Reasonable or Random: 72-Hour Limits to Psychiatric Holds

Psychiatr Serv. 2021 Feb 1;72(2):210-212. doi: 10.1176/appi.ps.202000284. Epub 2020 Aug 4.

Abstract

Across the United States, state laws most commonly limit the duration of emergency psychiatric holds to 72 hours. Estimates suggest that more than 1 million emergency psychiatric holds are placed in the United States each year, and this 72-hour limit can shape the lives of patients, clinicians, law enforcement officials, and others in the community. Yet, from where did this time frame originate, and why is it so prevalent in psychiatric care? The author examines the evolution of 72-hour limits on psychiatric holds in the United States, as well as the evidence for or against use of this specific time frame in emergency psychiatric care. Given limited research into policies that affect millions of people, the author concludes that further study is needed to understand how these time limits influence outcomes related to psychiatric care and to strengthen the evidence base for civil commitment practices.

Keywords: 72-Hour hold; Commitment of mentally ill; Emergency medicine; Emergency services, psychiatric; Involuntary commitment; Psychiatric hold.

MeSH terms

  • Commitment of Mentally Ill*
  • Emergencies
  • Emergency Service, Hospital
  • Humans
  • Law Enforcement
  • Mental Disorders* / therapy
  • United States