Moore, Kaufman and Feinberg, Circuit Judges. Moore, Circuit Judge (dissenting).
IRVING R. KAUFMAN, Circuit Judge:
We have, thankfully, come a long way from the days when ignorance induced fear of the mentally ill. As great strides in psychiatric knowledge have been paralleled by evolving concepts of due process, humane procedures for the commitment and treatment of the mentally ill have replaced snake pits and witch hunts. The time has long since passed when a mere charge that one was "possessed by demons" would automatically result in banishment for insanity.
Petitioner's allegations in this proceeding must be weighed against this background of gradual development. These allegations, which are in the main uncontested, may be briefly summarized: In 1941, while incarcerated in Clinton State Prison, Roy Schuster expressed his belief in the existence of "corruption" in the prison administration. Shortly thereafter, solely on the strength of a prison doctor's finding the Schuster's charges evidenced "the paranoid idea that members of the [prison] personnel are against him," Schuster was transferred from Clinton to Dannemora State Hospital for the Criminally Insane. In accordance with New York law as it then stood, Schuster was afforded no meaningful hearing on the issue of his sanity, was not permitted the assistance of counsel, was given no opportunity to call his own witnesses, was given no advance notice of the nature of the transfer proceedings, and was transferred to Dannemora within twenty-four hours after he was first seen by the prison doctor.
Despite repeated attempts to void the transfer in both state and federal courts, Schuster remains in Dannemora, more than twenty years after he would have been eligible for parole had he not been transferred from Clinton. His petition was dismissed on December 8, 1967 by Judge Port below, after a hearing primarily devoted to the validity of Schuster's charges of prison corruption. At no time during the course of his several state and federal actions has the question of Schuster's sanity adequately been determined.
For the reasons we shall set forth, we believe that before a prisoner may be transferred to a state institution for insane criminals, he must be afforded substantially the same procedural safeguards as are provided in civil commitment proceedings, including proper examination, a hearing upon notice, period-review of the need for commitment, and trial by jury. If these procedures result in a determination that Roy Schuster is sane, he should be returned to Clinton Prison, where he will be eligible for parole. As an observer has recently noted, those "twice cursed" -- as criminal and as mentally ill -- should not be "punished" for the "crime" of becoming mentally sick while serving a prison sentence. Morris, The Confusion of Confinement Syndrome: An Analysis of the Confinement of Mentally Ill Criminals and Ex-Criminals by the Department of Correction of the State of New York, 17 Buff.L.Rev. 651 (1968) [herein-after cited as Morris].
Schuster's Crime and Trial
During the 1920's, Roy Schuster was a successful tap-dancer, performing in theaters across the nation. His earnings were considerable by the standards of the day, reaching over $200 a week. On one tour through Milwaukee, Schuster, then 22, met a girl, fell in love, and after a brief courtship agreed to marry her, although he later insisted that she was pregnant by another man at the time. At his wife's inducement, he abandoned the stage and settled down to raise a family. Accordingly, Schuster became a dance instructor at Ned Wayburn's dancing school at a substantially diminished salary. Being industrious, however, he was able to increase his weekly income to approximately $150.
Then came the Depression. Schuster's income was cut to $75 and then cut again and again to as little at $11 a week. As the creditors closed in, the romance evaporated. Schuster and his wife quarreled frequently and he even accused her of adultery and neglect of their daughter Coleen, then three years of age. The two separated, reconciled, and separated again. Schuster became so upset when the formal separation action was commenced that he attempted suicide. Mrs. Schuster responded to his distress by securing a court order directing Schuster to pay a fixed sum for the support of his family. Soon he found the payments burdensome and difficult to meet in those lean days. But Amy Schuster pressed for her payments. In settlement discussions she insisted that she would take no less than $40 a week, no matter how little Schuster was earning.
Finally, Mrs. Schuster threatened to have her husband jailed for contempt of court if he did not pay. Faced with this equivalent of the debtor's prison, Schuster became more distraught. He pleaded with his wife that if she went ahead with her plan, he would lose the small dance studio he had just opened and be irrevocably ruined with no benefit to anyone. During the course of settlement discussions the acrimony mounted and Schuster threatened suicide on several occasions. Finally, Amy agreed to meet him one morning to discuss the securing of the contempt order in front of 51 Chambers Street, New York where both Amy's and Roy's lawyers maintained offices.
Schuster and his wife met as planned. They went first to his lawyer's office but he was not in. They then proceeded to her lawyer's office. Schuster allegedly pleaded with Amy's lawyer, "Will you please give me a chance, let me explain the situation? Let me prove to you I have no money. If you put me in jail Monday, you will put me out of business. You will destroy my future, you will make me commit suicide." With that tragic peroration he drew a.32 caliber revolver from his pocket. Bedlam ensued and in the chaos Schuster fired several shots wounding her lawyer and killing his wife.
Subsequently, Schuster was indicted for murder in the first degree. His defense was that he had carried the revolver with the intention of committing suicide. He insisted that his wife's lawyer lunged for the gun when Schuster drew it from his pocket and that at the moment Schuster was in a state of "panic" and was not aware of what was happening. The gun, according to his testimony at the trial, somehow was discharged in all the excitement.
To rebut the claim of "panic" the state introduced expert evidence that Schuster was not suffering from any mental disease. The state's psychiatric expert, Dr. Perry M. Lichtenstein, then Resident Physician at the City Prison, denied repeatedly that Schuster was suffering from any form of delusion or mental disease. After a trial lasting one week, a jury found Schuster guilty of murder in the second degree. On November 2, 1931, Schuster, then 27 years old, was sentenced to a term of from twenty-five years to life.
