Ralph M., Matter of

• Decision Date: 21 May 1979
• Parties: In the Matter of RALPH M. 1 A Person Alleged to be a Juvenile Delinquent, Respondent. Family Court, New York County
• Court: New York Family Court

Page 608

417 N.Y.S.2d 608

99 Misc.2d 828

In the Matter of RALPH M. ¹ A Person Alleged to be a Juvenile Delinquent, Respondent Family Court, New York County.

May 21, 1979.

Judith S. Levy, Asst. Corp. Counsel, New York City, for petitioner.

Steven Hiltz, Legal Aid Society, New York City, Law Guardian.

Susan Barnett, Senior Atty., N.Y.S. Division for Youth, New York City, Gloria Zeche, Mental Health Information Service, New York City, Nancy Roth, Albany, Robert Abrams, Atty. Gen. of the State of New York by Thomas P. Dorsey, Anne Marsha Tannenbaum, Asst. Attys. Gen., New York City, for State of N.Y.

AILEEN HAAS SCHWARTZ, Judge:

The issue of mental illness in a criminal or juvenile delinquency proceeding tests our society's dedication to the principle of fundamental fairness. ² Two questions are raised in this case: 1. Does the preponderance standard of proof prescribed by Family Court Act § 760(4) comply with procedural due process requirements in the wake of Addington v. Texas, --- U.S. ----, 99 S.Ct. 1804, 60 L.Ed.2d 323 (1979)? 2. Is respondent entitled to the procedural safeguards of Mental Hygiene Law, Article 9, including the right to jury trial review, as an equal protection right pursuant to Baxstrom v.

Herold, 383 U.S. 107, 86 S.Ct. 760, 15 L.Ed.2d 620 (1966)? ³

On September 25, 1978, respondent was found to have committed acts that would constitute the crime of Unauthorized use of a vehicle, P.L. 165.05, upon admission (Schwartz, J.). Prior thereto, on June 20, 1978, respondent had been found to have committed acts that would constitute the crime of Criminal possession of a weapon in the fourth degree, P.L. 265.01, upon admission (Miller, J.). Shortly after institution of the proceeding before Miller, J., respondent began to manifest severe emotional behavior on several occasions resulting in emergency temporary psychiatric hospitalization upon the orders of several judges.

A dispositional hearing pursuant to Family Court Act § 743, § 745 and § 760 was scheduled. That the respondent required "supervision", "treatment" and "confinement" was virtually uncontested. Family Court Act § 743. Rather was the hearing devoted in major portion to the issue of "mental illness . . . as defined in section 1.03 of the mental hygiene law, which is likely to result in serious harm to himself or others." Family Court Act § 760.

Three psychiatrists testified: Dr. Peter Guggenheim, Medical Director of Mental Health Services (Family Court), Dr. Paul Perry, Attending Psychiatrist at Bellevue Hospital, and Dr. Victor D'Arc, Chief Psychiatrist, Manhattan Children's Psychiatric Center. Each psychiatrist diagnosed respondent as suffering from schizophrenia, paranoid type. Each testified to respondent's state of acute psychosis, suicidal and aggressive. Dr. Guggenheim traced respondent's development during the past year and recounted some twelve interviews. Respondent had been diagnosed as acutely psychotic on several occasions and repeatedly hospitalized on an emergency basis. The recommended treatment plan, confirmed by the attending doctors at Bellevue Hospital, included placement at a residential treatment center that could provide psychotherapy and psychotropic medication. "Only with medication," the plan emphasized, "can this youngster's psychiatric status be controlled." Thorazine in varying dosages was prescribed. Respondent's pattern of conduct was marked by frequent "escapes" and protracted absences from hospitals and other facilities. On December 5, 1978, respondent was apprehended after one such "escape". Testimony by Dr. Guggenheim that respondent was acutely psychotic, that respondent had a "neck abrasion from hanging attempt", that respondent had spoken of a "suicide attempt" earlier in the day, and that respondent threatened suicide resulted in emergency psychiatric hospitalization upon order of this Court without opposition by the law guardian, counsel for respondent. Respondent absconded. Respondent was apprehended and returned to custody on January 31, 1979. Dr. Guggenheim last saw the respondent on that occasion. According to the doctor, who examined respondent on a top priority emergency basis, respondent had "deteriorated greatly." Respondent was "grossly and markedly suicidal, threatening and aggressive"; respondent was "suffering auditory, hallucinatory experiences." Respondent was remanded for emergency psychiatric hospitalization with the consent of the law guardian. Remand was extended with the law guardian's consent.

At the dispositional hearing, the doctor rejected the earlier treatment plan and unqualifiedly recommended psychiatric hospitalization to protect respondent from his suicidal intentions. Dr. Guggenheim spoke of the "great danger of harming himself."

