If your child is in a mental health crisis and refuses treatment, you can have your child committed by taking them to an emergency room, calling 988 to request a mobile crisis team, or filing a petition in juvenile or family court. A judge will order involuntary inpatient psychiatric treatment only if the evidence shows your child has a mental health condition that makes them an immediate danger to themselves, an immediate danger to others, or so gravely disabled they cannot meet their own basic needs. Every state has this process. The details differ, but the shape is the same.
Try Voluntary Admission First
Before starting a court process, know that a simpler option usually exists. In practically all states, a parent or guardian can consent to a child’s psychiatric hospitalization as long as a physician independently determines the admission is medically appropriate. Because you are the consenting party, this counts as a voluntary admission even if your child objects. The U.S. Supreme Court upheld this arrangement in Parham v. J.R.1Justia. Parham v. J.R., 442 U.S. 584 (1979)
Voluntary admission is faster, less adversarial, and avoids a courtroom entirely. Many families exploring commitment find this route gets their child into care without a hearing. The catch: many states give older teenagers the legal right to refuse a parent-consented admission. The age threshold varies. Some states set it at 14, some at 16, and a few let clinicians decide based on whether the minor can participate meaningfully in the decision. When your teen has reached that age and refuses, involuntary commitment becomes the only path to inpatient care.
What the Law Requires
Courts do not order commitment because a child is defiant, failing school, or hard to live with. The legal threshold is much higher, and it centers on immediate safety. A judge needs evidence of a mental health condition that creates one of three situations:
- Danger to self: recent suicide attempts, serious self-harm, or credible threats indicating imminent risk to the child’s own life.
- Danger to others: violent acts, specific threats of physical harm, or behavior that puts other people in reasonable fear of being hurt.
- Grave disability: a condition that leaves the child unable to meet basic needs for food, shelter, or safety. For younger children, this is evaluated against what is developmentally normal for their age.
Involuntary commitment is a serious restriction on personal freedom, so due process demands more than a parent’s frustration or a behavioral problem that better fits outpatient therapy.
Less Restrictive Alternatives Come First
The judge will also want to know why lesser options cannot keep your child safe. Under the Americans with Disabilities Act, the Supreme Court held in Olmstead v. L.C. that states must provide treatment in the most integrated, least restrictive setting appropriate for the person’s needs.2Justia. Olmstead v. L.C., 527 U.S. 581 (1999) In practice, expect to explain what you have already tried, whether outpatient counseling, a partial hospitalization program, or in-home crisis services, and why it failed. Coming to court prepared on this point strengthens a petition considerably.
How to Start the Process
Three main routes can get things moving. The right one depends on how urgent the situation is.
Take Them to the Emergency Room
In an active crisis, go to the nearest emergency room. Describe the specific dangerous behaviors you have witnessed, share any mental health history, and bring information about medications and prior treatment. Emergency physicians can place your child on a temporary psychiatric hold for evaluation. Be concrete. “He tried to swallow a bottle of pills last night” carries far more weight than “he’s been acting out.”
Call or Text 988
If you aren’t sure whether the situation warrants an ER visit, call or text 988. The 988 Suicide and Crisis Lifeline connects you with trained counselors, and the line is available for family members worried about a loved one, not only the person in distress. In many communities, 988 can dispatch a mobile crisis team to your home. These teams, staffed by mental health professionals and peer support workers, evaluate the child on-site and can coordinate transport to a facility if they determine an emergency hold is warranted.3SAMHSA. 988 Frequently Asked Questions A mobile crisis team at your door is far less traumatic for a child than a police response.
File a Petition in Court
The most formal route is petitioning a juvenile or family court directly. You file paperwork describing the specific facts and behaviors that show your child meets the legal standard. Petitions need to be detailed: dates, descriptions of incidents, names of witnesses, prior treatment records. If the court finds the petition shows sufficient grounds, it will order an evaluation or schedule a commitment hearing. This path takes longer, and it may be the right one when the crisis is serious but not immediately life-threatening.
The Emergency Hold
However the process begins, the first formal step is almost always a temporary emergency hold. Clinicians use this window to evaluate whether your child truly meets the legal criteria for continued involuntary treatment and to stabilize the immediate crisis. It is for evaluation and short-term stabilization, not long-term care.
How long a facility can hold your child without a court order varies by state. Some states allow 24 hours. Others permit 72 hours, the most common window. A handful allow five days, seven days, or longer. Weekends and holidays often do not count toward these limits. If clinicians determine your child does not meet commitment criteria, they must release the child. If the child does meet the standard, the facility or a prosecutor initiates a formal commitment hearing.
The Commitment Hearing
A commitment hearing is a courtroom proceeding before a judge. The state must prove, by clear and convincing evidence, that your child meets the criteria for involuntary treatment. That is a higher bar than the “more likely than not” standard used in most civil cases, and lower than the “beyond a reasonable doubt” standard in criminal trials. The Supreme Court set this requirement in Addington v. Texas precisely because involuntary commitment is such a significant deprivation of liberty.