A. Schuster's Imprisonment
Schuster was sent first to Sing Sing and then transferred in 1935 to Clinton State Prison. There he made a good adjustment. He taught a "cell-study" course leading to a high school equivalency degree, and even received a letter from the New York State Board of Education commending him for his work. In the normal course of events, Schuster might have expected to serve his time and to be eligible for parole in 1948, when he was still not too old to build a new life. But, in 1941, life took another wrong turn for him. Schuster became convinced of corruption in the prison, particularly on the part of the official in charge of the prison education program. His expression of this belief led to his transfer to Dannemora State Hospital for the Criminally Insane. Although Schuster charges that the state "buried him alive" in Dannemora to prevent him from bringing the corruption to light, the district court was unconvinced the transfer was corruptly motivated. The state contends that there was no corruption, that Schuster was and is a "paranoid" and that his insistence upon the existence of a scandal is prime evidence of his delusion.
Schuster entered Dannemora on September 9, 1941, at the age of 37. Now 64 years old, he still languishes there.
Schuster's transfer to Dannemora accorded with the provisions of § 383 of the New York Correction Law, McKinney's Consol.Laws, c. 43, as it then read.*fn1 That section provided for automatic transfer upon the certification of a single prison doctor that the prisoner was "in his opinion insane." Schuster's commitment certificate, signed by Leaman H. Caswell, M.D., the physician at Clinton Prison, whose qualifications in psychiatry we are unable to determine from the record before us, sketchily summarized his single conversation with the prisoner, and went on to remark with breathtaking simplicity: "He was circumstantial in his conversation, very talkative, complained bitterly. He was paranoid and suspicious. * * * This man was reported for writing letters regarding cowardly attacks made against him by the personnel and requested that something be done about it. In his letters he has shown the paranoid idea that members of the personnel are against him." Dr. Caswell attempted no further diagnosis of Schuster's condition except for the understandable observation that the prisoner was "depressed." Although the certificate explicitly requested information as to whether the patient was "violent, dangerous, destructive, excited, * * * homicidal or suicidal," Dr. Caswell did not indicate Schuster exhibited any of these symptoms.
B. Hearing in the District Court
At the hearing before Judge Port, Schuster testified that in 1941 he met with two doctors, Dr. Caswell and a physician from Dannemora State Hospital for what appears to be a very brief period. Schuster had no warning that the interview was to determine his sanity. He testified that the two doctors devoted most of their "diagnostic" efforts to persuading him to recant his charges. This conversation was the only "hearing" Schuster received. At no time was he afforded an opportunity to cross-examine the doctors or to present evidence of any kind to contradict the "diagnosis" of these two prison doctors, neither of whom so far as we know, had any expertise in psychiatry. And at its conclusion, he testified, he was told to sign a twelve page transcript of the proceeding without being permitted to read its contents.*fn2 Schuster was not represented by counsel during the proceedings, although he requested an adjournment to secure legal assistance. There is nothing in the record before us which indicates the doctor from Dannemora ever expressed any opinion on Schuster's commitment.
As indicated, Schuster would have become eligible for parole in 1948, had he remained in Clinton. His present situation is far different; the district court judge observed that the present policy of the Parole Board appears to preclude the possibility of parole for any prisoner as long as he is in Dannemora Hospital. Schuster had a perfunctory hearing on the question of parole in 1948, but apparently no further action has been taken since that date.*fn3
It is of some interest that Judge Port expressly noted that at Dannemora Schuster had received no medication or treatment other than infrequent interviews with a staff doctor. The reason for this apparent neglect according to Dr. Izaak Gorlicki, assistant director of Dannemora, is that Schuster's paranoia is so "deeply rooted" that it would not respond to therapy. Moreover, Schuster has not been assigned to any work duty. When Schuster was asked by Judge Port if he did any work "up there," he explained, "Not now. I did for a while. I was librarian, but other than that, I study in my spare time and things like that to try and prepare for an honorable rehabilitation so that when I was released I wouldn't step out cold, I would be able to step into an honorable job * * *"
It is to be noted that there is general agreement that Schuster is not in need of custodial detention. At the hearing below, Dr. Gorlicki characterized his behavior at the hospital as "Very quiet. Cooperative. Has never been any problem in management. He has never been insulting to anyone." Asked on cross-examination if Schuster was being confined as criminally insane because of misbehavior, the Doctor replied "No, he behaves good [ sic ]. As a matter of fact he is a very useful person. He is isolated from the hospital and he keeps to himself, and seldom converses with the officers. He never makes any request unless he needs something."
From this testimony we are forced to the unhappy conclusion that Schuster is simply a forgotten man in a mental institution which has nothing to offer him. He receives no treatment, is not occupied in therapy of any kind, he appears not to be in need of the Dannemora type of confinement and is able to keep his equilibrium only through his own efforts and his hope that he is preparing himself for the day when he will be released.
C. Petitions for Habeas Corpus
Since 1948, Schuster has repeatedly challenged his commitment to Dannemora in the New York State courts but in each instance to no avail. His petitions in the state courts for habeas corpus asserting his sanity were dismissed in 1950, 1960 [before the New York courts permitted such a challenge in People ex rel. Brown v. Johnston, 9 N.Y.2d 482, 215 N.Y.S.2d 44, 174 N.E.2d 725, (1961)] and on October 2, 1962. Another petition, dated December 27, 1962 led to a hearing in a state court in March 1963 at which Schuster was represented by assigned counsel.
