In Colorado, an involuntary mental health hold, commonly called an M-1 hold, lets a peace officer or qualified clinician detain a person for up to 72 hours at a designated treatment facility when a mental health disorder appears to make them a danger to themselves or others, or leaves them gravely disabled. The framework sits in Title 27, Article 65 of the Colorado Revised Statutes, and it governs everything that follows: whether the person is released, certified for short-term treatment, medicated over their objection, or released with follow-up care.
What an M-1 Hold Is and How Long It Lasts
An M-1 hold is a short-term emergency detention. It lasts up to 72 hours, but weekends and holidays do not count toward that window if the facility does not offer evaluation and treatment services on those days.1Justia. Colorado Revised Statutes Section 27-65-105 (2022) – Emergency Procedure A Friday evening hold can stretch well past three calendar days before the clock runs out.
The purpose of the hold is evaluation and stabilization, not punishment. Clinical staff use the 72 hours to decide whether the person meets criteria for continued involuntary treatment, can be persuaded to accept voluntary care, or should be released.
Who Can Place Someone on a Hold
The list of people authorized to initiate an M-1 hold is broader than most families expect. It includes peace officers, licensed physicians and psychologists, psychiatric nurses with specialized postgraduate training, licensed clinical social workers, licensed professional counselors, licensed marriage and family therapists, and addiction counselors with additional clinical preparation.1Justia. Colorado Revised Statutes Section 27-65-105 (2022) – Emergency Procedure
A family member cannot place a hold directly. What a family member can do is contact one of the professionals above, call 911, or reach out to a mobile crisis team. The professional or officer then decides, based on their own assessment, whether the criteria for a hold are met.
Peace officers who initiate holds must document their reasoning. The statute does not authorize force beyond what is necessary for safe transport to the facility.
What Happens During the 72 Hours
Once the person arrives at the designated facility, clinical staff evaluate them. If the person stabilizes and no longer appears dangerous or gravely disabled, the facility must release them. If they still meet the criteria, the facility has two options: obtain voluntary consent for ongoing care, or start the paperwork for involuntary short-term certification.
Throughout the hold, the person must be told of their rights, including the right to contact an attorney and, in most circumstances, the right to refuse medication. Families are typically notified unless doing so would create a safety risk. Facilities receiving a person on an M-1 hold must have qualified staff available around the clock to conduct evaluations.
Certification for Short-Term Treatment
If the evaluating professional concludes the person has a mental health disorder and, because of it, is a danger to self or others or is gravely disabled, the facility can certify the person for short-term involuntary treatment. That certification lasts up to three months.2Justia. Colorado Revised Statutes Section 27-65-109 – Certification for Short-Term Treatment
The certification notice must be signed by a professional person who participated in the evaluation and must state facts sufficient to establish reasonable grounds. The legal standard at any contested hearing is clear and convincing evidence, a higher bar than an ordinary civil case. The person has the right to counsel, and the court will appoint an attorney if they cannot afford one.2Justia. Colorado Revised Statutes Section 27-65-109 – Certification for Short-Term Treatment
If the person’s condition has not improved after three months, the facility can seek an extension. Extended certifications are also capped at three months per period, and each extension requires a new hearing.3Justia. Colorado Revised Statutes Section 27-65-108 (2022) – Extension of Certification The burden always sits with the facility to justify continued involuntary treatment. The committed person or their representative can request reevaluation at any time. If the facility determines the person no longer meets criteria, it must discharge them. Colorado law also requires that treatment happen in the least restrictive setting appropriate to the person’s condition, which may mean outpatient care rather than a locked unit.
The Non-Emergency Route: Court-Ordered Evaluation
Not every mental health crisis meets the standard for an immediate hold. Someone may be deteriorating over weeks or months without ever presenting as an imminent danger in a moment a professional witnesses. In that case, any individual can petition a court for a mandatory evaluation. The petition is filed in the county where the person lives or is physically present.4Justia. Colorado Revised Statutes Section 27-65-106 (2022) – Court-Ordered Evaluation
The petition must include factual allegations showing reasonable grounds to believe the person has a mental health disorder that makes them dangerous or gravely disabled, along with identifying information, the name and address of anyone legally responsible for the person’s care, and whether the person has an attorney. If the court finds probable cause, it orders the evaluation, which is then conducted by a licensed professional at a designated facility. The results determine whether the court moves to short-term certification.
