Case Name: In the Matter of the Application of Helen TRUE for a Writ of Habeas Corpus. Helen TRUE, Appellant, v. STATE of Idaho, DEPARTMENT OF HEALTH AND WELFARE, Respondents
Court: Idaho Supreme Court
Jurisdiction: Idaho
Decision Date: 1982-05-26
Citations: 103 Idaho 151
Docket Number: No. 13207
Parties: In the Matter of the Application of Helen TRUE for a Writ of Habeas Corpus. Helen TRUE, Appellant, v. STATE of Idaho, DEPARTMENT OF HEALTH AND WELFARE, Respondents.
Judges: BISTLINE and DONALDSON, JJ., concur.
Reporter: Idaho Reports
Volume: 103
Pages: 151–170

Head Matter:
645 P.2d 891
In the Matter of the Application of Helen TRUE for a Writ of Habeas Corpus. Helen TRUE, Appellant, v. STATE of Idaho, DEPARTMENT OF HEALTH AND WELFARE, Respondents.
No. 13207.
Supreme Court of Idaho.
May 26, 1982.
Michael H. Hinman and Russell E. Webb, Idaho Falls, for appellant.
David H. Leroy, Atty. Gen., Boise, K. Randall Smith, Asst. Atty. Gen., Idaho Falls, for respondents.

Opinion:
McFADDEN, Justice.
ON REHEARING
The previous opinion in this case is hereby withdrawn; the following opinion is substituted in lieu thereof.
Helen True appeals from an order entered by the district court quashing a writ of habeas corpus. The return on the writ of habeas corpus discloses that the appellant is a patient at State Hospital South in the custody of the Idaho Department of Health and Welfare pursuant to a judicial hospitalization order dated December 30, 1971. It is undisputed that at some point in time following the appellant's being placed in the custody of the department she was placed on conditional release (outpatient) status, but was then summarily returned to State Hospital South for rehospitalization on August 22, 1974.
The appellant subsequently instituted the instant habeas corpus proceedings on August 31, 1978, challenging the constitutionality of her rehospitalization. The issue before us is whether due process principles enunciated by the United States Supreme Court in Morrissey v. Brewer, 408 U.S. 471, 92 S.Ct. 2593, 33 L.Ed.2d 484 (1972), dictate that a patient committed to the custody of the Department of Health and Welfare but who has been conditionally released from institutional hospitalization must be afforded written notice and a hearing prior to the revocation of his conditional release status.
At the time the appellant was rehospitalized, then in effect I.C. § 66-338 and 339 (1974), governed the conditional release of those persons committed to the custody of the Department of Health and Welfare. 1.C. § 66-338(a) (1974) authorized the director of the department or his designated representative to "release an improved patient on the condition that he receive outpatient treatment or on such other reasonable conditions as may be specified." However, an improved patient's conditional release status could be revoked in two situations. First, a conditionally released patient could be immediately rehospitalized in the event the patient had failed to fulfill the conditions of his release and the director of the department or his designated representative "ha[d] reason to believe that conditions justifying hospitalization continue[d] to exist." I.C. § 66-338(b) (1974). Second, the director of the department or his designated representative could order the immediate rehospitalization of a conditionally released patient in the event it was reported "by any two (2) persons who are either licensed phy sicians, health officers, designated examiners or peace officers, the prosecuting attorney or a judge of a court . [that the patient] ha[d] relapsed and [was] again in need of hospitalization. I.C. § 66-339 (1974). Inherent to both situations was a determination that the conditions warranting hospitalization of the patient in the first instance were again present, i.e., the patient was mentally ill or mentally retarded and because of his ailment was likely to injure himself or others. See I.C. § 66-329(i)(l), (2) (1974). In both situations the order of rehospitalization was ex parte, and when indorsed by a judge authorized the immediate detention of the patient. I.C. § 66-338(b) and 339 (1974).
The Department of Health and Welfare argues that the summary procedure for revocation of an improved patient's conditional release status contained in I.C. § 66-338(b) and 339 (1974) withstands due process scrutiny on the dual grounds that: (1) the state's interest in protecting society from the patient and the patient from himself by way of proper, uninterrupted treatment outweighs any deprivation to the patient when he is rehospitalized; and (2) the provision for post-rehospitalization judicial review contained in I.C. § 66-340 (1974), in addition to matters which might be brought to the court's attention by way of habeas corpus (I.C. § 66-347) provides adequate safeguards against arbitrary state action. Underlying the argument is the view that the decision to rehospitalize a patient who has been conditionally released from the custody of the Department of Health and Welfare is predominantly a medical determination; a determination which should not be unduly interfered with by the judiciary.
