Cameron v. Tomes, Civ. A. No. 86-3607-K.

• Decision Date: 14 February 1992
• Docket Number: Civ. A. No. 86-3607-K.
• Citation: 783 F. Supp. 1511
• Parties: Robert E. CAMERON, Plaintiff, v. Henry TOMES, in his capacity as Commissioner of the Department of Mental Health, and James P. Sansouchi, in his capacity as Administrator of the Massachusetts Treatment Center, Defendants.
• Court: U.S. District Court — District of Massachusetts

783 F. Supp. 1511

Robert E. CAMERON, Plaintiff, v. Henry TOMES, in his capacity as Commissioner of the Department of Mental Health, and James P. Sansouchi, in his capacity as Administrator of the Massachusetts Treatment Center, Defendants.

Civ. A. No. 86-3607-K.

United States District Court, D. Massachusetts.

February 14, 1992.

COPYRIGHT MATERIAL OMITTED

COPYRIGHT MATERIAL OMITTED

Robert Dennis Keefe, David M. Rocchio, Hale & Dorr, Boston, Mass., for plaintiff.

Michelle A. Kaczynski, Atty. General's Office, Civ. Bureau, Elisabeth J. Medvedow, Atty. General's Office, Crim. Bureau, Boston, Mass., for defendants.

OPINION

KEETON, District Judge.

This action for equitable relief is brought by a patient involuntarily committed to the Massachusetts Treatment Center for the Sexually Dangerous ("Center"). Plaintiff Robert Cameron ("Cameron") alleges that defendants have violated his federal constitutional rights by failing to provide him with minimally adequate treatment. In particular, Cameron contends that defendants persist in rigidly applying the Center's rules and policies to him, despite defendants' actual knowledge that the strict enforcement of those rules and policies interferes with Cameron's ability to respond to treatment. The court conducted a six-day nonjury trial that commenced in November 1991 and ended in January 1992.

I. Background

On December 13, 1978 Cameron pled guilty in Vermont to charges of rape. He was subsequently extradited to Massachusetts in June of 1979 to plead guilty to a similar crime. In 1983 Cameron was paroled from his Vermont sentence and transferred to Massachusetts to begin serving his Massachusetts sentence at MCI Walpole. On June 29, 1984, Cameron was adjudged a sexually dangerous person based on the fact that he had been convicted of two separate violent sexual assaults. Plaintiff's Exhibit 1. He was committed to the Center on November 14, 1985, as a Sexually Dangerous Person for a term of one day to life, pursuant to Mass.Gen.L. ch. 123A, § 6, as the law then existed.

At the time of trial the Center had a patient population of 232 men, all whom have been adjudged sexually dangerous. Most of these men have underlying criminal convictions. As a result, the Center is operated jointly by the Department of Mental Health and the Department of Correction. Cameron's time at the Center is applied to his criminal sentence. See Langton v. Johnston, 928 F.2d 1206, 1210 n. 4 (1st Cir.1991). His criminal sentence expires on February 15, 1992.

II. Constitutional Rights of the Involuntarily Committed

In Youngberg v. Romeo, 457 U.S. 307, 102 S.Ct. 2452, 73 L.Ed.2d 28 (1982), the Supreme Court held that involuntarily committed mentally retarded persons enjoy the right, under the due process clause of the fourteenth amendment, to safe conditions of confinement, id. at 315-16, 102 S.Ct. at 2458, the right to freedom from unnecessary bodily restraint, id. at 316, 102 S.Ct. at 2458, and the right to such minimally adequate treatment and training as is reasonably necessary to protect those interests. Id. at 319, 102 S.Ct. at 2460. A patient does not have a constitutional right to an ideal environment or an ideal treatment plan, or even a guarantee that the patient will be cured. See Doe v. Gaughan, 808 F.2d 871, 886 (1st Cir.1986) (quoting Doe by Roe v. Gaughan, 617 F.Supp. 1477, 1487-88 (D.Mass.1985)); Ohlinger v. Watson, 652 F.2d 775, 779 (9th Cir.1980). Rather, the involuntarily committed have the constitutional right

"to minimally adequate habilitation ... which will tend to render unnecessary the use of chemical restraint, shackles, solitary confinement, locked wards, or prolonged isolation from one's normal community; and conditions of life which are normal enough to promote rather than detract from one's chances of living with fewer restrictions on one's movement."

Mihalcik v. Lensink, 732 F.Supp. 299, 303 (D.Conn.1990) (quoting Thomas S. by Brooks, v. Flaherty, 699 F.Supp. 1178, 1200-01 (W.D.N.C.1988), aff'd, 902 F.2d 250 (4th Cir.1990)) (emphasis in original). The First Circuit has applied the Youngberg test to involuntarily committed persons in general, rather than limiting Youngberg to mentally retarded persons. See Doe, 808 F.2d at 871.

