By Catherine Wiersch
We all have tough days when stress builds up and someone suggests a walk, a nap, or vacation. But when faced with a true mental health crisis—where someone may be a danger to themselves or others—self-care isn’t enough. That’s where mental health crisis holds and civil commitments come into play.
Though intimidating, these civil processes are designed to protect individuals in crisis and, if necessary, connect them with treatment. Understanding how the law works helps reduce fear, fight stigma, and promote compassionate responses.
In Nevada, NRS 433A outlines legal holds and civil commitments based on mental illness only. Nearly 300 petitions for civil commitment are filed a month.
The process starts with a mental health crisis hold. This is a short-term hospitalization, not to exceed 72 hours, and used when someone poses an immediate risk to themselves or others, or cannot care for themselves, due to mental illness.
After 72 hours, a civil commitment petition may be filed with the court to request ongoing treatment—up to six months—if the legal criteria are met.
The legal criteria requires a person be a danger to themselves (e.g., suicidal behavior), threatens harm to others (e.g., homicidal behavior), or is severely impaired and unable to meet basic needs. All due to a mental illness. The conduct and the mental illness must connect.
While a family member or stranger can initiate a 911 call for help, it is the mental health professionals, physicians, or law enforcement that can initiate a legal hold after personal observations of concerning conditions/behaviors.
The goal is safety, stabilization, and assessment—not punishment. Once on a crisis hold, the individual is taken to a hospital or psychiatric facility for evaluations. Clinicians assess their mental and medical conditions.
If the behavior isn’t linked to mental illness or if the person stabilizes, they may be released. If 72 hours passes, and the person is still meeting criteria for a legal hold, a petition for civil commitment may be filed.
The filing triggers a court hearing where a judge reviews evidence to decide if continued treatment is necessary. This filing also infringes on a person’s liberty interest.
This infringement kicks into gear a series of other rights: the right to be informed of the reasons for the hold, to access legal counsel, to an adversarial hearing, and to refuse certain treatments (unless it’s an emergency). A commitment cannot exceed six months but can be extended if the criteria persist.
This process is important because we are not only restricting a person’s movement, some may lose autonomy of the body through forced medications.
This process is more than just “making people better.” While the legal process is complex and overwhelming, it is ultimately about interceding on behalf of someone who may have an altered state of reality. Being informed of the process allows patients, families, and communities to respond with greater knowledge, compassion, and confidence.
About the author
Catherine Wiersch is a Chief Deputy at the Clark County Public Defender’s Office. Her current assignment is in specialty courts, serving as the lead attorney for Civil Commitments and the Assisted Outpatient Treatment Program.
About the article
This article was originally published in the Communiqué (Nov. 2025), the official publication of the Clark County Bar Association. See https://clarkcountybar.org/about/member-benefits/communique-2025/communique-nov-2025/. The printed magazine will be mailed out to CCBA members on October 30, 2025.
The articles and advertisements appearing in Communiqué magazine do not necessarily reflect the opinion of the CCBA, the CCBA Publications Committee, the editorial board, or the other authors. All legal and other issues discussed are not for the purpose of answering specific legal questions. Attorneys and others are strongly advised to independently research all issues.
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