Opinion ID: 4310658
Heading Depth: 5
Heading Rank: 1

Heading: Therapy Sessions

Text: The defendants first object to the admission of portions of recordings taken of Belford’s sixteen therapy sessions to treat her anxiety and depression with Dawn Edgar, her therapist. Edgar testified at trial, and these recordings were admitted through her testimony as evidence of Belford’s state of mind. The Government contends that they are admissible under two separate hearsay exceptions: (1) as evidence of the declarant’s state of mind, and (2) as a statement made for purposes of medical diagnosis or treatment. Fed. R. Evid. 57 803(3) & (4). Rule 803(4) provides a hearsay exception for a “Statement Made for Medical Diagnosis or Treatment,” which is defined as follows: “A statement that: (A) is made for—and is reasonably pertinent to—medical diagnosis or treatment; and (B) describes medical history; past or present symptoms or sensations; their inception; or their general cause.” Fed. R. Evid. 803(4). The defendants argue that Belford’s statements to her therapist are not covered by Rule 803(4), because this exception should not apply to statements made to mental health professionals. They contend that statements made to mental health professionals do not exhibit the same indicia of reliability as do statements made to other medical professionals. The defendants claim that these statements are unreliable because the issue of the truth of a patient’s statements regarding his or her mental condition is not as relevant for mental health professionals as it is for physical health doctors. As a result, the defendants argue that the statements were not made for “medical diagnosis or treatment,” and thus do not qualify for the Rule 803(4) exception. We disagree. We have not previously decided whether Rule 803(4) covers statements made to a mental health professional, rather than to a physician. However, the plain text of the Rule does not limit its application to statements made to a physician. Rule 803(4) focuses on the purpose for which the statement is made, not on the identity of the recipient. The advisory committee note to Rule 803(4) makes clear that statements made to a broad category of individuals other than physicians are covered by the exception, such as those made to “hospital attendants, ambulance drivers, or even members of the family.” Fed. R. Evid. 803 advisory committee 58 note to paragraph (4). There is no indication from Rule 803(4) or its accompanying advisory committee notes that it should not extend to statements made to mental health professionals. The defendants have provided no persuasive authority in support of their position. If Rule 803(4) extends to cover statements made to non-medical persons such as family members, it logically also covers statements made to other medical professionals, including those who specialize in mental health. Accordingly, we hold that the exception in Rule 803(4) applies to statements made to therapists and mental health professionals. The decisions of our sister Courts of Appeals support this conclusion, as every Court of Appeals to consider this issue has determined that statements made to a mental health professional for purposes of diagnosis or treatment qualify under the hearsay exception in Rule 803(4). See, e.g., United States v. Kappell, 418 F.3d 550, 556 (6th Cir. 2005); Danaipour v. McLarey, 386 F.3d 289, 297 (1st Cir. 2004); United States v. Yellow, 18 F.3d 1438, 1442 (8th Cir. 1994); Morgan v. Foretich, 846 F.2d 941, 949 n.17 (4th Cir. 1988); United States v. Lechoco, 542 F.2d 84, 89 n.6 (D.C. Cir. 1976), abrogated on other grounds by In re Sealed Case, 352 F.3d 409 (D.C. Cir. 2003). Belford made the statements in question to her therapist, who she was consulting for treatment of her anxiety and depression. Thus, these statements were made for “medical diagnosis or treatment.” Fed. R. Evid. 803(4)(A). These statements concerned Belford’s emotional state, including discussions of her anxiety and depression, as well as their cause. These types of statements are plainly within the confines of Rule 803(4)(B) as they are a description of 59 Belford’s “past or present symptoms or sensations; their inception; or their general cause.” Fed. R. Evid. 803(4)(B). Accordingly, we hold that Belford’s statements to her therapist were admissible pursuant to Rule 803(4).14 14 In the alternative, the Government argues that these recordings are admissible pursuant to Rule 803(3), the state of mind exception. The District Court admitted them because it found that they qualified under Rule 803(3) to show Belford’s emotional state, which was a necessary element of the charges. Rule 803(3) provides that: A statement of the declarant’s then-existing state of mind (such as motive, intent, or plan) or emotional, sensory, or physical condition (such as mental feeling, pain, or bodily health), but not including a statement of memory or belief to prove the fact remembered or believed unless it relates to the validity or terms of the declarant’s will. Belford’s statements to her therapist consist of Belford’s description of her emotional condition. As the District Court correctly observed, the recorded nature of the statements was relevant to showing Belford’s state of mind because the tenor of her voice in the recordings provided strong evidence of her emotional condition at the time. These statements were admitted to show the effect that the defendants’ stalking campaign had on Belford and her resulting emotional state, not for the truth of what she was saying. Belford’s emotional condition and state of mind are directly relevant to the Government’s burden to prove that the defendants’ actions caused her substantial emotional distress. Accordingly, this 60