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Involuntary Mental Commitment addressed in recent Massachusetts SJC decision

Massachusetts statute allows for a person to be involuntarily hospitalized for an extended period of time if a physician or police officer believes that the person is a danger to themselves or others as a result of their mental illness.  In the Matter of J.P., J.P. a mentally ill man appealed his involuntary commitment to a mental hospital, arguing that the lower court impermissibly relied on hearsay evidence in making the order.

What happened in the J.P. case?

J.P. was at the emergency room in a hospital when he was presenting signs of serious mental illness.  He was brought to the hospital after threatening his mother and exhibiting paranoid behavior.  He was then involuntarily committed to Suncoast Behavioral Health.  The attending physician, Dr. Lee said that J.P. was a harm to himself and others as a result of his illness.  Dr. Lee diagnosed J.P. with schizoaffective disorder, bipolar type.

Dr. Lee testified about J.P.’s condition and as a result, J.P. was committed to the hospital for up to six months.  The long term involuntary commitment of persons with mental illness is permissible if the judge finds proof beyond a reasonable doubt that discharge would create a likelihood of serious harm. There are three elements that must be proved to show “likelihood of serious harm”

(1) a substantial risk of physical harm to the person himself as manifested by evidence of, threats/attempts at suicide or serious bodily harm;

(2) a substantial risk of physical harm to other persons as manifested by evidence of homicidal or other violent behavior or evidence that others are placed in reasonable fear of violent behavior and serious physical harm to them; or

(3) a very substantial risk of physical impairment or injury to the person himself as manifested by evidence that such person’s judgment is so affected that he is unable to protect himself in the community and that reasonable provision for his protection is not available in the community

These are all attributes that are likely to be proven by medical records or a doctor’s statements, but other people’s statements could also attest to these factors.  But, there could be a hearsay problem when it comes to statements made by people who are not medical professionals.

Dr. Lee’s testimony was a huge reason why the judge found that J.P.’s condition met all of these factors, and thus why J.P. was committed to the hospital against his will.  Dr. Lee testified that J.P. was being offensive towards him because of his Asian ethnicity, that J.P. was threatening the nurses, threatened to kill other patients, and was overall  hostile, aggressive, and uncooperative to the doctors.  All of these things made Dr. Lee feel scared and uncomfortable.  At trial, both Dr. Lee’s statements and J.P.’s mother’s statements were admitted, and J.P. appealed and argues that the statements are inadmissible hearsay.

What is hearsay? 

Hearsay is an out court court statement used to assert the truth of something, and is usually inadmissible in court.  However, sometimes hearsay is very valuable and there are many exceptions to the hearsay rule.

How did the SJC rule?

The SJC held that the J.P.’s mother’s statements were hearsay.  J.P.’s mother told a social worker about J.P.’s condition.  These were out of court statements that were offered for their truth and is the textbook definition of inadmissible hearsay.

On the other hand, Dr. Lee’s statements, a nurse’s statements, and J.P.’s medical records are exceptions to the hearsay rule.  A doctor or nurse’s statement made during medical treatment are usually admissible if sufficiently related to the treatment.  Here, J.P.’s behavior was central to the treatment of his mental illness, so the doctor’s and nurse’s statements were admissible, as well as the medical record.

Despite the doctor’s testimony and the judge’s findings “beyond a reasonable doubt” that  J.P. was a danger to himself and others, J.P. was discharged from Suncoast Behavioral Health around three weeks after first committed.  This is an immense difference from the six months that the judge recommended.

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