Opinion ID: 2185395
Heading Depth: 1
Heading Rank: 3

Heading: an evidentiary hearing

Text: T.H. insists that he has a right to an evidentiary hearing when he objects to a periodic review, and he argues that the court arbitrarily denied him a guaranteed hearing. T.H. cites the first sentence of the second paragraph of NDCC 25-03.1-31 as expressing his right to a hearing upon periodic review if he merely objects to its conclusions: If a periodic review report concludes that the patient continues to require treatment and hospitalization, and the patient objects ..., the patient shall have the right to a hearing, an independent evaluation, and may petition the court for discharge. (Emphasis supplied). The State replies that [t]he plain language of the statute does not provide for a hearing where the independent examiner also concludes that the person continues to require treatment, citing the expression in the last paragraph of NDCC 25-03.1-31: If such report [by an independent expert examiner] concludes that the patient continues to be a person requiring treatment and in need of hospitalization, the court shall so notify the patient and shall dismiss the petition for discharge. If the conclusion is to the contrary, the court shall set a hearing date.... (Emphasis supplied). T.H. summarizes this clash of views this way: You see, the county courts used the last paragraph of section 25-03.1-31 as their basis for denying [T.H.]'s Petitions for Discharge, while [T.H.] depends on the second paragraph to get his hearing before the court. As a result, paragraph 3 cancels out paragraph 2 and [T.H.]'s due process rights get violated. Whatever other ambiguities lie obscured in this section's mechanics, we conclude that an evidentiary hearing is not contemplated when the reviewing examiners, both the facility's and the patient's, agree, and satisfactorily explain why, the patient still needs treatment. In 1977 the Legislature broadly reformed the mental-health statutes and enacted NDCC Ch. 25-03.1 to adopt a magistrate system for each commitment; to procedurally safeguard the individual rights of an involuntary patient; and to foster treatment less restrictive than hospitalization through community resources whenever possible. In the Interest of T.J., 482 N.W.2d 850 (N.D.1992). This reform came just a few years after the United States Supreme Court decided O'Connor v. Donaldson, 422 U.S. 563, 95 S.Ct. 2486, 45 L.Ed.2d 396 (1975) (Even though the initial treatment was proper, the State cannot constitutionally continue involuntary confinement, if the patient is not dangerous to himself or others.) Thus, an important component of the reform was the direction for periodic reviews of a continuing and indeterminate treatment order. The 1977 Mental-Health Act divided the procedure for periodic reviews between consecutive sections. 1977 N.D.Laws, Ch. 239, §§ 31 and 32, codified in NDCC 2503. 1-31 and 25-03.1-32. In 1979, these two sections were merged into a single section: (REVIEW OF CURRENT STATUS OF CONTINUING HOSPITALIZATION TREATMENT). Every individual subject to an order of continuing hospitalization treatment has the right to regular, adequate, and prompt review of his current status as a person requiring treatment and in need of hospitalization. Six months from the date of an order of continuing hospitalization treatment, and every six months year thereafter, the director or superintendent where an individual is hospitalized shall review his status as a person requiring treatment and in need of hospitalization. The results of each periodic review conducted under this chapter shall be made part of the patient's record, and shall be filed within five days of the review, in the form of a written report, with the court which last ordered the patient's hospitalization where the facility is located. Within this five-day period, the director or superintendent shall give notice of the results of the review to the patient, his attorney, and his nearest relative or guardian. If a periodic review report concludes that the patient continues to require treatment and hospitalization, and the patient objects to either or both of those conclusions, the patient shall have the right to a hearing , an independent evaluation, and may petition the court for discharge. This petition may be presented to the court or a representative of the hospital or facility within seven days, excluding weekends and holidays, after the report is received. If the petition is presented to a representative of the hospital or facility, he shall transmit it to the court forthwith. The court shall set a hearing which shall be within fourteen days of the date of receipt of the petition. The petition shall be accompanied by a report from a physician, psychiatrist, or clinical psychologist setting forth the reasons for his or her conclusions that the patient no longer is a person requiring treatment or