New York Law Review

Tag: mental health law

  • Matter of Torsney, 47 N.Y.2d 667 (1979): Standard for Release of Persons Acquitted by Reason of Insanity

    47 N.Y.2d 667 (1979)

    A person acquitted of a crime by reason of mental disease or defect cannot be held indefinitely without a showing of present mental illness and a need for immediate inpatient treatment; mere dangerousness alone is insufficient for continued involuntary commitment.

    Summary

    Robert Torsney, a police officer, was acquitted of murder by reason of mental disease or defect after shooting a 15-year-old. He was committed to the Department of Mental Hygiene. After psychiatric evaluations recommended his release, the Commissioner petitioned for discharge, which the trial court granted with conditions. The Appellate Division reversed, ordering recommitment. The Court of Appeals reversed, holding that continued confinement requires a showing of present mental illness and a need for immediate inpatient treatment, not just dangerousness. The court emphasized equal protection rights, stating a detainee’s release must be measured by the same substantive standards governing involuntary civil commitment of any other individual.

    Facts

    Torsney, a New York City police officer, shot and killed a 15-year-old. At trial, he claimed lack of criminal responsibility due to psychomotor epilepsy. The jury found him not guilty by reason of mental disease or defect. He was committed to the Commissioner of the Department of Mental Hygiene and initially placed in Mid-Hudson Psychiatric Center, later transferred to Creedmoor Psychiatric Center. Staff at Creedmoor recommended his release, finding him not dangerous or mentally ill.

    Procedural History

    The Commissioner of Mental Hygiene petitioned the committing court for Torsney’s discharge. The trial court ordered Torsney released with conditions. The Appellate Division reversed, ordering Torsney recommitted. Torsney and the Commissioner appealed to the New York Court of Appeals.

    Issue(s)

    1. Whether the Appellate Division properly construed the standard for release of persons held in the custody of the Commissioner of the Department of Mental Hygiene pursuant to CPL 330.20.
    2. Whether, evaluated under the proper standard for release, the weight of the credible evidence presented at the hearing requires the detainee’s continued confinement, discharge, or release on condition.

    Holding

    1. No, because CPL 330.20 requires a detainee’s release unless it is found that he is presently dangerous to himself or others by reason of a mental disease or defect requiring immediate in-patient treatment; dangerousness alone is insufficient.
    2. The weight of the credible evidence mandates reinstatement of the hearing court’s order, because every opinion offered at the hearing substantiated Torsney’s claim that he is neither suffering from a mental illness or defect nor dangerous to himself or others.

    Court’s Reasoning

    The Court of Appeals held that automatic commitment after acquittal by reason of mental disease or defect is permissible only for a reasonable period to determine the person’s mental condition on the date of acquittal. To permit commitment without a hearing to determine present mental condition and dangerousness would violate due process and equal protection. Incorporating a standard of dangerousness without a corresponding finding of mental illness requiring immediate in-patient treatment, as the Appellate Division did, is unconstitutional. The court stated: “Thus, we interpret CPL 330.20 as requiring a detainee’s release unless it is found that he is presently dangerous to himself or others by reason of a mental disease or defect.” The court emphasized that an individual’s liberty cannot be deprived by “warehousing” him in a mental institution when he is not suffering from a mental illness or defect and in no need of in-patient care and treatment on a ground which amounts to a presumption of a dangerous propensity flowing from, as in this case, an isolated, albeit tragic, incident occurring years ago. The court considered all expert opinions elicited during the hearing; the court noted that the experts were in agreement that Torsney did not meet the standard for continued commitment.

  • Tarasoff v. Regents of the University of California, 551 P.2d 334 (Cal. 1976): Duty to Protect Third Parties from Patient Threats

    Tarasoff v. Regents of the University of California, 551 P.2d 334 (Cal. 1976)

    When a therapist determines, or pursuant to the standards of the profession should determine, that a patient presents a serious danger of violence to another, the therapist incurs an obligation to use reasonable care to protect the intended victim.

