Fasulo v. Arafeh

• Decision Date: 20 September 1977
• Citation: 378 A.2d 553,173 Conn. 473
• Parties: Ann FASULO v. Mehadin K. ARAFEH, Superintendent, Connecticut Valley Hospital. Marie BARBIERI v. Mehadin K. ARAFEH, Superintendent, Connecticut Valley Hospital.
• Court: Connecticut Supreme Court

Page 553

378 A.2d 553

173 Conn. 473

Ann FASULO v. Mehadin K. ARAFEH, Superintendent, Connecticut Valley Hospital.

Marie BARBIERI v. Mehadin K. ARAFEH, Superintendent, Connecticut Valley Hospital.

Supreme Court of Connecticut.

Argued March 2, 1977.

Decided Sept. 20, 1977.

Terence Thatcher, student intern, supervised by Mary F. Keller, New Haven, with whom, on the brief, were Stephen Wizner, Dennis E. Curtis, and Judith M. Mears, New Haven, for appellants (plaintiff in each case).

Carol A. Feinstein, Asst. Atty. Gen., with whom were Maurice Myrun, Asst. Atty. Gen., and, on the brief, Carl R. Ajello, Atty. Gen., for appellee (defendant in each case).

Before HOUSE, C. J., and LOISELLE, BOGDANSKI, LONGO and SPEZIALE, JJ.

LONGO, Associate Justice.

The plaintiffs, Ann Fasulo and Marie Barbieri, alleging that they were illegally confined in the Connecticut Valley Hospital by the defendant superintendent, petitioned the Superior Court for writs of habeas corpus. The court denied the writs and the plaintiffs appealed.

Ann Fasulo was civilly committed to Connecticut Valley Hospital in 1951, as was Marie Barbieri in 1964. Both plaintiffs press two major claims in this appeal. First, they argue that since there is a requirement of periodic court review of the necessity for confinement of those individuals who have been acquitted of an offense on the grounds of mental disease or defect, but not for persons like themselves who are civilly committed, their continued confinement violates the equal protection guarantee of article first, § 20, of the Connecticut constitution. They also claim that because their commitments are of indefinite duration and there is no procedure for periodic court review of the necessity for their confinement, their confinement is in violation of the due process guarantee of article first, § 8, of the Connecticut constitution.

We consider the plaintiffs' due process claim. Though the plaintiffs do not challenge their initial involuntary commitments, the due process safeguards incorporated into that procedure help to illuminate the plaintiffs' grievances. Among the important requirements of General Statutes § 17-178 are a judicial hearing initiated by the state at which the state bears the burden of proving that involuntary commitment is necessary, testimony by independent physicians who have recently examined the subject, and the rights to be represented by counsel, to present a defense and to cross-examine witnesses. Under General Statutes § 17-178 the necessity for confinement is to be determined according to a legal standard as a conclusion of law. The due process clause of the Connecticut constitution shares but is not limited by the content of its federal counterpart. Roundhouse Construction Corporation v. Telesco Masons Supplies Co., 168 Conn. 371, 374, 362 A.2d 778. In O'Connor v. Donaldson, 422 U.S. 563, 580, 95 S.Ct. 2486, 2496, 45 L.Ed.2d 396, Mr. Chief Justice Burger in a concurring opinion spoke of the process due a person civilly committed to a mental institution: "There can be no doubt that involuntary commitment to a mental hospital, like involuntary confinement of an individual for any reason, is a deprivation of liberty which the State cannot accomplish without due process of law. Specht v. Patterson, 386 U.S. 605, 608, 87 S.Ct. 1209, 18 L.Ed.2d 326 (1967). Cf. In re Gault, 387 U.S. 1, 12-13, 87 S.Ct. 1428, 18 L.Ed.2d 527 (1967). Commitment must be justified on the basis of a legitimate state interest, and the reasons for committing a particular individual must be established in an appropriate proceeding. Equally important, confinement must cease when those reasons no longer exist. See McNeil v. Director, Patuxent Institution, 407 U.S. 245, 249-250, 92 S.Ct. 2083, 32 L.Ed.2d 719 (1972); Jackson v. Indiana, 406 U.S. 715, 738, 92 S.Ct. 1845, 32 L.Ed.2d 435 (1972)."

