the five private hospitals that currently rely most heavily on County crisis teams for 5150 evaluations: UCI Health in Lakewood, Pomona Valley Hospital Medical Center, Providence Saint John’s Health Center in Santa Monica, Providence Little Company of Mary Medical Center in Torrance and UCLA West Valley Medical Center.

The Los Angeles County Department of Mental Health will be responsible for training participating physicians and authorizing them to conduct the evaluations.

The effort is part of the County’s broader Alternative Crisis Response system, which sends mental health professionals rather than armed law enforcement officers to many people experiencing behavioral health emergencies.

Los Angeles County currently has 71 mobile crisis response teams operating 24 hours a day, seven days a week.

County officials say the expansion of alternative crisis response has coincided with fewer mental health calls being handled by law enforcement. Between 2023 and 2025, mental-health-related calls to the Los Angeles County Sheriff’s Department declined 16 percent, while arrests resulting from mental health calls dropped 24 percent.

At the same time, demand for mobile mental health services has increased. Referrals from the County’s 24-hour mental health crisis line for mobile crisis responses rose 31 percent between 2023 and 2025.

“Every person experiencing a behavioral health crisis in Los Angeles County deserves a timely, compassionate response from a qualified professional,” Horvath said.

“When someone is already in an emergency department, we should be using the expertise of the physician at their bedside while preserving our mobile crisis teams for people who need help in the community,” Horvath said. “This pilot can reduce unnecessary delays, strengthen our crisis response system, and ensure that decisions are made with both clinical expertise and respect for patients’ rights and dignity.”

The motion directs the Department of Mental Health to develop a plan to expand the physician training program to all eligible non-County hospitals that are not currently LPS-designated by the end of 2027.

“This is about making a system that is already working work even better,” Hahn said. “We can equip our ER doctors to better help their patients, while allowing our County’s mental health crisis teams to focus on where they are needed in the field.”

The department must report back to the Board of Supervisors within 120 days on implementation of the pilot, including hospital participation, training and certification procedures and any barriers encountered.

Quarterly updates will follow as the County develops plans for broader implementation based on the results of the five-hospital pilot.


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