At the 1963 state hearing, only one psychiatrist, a Dr. Carson, testified. He admitted that Schuster was "an individual whose conduct in general is correct, who uses impeccable logic" and that "he shows no obvious signs of mental illness such as deterioration, untidiness, hallucinatory experiences, bizarre ideas or bizarre behavior." Nonetheless, Dr. Carson concluded that Schuster was mentally ill since he had a paranoid condition. "This is the type of illness," Carson explained, "in which an entire delusional but logical belief is based on a single false premise, and if one allows the truth of the false premise the patient's behavior no longer appears abnormal * * *" Dr. Carson conceded that while he could believe cheating took place in the Regents' examinations in the prison, and that prison officials would be reluctant to have depositions submitted to that effect, he could not believe that anyone would commit a man to a hospital for the criminally insane because of it. Accordingly, he concluded that Schuster must be insane. He was unmoved by Schuster's claim, which the state did not deny, that the prison warden, chief clerk and controller had been dismissed shortly after Schuster made his charges of corruption. We note, further, that the court in the 1963 hearing, refused to consider the legality of Schuster's transfer to Dannemora and concentrated only upon his then sanity. The court thus dismissed the writ, a decision affirmed by the Appellate Division, 3 Dept., 22 App.Div.2d 762, 253 N.Y.S.2d 534 (1964) and, without opinion by the New York Court of Appeals, 15 N.Y.2d 968, 259 N.Y.S.2d 856, 207 N.E.2d 527 (1965).
Undaunted, Schuster initiated a petition for habeas corpus on July 13, 1965, in the United States District Court for the Northern District of New York, alleging that he was sane and that the state procedure by which he was adjudged insane and transferred to Dannemora was unconstitutional. In considering Schuster's request for assignment of counsel after the district court's dismissal of that writ, this court after reviewing the transcript of the 1963 hearing remanded the proceeding to the district court by an order dated February 28, 1967 for an evidentiary hearing on the issue whether the initial transfer to Dannemora was corruptly motivated and directed that counsel be assigned. A hearing on this remand was held on July 12, 1967, during which the court examined not only the issue of corrupt transfer but also such questions as whether petitioner was mentally ill in 1941, and is now, and whether the procedures which had been accorded petitioner were proper. Judge Port again dismissed the writ on December 8, 1967, and this appeal followed.*fn4
The Right to a Full Hearing
Schuster has maintained that his transfer to Dannemora in 1941 was effected in violation of his right to equal protection of the law under the 14th Amendment. His claim is grounded on the contention that he was not given the same procedural rights in contesting the transfer which are afforded civilians similarly facing involuntary commitment to a mental institution. It is urged on his behalf, therefore, that he be returned to Clinton Prison where he will be eligible for parole and at least be removed from the grievously distressing atmosphere of an institution like Dannemora which houses the insane.
A. The Effect of the Transfer from Clinton Prison to Dannemora
The state characterizes Schuster's transfer from Clinton to Dannemora as no more than a mere administrative matter, claiming that it represented a simple change in the place of detention and that this action was beyond the purview of judicial review. See People ex rel. Sacconanno v. Shaw, 4 App.Div.2d 817, 164 N.Y.S.2d 750 (3d Dept.1957); Urban v. Settle, 298 F.2d 592 (8th Cir. 1962); 18 U.S.C. § 4241.*fn5 "There is no doubt," as the Supreme Court has recently remarked, "that discipline and administration of state detention facilities are state functions. They are subject to federal authority only where paramount federal constitutional or statutory rights supervene. It is clear, however, that in instances where state regulations applicable to inmates of prison facilities conflict with such rights, the regulations may be invalidated." Johnson v. Avery, 393 U.S. 483, 89 S. Ct. 747, 21 L. Ed. 2d 718 (1969). It is not to difficult, in this regard, to discern that a transfer of the character confronting us involves rights of the nature described by the Supreme Court. Not only did the transfer effectively eliminate the possibility of Schuster's parole, but it significantly increased the restraints upon him, exposed him to extraordinary hardships, and caused him to suffer indignities, frustrations and dangers, both physical and psychological, he would not be required to endure in a typical prison setting.
The adversities and rigors of an institution such as Dannemora have been catalogued in a scholarly and persuasive study of the problem by a distinguished committee of the Association of the Bar of the City of New York. Special Committee on the Study of Commitment Procedures and the Law Relating to Incompetents of the Ass'n of the Bar of the City of New York, Mental Illness, Due Process, and the Criminal Defendant 23-26 (1968) [hereinafter cited as N.Y. Bar Report]. The members of this eminent body included New York State's Commissioner of Correction, a deputy commissioner of the Department of Mental Hygiene, four state Supreme Court Justices, the Director of Matteawan State Hospital, the Director of Central Islip State Hospital, the Director of Psychiatry at Bellevue Hospital, New York, two assistant district attorneys, the Director of the Mental Health Information Service for the First Judicial Department, a professor of law, and other distinguished practicing attorneys and physicians. It spent two years exhaustively studying the problem, aided by an able staff under the direction of Malachy T. Mahon, now Dean of the Law School of Hofstra University. As a measure of its position as a respected initiator of needed reforms, we notice that the Committee's prior report, made in 1962, led to substantial changes in the Mental Hygiene Law, McKinney's Consol.Laws, c. 27, particularly in what is now §§ 72-74, the procedures for involuntary civil commitment.
