What Is an M1 Hold in Colorado? Criteria, Rights, and 72 Hours

An M1 hold in Colorado is an emergency psychiatric detention that lets a qualified professional hold a person for up to 72 hours when a mental health disorder makes them an imminent danger to themselves or others, or so disabled they cannot meet their own basic needs. The name comes from the M-1 form (the “Emergency Mental Health Hold Application”) that authorizes it.¹ The procedure lives at C.R.S. § 27-65-106, which replaced the former § 27-65-105 after Colorado reorganized its behavioral health statutes in 2022.²

Who Can Place One

Only specific people can start an M1 hold. A certified peace officer with probable cause to believe someone has a mental health disorder and is an imminent danger or gravely disabled can take that person into protective custody and transport them to a designated facility.² “Intervening professionals” (physicians, licensed clinical psychologists, and certain mental health clinicians) can file the hold directly. A court can order an emergency evaluation under the same statute.

Family members cannot place an M1 hold themselves. If you are worried about a loved one, call local law enforcement or Colorado’s statewide crisis line at 844-493-8255 and describe what you are seeing. If the responding officer or crisis clinician observes behavior that meets the legal criteria, they can invoke the hold. You also have the option of petitioning the court for an evaluation order, though that route moves more slowly than a direct professional response.

The Legal Criteria

An M1 hold is not a tool for family disagreements or unusual lifestyles. The person must meet at least one of three legal standards, and the professional placing the hold has to document the evidence.

Danger to Self

The person shows signs of imminent self-harm: suicidal statements, a recent attempt, active self-injury. The threat must be immediate and tied to a mental health disorder, not a general expression of unhappiness. Clinicians look for a plan, access to means, and recent escalation.²

Danger to Others

The person presents a credible, imminent threat of physical harm to someone else, usually shown through specific threats, recent violence, or conduct a reasonable professional would see as likely to produce harm. Vague statements alone rarely meet this threshold; the danger has to be concrete and tied to a mental health condition.²

Gravely Disabled

The person is so impaired by a mental health disorder that they cannot provide for basic physical needs (food, clothing, shelter, or medical care) to the point that survival is at risk. Poor decisions or an unconventional life do not meet this standard. Someone living roughly by choice does not qualify. Someone who is psychotic and has not eaten in days because they believe their food is poisoned might.²

What Happens in the 72 Hours

Once the M-1 form is filed, the person is transported to a facility designated by the Colorado Behavioral Health Administration, usually a crisis stabilization unit or hospital psychiatric unit. The 72-hour clock starts when the hold is placed or ordered and runs continuously, with no pause for weekends or holidays.² A hold placed at 3:00 p.m. Friday expires at 3:00 p.m. Monday, holiday or not.

The person must receive an evaluation as soon as possible after arrival and must receive treatment appropriate to their condition for the full duration of the hold.² Clinicians use the window to observe behavior, see how the person responds to a structured setting, and adjust medications. If at any point the evaluating clinician decides the person can be cared for without detention, the facility must release them or offer voluntary services.

Medical Screening First

Before a person can be admitted to a psychiatric unit, they typically go through a medical screening (sometimes called “medical clearance”) in an emergency department. The point is to rule out a physical cause such as a drug interaction, head injury, or metabolic problem. The baseline assessment generally includes a detailed history, a physical exam, and a full set of vital signs. Routine labs are not always required; testing should follow what the individual exam reveals. Higher-risk patients, including older adults, people with new or unusual symptoms, and those experiencing homelessness, may need bloodwork or a toxicology screen. This step can add several hours before the person reaches the psychiatric facility, but skipping it risks missing a treatable medical cause.

Your Rights During the Hold

Being held involuntarily does not erase your legal protections. Colorado law states that, unless a court specifically orders otherwise, a person does not forfeit any legal right by reason of the involuntary treatment statutes.³ In practice, the facility must honor several specific rights throughout the hold:

Written notice, shortly after arrival and in a language you understand, explaining why you are being held and what your rights are.
The right to contact an attorney. If the hold escalates to a certification and you cannot afford counsel, the court must appoint one.
The right to make phone calls, local and long-distance. Facilities cannot cut you off from the outside world.
Appropriate care for any physical health conditions that come up during the hold.
The right to refuse psychiatric medication, unless the refusal itself creates an imminent emergency.
The right to request an evaluation by a mental health professional of your choosing.

Staff who violate these procedural protections face potential administrative and legal consequences. If you believe your rights were violated during a hold, the Colorado Behavioral Health Administration accepts complaints about designated facilities.