    Summary

    This landmark case established a therapist’s duty to protect third parties from a patient’s threatened violence. Prosenjit Poddar, a patient, informed his therapist at the University of California that he intended to kill Tatiana Tarasoff. The therapist informed the police, who briefly detained Poddar but released him. No one warned Tarasoff or her family. Poddar later killed Tarasoff. Her parents sued, alleging the therapists and the University had a duty to warn Tatiana. The California Supreme Court held that mental health professionals have a duty to protect individuals from a patient’s credible threats of violence, even if it means breaching patient confidentiality.

    Facts

    Prosenjit Poddar was a patient at the University of California, Berkeley’s counseling center. He told his therapist, Dr. Lawrence Moore, that he intended to kill Tatiana Tarasoff. Dr. Moore, believing Poddar was a danger to Tarasoff, contacted the police. The police interviewed Poddar, who appeared rational, and released him. Dr. Moore’s supervisor directed that no further action be taken to detain Poddar. Neither Dr. Moore nor anyone else warned Tarasoff or her family about Poddar’s threats. Poddar subsequently killed Tarasoff.

    Procedural History

    Tarasoff’s parents sued the Regents of the University of California, the therapists, and the police. The trial court dismissed the suit. The plaintiffs appealed, and the California Supreme Court initially reversed, finding a duty to warn. After a rehearing, the court modified its ruling, establishing a duty to protect. The case was remanded for trial.

    Issue(s)

    Whether a therapist has a duty to protect a third party from a patient’s threats of violence, even when doing so requires breaching patient confidentiality?

    Holding

    Yes, because when a therapist determines, or should determine, that a patient presents a serious danger of violence to another, the therapist incurs an obligation to use reasonable care to protect the intended victim. This duty may be discharged by warning the intended victim, warning others likely to apprise the victim of the danger, notifying the police, or taking other steps reasonably necessary under the circumstances.

    Court’s Reasoning

    The court balanced the importance of patient confidentiality with the public interest in safety from violence. The court acknowledged the therapist’s duty to act with reasonable care to protect the intended victim, reasoning that “the protective privilege ends where the public peril begins.” The court stated, “When a therapist determines, or pursuant to the standards of his profession should determine, that his patient presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. The discharge of this duty may require the therapist to take one or more of various steps, depending upon the nature of the case. Thus, it may call for him to warn the intended victim or others likely to apprise the victim of the danger, to notify the police, or to take whatever other steps are reasonably necessary under the circumstances.” The court emphasized that the therapist’s actions must be reasonable under the circumstances and consistent with the standards of the profession. The court rejected the argument that imposing such a duty would unduly burden therapists or undermine the therapeutic relationship. The dissenting justices argued that the ruling would create an unworkable standard for therapists and would compromise patient confidentiality, thus hindering effective treatment.

  • Lublin v. Central Islip Psychiatric Center, 43 N.Y.2d 336 (1977): Burden of Proof for Release After Acquittal by Reason of Insanity

    Lublin v. Central Islip Psychiatric Center, 43 N.Y.2d 336 (1977)

    An individual, validly committed after being acquitted of a crime by reason of mental disease or defect, bears the burden of proving by a fair preponderance of the evidence that they can be released without posing a danger to themselves or others.

    Summary

    Lublin, acquitted of murdering his wife by reason of insanity and committed to a psychiatric center, petitioned for release, arguing he was no longer a danger. The trial court denied his petition, placing the burden of proof on Lublin. The Appellate Division reversed, asserting the burden should be on the Commissioner of Mental Hygiene. The New York Court of Appeals reversed, holding that the individual seeking release from commitment after an insanity acquittal must prove by a fair preponderance of evidence that they are no longer dangerous. The Court reasoned that the state’s interest in protecting the public and providing for the mentally incompetent outweighs the individual’s liberty interest in this specific context.

    Facts

    Lublin killed his wife by stabbing her multiple times and then attempted suicide. He was found not guilty of murder by reason of mental disease or defect and committed to the custody of the Commissioner of Mental Hygiene. Lublin was institutionalized for almost two years. The Commissioner repeatedly decided not to seek Lublin’s conditional release or discharge. Lublin initiated a proceeding seeking release, claiming he was no longer a danger to himself or others.