In considering the problem posed we are faced with the obvious but terrifying possibility that the transferred prisoner may not be mentally ill at all. Yet he will be confined with men who are not only mad but dangerously so. As the New York Courts have themselves indicated, he will be exposed to physical, emotional and general mental agony. Confined with those who are insane, told repeatedly that he too is insane and indeed treated as insane, it does not take much for a man to question his own sanity and in the end to succumb to some mental aberration. Cf. Dennison v. New York, 49 Misc.2d 533, 267 N.Y.S.2d 920 (Ct.Cl.1960), rev'd on other grounds 28 A.D.2d 608, 280 N.Y.S.2d 31 (3d Dept.1967); People ex rel. Cirrone v. Hoffmann, 255 App.Div. 404, 407, 8 N.Y.S.2d 83, 86 (3d Dept.); People ex rel. Brown v. Johnston, supra.
Moreover, the facts reveal that there always lurks the grisly possibility that a prisoner placed in Dannemora will be marooned and forsaken. For example, Matteawan State Hospital is the functional equivalent of Dannemora for those convicted of misdemeanors, for female prisoners and for those civilly committed who are found to be dangerous under Mental Hygiene Law § 85. See Correction Law § 400. The commitment procedures for prisoners to either hospital are identical. See Correction Law § 408. Matteawan has 119 inmates who have been confined there since 1935, 29 since 1925, and 4 patients who have been there since at least 1915 -- over half a century. Morris, supra, at 656. The New York Bar Association study discloses the startling information that as of November 1, 1965, one inmate, then 83 years old, had been at Matteawan since 1901, when as an uneducated boy of 19 years he was imprisoned in this maximum-security institution for the insane. N.Y. Bar Report at 72. The study also reveals another individual who was accused of stealing a horse and buggy in 1905, committed to Matteawan after pleading not guilty and found to suffer "acute delusional insanity." This inmate was more fortunate than the former; he was released 59 years later at the age of 89 because he was no longer "a menace to society or other patients." N.Y. Bar n. 1 at 72. See also Dennison v. State, supra, in which the plaintiff was initially awarded $115,000 in damages after wrongly spending 24 years in Dannemora because he had stolen candy valued at $5.00 at the age of 16.*fn6
Moreover, there is considerable evidence that a prolonged commitment in an institution providing only custodial confinement for the "mentally sick" and nothing more may itself cause serious psychological harm or exacerbate any pre-existing condition. As one psychiatrist has explained: "Under prevailing conditions, we super-impose new disabilities on existing disabilities -- at least in many cases -- when we forcibly commit sick people to places called mental hospitals which in reality remain custodial asylums." Hearings on Constitutional Rights of the Mentally Ill before the Subcomm. on Constitutional Rights of the Senate Comm. on the Judiciary, 87th Cong., 1st Sess. pt. 1 at 44. And, as another has warned: "There is repetitive evidence that once a patient has remained in a large mental hospital for two years or more, he is quite unlikely to leave except by death. He becomes one of the large mass of so-caller 'chronic' patients." Bloomberg, A Proposal for a Communitybased Hospital as a Branch of a State Hospital, cited in Katz, Goldstein & Dershowitz, Psycho-Analysis, Psychiatry & the Law, at 664 (1967).*fn7
In addition, by its very nature, confinement at an institution for the criminally insane is far more restrictive than at a prison. Nothing more dramatically illustrates this difference than the petty indignities to which inmates in the former are subjected. For example, their visiting and correspondence rights are curtailed. In the appendix we reproduce a pro se petition by a prisoner in a similar institution in Massachusetts listing at least thirty-five such differences illustrating that these seemingly small but numerous indignities may accumulate to the point where the prisoner-patients consider them the most galling of all restraints.
Finally as the court below stated, prisoners held in Dannemora are in practice not even called for hearing by the Parole Board. By contrast, had Schuster remained in Clinton, he might have returned to society over 20 years ago. Additionally, as long as Schuster is considered insane, New York law prevents him from seeking to vacate his original conviction by a writ of coram nobis. People v. Booth, 17 N.Y.2d 681, 216 N.E.2d 615, 269 N.Y.S.2d 457 (1966).
We are not alone in attributing significance to a transfer from a prison to an institution for the criminally insane. Recognizing that such a transfer may cause further substantial deprivation of liberties, New York's own courts have permitted a prisoner to challenge his transfer by writ of habeas corpus. People ex rel. Brown v. Johnston, supra. Thus, the New York Court of Appeals stressed that "any further restraint in excess of that permitted by the judgment or constitutional guarantees should be subject to inquiry. An individual, once validly convicted and placed under the jurisdiction of the Department of Correction * * * is not to be divested of all rights and unalterably abandoned and forgotten by the remainder of society." 9 N.Y.2d at 485, 215 N.Y.S.2d at 45-46, 174 N.E.2d at 726 (emphasis in the original).
Accordingly, we would delude ourselves if we believed that a prisoner's transfer to a prison maintained for the criminally insane is a mere administrative matter. Prison and asylum are divided by far more than the few miles that separate Clinton and Dannemora. In view of the substantial deprivations, hardships and indignities such a move may produce, judicial scrutiny is necessary to ensure that the procedures preceding the transfer adequately safeguard the fundamental rights of the prisoner.
B. Differences in Commitment Procedures for Prisoners and Civilians
Under § 383 of the Correction Law, as it read at the time of Schuster's transfer in 1941, a prisoner could be transferred to Dannemora solely on the certification of a single doctor (even a nonpsychiatrist), without a hearing or judicial review of any kind. However, at that time an involuntary commitment of a civilian to a mental institution required the examination of two qualified examiners (instead of a single prison physician, who conceivably could be influenced by Schuster's charges that the institution he served was corrupt), notice of the commitment proceedings (Schuster claims he was not told in advance of the nature of the proceeding which led to his transfer and was transferred within 24 hours after he was seen by a prison doctor), a hearing before a judge on the question of sanity, which insured the right of cross-examination, etc., and a court order of commitment -- none of which was afforded Schuster. Law of April 24, 1933, ch. 395 § 12,  Laws of N.Y. pp. 931-34 (repealed 1965; now replaced by N.Y. Mental Hygiene Law §§ 72-74).
