Doe v. Region 13 Mental Health-Mental Retardation Com'n

• Decision Date: 19 May 1983
• Docket Number: No. 82-4189,HEALTH-MENTAL,82-4189
• Citation: 704 F.2d 1402
• Parties: 31 Fair Empl.Prac.Cas. 1332, 32 Empl. Prac. Dec. P 33,624, 1 A.D. Cases 447 Jane DOE, Plaintiff-Appellant, v. The REGION 13 MENTALRETARDATION COMMISSION, d/b/a Gulf Coast Mental Health Center, and G. Kinsey Stewart, Defendants-Appellees.
• Court: U.S. Court of Appeals — Fifth Circuit

Page 1402

704 F.2d 1402

31 Fair Empl.Prac.Cas. 1332,

32 Empl. Prac. Dec. P 33,624, 1 A.D. Cases 447

Jane DOE, Plaintiff-Appellant, v. The REGION 13 MENTAL HEALTH-MENTAL RETARDATION COMMISSION d/b/a Gulf Coast Mental Health Center, and G Kinsey Stewart, Defendants-Appellees.

No. 82-4189.

United States Court of Appeals Fifth Circuit.

May 19, 1983.

James K. Wetzel, Gulfport, Miss., for plaintiff-appellant.

Nick B. Roberts, Jr., Gulfport, Miss., for defendants-appellees.

Appeal from the United States District Court for the Southern District of Mississippi.

Before POLITZ and JOLLY, Circuit Judges, and HUNTER^*, District Judge.

E. GRADY JOLLY, Circuit Judge:

This appeal comes from a grant of judgment notwithstanding the verdict by the court below in favor of the defendants-appellees Region 13 Mental Health-Mental Retardation Commission, d/b/a Gulf Coast Mental Health Center ["GCMHC"] and the Executive Director of GCMHC, Dr. G. Kinsey Stewart, entered against the plaintiff-appellant Jane Doe, a former employee at GCMHC. The case involves an alleged violation of section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Sec. 794.

Because we find that the district court's grant of the J.N.O.V. was proper under the standards set forth in Boeing Co. v. Shipman, 411 F.2d 365, 374-75 (5th Cir.1969) (en banc), we affirm.

I.

Region 13 is one of fifteen regional programs authorized by the Mississippi State Legislature in the early 1970's to comply with the National Community Mental Health Centers Act, 42 U.S.C. Sec. 2681, et seq., begun during the Kennedy administration. The program seeks to provide out-patient, in-patient and emergency treatment for persons suffering mental disorders. Region 13 comprises a cooperative effort among Harrison, Hancock, Pearl River and Stone Counties in south Mississippi and is governed by a voluntary Board of Commissioners.

GCMHC is a mental health center operated by Region 13, with its main offices located in Gulfport, Mississippi. GCMHC operates thirteen programs, including programs specifically designed for children. As executive director, Dr. Stewart has general administrative responsibility over the center and its seventy-odd employees. Dr. Stewart has been director of GCMHC since its inception.

GCMHC is funded through a complex mixture of federal, federal-state, state and local financing. The federal funding has been primarily of a block-grant nature, for specific purposes, including a "Children and Youth Grant" which funds staffing of the program for children.

Ms. Doe was reared outside of Mississippi. She obtained an undergraduate psychology degree in an eastern state and in 1977 obtained a graduate degree in psychology also from a university in that state.

Ms. Doe began suffering spells of anxiety, insomnia and depression in 1977. Over a six-to-eight month period she saw a psychiatrist on a weekly basis. The psychiatrist prescribed sleeping pills to help with her problems. At one point in 1977 Ms. Doe took a potentially lethal overdose of the pills and had to be hospitalized for a brief time. Although at trial Ms. Doe did not characterize this incident as an effort to commit suicide, it is capable of being so interpreted.

In June 1978 Ms. Doe applied with GCMHC to work in the Children and Youth Services program. On her application, she stated that her "general health" was "excellent" and that she had no "physical handicap or defect which would prevent a normal performance of duties." Ms. Doe was hired in August 1978 on a probationary basis as a Mental Health Associate with the Child Youth Service program.

By all accounts, Ms. Doe was a superior employee. She maintained a heavy caseload, working at any one time on a one-to-one basis with some thirty out-patient children and adolescents and with their families. She also worked with a local public school and with the local Head Start agency.

According to her immediate supervisor, Ms. Doe "did an excellent job." She carried one of the heaviest caseloads, saw more patients and did a good job as consultant with the local school. Her paper work was prompt and thorough. She had no problems with absenteeism. In February 1979, after an evaluation of her work which found her to be "outstanding," her probationary status was removed and she was given a raise.

