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STREICHER v. PRESCOTT

May 19, 1987

Alma Streicher, et al., Plaintiffs,
v.
William Prescott, M.D., et al., Defendants; James Angus McDonald, et al., Plaintiffs v. William Prescott, M.D., et al., Defendants



The opinion of the court was delivered by: PARKER

 Barrington D. Parker, Senior District Judge:

 These consolidated proceedings present serious questions involving patients confined since before 1973 to St. Elizabeths Hospital, a public mental health facility, located in the District of Columbia. *fn1" These patients were all involuntarily committed in civil proceedings more than 14 years ago under a standard of proof requiring the government to demonstrate that the respondent-patients were mentally ill by a "preponderance of the evidence." In 1973 our Circuit Court declared that standard of proof unconstitutional and raised the government's evidentiary burden in civil commitment cases to that of "beyond a reasonable doubt." In re Ballay, 157 U.S. App. D.C. 59, 482 F.2d 648 (D.C. Cir. 1973). Six years later, the Supreme Court struck down the "preponderance of evidence" standard and imposed a reduced standard of "clear and convincing" evidence. Addington v. Texas, 441 U.S. 418, 60 L. Ed. 2d 323, 99 S. Ct. 1804 (1979). The District of Columbia Court of Appeals, in response to the Supreme Court's pronouncement in Addington, lowered the standard for this jurisdiction consistent with that announced in Addington. In re Nelson, 408 A.2d 1233 (D.C. 1979).

 Despite the Supreme Court's determination that the "preponderance" standard was unconstitutional, none of the civilly committed patients confined before 1973 have ever secured judicial review to determine whether or not the evidence which supported their initial commitment under the "preponderance" standard would be sufficient to support confinement under the new constitutional standard. In fact, none of these patients has ever received any form of judicial review since their initial commitment prior to 1973.

 Concerned that patients may have been inappropriately committed and denied their liberty without a real and meaningful opportunity for judicial review, counsel from the Mental Health Law Project and the Public Defender's *fn2" office instituted this class action proceeding seeking declaratory and other equitable relief on behalf of all patients committed prior to 1973. Named as defendants were William Prescott, M.D., Superintendent of St. Elizabeths and Marion Barry, Mayor of the District of Columbia. Plaintiffs Alma Streicher and James McDonald, individually and as class representatives, seek a declaratory judgment that all such patients committed before 1973 under an unconstitutional standard of proof are entitled to judicial review of their commitment status according to the constitutionally required "clear and convincing" evidentiary standard. *fn3" Their demand for relief requires the Court to determine first, whether these patients were deprived of their liberty interests because they were committed under an unconstitutional standard of proof, and second, whether the patients' rights to due process necessitate new judicial hearings.

 This Court concludes after review and consideration of the authorities relied upon and arguments advanced by counsel for the parties, that these patients, all of whom have been detained and forcibly residing in St. Elizabeths for more than 14 years, are entitled to judicial review of their present commitment status under prevailing constitutional standards.

 I. BACKGROUND

 The public interest groups originally instituted this class action in 1983 on behalf of all patients involuntarily committed to St. Elizabeths, for greater than six months. In their original petition for relief, plaintiffs sought a declaration from the Court that each patient was constitutionally entitled to automatic judicial review of his/her commitment at six month intervals. *fn4" Earlier in this proceeding, the named defendants as officials of the hospital sought summary judgment arguing that existing review procedures were more than adequate to satisfy the patients' constitutionally mandated due process rights. Defendants' motion was denied upon a finding that genuine questions of material fact were present regarding the adequacy of the review procedures for patients committed under appropriate constitutional standards.

 At the same time, plaintiffs' counsel indicated they intended to submit a motion for partial summary judgment on behalf of all patients who were committed before 1973 under standards now held unconstitutional. That motion is presently before this Court, and plaintiffs seek partial summary judgment on behalf of all such patients.

 Plaintiffs have identified two subclasses of patients whose commitment decisions they claim are constitutionally suspect. The first includes all patients committed before 1973, when, as previously noted, our Circuit Court declared the "preponderance" standard unconstitutional. The second subclass, a subset of the first, comprises all patients who were committed before 1965 when Congress enacted the Hospitalization of the Mentally Ill Act, codified at 21 D.C. Code 501 et seq. (1981) (hereinafter cited as the Ervin Act). *fn5"

 Plaintiffs' motion presents purely legal questions appropriate for partial summary judgment. They argue first that the standard of proof enunciated in In re Ballay, and Addington, supra, should be applied retroactively, and thus, all patients committed under the prior "preponderance of evidence" standard would be entitled to a new hearing under the prevailing "clear and convincing evidence standard." In the alternative, plaintiffs contend that their commitment under an unconstitutional standard constitutes a denial of liberty without due process of law. They maintain that the fifth amendment due process clause entitles them to an automatic judicial review of their original commitments under current constitutional standards. Finally, they argue that the equal protection clause entitles patients committed under the Ervin Act's predecessor to a new commitment hearing with all the procedural rights guaranteed under that Act.

 Plaintiffs contend that their initial hearings were conducted under standards which created an unconstitutionally high risk of erroneous commitment and that existing review procedures are insufficient to protect their liberty interests. They propose that judicial review of their commitment, conducted according to current constitutional standards would correct any prior erroneous commitment decisions. Further, they argue that judicial review is in the interests of the District of Columbia as well since it has no interests in continuing unnecessary commitments, because confinement in St. Elizabeths is far more costly than outpatient care. *fn6" Finally, they argue that unlike the case of the criminal defendant, confinement of the mentally ill does not serve any deterrent or retributive goals. The District's interests in detaining an allegedly mentally ill person cease when the purpose for the detention no longer exists. *fn7"

 Defendants oppose a retroactive application of Addington arguing that such a principle should not be applied to afford patients a commitment hearing under the new standard. They also maintain that the patients' substantive liberty interests are adequately protected by the existing review procedures.

 Defendants argue that the existing Hospital review procedures, coupled with the opportunity for judicial review, would have corrected and resolved any prior erroneous commitment decisions and, thus render automatic review unnecessary. Moreover, automatic judicial review for the approximately 600 patients confined prior to 1973 would impose excessive and costly administrative burdens upon a system already too overburdened with merely trying to provide substantive care for both in-patients and out-patients.

 II. ANALYSIS

 A. Standards for Due Process and Retroactivity

 In the context of this proceeding, due process is a flexible concept. The court is required to balance the value of the patients' liberty interests and the risk of their erroneous commitment against the government's interests in conserving fiscal and administrative resources. Mathews ...


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