March 24th, 2025
The Honorable Caroline Menjivar
Senate Health Committee
1021 O Street, Room 3310
Sacramento, CA 95814
Re: MHAC Opposition to Assembly Bill 416 (Krell)
Dear Chair,
Mental Health America of California is writing to oppose Assembly Bill 416 (Krell), legislation which expands eligibility of people who can place individuals on a 5150 involuntary hold to an emergency physician.
MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. If an individual is experiencing a mental health emergency, only those with the appropriate expertise and resources should have the authority to write a 5150 hold.
Section 5150 of the Welfare and Institutions Code currently designates who can initiate a 5150 involuntary hold, such as individuals working at county-designated facilities, peace officers, or specific county-designated individuals. AB 416 seeks to reduce the number of individuals with mental health disabilities who are held in Emergency Departments by allowing emergency physicians to initiate a 5150 hold. However, these physicians may not have the appropriate licensure, practice discipline, or clinical experience necessary to properly assess and write a hold. While Emergency Departments are often the entry point for many who experience a mental health crisis, they are not always equipped to provide mental healthcare.
Furthermore, current statute already provides a pathway for an emergency physician to become county designated. There is no justification for a blanket designation to professionals who may not have the proper qualifications, and who are not working in county-designated facilities where they cannot provide appropriate evaluation and treatment.
Lastly, our behavioral health system should aim at reducing the number of 5150 holds being placed on individuals. Crisis mobile teams are an effective community-based intervention designed to provide 24/7 de-escalation and relief to individuals experiencing a behavioral health crisis wherever they are, including at home, work, school, or in the community. This strategy is instrumental in providing ongoing support and services and reducing unnecessary law enforcement involvement and emergency department utilization.
Expanding who can write a 5150 hold does not equate to more effective mental health services and should not be used as a justification to reduce emergency room overcrowding. Instead, investing in strategies that prevent crises, reduce emergency department utilization, and avoid placing a 5150 hold are more effective, person-centered approaches that help reduce systemic burdens. For these reasons MHAC opposes AB 416 (Krell) and asks for your “No” vote. If you have any questions, or if MHAC can provide any assistance on this bill or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.
In Community,
Heidi L. Strunk
President & CEO