CACI No. 4002. “Gravely Disabled” Explained
Judicial Council of California Civil Jury Instructions (2025 edition)
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4002.“Gravely Disabled” Explained
The term “gravely disabled” means that a person is presently unable to
provide for the person’s basic needs for food, clothing, shelter, personal
safety, or necessary medical care because of [a mental health disorder/a
severe substance use disorder/a co-occurring mental health disorder and
a severe substance use disorder/impairment by chronic alcoholism]. [The
term “gravely disabled” does not include persons with intellectual
disabilities by reason of the disability alone.]
[[Insert one or more of the following:] [psychosis/bizarre or eccentric
behavior/delusions/hallucinations/[insert other]] [is/are] not enough, by
[itself/themselves], to find that [name of respondent] is gravely disabled.
[He/She/Nonbinary pronoun] must be unable to provide for the basic
needs of food, clothing, shelter, personal safety, or necessary medical care
because of [a mental health disorder/a severe substance use disorder/a
co-occurring mental health disorder and a severe substance use disorder/
impairment by chronic alcoholism].]
[“Personal safety” means the ability of a person to survive safely in the
community without involuntary detention or treatment.]
[“Necessary medical care” means care that a licensed health care
practitioner, while operating within the scope of their practice,
determines to be necessary to prevent serious deterioration of an existing
physical medical condition, which, if left untreated, is likely to result in
serious bodily injury. “Serious bodily injury” means an injury involving
extreme physical pain, substantial risk of death, or protracted loss or
impairment of function of a bodily member, organ, or of mental faculty,
or requiring medical intervention, including but not limited to
hospitalization, surgery, or physical rehabilitation.]
[If you find [name of respondent] will not take [his/her/nonbinary pronoun]
prescribed medication without supervision and that a mental health
disorder makes [him/her/nonbinary pronoun] unable to provide for [his/
her/nonbinary pronoun] basic needs for food, clothing, shelter, personal
safety, or necessary medical care without such medication, then you may
conclude [name of respondent] is gravely disabled.
In determining whether [name of respondent] is gravely disabled, you
may consider evidence that [he/she/nonbinary pronoun] did not take
prescribed medication in the past. You may also consider evidence of
[his/her/nonbinary pronoun] lack of insight into [his/her/nonbinary
pronoun] mental health condition.]
In considering whether [name of respondent] is gravely disabled, you may
not consider the likelihood of future deterioration or relapse of a
condition.
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In determining whether [name of respondent] is gravely disabled, you
may consider whether [he/she/nonbinary pronoun] is unable or unwilling
to voluntarily accept meaningful treatment.
New June 2005; Revised January 2018, May 2019, May 2020, May 2022, May 2024
Directions for Use
This instruction provides the definition of “gravely disabled” from Welfare and
Institutions Code section 5008(h)(1)(A) and (h)(2), which will be the applicable
standard in most cases. The instruction applies to both adults and minors.
(Conservatorship of M.B. (2018) 27 Cal.App.5th 98, 107 [237 Cal.Rptr.3d 775].)
If a county’s relevant governing body has adopted a resolution postponing the
changes made to Welfare and Institutions Code section 5008, omit from the
definition of “gravely disabled” the terms “personal safety” and “necessary medical
care,” as well as “severe substance use disorder” and “a co-occurring mental health
disorder and a severe substance use disorder.” (Welf. & Inst. Code, § 5008(h)(4)
[authorizing a county’s deferral of changes made in Senate Bill 43 (Stats. 2023, ch.
637)].) These four terms should not be given in those counties until January 1,
2026, or an earlier date specified in the county’s resolution.
Read the bracketed sentence at the end of the first paragraph if appropriate to the
facts of the case. There is another standard in Welfare and Institutions Code section
5008(h)(1)(B) involving a finding of mental incompetence under Penal Code section
1370. A different instruction will be required if this standard is alleged.
The Welfare and Institutions Code defines “severe substance use disorder.” (Welf. &
Inst. Code, § 5008(o).) Give additional information about this term if appropriate.
