The Los Angeles County Board of Supervisors approved a motion on Aug. 11 by Supervisor Janice Hahn, 4th District, and co-authored by Supervisor Lindsey Horvath, 3rd District, to launch a pilot program to train and authorize emergency room physicians at five private hospitals to conduct 5150 psychiatric holds. The new approach will free the county’s mental health crisis teams to respond more quickly to people experiencing emergencies in the community.

Los Angeles County has spent the past several years expanding the Alternative Crisis Response system, which sends mental health professionals – rather than armed law enforcement officers – to assist people experiencing mental health crises. The county has 71 mobile crisis response teams operating 24 hours.

The expansion is working, the supervisors said. As more people have turned to calling 988 and the county’s mental health crisis line for help, calls to law enforcement involving mental health crises have declined. Between 2023 and 2025, mental-health-related calls to the Los Angeles County Sheriff’s Department dropped 16%, while arrests resulting from mental health calls declined 24%.

Hahn is seeking to shorten the mental health crisis teams’ response times with the new proposal. One major drain on the teams’ resources comes from responding to calls from private hospital emergency rooms to initiate 5150 holds, which allow authorized professionals to detain a person against their will for a psychiatric evaluation for up to 72 hours when they pose a risk to themselves or others.

While County hospitals have long had staff authorized to initiate 5150 holds, a new 2025 state law (Assembly Bill 416) recently allowed emergency room doctors in private hospitals to become LPS-authorized, certifying them to initiate the holds. At least 35 private hospitals across Los Angeles County do not have LPS-authorized physicians and instead rely on calling the county’s Psychiatric Mobile Response Teams. County mental health crisis teams spend an average of 1,100 hours every month responding to hospitals to conduct 5150 evaluations.

“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. 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 Hahn-Horvath motion approved by the board directs the L.A. County Department of Mental Health to launch a pilot program to train physicians to become LPS certified. The pilot will start at the at the five private hospitals that currently rely most heavily on County crisis teams for 5150 evaluations. The hospitals are Providence Saint John’s Health Center in Santa Monica, Pomona Valley Hospital Medical Center, UCI Health in Lakewood, Providence Little Company of Mary Medical Center in Torrance and UCLA West Valley Medical Center.

The motion also directs DMH to develop a plan to expand the training program to all eligible non-county, non-LPS-designated hospitals by the end of 2027.

“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. 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 requires DMH to report back within 120 days on the implementation of the pilot, including hospital participation, training and certification protocols. For information, visit dmh.lacounty .gov.