The opinion of the court was delivered by: NEAHER
MEMORANDUM OF DECISION AND ORDER
Project Release, a not-for-profit organization, and Carrie Greene, a State mental patient, brought this action to challenge the constitutionality of the voluntary, involuntary and emergency commitment procedures contained in New York Mental Hygiene Law (hereinafter "M.H.L.") §§ 9.13, 9.27, 9.39. Project Release is a self-help organization composed of current and former mental health patients, many of whom have been admitted to mental hospitals under M.H.L. Greene was admitted to a State mental hospital initially under the emergency procedure, M.H.L. § 9.39. She subsequently acceded to voluntary commitment, M.H.L. § 9.13, but was not permitted to leave the hospital upon request. Instead, her commitment was converted to involuntary status pursuant to the procedures outlined in M.H.L. § 9.27. At a required hearing in New York State Supreme Court, Greene's involuntary commitment was reviewed and she was denied release.
Plaintiffs do not allege that defendants failed to comply with the statutory procedures, nor that the application of these procedures in their situations created a deprivation of a constitutional right. Rather, they assert broadly that the statutory scheme is facially unconstitutional because it fails to include certain criteria enumerated in their complaint. The resolution of the issues in this case turns on whether standards and procedures contained in the statute accord with constitutional requirements. As presented by these parties, the question is a legal and not a factual one, and can be determined on summary judgment. Rule 56, F.R.Civ.P.; see Gotkin v. Miller, 514 F.2d 125, 130 (2d Cir. 1975).
New York State Commitment Procedures
M.H.L. provides a comprehensive system for the hospital admission of the mentally ill. A mentally ill person may enter a hospital voluntarily or informally, or may be brought into the hospital through involuntary or emergency procedures. Standards incorporated in the statute determine the applicable form of admission in an individual case, and the statute specifies procedural requirements and certain patient rights. Plaintiffs raise a broad challenge to New York's entire civil commitment system which can only be resolved upon a full analysis of the statutory scheme.
Voluntary and Informal Admissions
"Any suitable person in need of care and treatment" may be admitted as a voluntarily committed mental patient upon that person's voluntary, written application. M.H.L. § 9.13. "Person in need of care and treatment" is defined as someone who "has a mental illness for which in-patient care and treatment in a hospital is appropriate." M.H.L. § 9.01. To be found "suitable," a patient must be aware that he is applying to a mental hospital, and must understand the consequences of voluntary commitment; especially, the patient must comprehend the limitations governing release and the possibility that his status may be converted to involuntary commitment. M.H.L. § 9.17(a).
A voluntarily committed mental patient may give notice at any time of his desire to be discharged. Upon receipt of such notice, the patient must be promptly released unless the hospital director believes that the patient is in need of involuntary care. If the hospital director denies the patient release, the patient may be held for seventy-two hours for examination and evaluation. The patient then must be released unless the director has applied for a court order authorizing involuntary commitment. The patient, the Mental Health Information Service (MHIS), and certain designated persons must receive notice of this court application forthwith, and may demand a court hearing, to be held within three days of the demand. M.H.L. § 9.13. The requirements and procedures involved in any involuntary commitment then apply. See M.H.L. § 9.27, discussed infra.
If a patient remains hospitalized under the voluntary commitment procedures, MHIS must at least yearly review that patient's status to determine whether there is "any ground to doubt" the patient's suitability for voluntary treatment and willingness to be hospitalized. If any doubt exists, MHIS must, upon notice to the patient, apply for a court order to resolve that issue. A court hearing is available upon the request of MHIS, the patient, or a person acting on behalf of the patient. If MHIS finds that the patient is suitable and willing, it must file a certification of its conclusions in the patient's record. M.H.L. § 9.25.
A person may also seek admission to a mental hospital as an informal patient. The standards for acceptance for informal admission are the same as the standards for voluntary admission. See M.H.L. §§ 9.01, 9.17. An informal patient, however, need not submit a written application, and may leave at any time. M.H.L. § 9.15.