As recognized by General Statutes § 17-178, the authority of the state to confine an individual is contingent upon the individual's present mental status, which must be one of mental illness amounting to a need for confinement for the individual's own welfare or the welfare of others or the community. See General Statutes § 17-176. The original involuntary commitment proceeding can only establish that the state may confine the individual at the time of the hearing and for the period during which the individual is subject to the requisite mental illness. As the United States Supreme Court has recognized, "At the least, due process requires that the nature and duration of commitment bear some reasonable relation to the purpose for which an individual is committed." Jackson v. Indiana, 406 U.S. 715, 738, 92 S.Ct. 1845, 1858, 32 L.Ed.2d 435. Once the purpose of the commitment no longer exists, there is no constitutional basis for the state to continue to deprive the individual of his liberty. See O'Connor v. Donaldson, supra, 422 U.S. 575, 95 S.Ct. 2486. To satisfy due process, the procedure for releasing a civilly committed patient must be adequate to assure release of those who may no longer constitutionally be confined. Due process is a flexible concept, the content of which must be renewed each time it is used to measure the adequacy of challenged procedures. In general, "the thoroughness of the procedure by which (a) deprivation is effected must be balanced against the gravity of the potential loss and the interests at stake." Hart Twin Volvo Corporation v. Commissioner of Motor Vehicles, 165 Conn. 42, 45, 327 A.2d 588, 590. It is significant to this case that the process afforded an individual must be "tailored to the capacities and circumstances of those who are to be heard." Goldberg v. Kelly, 397 U.S. 254, 268-69, 90 S.Ct. 1011, 1021, 25 L.Ed.2d 287.

These plaintiffs have been deprived of their liberty. Their loss is already great, but can be initially justified as a result of the legitimate exercise of the parens patriae power of the state. The plaintiffs, however, have been committed indefinitely and confined for periods of twenty-six and thirteen years respectively, thus requiring us to heed the warning of the United States Supreme Court that the longer the commitment, the greater the safeguards which are required to ensure that no one is deprived of liberty without due process. See McNeil v. Director, Patuxent Institution, 407 U.S. 245, 249-50, 92 S.Ct. 2083, 32 L.Ed.2d 719. We must, therefore, review the plaintiffs' claims in light of the important interest at stake liberty and the great loss which its extended deprivation constitutes.

Any procedure to allow the release of involuntarily confined civilly committed individuals must take account of the controlled and often isolated environment of the mental hospital from which the confined individuals will seek release. It must calculate the possible incompetence of those confined, their limited knowledge of release procedures, the cost of pursuing review and the amount of effort necessary to pursue review. Further, the procedure must be adapted to the possible effect of drugs or other treatment on the patient's capacity and must be formulated with consideration of institutional pressures to rely on the medical judgments of the hospital staff rather than to pursue extrainstitutional legal remedies. See note, "Civil Commitment of the Mentally Ill," 87 Harv.L.Rev. 1190, 1398.

At present, Connecticut provides several routes by which a mental patient can challenge his confinement. General Statutes § 17-192 allows for release (1) by order of the Probate Court "upon application and satisfactory proof that such person has been restored to reason," or (2) "(i)f the officers, directors or trustees of a state hospital for mental illness are notified by the superintendent or other person in a managerial capacity of such institution that he has reason to believe that any person committed thereto by order of a probate court is not mentally ill or a suitable subject to be confined in such institution, such officers, directors or trustees may discharge such person." Under the second method the patient runs the risk of having his release prevented by a superintendent whose determination may later be found by a court to have been erroneous. See O'Connor v. Donaldson, supra; McNeil v. Director, Patuxent Institution, supra. Furthermore, the second procedure disregards the fundamental fact that the state's power legitimately to confine an individual is based on a legal determination under General Statutes § 17-178 "that the person complained of is mentally ill and dangerous to himself or herself or others or gravely disabled" and that the commitment shall only continue "for the period of the duration of such mental illness or until he or she is discharged in due course of law." The state's power to confine terminates when the patient's condition no longer meets the legal standard for commitment. Since the state's power to confine is measured by a legal standard, the expiration of the state's power can only be determined in a judicial proceeding which tests the patient's present mental status against the legal standard for confinement. That adjudication cannot be made by medical personnel unguided by the procedural safeguards which cushion the individual from an overzealous exercise of state power when the individual is first threatened with the deprivation of his liberty. See General Statutes § 17-178. In order to hold that judicial review of involuntary confinement is unnecessary, we would have to conclude either (1) that the procedural safeguards provided at the initial confinement hearing are not mandated by due process or (2) that subsequent deprivations of liberty are somehow constitutionally less serious and that the individual, therefore, can be confined with less process due. We reject both of these conclusions and hold that the due process clause of the Connecticut constitution mandates that involuntarily confined civilly committed individuals be...