We believe that the substantial disparity between the procedural protections afforded civilians facing involuntary commitment to a mental institution and those given Schuster deprived him of the equal protection of the laws, within the meaning of the Fourteenth Amendment. This is the only logical deduction that can follow from an analysis of recent Supreme Court decisions on the subject.
Baxstrom v. Herold, 383 U.S. 107, 86 S. Ct. 760, 15 L. Ed. 2d 620 (1966) sparked an awareness that we cannot tolerate two classes of insane persons -- criminal and non-criminal, -- when we are asked to examine commitment procedures available to both. In that case, the Court struck down § 384 of New York's Correction Law, which dealt with the commitment procedures for persons transferred to Dannemora as prisoners, whom the state wished to keep institutionalized after the expiration of their prison sentences. The procedures for commitment provided by § 384 were basically the same as those for civilly-committed persons except that the latter had the right to de novo review by jury trial of the question of their sanity under § 74 of the Mental Hygiene Law, whereas prisoners in Baxstrom's position did not. Additionally, the decision whether to send a person committed under § 384 to Dannemora or to a civil hospital was completely within the discretion of administrative officials, while one civilly committed could be sent to Matteawan only after a judicial determination that his presence in a civil hospital would be dangerous to the safety of others. Mental Hygiene Law, § 85. These differences the Court held, in a unanimous opinion, constituted a denial of equal protection. It rejected absolutely the state's argument that one could validly distinguish between the two groups because ex-convicts ipso facto had dangerous or criminal propensities. Positing that prisoners whose sentences are about to expire are entitled to the same procedural protection before further confinement as civilians who face initial commitment to a mental institution, Chief Justice Warren explained: "Classification of mentally ill persons as either insane or dangerously insane of course may be a reasonable distinction for purposes of determining the type of custodial or medical care to be given, but it has no relevance whatever in the context of the opportunity to show whether a person is mentally ill at all." 383 U.S. at 111, 86 S. Ct. at 763 (emphasis in the original).
Judge Port believed Baxstrom inapposite to the case at bar. He reasoned that because Johnnie Baxstrom was nearing the end of his sentence when he was committed under § 384 and hence was no longer a prisoner, his commitment was in effect "civil" and had to meet the standards of every other civil commitment. Since Schuster is still a prisoner, Judge Port concluded, he is entitled only to the same treatment as every other prisoner in custody.
This analysis, we believe, misses the mark. Baxstrom clearly instructs that the procedures to be followed in determining whether one is committable must be unaffected by the irrelevant circumstance that one is or has recently been under sentence pursuant to a criminal conviction, although the fact that one has committed a crime may be relevant to the substantive conclusion that he is mentally ill. As one court explained: "The Supreme Court struck down the New York system not because Baxstrom was reaching the end of his sentence, but because it held dangerousness is not relevant to the procedures for determining whether a 'person is mentally ill at all.' * * * Baxstrom thus might be said to require the conclusion that, while prior criminal conduct is relevant to the determination whether a person is mentally ill and dangerous, it cannot justify denial of procedural safeguards for that determination." Cameron v. Mullen, 128 U.S. App. D.C. 235, 387 F.2d 193, 201 (D.C. Cir. 1967). See also People v. Fuller, 24 N.Y.2d 292, at 306, 300 N.Y.S.2d 102, at 110, 248 N.E.2d 17, at 23 (1969).
The teaching of Baxstrom -- that a finding of dangerous or criminal behavior does not obviate the necessity for a separate and adequate determination of commitability -- has also found application in other related cases. Thus, for example, this court declared even before Baxstrom that an ex-convict who became insane after his release from prison could not be denied the same hearing available before commitment to one who had never been incarcerated. United States ex rel. Carroll v. McNeill, 294 F.2d 117 (2d Cir. 1961),*fn8 appeal dismissed as moot 369 U.S. 149, 82 S. Ct. 685, 7 L. Ed. 2d 782 (1962).
Baxstrom has also extended its influence to other related instances. Both the New York courts, People v. Lally, 19 N.Y.2d 27, 277 N.Y.S.2d 654, 224 N.E.2d 87 (1966) and the federal courts, Cameron v. Mullen, supra, Bolton v. Harris, 130 U.S. App. D.C. 1, 395 F.2d 642 (D.C. Cir. 1968), have made it clear that one who has been adjudicated not guilty by reason of insanity is entitled to the same procedures used to determine committability of an individual who is not otherwise before a court. In Lally, the court embraced not only the specific holding of Baxstrom, but its broad purpose as well, since the court declared its intent was "to comply with the spirit if not the express language of the Baxstrom decision." 277 N.Y.S.2d at 660, 224 N.E.2d at 92.
In Specht v. Patterson, 386 U.S. 605, 87 S. Ct. 1209, 18 L. Ed. 2d 326 (1967), the Supreme Court, again in a unanimous holding, further sharpened the distinction between a finding of criminal activity and a finding of committability by reason of mental illness, holding that a convicted sex offender was entitled to a further hearing on the question of illness before he could be sentenced to an indefinite term as an "habitual offender and mentally ill." Specht has since been followed by New York and applied to this state's sex offender statute. People v. Bailey, 21 N.Y.2d 588, 289 N.Y.S.2d 943, 237 N.E.2d 205 (1968).
