Aww dude , the chorus is fucking ridiculous D <| sep |> Ultimately there ' s a social worker or physician who authorizes and signs the paperwork . But beyond 72 hours , I believe , always requires some sort of court involvement , at which point I have no idea how things get decided . Last time I instituted such an involuntary hold , I had a clinic patient telling me that he was planning suicide all day every day , that he would suicide by car crash , that he had driven his car to my office that day , and he was unable to make any sort of verbal agreement to not harm himself for any duration of time . These cases are not generally subtle . Even then , in completing the involuntary hold paperwork , I was extremely aware of the potential for liability and completed the paperwork nervously and carefully .