R. B., Matter of

• Decision Date: 18 April 1978
• Parties: In the Matter of the Commitment of R. B., Appellant.
• Court: New Jersey Superior Court — Appellate Division

Page 542

158 N.J.Super. 542

386 A.2d 893

In the Matter of the Commitment of R. B., Appellant.

Superior Court of New Jersey,Appellate Division.

Argued March 13, 1978.

Decided April 18, 1978.

Daniel Baer, Trenton, for appellant R. B. (Stanley C. Van Ness, Public Advocate, Michael L. Perlin, Director, Div. of Mental Health Advocacy, Trenton, attorneys; Daniel Baer on the brief).

Peter G. Stewart, Newark, for respondent County of Essex (Neil G. Markowitz, Belleville, on the brief).

Steven Wallach, Deputy Atty. Gen., for respondent State of N.J. (John J. Degnan, Atty. Gen., attorney).

Before Judges MICHELS, PRESSLER and BILDER.

PER CURIAM.

R. B. (patient) appeals from a final order of commitment entered by the Essex County Juvenile and Domestic Relations Court pursuant to R. 4:74-7(f). On the finding that she was dangerous to herself or others as the result of mental illness, the order committed her to Essex County Hospital subject to a review three months thence. The basis of her appeal is that the evidence was insufficient to support an involuntary civil commitment.

Respondent County of Essex argues first that the appeal is moot by reason of the patient's administrative discharge by the hospital some nine weeks after the date of the commitment. Her return, however, to her pre-commitment personal status cannot, however, be regarded as rendering this controversy moot if serious collateral legal consequences nevertheless stem from the commitment order. Cf. In re Geraghty, 68 N.J. 209, 212, 343 A.2d 737 (1975). And see In re Ballay, 157 U.S.App.D.C. 59, 62-64, 482 F.2d 648, 651-653 (D.C. Cir. 1973). And see generally as to the collateral legal consequence doctrine applied in the criminal law context, Sibron v. New York, 392 U.S. 40, 88 S.Ct. 1889, 20 L.Ed.2d 917 (1968); Carafas v. LaVallee, 391 U.S. 234, 88 S.Ct. 1556, 20 L.Ed.2d 554 (1968). We are satisfied that there are such consequences here because of the lien against R. B.'s property filed by the county pursuant to N.J.S.A. 30:4-80.1 et seq., to secure a per diem rate of $66 for her care and maintenance by the hospital during the period of her commitment. Clearly, the patient is entitled to a credit for any sum included in the total lien amount representing a period during which she was improperly involuntarily confined, a sum here approaching $4,000. We need not, therefore, consider the viability or effect of other possible adverse consequences urged by her including social stigma, possible effects on future employability and deprivation of certain civil rights.

With respect to the merits of the appeal, we agree with the patient that the proofs were insufficient to warrant the commitment. The sole witness at the hearing was a psychiatrist who examined her several days before the hearing. His opinion that she was "potentially dangerous to others" was based essentially on this narrative:

Perhaps the most conspicuous feature to me was instant changes of moods where she could go from being quite pleasant and cooperative to being almost in a rage. I think she even had some insight into that, but it was very conspicuous, and to me it was a sign of instability. A sign of a lack of control of these surges of emotion, and to me was very typical of the person who can become explosively combative or some other kind of physical acting out. Almost as if it were a chemical reaction. It happens so quickly.

After showing this kind of reaction in a matter of a second or two she could become very calm and very cooperative. We could talk for a while. Then she would stand up and flush, and the reaction would come again.

I could easily relate what I saw to kinds of things and I saw in the commitment papers themselves.

I got the impression that she was beginning to have some insight into what was going on. She mentioned needing to have her medicine adjusted. She also mentioned having responded better to different medicine at a different time, and we talked about that and she is going to discuss that with her psychiatrist.

I felt that her most serious psychological liability at the time was this instant change of mood, which so seriously compromises her judgment. Because she acts she can act actually without passing judgment. She can act impulsively, and perhaps even be very sorry afterwards.

I was encouraged by the fact that at the end of the interview she was talking in terms of getting her medication adjusted, and going outside.

I would not, myself, at this time, having seen her just that one time recommend that she be made voluntary. But I do see some signs that her condition may be settling down, and that her prognosis for this particular illness is beginning to look pretty good.

We have no doubt that the testimony here could have supported a conclusion that the patient was mentally ill and in need of psychiatric treatment. The patient's mental illness itself, however, is not the test for an involuntary civil commitment. The test is the likelihood that by reason of the patient's mental illness there is a substantial risk that if not confined he will constitute a danger to others or to himself. As made clear by State v. Krol, 68 N.J. 236, 344 A.2d 289 (1975):

Commitment requires that there be a substantial risk of dangerous conduct within the reasonably foreseeable future. Evaluation of the magnitude of the risk...