In People ex rel. Goldfinger v. Johnston, 53 Misc.2d 949, 280 N.Y.S.2d 304 (Sup.Ct.1967), a New York court has extended the Baxstrom rationale to a youth transferred from a correctional school (where he was placed after pleading guilty to attempted assault), to an institution for defective delinquents. The court remarked, in requiring a hearing before the transfer could be effected "whatever procedural distinctions and niceties may hitherto have obtained, they are no longer valid since the advent of Baxstrom, Specht and Lally." 280 N.Y.S.2d at 307.
Most recently, in People v. Fuller, et al., supra, the New York Court of Appeals declared that persons convicted of felonies or misdemeanors who were then committed for treatment as narcotics addicts were entitled to a jury trial on the question of addiction. The court reasoned that since non-criminals civilly committed for addiction were given such a trial, it would violate the equal protection clause of the 14th Amendment to deny this right to those addicts who happened to be concurrently convicted of a crime. The court relied upon Baxstrom v. Herold, reading that case, as we do, to require an examination of the substance of the proceeding, not its form. It found commitment for treatment basically a proceeding involving a sick person who needed help. Schuster was sent to Dannemora for the same reason. He was alleged to be mentally sick (paranoid) and those transferring him there did so, we are told, for his "care and treatment." Accordingly we see no logic or reason for distinguishing Schuster's plight from Fuller's. See also In re Buttonow, 23 N.Y.2d 385, 297 N.Y.S.2d 97, 244 N.E.2d 677 (1968).
D. The Procedures Now Followed for Commitment of Criminals and Civilians
Since Schuster's transfer to Dannemora in 1941, New York has substantially revised its commitment procedures both for prisoners and non-prisoners,*fn9 indicating a continuing concern that the power to lock people away in "lunatic asylums," whether they be criminals or no, is awesome indeed, and can be abused.
Section 383 of the Correction Law now affords prisoners many of the safeguards that the Mental Hygiene Law provided to civilians in 1941. Before a prisoner may be transferred to Dannemora, he must be given an examination by two independent physicians and on appropriate notice a hearing at which the prisoner can introduce evidence and cross-examine witnesses, and judicial approval must also be secured. N.Y. Correction Law § 383 (McKinney 1968).
At the same time, however, the commitment procedures for non-prisoners have undergone still greater expansion. Thus, in addition to the two-physician certification, and provisions for appropriate notice, hearing and court action, New York also requires for persons being committed involuntarily, review of the need for further confinement 60 days after commitment, another review after one year, followed by periodic reviews every two years thereafter. These regular periodic reviews require in each instance a judicial determination of the need for further institutionalization. Mental Hygiene Law § 73 (McKinney, 1968 Supp.). Moreover, when any of these determinations is adverse to the civil patient, he may obtain de novo review on the issue of sanity by a jury. Mental Hygiene Law § 74 (McKinney, 1968 Supp.). New York has also created a "Mental Health Information Service" whose function it is to study and review the admission of involuntary civilian patients, inform the patients of their rights, present relevant information to the court, and participate in the proceedings mandated by §§ 72-74, etc. Mental Hygiene Law § 88 (McKinney, 1968 Supp.). See Note, The New York Mental Health Information Service: A New Approach to the Hospitalization of the Mentally Ill, 67 Colum.L.Rev. 672 (1967). Thus, it is true, as a sage commented, that time is what we want most but use worst, for there remains today almost as wide a chasm between the roads traveled by non-prisoners and prisoners as existed in 1941 when Schuster first arrived at Dannemora.
We believe, as we have already indicated, that implicit in Baxstrom v. Herold is the principle that such disparity as exists even under the present statutes between the procedural rights afforded prisoners and those extended to non-prisoners violates the fundamental requirements of equal protection. Whether a man should be committed for mental illness has no relevance to the place where he happens to be at the time he becomes ill. This much we have surely learned from Baxstrom and its progeny.
We hold, therefore, that before a prisoner may be transferred to Dannemora, he is entitled to substantially the same procedures including periodic review of the need for continued commitment in a mental institution and jury trial as are granted to civilians when they are involuntarily committed to a mental hospital. Morover, it does not seem amiss for us to remind those who will conduct the required hearings that the substantive test to be applied is that which New York has laid down for those facing civil commitment: not merely whether Schuster suffers from a "mental disease," but whether that disease is one that "requires care and treatment." Mental Hygiene Law § 2. (See our discussion of Schuster's treatment, infra.)
In holding as we do we wish to emphasize that we are mindful of the Supreme Court's admonition that "equal protection does not require that all persons be dealt with identically, but it does require that a distinction made have some relevance to the purpose for which the classification is made." Baxstrom, supra, 383 U.S. at 111, 86 S. Ct. at 763. See also Griffin v. Illinois, 351 U.S. 12, 20, 76 S. Ct. 585, 100 L. Ed. 891 (1956). Thus, our decision today does not mean that all distinctions between civilian and prisoner patients must be swept aside. We do say that prisoner patients are entitled to substantially the same safeguards afforded non-prisoners before commitment. For example, § 85 of the Mental Hygiene Law provides that before being committed to Matteawan, there must be a judicial determination that the individual to be committed is dangerous to himself and others. Such a procedure may not be appropriate for a prisoner because the additional security facilities of Matteawan or Dannemora might be thought necessary to confine convicts with sentences still to serve, who may be more prone to escape from a hospital than civilians.*fn10
The Bar Association Committee after long study phrased its results in the following recommendations which are in substantial agreement with our conclusions today:
"Mentally ill prisoners serving sentences should continue to be hospitalized in institutions under the jurisdiction of the Department of Correction. However, the procedures governing their hospitalization should be modified to provide to such persons some of the rights accorded to civil patients. Safeguards against unnecessary and possibly harmful confinement among the mentally ill are as necessary and important for prisoners as they are for anyone else.
