A prospective client came to me the other day with a case of involuntary commitment. He
had gone to a local hospital for medical treatment, and he ended up being confined for
about three days on a
psychiatric hold. The law permits hospitals to hold patients,
against their will, for a period if the hospital has probable cause to believe they are
mentally ill and may be a danger to themselves or others.
Since deprivation of freedom is an
arrest in the legal sense, these involuntary
commitments raise legal issues. There are several ways to challenge the commitment.
Under state law, it may be medical malpractice or false arrest. Under federal law, it can
be a violation of the patient's fourth amendment constitutional right to be free of an
unreasonable seizure. These cases tend to be factually complicated and legally
complex. They are very difficult, because they lie exactly in the intersection of two
important features of our society: the right to be free and the obligation of the state to
protect its citizens. The facts of these cases rarely present a clear cut choice of one over
The typical fact pattern involves strange or unorthodox behavior, which may or may not
be coupled with statements that could be perceived as threats. What does
never going to take me alive mean? Devoid of context, it doesn't mean much at all.
What if the person who made the statement believes that he has been visited by aliens,
and he is convinced that the aliens are coming back to take him away? There are
thousands of people walking the streets who believe they have been visited by aliens,
and that alone is not sufficient to get one locked up. On the other hand, it is not hard to
envision that a semi coherent person under the delusion that aliens are coming to take
him away could put his own or somebody else's life in danger. What if the person is not
held, and the next day he stabs the mail carrier to death, because he thought the mail
carrier was an alien? These are not easy cases.
People who have been detained on a psychiatric hold feel massively violated. When they
are released, it is because they have been cleared, often with no finding of mental illness
at all. They feel outrage, shame and humiliation. It is not hard to understand the terror
one experiences, having to prove that he or she is not
crazy in order to gain his or her
freedom. How do you prove you're not crazy?
The law allows a margin of error to the medical community. It is not enough that the assessment was wrong. What it takes to win one of these cases is to prove that no competent psychiatrist could reasonably have believed that the individual in question posed a threat to him or herself. If this high standard can be met, then it is a good case.