A careful and thorough review of the applicable propositions of law and relevant case law, however, inescapably lead us to the conclusion that a patient who has been conditionally released from institutional hospitalization possesses a liberty interest which is entitled to due process safeguards. While the entire panoply of procedures outlined in Morrissey are not appropriate in this context, we are of the opinion that at a minimum the following procedures are constitutionally mandated: (1) prompt written notice; and (2) a revocation hearing before a neutral hearing body to be held as soon as is reasonably possible following the patient's rehospitalization. Insofar as the language of I.C. § 66-338(b) and 339 (1974) exclude the necessity of notice and a hearing, they fail to pass constitutional scrutiny.
I
The United States Supreme Court has settled on a two-step analysis in determining the dictates of due process: (1) is the specific interest threatened by government action within the contemplation of the liberty or property language of the Fourteenth Amendment; and (2) assuming the existence of such an interest, what process is due. Goss v. Lopez, 419 U.S. 565, 95 S.Ct. 729, 42 L.Ed.2d 725 (1975); Board of Regents v. Roth, 408 U.S. 564, 92 S.Ct. 2701, 33 L.Ed.2d 548 (1972); Morrissey v. Brewer, 408 U.S. 471, 92 S.Ct. 2593, 33 L.Ed.2d 484 (1972); Goldberg v. Kelly, 397 U.S. 254, 90 S.Ct. 1011, 25 L.Ed.2d 287 (1970). The initial determination of whether an individual is entitled to any procedural protection involves an examination of the extent to which the person "will be 'condemned to suffer grievous loss.' [citations omitted]," (Morrissey v. Brewer, supra, 408 U.S. at 481, 92 S.Ct. at 2600, 33 L.Ed.2d at 494), by the allegedly arbitrary action of the state. This determination necessarily entails inquiring whether the asserted interest being threatened by state action is within the scope of the liberty or property language of the Fourteenth Amendment. Board of Regents v. Roth, supra, 408 U.S. at 370-71, 92 S.Ct. at 2705-06, 33 L.Ed.2d at 557. As to the nature of this inquiry, one commentator has observed:
"Determining the existence of these new entitlements depended on construction of the relevant statutes, and of the pertinent understandings between government and individuals, rather than on any balancing of interests; the existence of an entitlement turned not on 'the weight but [on] the nature of the interest at stake.' The Court appears, therefore, to have placed great emphasis both on making it possible for those who deal with the government in any way to rely on any clearly announced rules, and also on reducing the helplessness of persons who are in a dependent relationship to government with respect to basic needs. As to the latter in particular, the Court has evidently sought to assure that government decisions about needs are reasonably accurate and that individuals have a personal chance to be heard when vital necessities are at stake. Moreover, the Court appears to have proceeded on the premise that, when a reduction in helplessness requires participation in hearings, the cost in dollars cannot be accepted as a sufficient reason to proceed by discretionary choice, since due process will always involve administrative burdens of that sort." Tribe, American Constitutional Law, § 10-9, at 515-16 (1978).
"[O]nce it is determined that due process applies, the question remains what process is due." Morrissey v. Brewer, supra, 408 U.S. at 481, 92 S.Ct. at 2600, 33 L.Ed.2d at 494. As to this question, the court has stressed that "[t]he very nature of due process negates any concept of inflexible procedures applicable to every imaginable situation." Id., quoting Cafeteria & Restaurant Workers Local 473 v. McElroy, 367 U.S. 886, 895, 81 S.Ct. 1743, 1748, 6 L.Ed.2d 1230 (1961). Additionally, the court has insisted that the procedures needed will vary according to specific factual contexts, since "not all situations calling for procedural safeguards, call for the same kind of procedure." Morrissey v. Brewer, supra, 408 U.S. at 481, 92 S.Ct. at 2600, 33 L.Ed.2d at 494. In Mathews v. Eldridge, 424 U.S. 319, 334-35, 96 S.Ct. 893, 902-03, 47 L.Ed.2d 18, 32-33 (1976), the court announced a general formula for the determination of what process is due:
"[0]ur prior decisions indicate that identification of the specific dictates of due process generally requires consideration of three distinct factors: first, the private interest that will be affected by the official action; second, the risk of an erroneous deprivation of such interest through the procedures used, and the probable value, if any, of additional or substitute procedural safeguards; and finally, the government's interest, including the function involved and the fiscal and administrative burdens that the additional or substitute procedural requirement would entail."
In summary, the approach is utilitarian, requiring a preliminary showing that the asserted interest is a cognizable interest under the Fourteenth Amendment, and then requiring a balancing of the relative interests of the individual and the state. The foregoing approach has been adhered to by this court in numerous cases. See, e.g., Bowler v. Board of Trustees of School Dist. No. 392, 101 Idaho 537, 617 P.2d 841 (1980); Jones v. State Board of Medicine, 97 Idaho 859, 555 P.2d 399 (1976).
