In Ohio, a pink slip can hold you for up to 24 hours for a required clinical examination, and then for up to three court days after that examination while the hospital decides whether to seek your voluntary admission or file for court-ordered treatment. Because “court days” skip weekends and legal holidays, the real time on the calendar can run close to a week depending on when you arrive.
The Two-Phase Clock
Ohio Revised Code Section 5122.10 breaks the hold into two distinct phases.1Ohio Legislative Service Commission. Ohio Revised Code 5122 – Section 5122.10
Phase one is the examination window. The hospital or community mental health provider has 24 hours from your arrival to examine you. If the place you were first taken isn’t a licensed psychiatric facility, that hospital has the same 24 hours to transfer you to one that is.
Phase two starts after the examination. If the chief clinical officer believes you meet the criteria for court-ordered treatment, the facility can detain you for up to three court days following the day of the examination. During those three court days, the hospital has to do one of two things: obtain your voluntary admission, or file an affidavit in probate court seeking a commitment order. If neither happens by the end of the third court day, the facility must discharge you.
One detail matters if you’re moved between facilities: a transfer doesn’t restart the clock. The timeline runs from your first point of admission, so the second hospital picks up where the first left off.
Why the Calendar Time Runs Longer Than Three Days
“Court days” is the phrase that makes the arithmetic tricky. Saturdays, Sundays, and legal holidays don’t count.
Two examples show the range. Someone examined on a Thursday can be held through the following Tuesday, because the three court days run Friday, Monday, and Tuesday. Someone examined on a Friday might not see the clock start moving until Monday, with the three court days running Monday through Wednesday. Drop a holiday into either scenario and the stay stretches further.
Add in the initial 24 hours for the examination itself, plus a possible transfer from a general hospital to a psychiatric one, and a hold that reads like “three days” on paper can run six or seven days in real life.
When the Hold Must End Sooner
The 24-hour examination is the first real checkpoint, and it can end the hold entirely. If the chief clinical officer concludes after the exam that you are not a person with a mental illness subject to court order, the facility must release you. There is no discretion in the statute on this point.1Ohio Legislative Service Commission. Ohio Revised Code 5122 – Section 5122.10
That checkpoint exists because the person who initiated the pink slip is often a police officer, sheriff, or other official making a field judgment rather than a psychiatrist conducting a full evaluation. The examining clinician is looking for evidence of active psychosis, suicidal thoughts or behavior, danger to others, or an inability to meet basic self-care needs. The clinician is also supposed to consider whether you could be treated safely in a less restrictive setting than an inpatient unit. If yes, the facility should pursue that option instead of continuing the hold.
The same applies at any point during the three court days that follow. Nothing in the statute requires the hospital to run the clock all the way out. If the clinical picture no longer supports continued detention, the facility should release you.
What Happens If the Hospital Wants to Hold You Longer
To keep you beyond the emergency window, the hospital has to move the case into probate court by filing a sworn affidavit under Ohio Revised Code Section 5122.11. The affidavit must identify which statutory category of mental illness applies and lay out specific factual allegations. It may be accompanied by a certificate from a psychiatrist, or from a licensed clinical psychologist and a licensed physician, who has examined you and concluded you meet the commitment criteria. If you refused to submit to that examination, the applicant has to say so under oath.2Ohio Legislative Service Commission. Ohio Revised Code 5122 – Section 5122.11
Once the affidavit is filed, your status shifts from an emergency medical hold to a judicial proceeding. A probate judge or court-appointed referee reviews the affidavit and, if probable cause exists, may issue a temporary detention order or set the matter for a hearing.
You are entitled to a lawyer at this stage. If you can’t afford one, the court must appoint one at no cost. You are also entitled to an independent psychiatric evaluation, paid for by the court if you are indigent.3Ohio Legislative Service Commission. Ohio Revised Code 5122 – Section 5122.15 The facility’s clinicians have already reached their conclusion; having your own expert review the file and potentially testify is one of the most effective ways to contest a commitment.
You or your attorney can waive the initial probable cause hearing, but doing so triggers a firm deadline. A full hearing must be held within 30 days of your original involuntary detention. If the court misses that window, the facility must discharge you.4Ohio Legislative Service Commission. Ohio Revised Code 5122 – Section 5122.141
At the full hearing, the state has to prove its case by clear and convincing evidence. That standard sits between the ordinary civil “preponderance” standard and the criminal “beyond a reasonable doubt” standard. The U.S. Supreme Court required this heightened proof in Addington v. Texas, recognizing that involuntary commitment involves a fundamental liberty interest with lasting consequences. The burden is on the state, not on you.5LII / Legal Information Institute. Protective Commitment and Due Process
Firearm Consequences to Know Before a Hearing
A pink slip and a court commitment are treated very differently under federal firearms law, and the distinction is worth understanding before any hearing.
Federal law prohibits anyone who has been “committed to a mental institution” from possessing firearms or ammunition. A violation carries penalties of up to a $250,000 fine and 10 years in prison. Federal regulations define “committed” as a formal commitment by a court, board, commission, or other lawful authority. The definition specifically excludes someone held only for observation, and someone admitted voluntarily.6U.S. Department of Justice. Federal Firearms Prohibition Under 18 U.S.C. 922(g)(4)
The practical effect: a pink slip by itself, which is an emergency hold for examination rather than a court-ordered commitment, generally does not trigger the federal firearm prohibition. The picture changes if the hold leads to a court order for hospitalization. Ohio requires probate judges to notify the Bureau of Criminal Identification and Investigation when a person is found to be mentally ill and subject to hospitalization by court order, and that information feeds into the background check system used for firearm purchases and concealed carry permits. Anyone facing a commitment hearing should raise the firearm question specifically with their attorney beforehand.