    Procedural History

    The Suffolk County Court denied Lublin’s petition for release, finding he failed to prove he could be released without danger. The Appellate Division reversed, holding the burden of proof should have been on the Commissioner and remanded for a new hearing. The New York Court of Appeals granted review.

    Issue(s)

    Whether an individual, validly committed after being acquitted of a crime by reason of mental disease or defect, who subsequently seeks release, must prove by a fair preponderance of the evidence that they can be released without posing a danger to themselves or others?

    Holding

    Yes, because given the clear evidence of a dangerous mental condition, as evidenced by the commission of a violent act, it is appropriate that the condition be presumed to continue until the contrary is proven by the individual seeking release.

    Court’s Reasoning

    The Court of Appeals reasoned that the traditional rule places the burden of proof on the party seeking affirmative relief. The Court emphasized that the question of burden of proof becomes significant when evidence is delicately balanced. Weighing Lublin’s liberty interest against the State’s parens patriae interest in the mentally incompetent and its police power to protect citizens, the Court found the State’s interest outweighs the individual’s. As Justice Titone stated, “where the underlying act was one of extreme violence, reasonable medical doubts and judicial doubts should be resolved in favor of the public * * * and, a fortiori, the burden of proof should devolve upon the detainee to show that he no longer constitutes a danger to himself or others.” The court clarified that the applicable standard of proof is a “fair preponderance of the credible evidence.” The court explicitly limited its holding to situations where the individual is seeking initial release, not revocation of conditional release.

  • Kesselbrenner v. Anonymous, 33 N.Y.2d 161 (1973): Due Process Rights of Civilly Committed Mental Patients

    Kesselbrenner v. Anonymous, 33 N.Y.2d 161 (1973)

    Civilly committed mental patients, not charged with any crime, cannot be confined in a correctional facility primarily for mentally ill convicted criminals because such confinement violates due process if a less restrictive alternative is available.

    Summary

    This case concerns the constitutionality of a New York law that mandated the transfer of dangerously mentally ill patients from civil state hospitals to Matteawan State Hospital, a correctional facility for mentally ill criminals. The New York Court of Appeals held that confining a civilly committed patient in a correctional facility, when less restrictive alternatives exist, violates due process. The court reasoned that the nature of confinement must bear a reasonable relationship to its purpose, and that incarcerating a non-criminal in a prison-like environment is punitive rather than therapeutic.

    Facts

    The appellant, a patient at Manhattan State Hospital, had a history of admissions and unprovoked assaults. Two physicians certified him as “dangerously mentally ill” under Section 85 of the Mental Hygiene Law. The hospital director sought a court order to transfer him to Matteawan State Hospital. The appellant was diagnosed with chronic undifferentiated schizophrenia, exhibiting delusions and hallucinations. Although some doctors believed his condition could improve with treatment, all agreed on his current dangerousness and need for secure confinement.

    Procedural History

    The Supreme Court, Special Term, found the appellant dangerously mentally ill but refused to commit him to Matteawan, deeming the statute unconstitutional. The Appellate Division reversed, ordering commitment to a Department of Correction facility. The New York Court of Appeals then reversed the Appellate Division, reinstating the Supreme Court’s order.

    Issue(s)

    Whether the mandatory transfer of a dangerously mentally ill civil patient to a correctional facility like Matteawan, when less restrictive alternatives exist, violates the Due Process Clause of the Fourteenth Amendment?

    Holding

    Yes, because subjecting a person to a greater deprivation of personal liberty than necessary to achieve the purpose for which they are being confined violates due process. Confinement must be therapeutic, not punitive, and incarceration in a penal facility is incompatible with this purpose when suitable alternatives are available.