For example, severe substance use disorder requires a diagnosis, so it may be
preferable to identify the individual’s diagnosed severe substance use disorder.
The next to last paragraph regarding the likelihood of future deterioration may not
apply if the respondent has no insight into the respondent’s mental health condition.
(Conservatorship of Walker (1989) 206 Cal.App.3d 1572, 1576-1577 [254 Cal.Rptr.
552].)
If there is evidence concerning the availability of third parties that are willing to
provide assistance to the proposed conservatee, see CACI No. 4007, Third Party
Assistance.
Sources and Authority
• “Gravely Disabled” Defined. Welfare and Institutions Code section 5008(h).
• “Severe Substance Use Disorder” Defined. Welfare and Institutions Code section
5008(o).
• “Personal Safety” Defined. Welfare and Institutions Code section 5008(p).
• “Necessary Medical Care” Defined. Welfare and Institutions Code section
5008(q).
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• “Serious Bodily Injury” Defined. Welfare and Institutions Code section
15610.67.
• “The enactment of the LPS and with it the substitution of ‘gravely disabled’ for
‘in need of treatment’ as the basis for commitment of individuals not dangerous
to themselves or others reflects a legislative determination to meet the
constitutional requirements of precision. The term ‘gravely disabled’ is
sufficiently precise to exclude unusual or nonconformist lifestyles. It connotes an
inability or refusal on the part of the proposed conservatee to care for basic
personal needs of food, clothing and shelter.” (Conservatorship of Chambers
(1977) 71 Cal.App.3d 277, 284 [139 Cal.Rptr. 357], footnotes omitted.)
• “[T]he public guardian must prove beyond a reasonable doubt that the proposed
conservatee is gravely disabled.” (Conservatorship of Jesse G. (2016) 248
Cal.App.4th 453, 461 [203 Cal.Rptr.3d 667].)
• “The stricter criminal standard is used because the threat to the conservatee’s
individual liberty and personal reputation is no different than the burdens
associated with criminal prosecutions.” (Conservatorship of Smith (1986) 187
Cal.App.3d 903, 909 [232 Cal.Rptr. 277] internal citations omitted.)
• “Bizarre or eccentric behavior, even if it interferes with a person’s normal
intercourse with society, does not rise to a level warranting conservatorship
except where such behavior renders the individual helpless to fend for herself or
destroys her ability to meet those basic needs for survival.” (Conservatorship of
Smith, supra, 187 Cal.App.3d at p. 909.)
• “Under [Welfare and Institutions Code] section 5350, subdivision (e)(1), ‘a
person is not “gravely disabled” if that person can survive safely without
involuntary detention with the help of responsible family, friends, or others who
are both willing and able to help provide for the person’s basic personal needs
for food, clothing, or shelter.’ ” (Conservatorship of Jesse G., supra, 248
Cal.App.4th at p. 460.)
• “While [third person] may not have shown that he could manage appellant’s
mental health symptoms as adeptly as would a person professionally trained to
care for someone with a mental disorder, that is not the standard. As appellant
states, ‘[t]he question in a LPS conservatorship case where the proposed
conservatee asserts a third party assistance claim is not whether the third party
will be able to manage the person’s mental health symptoms completely. Rather,
the dispositive question is whether the person is able to provide the proposed
conservatee with food, clothing, and shelter on a regular basis.”
(Conservatorship of Jesse G., supra, 248 Cal.App.4th at p. 463, fn. 4.)
• “We . . . hold that a person sought to be made an LPS conservatee subject to
involuntary confinement in a mental institution, is entitled to have a unanimous
jury determination of all of the questions involved in the imposition of such a
conservatorship, and not just on the issue of grave disability in the narrow sense
of whether he or she can safely survive in freedom and provide food, clothing or
shelter unaided by willing, responsible relatives, friends or appropriate third
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persons.” (Conservatorship of Davis (1981) 124 Cal.App.3d 313, 328 [177
Cal.Rptr. 369].)