"Recommendation No. 1 (Admission procedure). The Correction Law (sections 383, 408) should continue to provide for hospitalization of mentally ill prisoners under sentence in an institution within the Department of Correction upon judicial order entered after notice, examination by two examining physicians, and an opportunity to be heard. In addition, however, these statutes should be amended to provide that the Mental Health Information Service should receive notice of such applications, and should have the same powers and perform the same services as set forth in Article 5 of the Mental Hygiene Law as to civil patients.
"Recommendation No. 2 (Periodic review). The procedures for the involuntary retention and periodic judicial review of ordinary civil patients, including on the occasions of such review the assistance of the Mental Health Information Service, should apply to prisoners hospitalized while serving a sentence."
E. The Adequacy of Existing Remedies
The state has vigorously argued that Schuster has already received all rights to which he is entitled in his 1963 state habeas corpus hearing. We believe however, as did the Supreme Court and the New York Court of Appeals, that habeas corpus is not an adequate substitute for a proper pre-commitment hearing. The writ was available to the patients in both Baxstrom and Lally, yet neither court deemed this remedy sufficient. Instead they concluded that equal protection required the same procedural protection for ex-prisoners and those acquitted by reason of insanity as was afforded those civilly committed. See Cameron v. Mullen, supra, at 201; Bolton v. Harris, supra. Schuster's 1963 hearing indicates how inadequate the great writ can be in circumstances such as this. Only one doctor testified, and he was a man in whom Schuster placed no trust. The insubstantiality of that doctor's testimony may be characterized as follows: Schuster believes in corruption. I don't believe such corruption existed, ergo Schuster is insane.
In particular, the burden of proof in a habeas corpus proceeding is traditionally upon the petitioner. Bolton v. Harris, supra. In the case before us, the district court's finding on the crucial question of corruption was simply that Schuster has "failed to sustain the burden of proof on this issue." In a commitment proceeding, by contrast, the burden traditionally seems to have been on the state. Moreover, it may well be that the New York courts will no longer permit habeas corpus as a proper remedy for prisoners committed under § 383 in the belief that the amendment of that section in 1962 obviated the need for the writ, granted for the first time just one year before the amendment in People ex rel. Brown v. Johnston. See People ex rel. Carroll v. Herold, 27 App.Div.2d 958, People ex rel. Conover v. Herold, 24 App.Div.2d 773, 263 N.Y.S.2d 858 (3d Dept.1965); N.Y. Bar Report n. 26 at 23.*fn11
Most judicial reform is accompanied by cries of horror and dismay that the action by the court has surely carried society over the brink and into the abyss of administrative chaos. Certainly this was true of Baxstrom. When § 384 was invalidated, the New York authorities decided to transfer all patients confined in Dannemora or Matteawan pursuant to that provision -- a total of 992 inmates -- to civil hospitals. This transfer was designated by them as "Operation Baxstrom."*fn12 When this decision was announced, some segments of the community were anxious and outraged. Involved labor unions demanded special pay and training for working with the Operation Baxstrom transferees because they were presumptively "dangerous." Residents in the neighborhoods of civil mental hospitals protested the presence of "criminal lunatics" in their midst. Yet in only one year the protests evaporated. The transfer has been an astounding success. Of these nearly 1000 exprisoners whom the appropriate state authorities had prior to Baxstrom determined to be too dangerous to be placed in a civil hospital, 176 have been fully discharged -- 147 to their home communities and the rest to other hospitals; 454 others have elected to remain in civil mental hospitals on voluntary or informal status; and only seven have had to be returned to Matteawan after a judicial determination that they were dangerous. As one author has noted, the Baxstrom patients were almost as pure as Ivory Snow; they were 99 28/100 per cent free from dangerous mental illness. See Morris, supra, at 672.
What could explain this massive misplacement of people in Matteawan and Dannemora -- places which are more restrictive prisons than hospitals? The New York Bar Report indicated it was "another instance of institutionalized expectations putting blinders on our perceptions." N.Y. Bar Report at 227. The very fact that these men were in Dannemora may have induced the circular reasoning which impelled the New York authorities to the conclusion that they were "dangerous." Perhaps independent judicial examination of patients in Dannemora pursuant to the guidelines laid down in § 73 may contribute to an atmosphere permitting clearer vision. At the very least, the results of Operation Baxstrom indicate that it is not unlikely that a significant number of the patients committed to Dannemora under § 383 -- particularly those committed under the pre-1962 law like Schuster -- may not be so mentally ill as to require denying them the "freedom" of a regular prison.
In any event, we do not believe our decision today even though it requires inter alia periodic review of the need to continue prisoners in institutions for the criminally insane will open the proverbial floodgates and unduly burden the courts with frivolous cases. We cannot safely predict that every prisoner-patient will demand the review we here make available. For example, 454 of the patients transferred to civil hospitals in Operation Baxstrom, nearly half the total number, chose to remain hospitalized on a voluntary basis even though they could have contested the validity of their commitment in court by jury trial. N.Y. Bar Report n. 32 at 26. Also, a six-year study of civil commitment procedures by the American Bar Foundation confirms this premise. Its authors state: "In practice this right [to the jury trial in civil commitment proceedings] is seldom invoked, either in California or in those other jurisdictions included in this study. So infrequent are they that over the several months occupied in the study of Los Angeles we were able to observe only two jury trials." Rock, et al., Hospitalization and Discharge of the Mentally Ill, at 102 (1968).