    Court’s Reasoning

    The court emphasized that due process requires the nature and duration of commitment to bear a reasonable relationship to its purpose, citing Jackson v. Indiana. It reasoned that confining a non-criminal in Matteawan, a correctional facility, is punitive and not therapeutic. The court highlighted the differences between hospitals under the Department of Mental Hygiene, which prioritize care, treatment, and rehabilitation, and Matteawan, a security-oriented institution primarily for mentally ill criminals. The court noted the greater restrictions on freedom of movement, correspondence, and visitors in Matteawan. The court also noted the existence of less restrictive alternatives, such as closed wards in other state hospitals. The court quoted Matter of Ellery C., noting the hazard of the patient emerging “well tutored in the ways of crime.” It stated that a “continuing failure to provide suitable and adequate treatment cannot be justified by lack of staff or facilities,” citing Rouse v. Cameron. Ultimately, the court found no way to construe Section 85 to preserve its constitutionality given the absence of alternatives to Matteawan. The court acknowledged the petitioner’s concern about funding but asserted that this deficiency does not justify transferring the appellant to Matteawan. The court dismissed the petitioner’s reliance on Baxstrom v. Herold, stating that the propriety of commitment of a dangerously mentally ill patient to a Department of Correction institution was entirely peripheral to either court’s decision. It also dismissed appellant’s equal protection argument.

  • People ex rel. Anonymous v. Waugh, 27 N.Y.2d 751 (1970): Habeas Corpus and Mental Health Commitments

    People ex rel. Anonymous v. Waugh, 27 N.Y.2d 751 (1970)

    A writ of habeas corpus challenging the legality of a mental health commitment requires proof to warrant granting relief; the court may appoint a psychiatrist as a medical witness if the fact of mental illness is contested.

    Summary

    The New York Court of Appeals affirmed the denial of a writ of habeas corpus sought by the petitioner challenging the legality of his mental health commitment. The court held that the petitioner failed to provide sufficient evidence to warrant the relief requested, as the record clearly established the legality of his commitment and his mental illness. The court noted that if the petitioner contested the finding of mental illness in the future, he could request the court to appoint a psychiatrist as a medical witness. Alternatively, if the petitioner conceded his mental illness, he could utilize administrative procedures to investigate the adequacy and justice of his care and treatment under the Mental Hygiene Law.

    Facts

    The petitioner, whose name is not revealed in the record, was involuntarily confined due to mental illness. He sought a writ of habeas corpus, challenging the legality of his commitment. The specific factual details leading to his commitment and the exact nature of his mental illness are not provided in the court’s memorandum.

    Procedural History

    The petitioner sought a writ of habeas corpus. The lower court denied the writ. The Court of Appeals reviewed the denial and affirmed the lower court’s decision.

    Issue(s)

    Whether the petitioner presented sufficient proof to warrant the granting of a writ of habeas corpus challenging the legality of his mental health commitment.

    Holding

    No, because the petitioner failed to adduce any proof which would warrant the granting of the relief sought, and the evidence in the record clearly established the legality of his commitment and the fact of his mental illness.

    Court’s Reasoning

    The Court of Appeals based its decision on the lack of evidence presented by the petitioner to challenge the legality of his commitment. The court stated, “Petitioner-appellant has failed to adduce any proof which would warrant our granting the relief sought. The evidence in the record clearly establishes the legality of his commitment and the fact of his mental illness.”

    The court further outlined options available to the petitioner. If the petitioner were to challenge the finding of mental illness in the future, he could request the court to appoint a psychiatrist as a medical witness on his behalf during a habeas corpus proceeding. The court referenced Opinion of the State Comptroller, Feb. 5, 1965, No. 65-6, regarding this process.

    Alternatively, if the petitioner conceded the fact of mental illness, he could utilize administrative procedures provided by the Legislature under the Mental Hygiene Law, specifically sections 86 and 88, to investigate the care and treatment received and address any inadequacies or injustices.

    Section 86 of the Mental Hygiene Law empowers the Commissioner of Mental Hygiene to conduct investigations, subpoena witnesses, and issue orders, which require court approval to be binding.

    Section 88 established the Mental Health Information Service to supervise and protect the rights of the mentally ill, particularly concerning the retention, care, and treatment of involuntary patients.

    The court emphasized the importance of these statutory mechanisms for ensuring the appropriate care and treatment of individuals involuntarily committed for mental illness.