II
Applying the first level of the test and scrutinizing the interest of a conditionally released mental health patient, the court in Meisel v. Kremens, 405 F.Supp. 1253, 1256 (E.D.Pa.1975) concluded that:
"At issue in the instant case is not the absolute liberty a person alleged to be mentally ill enjoys prior to his initial commitment to a mental institution, but rather the 'conditional liberty' enjoyed by a person who, after commitment to a mental institution, is then released on parole. . The liberty at stake in a civil commitment proceeding is as valuable an interest as the liberty at stake in a criminal trial. In re Ballay, supra [D.C.Cir. 482 F.2d 648] at 668; Heryford v. Parker, infra, [10th Cir. 396 F.2d 393] at 396; Lessard v. Schmidt, infra, 349 F.Supp. [1078] at 1090. And the Supreme Court has unanimously held that the 'conditional liberty' of the paroled criminal falls within the scope of the Fourteenth Amendment and is entitled to the protection of the Due Process Clause. Morrissey v. Brewer, supra, 408 U.S. at 482, 92 S.Ct. 2593 [at 2600]. A New York appel late court has recently applied the principles of Morrissey to the revocation of the aftercare status of drug dependent persons, Ball v. Jones, 43 A.D.2d 281, 351 N.Y.S.2d 199 (1974), and the rationale of that decision has been adopted by a federal district court, Government of the United States ex rel. Shaban v. Essen, 386 F.Supp. 1042 (E.D.N.Y.1974). For my part, I cannot see how the 'conditional liberty' of the paroled mental patient differs in any significant respect from the 'conditional liberty' of the paroled criminal or the paroled drug dependent person. Accordingly, I hold that the former likewise falls within the scope of the Fourteenth Amendment and must be protected by the constitutional safeguards of due process."
The rationale of the Meisel decision was followed by another federal district court in the case of Lewis v. Donahue, 437 F.Supp. 112 (M.D.Okla.1977). In Lewis, the plaintiff was involuntarily committed to an Oklahoma state mental hospital, and eight days later she was released and placed on outpatient aftercare status. Two and one half months later she was rehospitalized pursuant to Section 73 of Title 43A of the Oklahoma statutes, which provided for the revocation of outpatient aftercare status by way of judicial order, issued summarily, upon ex parte application. The court held that the patient in question had a constitutionally protected interest in her conditional liberty, and that the statutory scheme for rehospitalization denied due process because it permitted revocation without notice or opportunity to be heard before rehospitalization. Id. at 114. In reaching its conclusion, the court stated:
"The granting of out-patient standing did change plaintiff's situation — she ceased to be a person who was institutionalized and became a person permitted to enjoy a substantial degree of liberty. Conversely, revocation of leave effected an involuntary transfer from a relatively non-restrictive environment to a restrictive one, and a correlative deprivation of a measure of freedom.
The [statute requires] that release, or conditional release, of a patient be predicated upon a determination made by an appropriate authority that the patient is either restored to mental health, or that institutionalization is no longer likely to be beneficial and that patient's discharge will not be detrimental to his, or the public's welfare. In the latter instance, involuntary medical treatment may, but need not, continue. Thus, an out-patient's enjoyment of his liberty is conditioned only upon his not again becoming a danger to himself or others.
A leave may properly be indeterminate, or terminable upon the happening of certain conditions. But it cannot be denied that conditional, as well as absolute, rights fall 'within the contemplation of the "liberty or property" language of the Fourteenth Amendment.' Morrissey v. Brewer, 408 U.S. 471, 481, 92 S.Ct. 2593, 2600, 33 L.Ed.2d 484 (1972). See also Meisel v. Kremens, 405 F.Supp. 1253 (E.D.Pa.1975)." Id.
The concept that "conditional liberty" falls within the ambit of protection afforded by the due process clause of the Fourteenth Amendment has been recognized in two analogous fact situations. The first of these two cases is Ball v. Jones, 43 A.D.2d 281, 351 N.Y.S.2d 199 (1974), aff'd 36 N.Y.2d 339, 368 N.Y.S.2d 467, 329 N.E.2d 159 (1975). In Ball, the petitioners had been placed in the custody of the New York Narcotic Addiction Control Commission for inpatient care, and were thereafter released on aftercare (outpatient) status. Following various incidents, their outpatient status was summarily revoked. Citing Morrissey, the court held that the principles announced therein were sufficiently broad to encompass the revocation of outpatient status because return to inpatient status inflicts as "grievous" a loss as does revocation of parole. 351 N.Y.S.2d at 203-04.
