What’s Wrong with Britney?

What's wrong with Britney Spears? The troubled pop singer was hospitalized Thursday night in Los Angeles after she reportedly refused to hand over one of her kids during a child-custody exchange with ex-husband Kevin Federline. People magazine, among other media outlets, reported that Spears, 26, had been taken to Cedars-Sinai Hospital and placed on an involuntary 72-hour hold for medical evaluation. Los Angeles Police Department spokeswoman April Harding would not comment on whether Spears had been sent to the hospital against her will, saying only that the officers sent the star to the hospital in an ambulance "for her own welfare."  "The officer determined she needed medical treatment and called an ambulance," Harding told NEWSWEEK. "She has been taken to the hospital." At a hearing Friday afternoon, a court granted Federline sole custody of the children until another hearing, scheduled for Jan. 14. (On Saturday, several celebrity Web sites reported that Spears had left the hospital.)

Bruce Spring, M.D., an assistant professor of clinical psychiatry at the University of Southern California's Keck School of Medicine, has participated in hundreds of examinations of patients brought to his hospital under similar circumstances. In an interview with Jenny Hontz, Spring explained how patients are brought in, the variety of tests and evaluations they undergo and the possible outcomes. Excerpts:

NEWSWEEK: When police are called, what can they do if they believe a person needs to be sent to the hospital?
Bruce Spring: There are certain legal powers they can use. When police are concerned about someone's health and well-being, they can sometimes convince them to seek help voluntarily. If they believe the person needs help, and they will not go willingly--let's say someone has a medical condition, and police are concerned about that--there are ways people can get involuntarily treated, with respect to medical, not psychiatric conditions. If it's for psychiatric reasons, they have to meet certain criteria to put them on an involuntary hold. Unless the criteria apply, police are not legally able to take them involuntarily for observation and possible treatment.

Can you explain what a 72-hour involuntary detention in California is?
There is a section of the California code, section 5150, which allows a person to be held in a psychiatric facility against their will, involuntarily, if there is reason to believe they are a danger to themselves, a danger to others or unable to care for themselves on the basis of a mental disorder.

Who is authorized by the court to make that determination?
It could be the cop. It could be there are psychiatric mobile teams. Many hospitals have facilities or a person authorized by law to write a 5150.

We hear in this instance the police sent Britney to Cedars-Sinai Medical Center. Would they have a psychiatrist on staff that could evaluate her?
The police, actually, are authorized to write 5150s themselves, and they then bring the person on the 5150 hold to an authorized facility. And they present the patient and the hold. Then, it's the responsibility of the hospital or the admitting physician to determine that the hold is valid. I don't know anything about Britney Spears, so I can't tell you anything about her. But most likely the police put her on 5150 hold, or a psychiatric mobile-emergency team put her on 5150 hold and brought her to the hospital and said, "Here's a patent we think is a danger to herself, a danger to others or gravely disabled, and please take care of her."