Updated

Colorado theater shooting suspect James Holmes was taken from jail to the psychiatric ward of a hospital in November because he was considered a danger to himself, and he was frequently held in restraints while hospitalized, according to a court document released Friday.

The document said Holmes was taken to Denver Health Medical Center on Nov. 15 because he was "in immediate need of a psychiatric evaluation." It said he was held there for several days.

The document also described an earlier incident in which Holmes was hospitalized for "potential self-inflicted head injuries in his cell." It did not say when that incident occurred.

The revelations heighten expectations that Holmes would plead not guilty by reason of insanity on Tuesday, his next scheduled court appearance.

Holmes' lawyers said on Nov. 14 that he had been taken to a hospital but did not say why. It's not clear if that was the same incident that the new document said occurred on Nov. 15 or the earlier incident.

The hospitalizations were disclosed in a motion by Holmes' lawyers asking the judge to order investigators to preserve hospital surveillance video of the November incident.

Holmes faces multiple counts of murder and attempted murder in the July 20 shootings in the Denver suburb of Aurora. Twelve people were killed and 70 injured.

His mental health has been mentioned with increasing frequency in court documents and hearings, and last week, defense attorneys publicly acknowledged for the first time that they were considering an insanity plea.

That would have both benefits and risks for Holmes. If he were found not guilty by reason of insanity, he would avoid prison or execution. Even though he could be sent to the state mental hospital indefinitely, he might be released someday if doctors find he is no longer insane. But under Colorado law, an insanity plea means prosecutors would have access to potentially incriminating evidence such as mental health records.

If Holmes simply pleads not guilty, prosecutors would not have access to that evidence. But that plea would remove the possibility of being committed to the mental hospital.

Regardless of whether he pleads insanity, Holmes could get the death penalty or life in prison without the possibility of parole if he were convicted.

Prosecutors have not said if they will seek the death penalty. They must declare their intentions within 60 days of the day Holmes enters his plea.

Last week, Holmes' lawyers asked the judge hearing the case, William Sylvester, to declare a state law on the insanity plea unconstitutional, saying it violated his Fifth Amendment protection against self-incrimination. They also said they could not give Holmes effective advice on how to plead because of questions they had about the insanity law.

In a ruling released Friday, Sylvester refused to declare the law unconstitutional, saying appeals courts already have upheld it.

He also said he would not address "hypothetical" questions raised by the defense.

Sylvester granted one defense request, for a written explanation of the consequences of pleading not guilty by reason of insanity.