When a family calls me in a crisis, one of the first questions is: “Can we make them go?” The answer depends on where you live, and most families learn their state’s rules for the first time in an emergency room.
No state has a hold law written specifically for eating disorders. Every state allows a short-term involuntary psychiatric evaluation when mental illness creates serious risk. The question is whether malnutrition and refusal of medical care count as danger to self. In all five states below, the law now points in that direction.
If you’re in recovery and reading this, this email is not about you being forced into anything. It’s about your family having a plan, the same way you’d want them to know where the fire extinguisher is.
New York
Emergency admission (MHL 9.39): up to 15 days.
Two-physician admission (MHL 9.27): up to 60 days. A relative can apply.
Who starts it: physicians. Police or mobile crisis can bring a person in for evaluation.
What changed: since 2025, serious harm includes being unable or unwilling to meet essential needs such as food or necessary medical care.
New Jersey
The process: screening, then a temporary court order, with a court hearing within 20 days.
Who starts it: the county designated screening center, often reached through an ER or crisis line.
The standard: “dangerous to self” names nourishment and essential medical care.
The catch: the standard isn’t met if willing family can meet the need with supervision. A family holding everything together at home can make a crisis look less urgent on paper.
Connecticut
Physician emergency certificate: up to 15 days. An APRN or licensed clinician can hold up to 72 hours.
Longer commitment: any person can apply to probate court.
The standard: dangerous to self, or “gravely disabled,” meaning unable to provide for basic needs such as food or medical care.
Florida
Baker Act: involuntary examination up to 72 hours. Police, certain professionals, or a family member by court petition can start it. It applies when self-neglect or refusal of care poses a real and present threat of substantial harm.
Marchman Act: for substance use only. A relative can petition, and a court may order services up to 90 days. It applies to eating disorders only when substance use co-occurs. There is no eating disorder equivalent.
California
5150 hold: up to 72 hours, which may extend to 14 days (5250).
Who starts it: police and county-designated professionals, usually through mobile crisis or an ER.
What changed: under SB 43, statewide as of January 2026, “gravely disabled” now includes inability to obtain necessary medical care.
When a hold may be necessary
Fainting, chest pain, a racing or very slow heart rate, or confusion
Critically abnormal labs or EKG, or a physician saying it’s unsafe to stay home
Unable to keep food or fluids down, or frequent purging
Rapid weight loss while refusing every level of voluntary care
Thoughts of suicide or self-harm
Your loved one understands their medical information but can’t apply it to their own body
If there is immediate danger, call 911. For a suicidal crisis, call or text 988.
A hold is a pause, not a treatment plan. Most last days, and a general psychiatric unit may not be equipped for refeeding. The families who get the best outcomes walk in with medical records, documentation, and an eating disorder capable next step already lined up.
Download: Emergency Holds Family Guide and Readiness Checklist
I made a two-page guide for you. Page one is the state chart. Page two is a checklist to fill out now, before anything happens: key contacts, medications, past hospitalizations, labs, and what has helped before. Keep a copy on your phone, give one to your emergency contact, and bring it to the ER.
Most families never need a hold. If you’re not sure where your family stands, a family consultation can help you set boundaries, get a medical baseline, and move your loved one toward care before it becomes an emergency. Call 845-362-1300 or email Iris@nicrd.com.
This is educational information, not legal advice. Laws and county practice change, so confirm with a local attorney and the treating team.
Taking care of you, Iris
Iris Epstein, RDN, CEDS, CAI Founder, Nutrition Improvement Center for Restrictive Disorders nicrd.com | Iris@nicrd.com | 845-362-1300
P.S. Do you live in a state I didn’t cover? Hit reply and tell me which one. If enough of you ask, I’ll add it to the guide.
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