Essentially, Ms. Doe continued to do an outstanding job by all objective standards until her termination in November 1979. She worked hard, was diligent and thorough, her patients liked her, and she had no excessive absences from work. She was reevaluated in October 1979, and again was rated "outstanding." She also received another pay raise.

Unfortunately, during the entire term of her employment at GCMHC, Ms. Doe suffered from essentially the same psychological symptomology as she had in 1977. Finding the Mississippi Gulf Coast something of a "culture shock," Ms. Doe continued to experience anxiety and depression after her move there in August 1978. The heat bothered her, the minor day-to-day problems of life bothered her, and she had great difficulties simply in "coping." She was lonely and missed her family and friends in her home state. She had little money, and her apartment was without telephone or furniture.

Her sole source of pleasure and stability was her work. The depression she suffered usually came on the weekends.

In November 1978, three months after moving to her new home and job, Ms. Doe began psychotherapy with a local clinical psychologist, Dr. Joseph Tramontana. Dr. Tramontana was a part-time staff member at GCMHC who maintained a private practice.

Over the course of these weekly, forty-five to fifty-minute sessions, which continued into the summer of 1980, Dr. Tramontana developed the following diagnosis of Ms. Doe. A "depressive neurosis" was the primary psycho-symptomology. She was alone and had a "great deal of difficulty being alone." She suffered from chronic insomnia and frequently resorted to drug/alcohol ingestion to counter that insomnia. She also suffered serious depression as a result of an unsatisfactory relationship with a man.

In stressful situations Ms. Doe employed a "numbers game" as a blocking technique to avoid dealing with the problem. This numbers game essentially involved adding random numbers in her head. Also, she had experienced a plane crash on her way to interview for the job in Mississippi, and for a time had an irrational phobia about planes. In addition, for a time she "daydreamed" that a monster was chasing her through a cemetery.

Most significantly, Ms. Doe's psychologist was concerned about the possibility of suicide. He considered the incident with the sleeping pills when Ms. Doe was a graduate student to be a serious attempt at suicide. And throughout her sessions with Dr. Tramontana, Ms. Doe made numerous references to the possibility and availability of suicide as an acceptable option. Occasionally Ms. Doe would call Dr. Tramontana and leave messages on his telephone answering machine, hinting at suicide. Over the course of her therapy with Dr. Tramontana, Ms. Doe made repeated references to suicide as a possible solution to her problems. Dr. Tramontana, believing that Ms. Doe had tried to kill herself once, felt that she continued to consider suicide "a viable alternative" and that she "might do it again."

Ms. Doe's condition, although consistently depressive-neurotic, fluctuated in its severity. Those fluctuations, according to her psychologist, were significant in the late-winter, early-spring of 1979.

In early May 1979, shortly after Ms. Doe had experienced problems with her boyfriend, Dr. Tramontana was leaving for the weekend. Thus left without her principal "support systems," Ms. Doe was anxious about facing the weekend. She did not want Dr. Tramontana to leave and asked for a back-up therapist. Dr. Tramontana suggested Dr. Leonard Ball, a psychiatrist who was the Medical Director at GCMHC. Dr. Ball talked with her, and she explained her difficulties, telling him that she wanted "the world to stop." Dr. Ball was concerned about her well-being and asked that she meet him at the emergency room at Gulfport Memorial Hospital. Dr. Ball recommended brief hospitalization to see if medication might alleviate her depression. She voluntarily admitted herself to the hospital and stayed for two or three days. She experienced no apparent problems with her work or her caseload as a result of her hospitalization.

The medication did not have any significant ameliorative effect, however, because at the end of May, Ms. Doe was rehospitalized. Her mother and stepfather were coming to Gulfport to see her because her brother, who lived in Mississippi, had told them about her first hospitalization. Dr. Tramontana was again going to be out of town for the weekend, and Ms. Doe preferred going to the hospital rather than facing her parents. Dr. Tramontana arranged with Dr. Ball to readmit her. Again, she remained in the hospital for two or three days. During this second hospital stay, Dr. Ball suggested to Ms. Doe that she should consider long-term hospitalization.

Over the course of the summer Ms. Doe remained fairly stable and continued to do a good job. Her immediate supervisor, Dr. Calhoun, while feeling that she was doing good work, was concerned about her obvious anxiety and agitation and recommended to her that she should be seeing someone.

Ms. Doe's anxiety worsened in early August, and she experienced great difficulty sleeping. She hadn't been able to sleep for two or three nights and went to Dr. Ball and asked for medication. He prescribed chloral hydrate, a potent sleeping pill, which she took home but did not take for fear that she could not hear the foster child whom she had taken in and with whom she was living at the time. Again, she couldn't sleep, and she called Dr. Tramontana, explained her problem, and he recommended that she call Dr. Ball. When she saw Dr. Ball at work he recommended that she readmit...