Q: Can they medicate me against my will on a psychiatric hold?
A: Not simply because you are on a hold. California requires a hearing first, and it is one of the strongest procedural rights in the whole system. Practitioners call it a Riese hearing; the statute calls it a capacity hearing, and the word "Riese" appears nowhere in the code.¹
What triggers it
Antipsychotic medication may be given to a person detained under §5150, §5250, §5260, §5270.15 or §5270.70 if that person does not refuse it, following disclosure of the right to refuse.²
If you "orally refuse or give other indication of refusal," the medication may then be administered "only when treatment staff have considered and determined that treatment alternatives to involuntary medication are unlikely to meet the needs of the patient, and upon a determination of that person's incapacity to refuse the treatment, in a hearing held for that purpose."³
Two prerequisites, joined by and. Not one.
Say the refusal out loud. The statute is triggered by an oral refusal or other indication of refusal. It does not require a form.
What they must tell you first
Before that, you are owed information — "as soon as possible after detention, written and oral information about the probable effects and possible side effects." Orally, at minimum:⁴
- The nature of the mental illness, or behaviour, that is the reason the medication is being given or recommended.
- The likelihood of improving or not improving without the medication.
- Reasonable alternative treatments available.
- The name and type, frequency, amount and method of dispensing the medication, and the probable length of time you will be taking it.
If you have not been told those four things, you have not been given what the statute requires.
The hearing
Timing. "Capacity hearings… shall be heard within 24 hours of the filing of the petition whenever possible." If any party needs more time, the hearing "shall be postponed for 24 hours," and hardship allows a further 24. Then the hard stop: "In no event shall hearings be held beyond 72 hours of the filing of the petition."⁵
Note where the clock starts — at the filing of the petition, not at your refusal. Nothing in the statute sets a deadline for the facility to file.
Who decides. A superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer — appointed from a list of attorneys unanimously approved by a panel of the local mental health director, the county public defender, and county counsel or the district attorney. **No employee of the county mental health program or of a county-designated facility may serve.**⁶
Where. At the facility, in a manner least disruptive of treatment; it may be conducted remotely.⁶
Your representation. You have "a right to representation by an advocate or legal counsel."⁷ And the system must come to you: the facility director or designee personally delivers the notice of filing, must tell you at that moment of your right to a hearing and to assistance, and "as soon after the filing… as is practicable, an attorney or a patients' rights advocate shall meet with the person" to help prepare.⁷
The decision. You get oral notification at the conclusion of the hearing, and written notification that "shall include a statement of the evidence relied upon and the reasons for the determination."⁸
The part we are not going to smooth over
The statute contains no definition of capacity. We read §5332, §5333, §5334 and §5336 in full. There is no test, no list of elements, no burden of proof and no standard of proof. The three-part test practitioners use — whether you are aware of your situation, whether you can understand the benefits, risks and alternatives, and whether you can knowingly and intelligently evaluate that information and participate in the decision — comes from case law, not from the code.⁹
That is worth knowing for two reasons. It means anyone quoting you a "statutory capacity test" is mistaken. And it means the argument at the hearing is about those judicially developed factors, which is exactly the kind of thing an advocate is for.
The emergency exception, quoted rather than summarised
This is the most overstated provision in the area, so here it is in full:
"In the case of an emergency, as defined in subdivision (m) of Section 5008, a person detained… may be treated with antipsychotic medication over the person's objection prior to a capacity hearing, but only with antipsychotic medication that is required to treat the emergency condition, which shall be provided in the manner least restrictive to the personal liberty of the patient."¹⁰
And "emergency" is defined narrowly, with three conjunctive elements: the action must be "immediately necessary," it must be "for the preservation of life or the prevention of serious bodily harm to the patient or others," and "it is impracticable to first gain consent."¹¹
Agitation is not an emergency. Refusal is not an emergency. Staff convenience is not an emergency. The statute also says, fairly, that "it is not necessary for harm to take place or become unavoidable prior to intervention" — the exception is real, it is just not general.
Two limits on the right itself
It covers antipsychotic medication. The right as written attaches to "antipsychotic medication" as defined in §5008(l) — not to benzodiazepines, mood stabilisers or antidepressants as such.²
It does not reach a §5300 commitment. The sections listing which holds this applies to name §5150, §5250, §5260, §5270.15 and §5270.70. **§5300 is not on that list.**²
If you lose
You "may appeal the determination to the superior court or the court of appeal," and appeals to the superior court are de novo.¹² Two honest notes: "nothing shall prohibit treatment from being initiated pending appeal," and your right to bring a habeas corpus petition under §5275 is expressly preserved.¹²
Do this: say clearly that you refuse the medication, and ask for the patients' rights advocate by name — access to one is a right that may never be denied for good cause.¹³ Ask when the petition was filed, because that is when your clock started. Ask for the four disclosures above if you have not had them. And if you have a view about which medication has worked for you before, say it: the facility is required to "acquire the person's medication history, if possible."¹⁴ What happens after the 72 hours → · A psychiatric advance directive says this in advance →
Sources
- Welfare & Institutions Code §§5332–5336. The term "Riese" appears nowhere in the code; the statutory name is "capacity hearing" — leginfo.legislature.ca.gov.
- Welfare & Institutions Code §5332(a), and §5325.2. "Antipsychotic medication" is defined at §5008(l).
- Welfare & Institutions Code §5332(b).
- Welfare & Institutions Code §5152(e)(1)–(4), incorporated by §5332(a); the parallel list is at §5213(b)(1)–(4).
- Welfare & Institutions Code §5334(a)(1) — leginfo.legislature.ca.gov. An expedited track for exigent circumstances is at §5334(a)(2), which by its own terms becomes inoperative on 1 January 2030.
- Welfare & Institutions Code §5334(b)–(c).
- Welfare & Institutions Code §5333(a)–(d) — leginfo.legislature.ca.gov. "Advocate" means a person providing mandated patients' rights advocacy services under Chapter 6.2 (commencing with §5500).
- Welfare & Institutions Code §5334(d).
- Welfare & Institutions Code §§5332, 5333, 5334, 5336, read in full on the operative text. None contains a capacity standard, elements, burden or standard of proof. The three-factor test derives from Riese v. St. Mary's Hospital & Medical Center.
- Welfare & Institutions Code §5332(e).
- Welfare & Institutions Code §5008(m) — leginfo.legislature.ca.gov.
- Welfare & Institutions Code §5334(e)(1), (e)(3), (e)(4), (f).
- Welfare & Institutions Code §5325(h) and §5326.
- Welfare & Institutions Code §5332(c)–(d).
All sections read on the operative text on 18 August 2026. This page describes the statute; it is not legal advice, and the capacity standard itself comes from case law rather than the code — which is a reason to have an advocate rather than a printout.