A person "alleged to be mentally ill and in need of involuntary care and treatment" may be a candidate for involuntary commitment. M.H.L. § 9.27(a). Someone "in need of involuntary care and treatment" is a person who "has a mental illness for which care and treatment in a hospital is essential to such person's welfare and whose judgment is so impaired that he is unable to understand the need for such care and treatment." M.H.L. § 9.01.
An involuntary commitment pursuant to M.H.L. § 9.27 must be supported by two certificates from examining physicians and an application setting forth facts demonstrating the existence of a mental illness and the need for involuntary care and treatment. M.H.L. § 9.27. When a person is brought to a hospital for involuntary commitment, he must be examined forthwith by a third physician who is on the hospital's psychiatric staff. If this physician also certifies the need for involuntary commitment, the patient may be admitted. M.H.L. § 9.27(e). The examining physicians are under a duty, however, to "consider alternative forms of care and treatment that might be adequate to provide for the person's needs without requiring involuntary hospitalization." M.H.L. § 9.27(d).
An involuntary commitment may also result if a director of community services or his designated physician certifies that an individual "has an illness for which immediate care and treatment in a hospital is appropriate and which is likely to result in serious harm to himself or others." M.H.L. § 9.37(a). "Likelihood to result in serious harm" exists if the patient presents:
"(1) substantial risk of physical harm to himself as manifested by threats of or attempts at suicide or serious bodily harm or other conduct demonstrating that he is dangerous to himself, or
"(2) a substantial risk of physical harm to others as manifested by homicidal or other violent behavior by which others are placed in reasonable fear of serious physical harm." Id.
The patient must be examined by a staff physician prior to admission, and the need for hospitalization must be confirmed. A second examination by a member of the hospital's psychiatric staff must occur within seventy-two hours of admission.
MHIS must receive immediate notice of a patient's involuntary commitment, M.H.L. § 9.29(a), and must inform the patient of his statutory rights. M.H.L. § 29.09(b) (2). Additionally, written notice of the admission and the patient's rights must be given within five days to the patient's next of kin who was not a commitment applicant, and to as many as three persons that the patient may designate in writing.
An involuntarily committed patient may be held without court authorization for sixty days. See M.H.L. § 9.33(a). The patient, however, has a right to a hearing, which may be requested at any time by the patient, a friend or relative, or MHIS. The court must conduct a hearing within five days of receipt of the request, and may hear testimony and examine the patient to determine the need for involuntary care and treatment. The court may order immediate release. M.H.L. § 9.31.
Unless the mental hospital director obtains court authorization for continued retention, an involuntarily committed mental patient must be released at the later of sixty days from admission or thirty days from a court denial of a request for release. The patient, as many as three persons designated by the patient, and MHIS must receive written notice of an application for this court authorization, and any of these parties may request a hearing. If requested, the hearing must be held within five days. The initial court order may authorize retention for six months; subsequent court orders are required to retain the patient for one and then two years. M.H.L. § 9.33.
A patient denied release by a court pursuant to § 9.31 or retained by court authorization pursuant to § 9.33 may obtain review by a trial court. The trial will be held before a jury unless the patient waives the jury right. M.H.L. § 9.35.
A person "alleged to have a mental illness for which immediate observation, care and treatment in a hospital is appropriate and which is likely to result in serious harm to himself and others" may be involuntarily committed and retained in a mental hospital for fifteen days. M.H.L. § 9.39(a). A patient brought to the hospital for emergency admission must be examined immediately by a staff physician, and must be examined again within forty-eight hours by a member of the hospital's psychiatric staff. M.H.L. § 9.39(a).
The patient and as many as three persons designated by the patient must be given notice of the patient's status and rights upon admission. MHIS must also be notified. The patient, a relative, friend, or MHIS may request a court hearing, which must be held within five days of any request, to determine whether reasonable cause exists to continue the patient's emergency commitment. Id.
Fifteen days after admission, the patient must be released unless the patient agrees to voluntary or informal status under M.H.L. § 9.13 or § 9.15, or unless the patient is involuntarily committed pursuant ...