Civil Commitment of the Mentally Dangerous Person: Toward A Safer System – Part Three of Three

In Part Two of this three-part post on the horrific stabbing murder of a young medical student studying quietly in the Winchester Public Library on February 24, I wrote of the many times that the accused murderer, Jeffrey Yao, had come to the attention of the Winchester Police Department as well as school authorities and neighbors, for years before his behavior reached this savage ending. Despite this, Yao was never once civilly committed to a psychiatric hospital for evaluation and treatment – which could have prevented this awful tragedy. The reason that Yao was never civilly committed, has to do with the legal standard for civil commitment in Massachusetts.

“Civil commitment” refers to the legal process through which a person considered mentally ill and dangerous to him/herself or others, can be ordered held in a psychiatric facility for evaluation and possible medical treatment.  Massachusetts police do have the authority to do so: Under state law, a police officer who has a good faith belief that a person may harm himself, herself or others due to suspected mental illness is allowed to bring that person to a hospital Emergency Department or a mental health facility to be examined and evaluated by medical professionals, notwithstanding the fact that the individual may not (yet) have committed any crime. If such a person will not cooperate willingly in that process, police have the legal authority to restrain such a person.

By law, a person who is brought to a hospital under such circumstances is under no legal obligation to participate in any evaluation or examination, which is something that a civil libertarian will tell you is a good thing. Not necessarily so, in my opinion as a Massachusetts criminal defense lawyer.  If the person refuses to cooperate or be evaluated, hospital personnel can invoke a state law that enables the hospital to hold the patient for three days. That should have been done at some point with Jeffrey Yao, and it wasn’t.

After the three-day commitment to a hospital psychiatric unit, if the patient wants to leave the facility but doctors are of the opinion that the patient should remain, the matter then goes into court under an emergency petition. There, the patient is entitled to be represented by a public defender, doctors appear as witnesses, and the decision about whether to hold the patient is made by a judge. Here is where the process is in my opinion becomes over-loaded with histrionic concerns over the potential for civil liberties “abuses.”  The judge presiding over the hearing is required to apply the highest standard of evidence in the law in reaching a decision: To require that the patient be held, the hospital and the doctors who testify are required to prove beyond any reasonable doubt that the patient is: A) Seriously mentally ill and B) Will likely harm him or herself or others if released, or C) That the patient if released would be unable to safely care for him or her self. Further, hospital personnel must also demonstrate that less restrictive options for the patient do not exist.

Those standards of evidence are nearly impossible to meet, and in my experience as a criminal defense attorney, 95% of judges are extremely unwilling to rule in the hospital’s favor. How can any doctor or hospital prove beyond any reasonable doubt that a mentally ill person is going to harm someone else or him/herself?  It’s nearly impossible, and when judged against the liberal ethos standards that prevail in most courthouses, it’s a near certainty that such a dangerous person will be released. By the above standards, if a hospital had moved to hold Jeffrey Yao beyond the statutory three day period, he would have been released back to his parents’ home.

In purely theory, a deranged person can be be civilly committed for a period as long as six months. But this very rarely happens, and if the patient demonstrates any “improvement”, however temporary, the individual will be released as soon as possible prior to the end of that six month commitment. If the patient doesn’t demonstrate any improvement the facility can apply to the court for additional commitment terms, up to one year at a time.

Let’s be real: If police belief strongly enough that someone is so seriously mentally ill that he or she is a threat to him or herself or others, that officers bring that person to a hospital for a psychiatric evaluation, then something very serious is going on. But the problem arises not at the hospital conference room with medical and psychiatric specialists and police personnel. They can be acting with the best of intentions and with everyone’s best interests in mind – including the patient. The problem starts when (even before) they get into a courtroom: The reason is that the vast majority of judges are decidedly liberal, and will almost always reject the idea of civilly committing a person against his or her will.

In my view, that philosophical opposition has to stop. Reality needs to dominate the courtroom in any such situation: Again, if both police and psychiatric specialists are both in agreement that an individual is mentally ill and a danger to himself or others, and their professional opinions are so strong that they have brought the matter to court, then something must be very wrong with the individual in question. Civil libertarians would jump from their chairs at such a reasonable proposition, raising the specter of an abusive, fictionalized government seeking to silence anyone they don’t like. To such alarmists I would say this: Be real. This is the freest country on earth. The mentally person you would argue should be released, may choose your or a loved one as the first person to kill.

Jeffrey Yao was, tragically, not the subject of an involuntary civil commitment proceeding. But he should have been.

Once again, my sympathies to the family of Deane Kenny Stryker. May this horrific event teach both the law enforcement and judicial community, how to better handle such dangerous individuals in the future.