in need of hospitalization. If no such report accompanies the petition because the patient is indigent or is unable for reasons satisfactory to the court to procure such a report, the court shall appoint an independent expert examiner to examine the patient, and the examiner shall furnish a report to the court. If such report concludes that the patient continues to be a person requiring treatment and in need of hospitalization, the court shall so notify the patient and shall dismiss the petition for discharge. If the conclusion is to the contrary, the court shall set a hearing date which shall be within fourteen days of receipt of the examiner's report. At the hearing, the burden of proof shall be the same as in an involuntary treatment hearing. 1979 N.D.Laws, Ch. 334, § 29. (Overstrike indicates deletion; underscore indicates addition.) The addition for the last two paragraphs largely came from the former second section, NDCC 25-03.1-32, which was simultaneously repealed. 1979 N.D.Laws, Ch. 334, § 33. Importantly, this revision deleted the sentence at the end of the original text of NDCC 25-03.1-31 that directed the court to automatically set a hearing within fourteen days whenever a patient petitioned for discharge. The effect of the revision leaves a periodic opportunity for a hearing, but allows the court to dismiss without a hearing when the independent examiner's report satisfactorily agrees with the facility's report that the patient still needs treatment. Without a factual dispute about whether the patient needs continuing treatment, a court has little to decide. Judges are not experts in mental health. 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 short comings 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 decision maker must make a medical-psychiatric decision. Parham v. J.R., 442 U.S. 584, 609, 99 S.Ct. 2493, 2507-08, 61 L.Ed.2d 101 (1979). Under NDCC 25-03.1-02(5) and (6), only a licensed physician, psychiatrist, or clinical psychologist, (or an addiction counselor for chemical dependency), is authorized to evaluate a patient for involuntary treatment. If required procedures are properly followed, and both the facility's report of examination and the independent examiner's report satisfactorily explain that the patient still needs involuntary treatment, then NDCC 25-03.1-31 does not compel the trial court to hold an evidentiary hearing. If there is a disagreement between the experts, lack of a satisfactory report from one expert, or another reason to think that an involuntary patient may no longer need treatment, then a trial court should hold an evidentiary hearing upon periodic review. The statute ensures an opportunity for the patient to object to the results of a periodic review. The statute does not require an evidentiary hearing unless there is a reason for one. A summary decision without an evidentiary trial is not unusual when there is no factual dispute. In civil cases, summary decision is authorized where the affidavits and documents show that there is no genuine issue as to any material fact and that any party is entitled to a judgment as a matter of a law. NDRCivP 56(c). It is not surprising, and it is not a denial of due process, for the Legislature to establish a comparable procedure for the periodic review of continuing mental-health orders. Efficient use of judicial resources through avoidance of unnecessary hearings is a valid reason to do so, so long as the patient's rights are safeguarded by fair procedures, and so long as the judicial appraisal of the review reports is purposeful, and not perfunctory. In this case, two evidentiary hearings were held, with the assistance of a court appointed counsel and of an independent examiner, to begin this continuing order for indefinite treatment in 1983 and 1984. Still, T.H. protests that he needs a hearing today to prove that he is not mentally ill because all he had then [in 1984] and has now is epilepsy. [2] Indeed, the periodic reports about T.H. dwell on his seizure disorder. Still, T.H.'s history of epilepsy, alone, does not compel an evidentiary hearing since the experts have said from the beginning that he is a drug addict, mentally ill, and in need of treatment. In seeking to set aside this continuing treatment order, T.H. advanced nothing factual to show his seizures were separate from his mental illness or his chemical dependency, or from his need for treatment. His 1991 independent examiner, Dr. Thakor, did not indicate that. T.H. made no factual showing that compelled an evidentiary hearing about his condition, although the trial court would have been free to hold a hearing if it had any doubt about the sufficiency of the reports. We conclude that NDCC 25-03.1-31 did not dictate that the Burleigh County court hold an evidentiary hearing here simply because, without any evidence to contest its conclusions, T.H. objected to the 1991 periodic review.