• “[A]n individual who will not voluntarily accept mental health treatment is not
for that reason alone gravely disabled.” (Conservatorship of Symington (1989)
209 Cal.App.3d 1464, 1468 [257 Cal.Rptr. 860].)
• “[T]he pivotal issue is whether [respondent] was ‘presently’ gravely disabled and
the evidence demonstrates that he was not. Accordingly, the order granting the
petition must be overturned.” (Conservatorship of Benvenuto (1986) 180
Cal.App.3d. 1030, 1034 [226 Cal.Rptr. 33], fn. omitted, citing to
Conservatorship of Murphy (1982) 134 Cal.App.3d 15, 18 [184 Cal.Rptr. 363].)
• “[A] conservatorship cannot be established because of a perceived likelihood of
future relapse. To do so could deprive the liberty of persons who will not suffer
such a relapse solely because of the pessimistic statistical odds. Because of the
promptness with which a conservatorship proceeding can be invoked the cost in
economic and liberty terms is unwarranted.” (Conservatorship of Neal (1987)
190 Cal.App.3d 685, 689 [235 Cal.Rptr. 577].)
• “A perceived likelihood of future relapse, without more, is not enough to justify
establishing a conservatorship. Neither can such a likelihood justify keeping a
conservatorship in place if its subject is not presently gravely disabled, in light
of the statutory provisions allowing rehearings to evaluate a conservatee’s
current status.” (Conservatorship of Jones (1989) 208 Cal.App.3d 292, 302 [256
Cal.Rptr. 415], internal citation omitted.)
• “[T]he definition of ‘ “[g]ravely disabled minor” ’ from section 5585.25 is not
part of the LPS Act, but is found in the Children’s Civil Commitment and
Mental Health Treatment Act of 1988. (§ 5585.) This definition applies ‘only to
the initial 72 hours of mental health evaluation and treatment provided to a
minor. . . . Evaluation and treatment of a minor beyond the initial 72 hours shall
be pursuant to the . . . [LPS Act].’ (§ 5585.20.) Accordingly, we must apply the
definition found in the LPS Act, and determine whether there was substantial
evidence Minor suffered from a mental disorder as a result of which she ‘would
be unable to provide for [her] basic personal needs’ if she had to so provide.”
(Conservatorship of M.B., supra, 27 Cal.App.5th at p. 107.)
• “Theoretically, someone who is willing and able to accept voluntary treatment
may not be gravely disabled if that treatment will allow the person to meet the
needs for food, clothing, and shelter. Under the statutory scheme, however, this
is an evidentiary conclusion to be drawn by the trier of fact. If credible evidence
shows that a proposed conservatee is willing and able to accept treatment that
would allow them to meet basic survival needs, the fact finder may conclude a
reasonable doubt has been raised on the issue of grave disability, and the effort
to impose a conservatorship may fail. It may be necessary in some cases for the
fact finder to determine whether the treatment a proposed conservatee is
prepared to accept will sufficiently empower them to meet basic survival needs.
In some cases of severe dementia or mental illness, there may simply be no
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treatment that would enable the person to ‘survive safely in freedom.’ ”
(Conservatorship of K.P. (2021) 11 Cal.5th 695, 711 [280 Cal.Rptr.3d 298, 489
P.3d 296].)
Secondary Sources
3 Witkin, California Procedure (6th ed. 2021) Actions, § 103 et seq.
2 California Conservatorship Practice (Cont.Ed.Bar) §§ 23.3, 23.5
32 California Forms of Pleading and Practice, Ch. 361A, Mental Health and Mental
Disabilities: Judicial Commitment, Health Services, and Civil Rights, §§ 361A.33,
361A.42 (Matthew Bender)
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