Similarly, in In re Bye, 12 Cal.3d 96, 115 Cal.Rptr. 382, 524 P.2d 854 (1974), cert. denied, 420 U.S. 996, 95 S.Ct. 1437, 43 L.Ed.2d 679 (1975), the petitioner, a narcotics addict, had his outpatient status summarily re voked by the California Narcotic Addict Evaluation Authority. The California Supreme Court reasoned:
"Similar to the parolee, the CRC outpatient may lead a relatively normal life while in his conditional status. That status, albeit subject to revocation, 'enables him to do a wide range of things open to persons who have never been convicted of any crime.' Although the outpatient may be required to submit to periodic and surprise testing for narcotic use and may also be ordered to maintain close contact with a specially trained parole agent, he retains his civil rights [citations omitted] and is not considered 'civilly dead' for certain purposes as is the parolee whose conditional liberty interest has heretofore been deemed protected. Equally important, as in the case of the parolee, the outpatient has relied on the state's promise that his conditional liberty will not be revoked unless he fails to abide by the conditions of his release and he is obligated to control his conduct accordingly.
Although the Legislature has denominated the narcotic rehabilitation plan 'civil' rather than 'penal' the use of one label rather than the other does not alter the applicability of due process protections to the outpatient's conditional liberty interest." 115 Cal.Rptr. at 386, 524 P.2d at 859.
The court then concluded that the petitioner is entitled to certain procedural due process safeguards to protect his conditional liberty status from arbitrary revocation. Id.
The views expressed in the cases of Meisel and Lewis, and the analogous cases of Ball and Bye, are not universally shared by other courts. In Dietrich v. Brooks, 27 Or. App. 821, 558 P.2d 357 (1976), the Oregon Court of Appeals did not find that state's conditional release statute unconstitutional. In Dietrich the appellant was involuntarily committed to an Oregon state mental hospital, and several months later conditionally released on a "trial visit." Thereafter, he was returned to the hospital after two persons signed an affidavit requesting revocation of the patient's leave. The patient challenged the statute and his rehospitalization as violating due process. The court impliedly recognized that a mental health patient while on conditional release has a protectible "conditional liberty" interest under the Fourteenth Amendment. Id. at 356-60. However, the court opined that there were "profound differences of nature, degree and function between [parole and conditional release] which [made] . . . different due process considerations appropriate." Id. at 360. Specifically, the court noted three distinctions: (1) the underlying nature of imprisonment and parole is penal, while conditional release is a therapeutic device; (2) the length of the deprivation of liberty differs, and (3) the relationship between the conditional liberty and the institutional program was greater with conditional release than with parole. Id. Thus, the court held that when looking at the overall statutory scheme of involuntary commitment, the procedural protections afforded the patient upon summary revocation of conditional release were adequate. Id. at 361.
Similarly, in Hooks v. Jaquith, 318 So.2d 860, 862 (Miss.1975), the Mississippi Supreme Court held that a mental health patient, whose conditional release status had been revoked, was not entitled to habeas corpus relief on the theory that he was unlawfully deprived of his liberty because the "leave" had been terminated without a prior hearing. In so holding, the court stressed that there is a fundamental difference between the revocation of mental health patient's conditional release and that of a convict's parole or probation.
"[T]his case is fundamentally different from those involving revocation of probation or parole. In the latter, revocation is based on a finding that there has been a willful and knowing violation of a condition or conditions imposed upon one previously convicted of having violated the criminal law. These people, at least presumably, are sane and their acts are the result of their own volition. They are not persons suffering from a condition or disease which requires continuing medical treatment.
In the case of mental patients, even more than in the case of patients suffering from physical ailments, a decision as to whether to keep the patient in the hospital or to discharge him must remain a medical one, to be decided by medical experts, based upon the mental condition of the patient and the necessity for hospital treatment, as determined by them." Id. at 861-62.
Moreover, the court stressed that a summary revocation of a mental health patient's conditional release is a medical determination rather than a factual or adversarial decision. Id. at 861. The status being one of continuing treatment, the dictates of due process are not germane to a mental health patient who has been previously and lawfully committed to hospitalization in the first instance.
A synthesis of the above cases leads us to conclude that the better view is the one reflected in the holdings of Meisel and Lewis and buttressed by the holdings in the analogous cases of Ball and Bye: A mental health patient committed to the custody of the Department of Health and Welfare who is conditionally released from hospitalization has a liberty interest in that status which cannot be terminated without due process of law. Nevertheless, the court is mindful that the analogy utilized in the cases between the liberty interest involved in the conditional release of a mental health patient and the liberty interest involved in the parole of a convicted criminal cannot be drawn too tightly. See discussion infra at 900-903.