The judge hears testimony from the mental health professionals who evaluated your child, reviews medical records and the petition, and considers input from all parties. If you filed the petition, be prepared to testify about what you witnessed. If the judge finds the standard is met, the court orders commitment for a specified period. Initial orders commonly run 45 to 90 days depending on the state. Courts can extend commitment through additional hearings, but each extension needs fresh evidence and its own proceeding.
Your Child’s Rights in the Process
Children in involuntary commitment proceedings have constitutional protections, and this is where the process can surprise parents who expect it to move quickly. Your child has the right to:
- An attorney. The court will appoint one if you have not retained one. Many states also appoint a guardian ad litem, a separate advocate focused on the child’s best interests, which may differ from what the child wants.
- Formal notice of the hearing and the basis for the commitment petition.
- Attend the hearing and testify on their own behalf.
- Cross-examine witnesses, present evidence, and argue against commitment through their attorney.
These rights apply even when you, as the parent, are certain commitment is the right call. It can feel adversarial when your child’s court-appointed lawyer argues against the very treatment you are trying to arrange, but the system assumes any restriction on liberty deserves scrutiny.
Your Role Once Your Child Is Committed
After a court orders commitment, your parental authority narrows but does not vanish. You retain the right to be informed about the treatment plan and progress, to be consulted on major decisions, and to participate in discharge planning. Facilities typically include you in treatment team meetings because the goal from day one is to get your child stable enough to return home or step down to less intensive care.
You also have the right to visit, though the treatment team controls when and how. Visits may be limited to certain hours, supervised, or temporarily restricted if the clinical team decides family contact is interfering with stabilization. That can be painful. It is usually a clinical judgment about what will help your child recover fastest.
Access to Medical Records
Parents generally have the right to access a minor child’s health records under federal privacy law. The HIPAA Privacy Rule treats parents as personal representatives with authority to review records related to their child’s care.4eCFR. 45 CFR 164.502 – Uses and Disclosures of Protected Health Information Exceptions matter. If your child independently consented to treatment under a state law that allows older minors to do so, you may lose automatic access to those records. A provider can also withhold records if they reasonably believe the child has been or could be subjected to abuse, or that giving you access would endanger the child.5HHS.gov. Personal Representatives and Minors
Paying for Inpatient Psychiatric Care
Parents are financially responsible for the cost of court-ordered treatment, and inpatient psychiatric care is expensive. Insurance helps, but coverage varies, and families often face significant out-of-pocket costs for copays, deductibles, and services the insurer declines to cover.
Two federal laws work in your favor. The Mental Health Parity and Addiction Equity Act requires that when a health plan covers both medical and mental health benefits, the financial requirements for mental health care, including copays, deductibles, and visit limits, cannot be more restrictive than those applied to medical and surgical benefits.6Office of the Law Revision Counsel. 42 U.S. Code 300gg-26 – Parity in Mental Health and Substance Use Disorder Benefits If your insurer is imposing higher costs or stricter limits on your child’s psychiatric hospitalization than on a medical hospitalization, that is potentially a parity violation worth challenging. The Affordable Care Act also requires individual and small-group plans to cover mental health services as an essential health benefit, so outright exclusions are not permitted in most plans.7Centers for Medicare & Medicaid Services. The Mental Health Parity and Addiction Equity Act (MHPAEA)
For families on Medicaid, the Early and Periodic Screening, Diagnostic, and Treatment benefit requires state Medicaid programs to cover medically necessary mental health services for children under 21, including inpatient psychiatric care when clinically warranted. If your state’s Medicaid program denies coverage that your child’s doctors say is necessary, you have the right to appeal.
Discharge and What Comes After
Commitment is not the end of the story. Facilities are required to develop an aftercare plan before discharging your child. That plan identifies ongoing mental health needs, describes the services and supports that will continue after discharge, names the providers responsible for follow-up, and includes a schedule for outpatient appointments. You should be involved in creating it and should receive a copy.
The transition home is where many families struggle. Inpatient structure and supervision disappear overnight, and the stressors that contributed to the crisis are often still there. Aftercare plans work only if families follow through on outpatient therapy, medication management, and other recommended services. Before discharge, ask the treatment team exactly what warning signs to watch for and what to do if those signs appear. Having a concrete plan for the next crisis, including whether to call 988, go to the ER, or contact the outpatient provider, reduces the chance of ending up back in the same emergency.
If the commitment order expires and your child still meets the criteria for involuntary treatment, the facility or your family can petition the court for an extension. Each extension requires a new hearing with fresh evidence. Courts do not grant indefinite commitment; they review at regular intervals to ensure children are released as soon as they can safely receive treatment in a less restrictive setting.