Whether a patient's due process rights have been violated necessarily depends upon a weighing of his liberty interests against relevant state interests. Id. at 321, 102 S.Ct. at 2461. Accordingly, the Youngberg Court established a deferential standard, holding that "the Constitution only requires that the courts make certain that professional judgment in fact was exercised. It is not appropriate for the courts to specify which of several professionally acceptable choices should have been made." Id. Thus the question is "not what treatment was actually provided, but whether the treatment decision was professionally made and falls within the scope of professional acceptability." Woe v. Cuomo, 729 F.2d 96, 105 (2nd Cir.), cert. denied, 469 U.S. 936, 105 S.Ct. 339, 83 L.Ed.2d 274 (1984). However, only decisions that are made by the "appropriate professional" are entitled to a presumption of correctness. Youngberg, 457 U.S. at 324, 102 S.Ct. at 2462.

In addition, under the eighth and fourteenth amendments a state may not show "deliberate indifference" to an inmate's mental health needs. See Cortenes-Quinones v. Jimenz-Nettleship, 842 F.2d 556, 558, 560 (1st Cir.), cert. denied, 488 U.S. 823, 109 S.Ct. 68, 102 L.Ed.2d 45 (1988). "The extension of the eighth amendment's protection from physical health needs ... to mental health needs is appropriate because, as courts have noted, there is `no underlying distinction between the right to medical care for physical ills and its psychological or psychiatric counterpart.'" Torraco v. Maloney, 923 F.2d 231, 234 (1st Cir.1991) (emphasis in original). The deliberate indifference standard has been held to apply to pretrial detainees who have not been convicted and may not be punished. The jail officials "violate the due process rights of their detainees if they exhibit a deliberate indifference to the medical needs of the detainees that is tantamount to an intent to punish." Danese v. Asman, 875 F.2d 1239, 1243 (6th Cir.1989), cert. denied, 494 U.S. 1027, 110 S.Ct. 1473, 108 L.Ed.2d 610 (1990).

If Cameron can show that the Center was deliberately indifferent to his mental health needs while he was involuntarily committed for treatment — not punishment — then a fortiori he has shown that the Center violated the Youngberg standard. This is because persons "who have been involuntarily committed are entitled to more considerate treatment and conditions of confinement than criminals whose conditions of confinement are designed to punish." Youngberg, 457 U.S. at 322, 102 S.Ct. at 2461. A state's decisions about the treatment of an involuntarily committed patient cannot be constitutionally sufficient if in making them the state has shown deliberate indifference to the patient's mental health needs.

Cameron argues that defendants are violating his constitutional rights because he is not receiving minimally adequate treatment at the Center. In particular, he contends that he cannot be treated at the Center because the confrontational and prison-like management of the Center harms his ability to respond to treatment and thus inhibits treatment. For the reasons explained below, I find that in certain instances the Center has failed to provide Cameron with the standard of treatment required by Youngberg. Moreover, I find that in certain areas the Center has even acted with deliberate indifference to Cameron's mental health needs.

III. Defendants' Motion For Directed Verdict

At the close of the evidence defendants moved to dismiss the action pursuant to Fed.R.Civ.P. 52(c) on two grounds. First, defendants contend that this action must be dismissed because there is no constitutional right to psychological or psychiatric treatment under the fourteenth amendment. As support for this contention defendants cite Knight v. Mills, 836 F.2d 659 (1st Cir.1987). Second, defendants claim that Cameron's action is barred by res judicata. In particular, defendants contend that Cameron's claims were adjudicated in Langton v. Johnston, 928 F.2d 1206 (1st Cir.1991), and thus are barred.

A. Constitutional Right to Treatment

Defendants contend that this action must be dismissed because Cameron does not have a constitutional right to treatment. This contention must be rejected. First, as I stated in Part II, supra, the Supreme Court has recognized that involuntarily committed patients do have a constitutional right to minimally adequate treatment based upon the exercise of professional judgment. Youngberg, 457 U.S. at 322, 102 S.Ct. at 2461. Thus, although Cameron may not have a right to any particular treatment — including psychological treatment — he does have a right to treatment that is based, at a minimum, on the exercise of professional judgment.

Second, Knight v. Mills, 836 F.2d 659 (1st Cir.1987), does not support defendants' contention that there is no constitutional right to psychological or psychiatric treatment. In Knight a patient at the Treatment Center who, like Cameron, had been involuntarily committed for a period of one-day-to-life as a sexually dangerous person, sought damages from officials at the Center on the ground that they had violated his right to treatment as established in Jackson v. Indiana, 406 U.S. 715, 92 S.Ct. 1845, 32 L.Ed.2d 435 (1972). The court affirmed the district court's dismissal of the plaintiff's claim on the ground that "the Supreme Court ... had not resolved the issue of a constitutional right to psychological treatment by 1981," and thus defendants were entitled to qualified immunity. Knight, 836 F.2d at 668. Thus, the court did not hold that there is no constitutional right to treatment.

Moreover, to the extent Knight can be read as holding that there is no constitutional right to...