Pursuant to the provisions of I.C. § 66-338(a), a mental health patient in the custody of the Department of Health and Welfare, whose condition has improved, may be conditionally released from hospitalization provided he receives outpatient treatment and/or abides by other specified conditions. As noted earlier, inherent in a decision to conditionally release a mental health patient from hospitalization is a determination that he no longer poses a danger to himself or to others, and is able to function outside the hospital without major social services support. One court has characterized the conditional release of mental health patients as follows:
"The clinical program prescribed will of course vary in nature and degree with the type of mental illness with which the individual is afflicted. The conditions imposed upon the outpatient may simply involve the taking of certain prescribed medications, or, in addition, extensive counselling, therapy, and observation at the local mental health clinic might be required. As long as the outpatient complies with the regimen meted out through his supervisor and suffers no deterioration in his condition, his conditional liberty will not be revoked." In Re Anderson, 73 Cal.3d 98, 140 Cal.Rptr. 546, 550 (1977).
Similarly, it has been noted that under conditional release programs "the patient is generally free to regulate his own life, just as if he had been discharged from the hospital." Call, "Constitutional Law: The Summary Revocation of an Involuntary Mental Patient's Convalescent Leave — Is it Unconstitutional?" 33 Okla.L.Rev. 366, 370 (1980). Under this paradigm, although the conditional released mental health patient's liberty interest is indeterminate, he is nevertheless free to form "[the] enduring attachments of normal life," and enjoy "many of the core values of unqualified liberty." Morrissey v. Brewer, supra, 408 U.S. at 482, 92 S.Ct. at 2600, 33 L.Ed.2d at 495. Thus viewed, the revocation of a mental health patient's conditional release status and order of rehospitalization constitutes a "massive curtailment of liberty" (Humphrey v. Cady, 405 U.S. 504, 509, 92 S.Ct. 1048, 1052, 31 L.Ed.2d 394 [1972] > — a deprivation which can only be accomplished by the State in accordance with due process of law. Lewis v. Donahue, supra; Meisel v. Kremens, supra.
Whether one calls the revocation of a mental health patient's conditional release status as a "medical" as opposed to a "factual" or "adversarial" decision, or label the status a "continuing cause of treatment" does not address the dispositive question, and as the court in the case of In Re Anderson, supra, 140 Cal.Rptr. at 551 (1977), observed "is simply a variation of the now discredited right-privilege distinction." We are therefore of the opinion that the reasoning of the Hooks decision is unpersuasive in this regard, and note that the concerns of the court in Hooks more appropriately go to the question of the balancing of the relative interests of the state and the individual in view of the purpose and function of involuntary returns of mental health patients from a conditional release.
Before turning to the question of what process is due a mental health patient whose conditional release status is subject to revocation, we turn our attention to the Department of Health and Welfare's contention that the post-rehospitalization judicial review procedure contained in I.C. § 66-340 (1974) as well as the provision for habeas corpus review contained in I.C. § 66-347 withstand constitutional scrutiny. These two statutory provisions read respectively as follows:
"66-340. Appeal from order of rehospitalization. — At any time within thirty (30) days after the director of the department of health and welfare or his designee orders a patient rehospitalized in accordance with the provisions of sections 66-338 or 66-339, Idaho Code, an appeal may be taken therefrom by any person aggrieved thereby to the district court of the county in which such facility is located, and such court shall have the power and jurisdiction to hear and determine said appeal, and to affirm or modify such order, or to order such patient to be involuntarily rehospitalized to the facility or other place of detention from which he was conditionally released."
"66-347. Writ of habeas corpus. — Any individual detained pursuant to this act shall be entitled to the writ of habeas corpus upon proper petition by himself or a friend to any court generally empowered to issue the writ of habeas corpus in the county in which he is detained."
Both statutory provisions enable a mental health patient to seek an after the fact determination of the propriety of an order of rehospitalization. The United States Supreme Court has recognized that provisions for subsequent judicial inquiry into the propriety of governmental depriva-, tions of liberty or property interests will withstand constitutional scrutiny in limited circumstances, i.e., the opportunity for ultimate judicial determination must adequately protect the interests of the individual affected by the summary action and there must be an overriding state interest in postponing inquiry. See Ingraham v. Wright, 430 U.S. 651, 97 S.Ct. 1401, 51 L.Ed.2d 711 (1977); Goss v. Lopez, 419 U.S. 565, 95 S.Ct. 729, 42 L.Ed.2d 725 (1975); Mathews v. Eldridge, supra; Boddie v. Connecticut, 401 U.S. 371, 91 S.Ct. 780, 28 L.Ed.2d 113 (1971). In the instant case, however, it cannot be said that either I.C. § 66-340 (1974) or I.C. § 66-347 adequately protect the interests of a mental health patient whose conditional release status has been revoked. Review under either provision is not mandatory. Neither provision requires that the patient be apprised of the reasons for his rehospitalization. Under these circumstances, there can be no assurances of meaningful review. But more importantly, both provisions are infirm because they place the bur den on the patient to bring forth sufficient facts to justify relief from an order of rehospitalization. It is the state, in cases where it seeks to deprive an individual of a protectible liberty or property interest, which must bring forth sufficient facts justifying its summary action. See Doe v. Gallinot, 486 F.Supp. 983 (C.D.Cal.1979); Fhagen v. Miller, 306 F.Supp. 634 (S.D.N.Y. 1969); In re Anderson, supra.
