Opinion ID: 2069196
Heading Depth: 1
Heading Rank: 3

Heading: Bases for Differences in Treatment

Text: In other contexts, it has been held that release standards and other procedures that apply in the cases involving civil committees may be inappropriate in matters involving criminal insanity acquittees. See, e.g., Jones v. United States, 463 U.S. 354, 367, 369, 103 S.Ct. 3043, 3051, 3052, 77 L.Ed.2d 694 (1983); Reese v. United States, 614 A.2d 506, 511 (D.C.1992); see also United States v. Ecker, 177 U.S.App. D.C. 31, 48, 543 F.2d 178, 195 (1976), cert. denied, 429 U.S. 1063, 97 S.Ct. 788, 50 L.Ed.2d 779 (1977). In Reese, based upon the different statutory schemes governing the hospitalization of insanity acquittees and civil committees, we held that the least restrictive treatment standard operates differently. Reese, 614 A.2d at 510. For civilly committed mental patients, [o]nce the court orders a patient's commitment, the Hospital is obligated to follow the least restrictive form of treatment. In re James, 507 A.2d 155, 157 (D.C.1986) (citing Richardson, supra, 481 A.2d at 480). However, for committed acquittees, we have recognized that while [t]he nature of the acquittee's treatment while confined may be relevant to the level of custody.... it is to be weighed in the context of affording reasonable assurances of public safety. Reese, 614 A.2d at 511 (citing De Veau v. United States, 483 A.2d 307, 312 (D.C.1984)). The court is obligated to make its own judicial determination that the acquittee patient has recovered sufficiently such that under the proposed conditions for release the person will not in the reasonable future be dangerous to himself or others. Ecker, 177 U.S.App. D.C. at 37, 543 F.2d at 184 (quoting Hough v. United States, 106 U.S.App. D.C. 192, 195, 271 F.2d 458, 461 (1959)). The civil commitment, by contrast, reflects a `profound congressional concern for the liberties of the mentally ill.' In re Plummer, 608 A.2d 741, 746 (D.C.1992). In Ecker, supra, in addressing the differences in treatment accorded the two categories of patients, the court observed that it had accepted since 1958 the proposition that dangerousness demonstrated by the commission of a crime and acquittal by reason of insanity constitutes a rational basis for the disparity in release provisions governing acquittees and committees. 177 U.S.App. D.C. at 48, 543 F.2d at 195; see also Overholser v. Leach, 103 U.S.App. D.C. 289, 291-92, 257 F.2d 667, 669-70 (1958) (insanity acquittees are an exceptional class of people who are treated by Congress in a different fashion from persons who have somewhat similar mental conditions, but who have not committed offenses or obtained verdicts of not guilty by reason of insanity at criminal trials). The statutes governing the release and conditional release of the two categories of patients are significantly different. For example, the Ervin Act, [6] which governs patients civilly committed under court order, provides for the patient or someone acting on his or her behalf, to request a current mental examination from the chief of service of the Hospital, and the chief of service is required to order the patient's immediate release if the reports of the qualified professionals lead to the conclusion that the patient is no longer mentally ill to the extent that he is likely to injure himself or others. D.C.Code § 21-546. If the chief of service determines that the patient continues to require hospitalization, but at least one of the physicians or psychologists who examined the patient has determined that release is appropriate, then the patient may petition the court for an order directing his release. Id. Statutory responsibility for monitoring the patient's progress and releasing the patient immediately upon a determination that hospitalization is no longer necessary is reposed in the chief of service of the Hospital. D.C.Code § 21-548. Under this statutory scheme, the Hospital has the authority to restore conditional release privileges of civilly committed patients after revocation. Unlike the procedure for civil committees, the Hospital can not restore conditional release privileges after revocation, but must await court approval. Compare D.C.Code §§ 21-546(a) and -548 with D.C.Code §§ 24-301(e) and -301(k). However, an acquittee may seek release or conditional release periodically by direct application to the court. D.C.Code § 24-301(k). There is no requirement of a preliminary request to the chief of the hospital before judicial review of an acquittee's request for release or conditional release. See id.