Mental Health Holds

“M-1” is a form approved by the Colorado Department of Behavioral Health that evaluators use to determine if an individual’s behavior is so risky that they need to be held in a hospital against their will. Mental health professionals and police officers often use the term “M-1” to talk about the entire evaluation process.
In Colorado Police Officers, Licensed Professional Counselors, Licensed Social Workers, Doctors and Nurses are legally able to place a person on an M1 hold. The decision to hold someone is based both on observation and interview. Hopefully, it’s also based on information collected from family or those connected to the individual (called collateral information.) During the interview a clinician is asking: how does the person appear? What’s their body language- lethargic? Aggressive? What’s their attitude- angry? Antagonistic? Or are they non-responsive? Can they talk in a logical way or is their thought process illogical? Do they think they are being watched, controlled? Are they hearing voices or seeing things that aren’t there?
And most importantly- what are they saying they will do? Or not do? An M1 hold requires that a person “appears to be mentally ill and, as a result of such mental illness, appears to be an IMMINENT danger to others, or himself/herself or gravely disabled.” Imminent is a serious word- that basically means without intervention this person is not going to be okay. They are going to kill themselves, kill someone else or simply die because they cannot or will not eat/drink or keep themselves safe.
An M-1 hold lasts for up to 72 hours. According to Colorado Statue “The person shall be released before seventy-two hours have elapsed if, in the opinion of the professional person in charge of the evaluation, the person no longer requires evaluation or treatment. Persons who have been detained for seventy-two-hour evaluation and treatment shall be released, referred for further care and treatment on a voluntary basis…” With medical necessity, a physician can continue the hold for up to 90 days and with court approval, longer-term certifications can be placed. Medical necessity for the hold has to be reviewed and approved by the physician every thirty days. Mind Springs Health has a nice pamphlet on the web. The first few pages do a great job explaining patients’ rights. Take a peek at it at: http://www.mindspringshealth.org/wp-content/uploads/legal-holds-brochure_web.pdf

Mental Health Holds