The next 48 hours will play a critical part in what comes next for Amanda Bynes. The actress was placed on an involuntary psychiatric hold by California sheriff's deputies on Monday night after she reportedly set a small fire in a stranger's driveway.
A spokesperson for the Ventura County Sheriff's Department said Bynes, 27, was, "involved in a disturbance in a residential neighborhood last night in Thousand Oaks" and after investigating the incident and speaking to Bynes, 27, they determined that she met the criteria for a 5150 psychiatric hold.
"The maximum is a 72 hour hold, but in most cases they don't need 72 hours," said Rusty Selix, executive director of the Mental Health Association of California. Selix, who is a lawyer, not a clinician, has no first-hand knowledge of the Bynes incident, but has extensive experience with 5150 cases and said in rare occasions a 5150 hold can be extended to 14 days.
"For someone to be admitted, a judicial proceeding takes place and someone has to make a finding that the person is a danger to themself or others ... [with the act of] setting fires in a driveway it is not problem to make that determination," he said. "You have to determine that it's a result of mental illness and there's usually a second order to medicate the person with or without their consent."
Selix said that second order usually involves the injection of fast-acting anti-psychotic medication that can typically stabilize the patient within 24 hours and get them to a level where they are no longer a danger to themselves or others. If the patient reaches that level they can then be discharged.
The same provision was used in 2008 on Britney Spears when the singer's erratic behavior sparked concern from family and officials. Spears was eventually placed under a conservatorship arrangement where her father took control of her multimillion-dollar estate and career as well as her "general well-being," including decisions regarding her food, clothing and medical care.
What happens next with Bynes is anyone's guess, according to Selix. "What should happen next is that she should get into a very structured program with, ideally, 24-hour residential care or a highly structured outpatient program where she's getting care several hours a day, several days a week depending on her level of functioning and the extent to which she has accepted her illness and is willingly taking medication," he said. What does happen, though, is dependent on what, if any, diagnosis Bynes is given.
Every state has a version of the 5150 hold, even if it has a different name, and if you are taken in under that provision in the Golden State it doesn't matter where your primary residence is. Selix said doctors should know pretty quickly if the patient is suffering from a mental health issue or substance abuse issue, or both. "Sometimes there are no symptoms, just substance abuse and in some cases you don't need meds because the substance abuse problems can be treated in a different way," he said. "You can figure out pretty quickly if addiction is the issue by seeing what's in their system and whether that is part or the whole problem."
Officials said it did not appear that the former Nickelodeon star's actions were a deliberate attempt to set the house on fire and that there was no damage to the home, which is why Bynes is not facing arson charges. Since announcing that she was quitting acting in 2010 Bynes has been involved in a series of incidents, including several alleged hit-and-run accidents, a DUI charge, Twitter battles with other stars and an arrest for drug possession in May after allegedly throwing a bong out of her New York apartment window.
As for what might happen after the 72-hour hold, Selix said either the patient comes out and willingly goes into a structured program, or they don't go willingly but face criminal charges and are brought in front of a judge who offers them jail or the option to enroll in a program. The third is that no charges are filed, they don't go into a program and they risk a relapse.
"That happens often," he said. "It is common to be taken in on a 5150 several times before people develop an awareness of the problem."