What Families Can Learn

Families often hit an information wall: they know their loved one was taken somewhere, but the facility will not tell them anything. Federal HIPAA rules generally bar providers from sharing mental health information without the patient’s consent. HHS guidance recognizes exceptions when a patient is in crisis and incapacitated, or when disclosure is needed to prevent serious harm.⁴ A provider may share limited information with family when the patient cannot consent and the provider believes disclosure serves the patient’s interest. It is a permission, not a mandate. If the patient is alert and objects to family involvement, the facility will generally honor that objection.

How the Hold Ends

Most M1 holds end with discharge. If the clinical team decides at any point in the 72 hours that the person no longer meets the criteria, they must release the person.² Before release, the facility must provide written discharge instructions to every person regardless of the circumstances of their discharge. A refusal to accept the instructions gets documented in the medical record. The instructions typically cover follow-up care, medication guidance, and crisis resources.

Some people choose to stay voluntarily after the hold ends. If the clinician thinks continued treatment would help but involuntary detention is no longer needed, the facility can offer services on a voluntary basis.² Agreeing to voluntary treatment gives you more control over your care and lets you leave when you choose.

If the Hold Becomes a Short-Term Certification

If the clinical team concludes the person still meets the criteria at the end of the 72 hours, they can certify the person for up to three months of involuntary short-term treatment under C.R.S. § 27-65-109. The decision shifts from an emergency clinical call to a court-supervised process. The notice of certification must be filed with the court within 48 hours, excluding weekends and court holidays, and once it is filed the court must immediately appoint an attorney for the patient.⁵

The person or their attorney can request a court hearing to challenge the certification at any time, and the court must hear the matter within ten days. At that hearing, the facility bears the burden of presenting clear and convincing evidence that the person still has a mental health disorder and remains a danger or gravely disabled. A judge or jury then confirms the certification, discharges the person, or enters a different order.⁵

If a hold ends in discharge and nothing further happens, there is no limit on how many separate holds a person can experience over time, but each one has to independently meet the statutory criteria. If a loved one is released and you still believe they are in danger, you can call the facility to share your concerns (they can listen even if HIPAA limits what they tell you), contact the local community mental health center, or petition the court for an evaluation.

Firearms and Background Checks

This is the consequence people worry about most, and the answer is narrower than most expect. Federal law prohibits firearm possession by anyone who “has been committed to a mental institution.”⁶ Federal regulations define that phrase as a formal commitment by a court, board, commission, or other lawful authority, and specifically exclude “a person in a mental institution for observation.”⁷ A 72-hour emergency hold for evaluation generally falls into the observation category, so an M1 hold on its own typically does not trigger the federal firearms ban.

The analysis changes if the hold escalates to a court-ordered short-term certification. A judicial commitment likely qualifies as a formal commitment under federal law. Colorado allows but does not require reporting of court-adjudicated involuntary hospitalizations to the federal NICS background check database, and emergency holds are not explicitly covered by the state’s reporting framework. A resolved M1 hold with no further judicial action is unlikely to appear on a federal firearms background check.

Who Pays for It

An involuntary hold does not come with a bill waiver. The person held, or their insurance, is responsible for the cost. Inpatient psychiatric care can run from several hundred to over a thousand dollars per day depending on the facility, and the emergency department screening before admission adds to the total.

Two federal protections limit the damage. Under EMTALA, any hospital with an emergency department must screen and stabilize a psychiatric emergency regardless of the patient’s ability to pay.⁸ The hospital can bill afterward, but it cannot refuse care because you are uninsured. Federal mental health parity rules require insurance plans to cover mental health treatment on terms comparable to physical health care, meaning no higher copays, stricter visit limits, or extra prior authorization just because the care is psychiatric. Updated parity rules took full effect for individual plans in policy years beginning in 2026.⁹ If you are uninsured, Colorado’s community mental health centers and crisis facilities may offer sliding-scale fees or help with Medicaid enrollment. Ask the facility’s billing or social work department before discharge.

1
Colorado Behavioral Health Administration. M-Forms
2
Justia. Colorado Revised Statutes Title 27, Article 65, Section 27-65-106 – Emergency Mental Health Hold
3
Justia. Colorado Revised Statutes Title 27, Article 65, Section 27-65-105 – Rights of Respondents
4
HHS.gov. Information Related to Mental and Behavioral Health, Including Opioid Overdose
5
Justia. Colorado Revised Statutes Title 27, Article 65, Section 27-65-109 – Certification for Short-Term Treatment – Procedure
6
Office of the Law Revision Counsel. 18 USC 922 – Unlawful Acts
7
eCFR. 27 CFR 478.11 – Meaning of Terms
8
Centers for Medicare & Medicaid Services. Frequently Asked Questions on EMTALA and Psychiatric Hospitals
9
U.S. Department of Labor. New Mental Health and Substance Use Disorder Parity Rules – What They Mean for Participants and Beneficiaries