Court-Ordered Medication
Medication is the most contested piece of involuntary treatment. Under C.R.S. 27-65-111, a treating physician can petition the court for an order requiring a person to accept medication when the person refuses. Once the petition is filed, the court must appoint counsel (if none is already assigned) and hold a hearing within ten days.5Justia. Colorado Revised Statutes Section 27-65-111 (2021) – Certification on an Outpatient Basis
The person, their guardian, their patient representative, or any party can contest the proposed medication at any hearing on the certification. If the person has a behavioral health orders form or psychiatric advance directive on file, the court must review it and treat the person’s stated preferences as the preferred option. The court can override those preferences only with clear and convincing evidence that the directive does not reflect effective participation in treatment decisions.6Colorado Bureau of Investigation. C.R.S. 27-65-111 Certification on an Outpatient Basis – Short-Term and Long-Term Care
If a person subject to outpatient certification refuses court-ordered medication and their condition worsens, the court can order a peace officer or secure transportation provider to bring them to a designated facility for treatment. The person does not need to be imminently dangerous for the court to authorize transport, though the facility must still be the least restrictive option appropriate to the situation.6Colorado Bureau of Investigation. C.R.S. 27-65-111 Certification on an Outpatient Basis – Short-Term and Long-Term Care
Rights During a Hold or Certification
Being detained does not strip a person of their fundamental rights. Colorado law lays out detailed protections that apply to everyone receiving mental health evaluation, care, or treatment, whether voluntary or involuntary. Facilities must advise patients of these rights, provide a written copy on admission, and post the full list prominently.7Justia. Colorado Revised Statutes Section 27-65-117 – Rights of Persons Receiving Evaluation, Care, or Treatment
- Sealed mail that staff cannot open, delay, or censor, and ready access to telephones for private calls.
- Frequent visitor access, with unrestricted access to an attorney, clergy member, or personal physician at any time.
- The right to wear personal clothing, keep personal possessions, and spend a reasonable amount of personal money.
- The right to be informed about diagnosis, medications, and side effects, and to participate in treatment planning.
Patients must also receive a written statement of their rights on admission, including the right to refuse treatment unless a court has specifically ordered otherwise.8Justia. Colorado Revised Statutes Section 27-65-120 – Rights Statement Seclusion and physical restraint follow strict procedural guidelines and cannot be used as punishment or for staff convenience. The law treats restraint as a last resort.
Federal law adds another layer. Under the Americans with Disabilities Act, mental health facilities must make reasonable modifications for patients with disabilities, which may include adjusted communication methods, service animal access, or additional time to explain treatment to patients with intellectual disabilities.
Advance Instructions: Behavioral Health Orders
Colorado allows adults to complete a behavioral health orders form specifying their preferences for psychiatric treatment, medication, and alternative therapies in advance. Providers, hospitals, and emergency personnel are legally required to follow a properly executed form as long as it is apparent and immediately available. The one exception is when following the instructions would cause the person substantial harm, in which case providers must make a good-faith effort to consult with the person’s designated agent and offer an alternative.9Colorado Public Law. C.R.S. 15-18.7-205 – Duty to Comply With Behavioral Health Orders
The form has limits. It cannot override an emergency hold or a court-ordered commitment; any instruction attempting to exempt the person from those procedures is void. And if what the person currently says conflicts with what the written form says, the written form controls for the specific treatment decision at issue.9Colorado Public Law. C.R.S. 15-18.7-205 – Duty to Comply With Behavioral Health Orders The reasoning is that the person drafted the form while stable, and a crisis may impair their current judgment. When a court considers involuntary medication, it must review any behavioral health orders form on file and start from the person’s advance preferences.
Firearms Consequences to Know Before a Hold
This is the consequence most people do not think about until it is too late. Under federal law, a person who has been committed to a mental institution is prohibited from possessing, purchasing, or transporting firearms or ammunition. The ban applies nationwide.10Office of the Law Revision Counsel. 18 U.S. Code Section 922 – Unlawful Acts
A formal court-ordered commitment under C.R.S. 27-65-109 clearly qualifies. Whether a 72-hour M-1 emergency hold on its own triggers the federal firearms ban is less settled and turns on whether the hold counts as a commitment under federal interpretation. A person adjudicated as mentally defective by a court also falls under the prohibition, and reportable events include being ordered to receive inpatient mental health services, being found incompetent to stand trial, or being acquitted by reason of insanity.
Colorado has a judicial procedure for restoring firearm eligibility after a mental health commitment under the federal NICS Improvement Amendments Act. The relevant statutes are C.R.S. 13-5-142.5 and C.R.S. 13-9-124. Restoration requires petitioning a court and demonstrating that the person no longer meets the criteria that triggered the prohibition. Anyone in this situation should consult an attorney, because state commitment records and federal firearms law interact in complicated ways.
Calling 988 Instead of 911
Before a hold ever happens, families often face a choice between 911 and the 988 Suicide and Crisis Lifeline. Trained counselors on 988 provide emotional support and de-escalation, and most calls are resolved without law enforcement involvement. The system is designed to promote care in the least restrictive manner possible.11SAMHSA. 988 Frequently Asked Questions
When phone support is not enough, 988 can dispatch a mobile crisis team of trained professionals and peer support providers who respond in person, conduct risk assessments, and connect the person with care, often avoiding hospitalization entirely. A 988 counselor will contact 911 only when someone is in immediate physical danger, such as a suicide attempt in progress, an active plan with available means, or a suspected overdose. Involuntary hospitalization through 988 happens only when imminent risk cannot be reduced any other way and mobile crisis efforts have not worked.11SAMHSA. 988 Frequently Asked Questions
The practical difference: 988 is built around de-escalation and voluntary connection to care, while 911 is more likely to result in law enforcement contact and, potentially, an M-1 hold.