Ill
As noted earlier in this opinion, the Supreme Court in Morrissey v. Brewer stated that different forms of deprivation of liberty require different forms of due process protection. To reiterate:
"[D]ue process is flexible and calls for such procedural protections as the particular situation demands. '[Cjonsideration of what procedures due process may require under any given set of circumstances must begin with a determination of the precise nature of the government function involved as well as of the private interest that has been affected by governmental action.' Cafeteria & Restaurant Workers Union v. McElroy, 367 U.S. 886, 895, 81 S.Ct. 1743, 1748, 6 L.Ed.2d 1230 (1961). To say that the concept of due process is flexible does not mean that judges are at large to apply it to any and all relationships. Its flexibility is in its scope once it has been determined that some process is due; it is a recognition that not all situations calling for procedural safeguards call for the same kind of procedure." 408 U.S. at 481, 92 S.Ct. at 2600, 33 L.Ed.2d at 494.
Thus, the question in this case is not whether the same procedures as provided for in cases of parole revocation as enunciated in Morrissey are required in cases involving rehospitalization of a conditionally released mental health patient; but rather, the question is whether such procedures are appropriate.
In this context, the court is mindful of the following statement of the Oregon Court of Appeals in the case of Dietrich v. Brooks, supra:
"Termination of a trial visit [conditional release] is not an isolated event. If it were, then a denial of liberty based upon the sworn statements of two people and the judgment of an admitting physician, standing alone, would be unconstitutional for lack of due process. Rather, it is one of a sequence of events within a course of confinement and treatment. It is the procedural protection which surrounds that course of confinement and treatment which must be measured against the Due Process Clause to determine if it is appropriate to the public purpose to be served and to the nature of the individual loss to be guarded against." 558 P.2d at 361.
Accord, In re Bye, supra.
Within this framework, the Meisel decision, and the analogous decision in Ball, are unpersuasive as to what process is due a conditionally released mental health patient upon rehospitalization. In both cases the courts applied the dictates of Morrissey in toto without any analysis of the governmental interest involved in summary revocation of the conditional releases of the mental health patient and narcotic addicts respectively, and its impact upon the private interests of the individuals so affected. Additionally, it is to be noted that in Lewis, the other federal district court case dealing specifically with the summary revocation of a mental health patient's conditional release, the court declined to enter into a discussion of what process was due the patient.
In the instant situation, the conditionally released mental health patient's interest in insuring that the revocation of his right to remain at liberty be based on an accurate evaluation of the facts and diagnosis must be balanced against the Department's need to conduct its program of treatment of the mentally ill and mentally retarded with a minimum of judicially imposed interference. The court is of the opinion that although mental health patients are entitled to due process when the Department seeks to revoke their conditional release status, important differences between the conditional release program for mental health patients and the parole system are such that the procedures outlined in Morrissey for parole revocation, both in terms of timing and formality, are inappropriate in the instant case.