Dr. Paul Perry who first met respondent at Bellevue Hospital during the last emergency remand, concurred in the diagnosis of Dr. Guggenheim and described respondent as depressed, suicidal, angry and threatening. Dr. Perry and Dr. Geller, who had attended respondent on earlier emergency hospitalizations, decided that respondent now required long-term psychiatric hospitalization, and the two psychiatrists so certified for initiation of involuntary commitment proceedings.

Dr. Victor D'Arc examined respondent on March 8, 1979, after respondent's admission to Manhattan Children's Psychiatric Center, pursuant to Mental Hygiene Law § 9.27, and continued the psychiatrist-patient relationship through the hearing which was commenced on March 14, 1979 and completed on March 19, 1979. The doctor concurred in the diagnosis of Dr. Guggenheim. Dr. D'Arc had first examined respondent in October-November 1978, and was then convinced that respondent required long-term psychiatric hospitalization. He testified that respondent remained in an acute state and was presently suicidal and "possibly homicidal."

The entire probation record was admitted into evidence with the recommendation by the probation department that respondent be placed with Division for Youth, Title 3.

For purposes of this opinion, suffice it to say that as indicated above the evidence established beyond a reasonable doubt (without real opposition) that respondent requires "supervision, treatment and confinement" within the context of Family Court Act § 743 and is adjudicated a juvenile delinquent.

Legal issues regarding involuntary commitment for psychiatric hospitalization dominated the dispositional proceeding. At the very inception of the hearing, the Court Sua sponte advised of its concern regarding the procedural due process sufficiency of the section 760 preponderance standard of proof and the respondent's "equal protection" rights pursuant to Baxstrom v. Herold, supra. Indeed, the issue of the constitutional sufficiency of the preponderance standard was raised during the hearing by respondent's application to the Court to dispense with the testimony of Dr. D'Arc as the doctor was and would continue in a psychiatrist-patient relationship in the event of a commitment. Although the doctor's testimony was limited to some extent upon consent, the Court denied the application upon the ruling that the preponderance standard was constitutionally infirm. The ruling was made at that stage because only Dr. D'Arc had personal knowledge of respondent's present condition and that factor was critical to a state of certitude greater than the preponderance standard. Parenthetically, it is noted that no decision was reached as to the exact standard required by due process. The case Sub judice and other like matters, however, proved vexing on that very issue.

The Attorney General supported the constitutionality of the preponderance standard and continues to support that standard notwithstanding Addington v. Texas, --- U.S. ----, 99 S.Ct. 1804, 60 L.Ed.2d 323 (1979), decided subsequent to this Court's ruling, Supra, that the preponderance standard is violative of procedural due process.

Addington v. Texas, --- U.S. ----, 99 S.Ct. 1804, 60 L.Ed.2d 323 (1979), answered a question that had long troubled the judiciary and the legal commentators: "(W)hat standard of proof is required by the Fourteenth Amendment to the Constitution in a civil proceeding brought under state law to commit an individual involuntarily for an indefinite period to a state mental hospital"? The Supreme Court "conclude(d) that the individual's interest in the outcome of a civil commitment proceeding is of such weight and gravity that due process requires the state to justify confinement by proof more substantial than a mere preponderance of the evidence." Id., at ----, 99 S.Ct. at 1810. The Court also "concluded that the reasonable doubt standard is inappropriate in civil commitment proceedings because, given the uncertainties of psychiatric diagnosis, it may impose a burden the state cannot meet and thereby erect an unreasonable barrier to needed medical treatment." Id., at ----, 99 S.Ct., at 1812-1813. ". . . (W)e turn," the Court stated, "to a middle level of burden of proof that strikes a fair balance between the rights of the individual and the legitimate concerns of the state." Id., at ----, 99 S.Ct., at 1812. The Court held that the "clear and convincing" standard is required to meet due process guarantees. Ibid.

The opinion of the Court was delivered by The Chief Justice and was one in which all other Members of the Court joined, except Mr. Justice Powell who took no part in the consideration or decision of the case. Notwithstanding the seeming "animal, vegetable or mineral" format, the opinion reveals the processes of the judicial mind grappling with an issue of profound importance in an area of tangled complexity. Concepts not words signify the import of Addington v. Texas, supra, for In re Gault, 387 U.S. 1, 87 S.Ct. 1428, 18 L.Ed.2d 527 (1967), and In re Winship, 397 U.S. 358, 90 S.Ct. 1068, 25 L.Ed.2d 368 (1970), serve as its jurisprudential underpinnings.

"The function of a standard of proof, as...