But even in the unlikely event that every prisoner in a Department of Correction mental hospital does demand the full panoply of procedures to which he is entitled, the total number of such prisoners under sentence at one time is so small compared to the number of involuntarily committed civilians in state mental hospitals that the effect on the administrative and judicial systems would be minimal. N.Y. Bar Report at 26. On April 1, 1964, there were 85,279 resident patients in the civil state hospitals. At the same time there were fewer than 2,971 patients of all classes in both Matteawan and Dannemora combined. State of N. Y., Dept. of Mental Hygiene, Office Directory of State and Licensed Mental Institutions 176 (1965) as quoted in N.Y. Bar Report at 26.*fn13 Moreover, The Department of Mental Hygiene has provided us with statistics which indicate that during the fiscal year ending March 31, 1968, 25,439 persons were involuntarily admitted to state civil mental hospitals, while 152 persons were admitted to Dannemora and 255 to Matteawan. Further, the New York Court of Appeals summarily dismissed the argument that its courts would be burdened when that court ordered jury trials for all criminals committed for treatment of narcotics addiction. People v. Fuller, supra, 24 N.Y.2d 292, 300 N.Y.S.2d 102, 248 N.E.2d 17. And it is a fair assumption that the number of addicts involved far exceeds the number of prisoners committed under § 383. We thus add but a trickle of water to an ocean. When measured against the possibility that persons committed as summarily as Schuster were wrongly subjected to the horrors of a prison for the insane, any inconvenience is so small by comparison that we cannot ignore our obligation to re-examine their cases. If we open any "floodgate" today, which we doubt, it is only to provide a flood of long-overdue relief.
Schuster's "Treatment" at Dannemora
At the hearing before Judge Port the rules of evidence were, as he noted in his opinion, "applied with a liberality probably not warranted by the remand." In this manner, evidence concerning the treatment accorded Schuster at Dannemora has been called to our attention. As we have already illustrated, that evidence tends to suggest that Schuster does not now receive any therapeutic treatment and does not presently need the merely custodial care with which the institution provides him.
The sole purpose served by Dannemora State Hospital is "confining and caring for such male prisoners as are declared mentally ill while confined in a state prison * * * and others provided for under section three hundred eighty-three." Correction Law § 375. And, according to New York law, one is "mentally ill" when he is "afflicted with mental disease to such an extent that for his own welfare or the welfare of others, or of the community, he requires care and treatment." Mental Hygiene Law § 2(8) (emphasis added).*fn14 The statutory scheme thus contemplates that a prisoner will be committed to Dannemora only if he is mentally ill and in need of treatment or special custodial care because of the problem he presents to himself or other prisoners. The legislature appeared to presume that one committed under its provisions would be provided with adequate care or treatment, the need for which justified the commitment.
In Rouse v. Cameron, 125 U.S.App.D.C. 366, 373 F.2d 451 (1966), the court indicated that persons committed to a mental hospital after pleading not guilty by reason of insanity have a constitutional right to treatment while institutionalized. Similarly the Supreme Judicial Court of Massachusetts recently declared that one accused of murder but who has been confined in a state mental hospital for the criminally insane instead of being sentenced to prison has a right to challenge the legality of his confinement if the state fails to provide him with adequate treatment. Nason v. Superintendent of Bridgewater State Hospital, 353 Mass. 604, 233 N.E.2d 908 (Mass.1968). Indeed, New York courts have themselves taken some steps toward acknowledging this right, at least in relation to those sentenced to indefinite terms as sex offenders. See People ex rel. Kaganovitch v. Wilkins, 23 App.Div.2d 178, 259 N.Y.S.2d 462 (4th Dept.1965); People v. Jackson, 20 App.Div.2d 170, 245 N.Y.S.2d 534 (3d Dept.1963); see also People v. Mosher, 24 App.Div.2d 47, 263 N.Y.S.2d 765 (4th Dept.1965). And, in People v. Fuller, supra, the New York Court of Appeals stressed the fact that the program under consideration was one for the rehabilitation of addicts, not merely for their detention. Moreover, a growing number of scholars have urged that persons involuntarily committed by the state to mental institutions have a constitutional right to treatment, grounded in either the prohibition against cruel and unusual punishment of the Eighth Amendment or in the due process or equal protection clauses of the Fourteenth Amendment. E.g., Note, Civil Restraint, Mental Illness, and the Right to Treatment, 77 Yale L.J. 87 (1967); Morris, supra, at 679-81; Birnbaum, The Right to Treatment, 46 A.B.A.J. 499 (1960). See also Sas v. Maryland, 334 F.2d 506, 509 (4th Cir. 1964); Robinson v. California, 370 U.S. 660, 82 S. Ct. 1417, 8 L. Ed. 2d 758; Easter v. District of Columbia, 124 U.S.App.D.C. 33, 361 F.2d 50 (1966).
While these cases deal with persons who are not currently under a sentence of imprisonment as Schuster is, it may be that this difference in and of itself does not provide an adequate basis for denying him the same protections. The incidence of having been convicted of a crime surely does not deprive a person of all constitutional protections for the duration of his sentence. See, e.g., Wright v. McMann, 387 F.2d 519 (2d Cir. 1967). While we do not pass upon the possibility of such a constitutional right to treatment, we are of the view that, in light of the procedural posture of this case, the state may wish to reexamine the validity of its confinement of ...