The United States Supreme Court has recently recognized on three different occasions that there are significant differences between the criminal setting and the civil commitment setting that necessitate differing due process considerations. In Addington v. Texas, 441 U.S. 418, 432-433, 99 S.Ct. 1804, 1812-1813, 60 L.Ed.2d 323, 334-335 (1979), the court held that due process required that a "clear and convincing" standard of proof be used in involuntary civil commitment proceedings. In so holding, the court rejected the argument that the criminal standard of proof, i.e., "beyond a reasonable doubt," be applied. Chief Justice Burger, writing for a unanimous court, stated emphatically that "a civil commitment proceeding can in no sense be equated to a criminal prosecution." 441 U.S. at 428, 99 S.Ct. at 1810, 60 L.Ed.2d at 332. Three important distinctions between the civil commitment setting and the criminal setting were noted in support of this conclusion. First, the state's power is exercised in a different manner in the two settings. In civil commitment proceedings the state's power is exercised with the purpose of providing care designed to treat the individual, whereas, in the case of criminal convictions, the state's power is exercised punitively. Id. Second, the risk of error in commitment proceedings is less than the risk associated with criminal proceedings. The court reasoned that because of the continuing administrative review afforded a mental health patient relative to his condition the risk of an erroneous civil commitment is less than an erroneous criminal conviction. 441 U.S. at 428 — 429, 99 S.Ct. at 1810-1811, 60 L.Ed.2d at 332-333. Finally, and probably most important, the court noted that the inquiry in the two settings is divergent. Criminal proceedings address themselves to specific, ascertainable facts while commitment proceedings require interpretations as to diagnosis and predictions of future behavior based on imprecise factors. 441 U.S. at 429, 99 S.Ct. at 1811, 60 L.Ed.2d at 333. Similarly, in Parham v. J. R., 442 U.S. 584, 616-617, 99 S.Ct. 2493, 2511, 61 L.Ed.2d 101, 127 (1979), the court held that when parents seek to have their child committed, or the state attempts to commit a ward of the state in voluntary commitment proceedings, fewer procedural protections are required than in juvenile delinquency proceedings. In so holding, the court again explained that commitment proceedings are different in kind from other proceedings:
"Although we acknowledge the fallibility of medical and psychiatric diagnosis, see O'Connor v. Donaldson, 422 U.S. 563, 584 [95 S.Ct. 2486, 2498, 45 L.Ed.2d 396] (1975) (concurring opinion), we do not accept the notion that the shortcomings of specialists can always be avoided by shifting the decision from a trained specialist using the traditional tools of medical science to an untrained judge or administrative hearing officer after a judicial-type hearing. Even after a hearing, the nonspecialist decisionmaker must make a medical-psychiatric decision. Common human experience and scholarly opinions suggest that the supposed protections of an adversary proceeding to determine the appropriateness of medical decisions for the commitment and treatment of mental and emotional illness may well be more illusory than real." 442 U.S. at 609, 99 S.Ct. at 2507, 61 L.Ed.2d at 123.
Finally, the case of Vitek v. Jones, 445 U.S. 480, 495, 100 S.Ct. 1254, 1264-1265, 63 L.Ed.2d 552, 566 (1980), is to be noted. In that case the court held that certain procedural safeguards must be satisfied before a prisoner may be transferred to a mental institution. The case is noteworthy because of Justice Powell's concurrence in part, which was necessary to obtain a majority. Based upon the recognition that "the issues of civil commitment 'are essentially medical in nature,' " Justice Powell opined that "due process merely requires that the State provide an inmate with qualified and independent assistance. Such assistance may be provided by a licensed psychiatrist or other mental health professional." 445 U.S. at 500, 100 S.Ct. at 1267, 63 L.Ed.2d at 569.
Although the United States Supreme Court has not addressed the due process implications of the revocation of a mental health patient's conditional release, it is apparent from the foregoing cases that reliance upon the criminal analogy is suspect in determining what process is due such an individual. This is particularly true under the interpretation of I.C. § 66-339 advanced today. See discussion, supra, at 3. It is to be recalled that a decision to revoke a mental health patient's conditional release status and to rehospitalize the patient must be accompanied by a determination that the conditions warranting hospitalization in the first instance are again present. The governmental interest therefore involved when a decision is made to rehospitalize a mental health patient on conditional release status is of significant magnitude: the protection of society from the patient and/or the protection of the patient from himself. Thus viewed, timing becomes more critical in the instant case than it is in the parole setting. In the parole situation a delay in the revocation of an individual's parolee status, while highly undesirable in cases where revocation is found to be justified, does not present a serious threat to the degree of rehabilitation achieved prior to the violation. In contrast, in cases where a mental health patient is suspected of remission, the Department's interest in rehospitalization for immediate treatment is paramount, as the progress towards recovery which had been achieved is seriously jeopardized by a remission which is left untreated. As to this point of analysis, the following description of the functional nature of outpatient treatment of mental health patients from the case of In re Anderson, supra, is persuasive.
"Community treatment of a mental patient facilitates the patient's adjustment to community life and in many cases speeds restoration of his sanity as well as affording state institutional personnel the opportunity to make an informed decision as to the patient's suitability for absolute discharge. [Citations omitted.] Yet in some cases the patient may not be ready for such conditional release, may fail to adjust to community life, or may suffer a relapse in his mental condition unrelated to the rigors of community life. In each instance, there is a reasonable probability that the patient's condition may deteriorate, or that he may endanger the safety of others if he remains on outpatient status. [Citation omitted.] . [T]he need for immediate recommitment is of paramount importance both for public and patient well-being, and the decision is peculiarly a medical one best made by a person well versed in the patient's case history." 140 Cal.Rptr. at 552.
Additionally, decisions to rehospitalize a mental health patient on conditional release are peculiarly medical in nature and as such are less subject to objective inquiry than a revocation decision in the parole system. See, e.g., In re Bye, supra; In re Anderson, supra. Accord, Glasco v. Brassard, 94 Idaho 162, 483 P.2d 924 (1971). Accordingly, some deference must be given to the decision of the Director of the Department or his designated representatives, professionals who work in the mental health field on a day to day basis, that revocation of a mental health patient's conditional release is justified for purposes of immediate treatment.
The great weight we accord the Department's need for immediate rehospitalization of a conditionally released mental health patient suspected of remission is such that the general rule that an individual be given an opportunity for a hearing before he is deprived of a protectible interest is inapplicable. The situation present when a decision is made to revoke the conditional release status of the patient is extraordinary: the patient because of a suspected remission in his mental condition possibly poses a danger to others and/or to himself.
Nonetheless, it would be wrong, and in certain instances tragic, to assume that all evaluations and reports that a conditionally released patient is in need of re-hospitalization are accurate. In order to militate against the possibility of an erroneous decision that rehospitalization is warranted, the court is also of the opinion that a mental health patient whose conditional release status is subject to revocation is entitled to mandatory notice and a hearing to follow as soon as is reasonably possible after the patient's return to the hospital.
Specifically, the minimal due process requirements are: (1) prompt written notice to the patient-of the reasons for and evidence relied on justifying rehospitalization as well as notice of the right to challenge the allegations and (2) a hearing before a neutral hearing body to be held as soon as is reasonably possible following the patient's rehospitalization, at which time the patient is to be afforded the right to counsel, the right to present evidence and examine witnesses, and upon a decision sustaining the order of rehospitalization, the right to a written statement by the fact-finding body as to the reasons for revocation of the patient's conditional release status. We stress that these are minimal requirements.
The record before the court is void of detailed information as to what transpired at the time the appellant was summarily returned to State Hospital South for rehospitalization on August 22, 1974. However, on the face of the petition for a writ of habeas corpus appellant has sufficiently stated grounds for its issuance to examine into whether her constitutionally protected rights were breached. See, e.g., Cole v. Cole, 68 Idaho 561, 201 P.2d 98 (1948). Accordingly, the order quashing the writ of habeas corpus is reversed and the cause remanded for further proceedings in accordance with the views expressed in this opinion.
Costs to appellant.
BISTLINE and DONALDSON, JJ., concur.
. In Morrissey two convicts alleged that they were denied due process because their paroles had been revoked without a hearing. The court agreed, holding that due process requires a reasonably prompt informal inquiry conducted by an impartial hearing officer near the place of the alleged parole violation or arrest prior to revocation. The purpose of the hearing is to determine if there is reasonable ground(s) to believe that the parolee has violated a condition of his parole. At the revocation hearing the minimum due process requirements are:
"(a) written notice of the claimed violations of parole; (b) disclosure to the parolee of the evidence against him; (c) opportunity to be heard in person and to present witnesses and documentary evidence; (d) the right to confront and cross-examine adverse witnesses (unless the hearing officer specifically finds good cause for not allowing confrontation); (e) a 'neutral and detached' hearing body such as a traditional parole board, members of which need not be judicial officers or lawyers; and (f) a written statement by the fact-finders as to the evidence relied on and reasons for revoking parole." Morrissey, supra 408 U.S. at 489, 92 S.Ct. at 2604, 33 L.Ed.2d at 499.
. In 1981, the Idaho Legislature amended I.C. § 66-338 and 339. Although the changes in the statutory language are slight, the court notes that the opinion is limited to a discussion of I.C. § 66-338 and 339 as they read at the time of the appellant's rehospitalization.
. The patient also challenged the statute and his rehospitalization as violating equal protection. As to this claim, the court ruled that "the legislature could [have] reasonably [concluded] that where the trial visit lasts for over one-half . the maximum duration of the involuntary commitment, the . [patient] has been at liberty for long enough a time that an additional hearing would be desirable." Dietrich, supra, 558 P.2d at 361.
. It is to be noted that the Dietrich case is not in direct opposition to the conclusion arrived at today. A significant fact taken into account in Dietrich is that under the Oregon statutory scheme, a mental health patient is foreclosed from a revocation hearing only when the patient's conditional release is revoked less than ninety days after it began. Ore.Rev.Stat. § 426.290(4) (1975). Otherwise, the patient has a statutory right to an administrative hearing, including the right to counsel, within seven days after rehospitalization.
. The plurality, however, was of the view that due process requires that the State provide an inmate with legal counsel. 445 U.S. at 500, 100 S.Ct. at 1267, 63 L.Ed.2d at 569.
. In view of the long lapse of time that has transpired since the appellant's rehospitalization, at a subsequent hearing the district court could consider whether the director of the Department or his designated representative have followed their continuing obligation under I.C. § 66-337 to examine the appellant at least every 120 days to determine if the conditions justifying hospitalization still exist.