Court Opinion

ID: 9747281
Source: CourtListenerOpinion
Date Created: 2023-08-27 15:08:25.852533+00
Date Added: 2024-06-11T07:25:22.432366
License: Public Domain

STEADMAN, Associate Judge:
Appellant was involuntarily admitted to St. Elizabeths Hospital for emergency observation and diagnosis under D.C.Code § 21-521 (1989). The application was signed by a physician who, appellant asserts, did not meet all the prerequisites set forth in the statute.1 At a hearing held pursuant to § 525, the trial court found that probable cause had been established to believe that “respondent is mentally ill, and, because of that illness, is likely to injure herself unless immediately hospitalized.” Accordingly, the court authorized continued emergency observation and diagnosis pursuant to § 524(a)(1), which cannot exceed seven days unless formal hospitalization proceedings are commenced. §§ 523, 528. A panel of this court affirmed the trial court’s conclusion that even if the original application for emergency hospitalization did not meet the prerequisites of §§ 521 and 582(b), such defects, if any, had been remedied pursuant to a line of cases culminating in In re Rosell, 547 A.2d 180 (D.C.1988). In re Herman, 594 A.2d 533 (D.C.1991). We subsequently granted appellant’s petition for rehearing en banc and vacated the panel’s opinion and judgment in order to give full court consideration to the effect of such so-called “application defects” on the trial court’s authority to order continued emergency hospitalization of a mentally ill person. In re Herman, 604 A.2d 1391 (D.C.1992).
We conclude that under the statutory scheme established for emergency hospitalizations, when the trial court becomes involved in the process pursuant to §§ 524 or 525, its focus should be on the present mental condition of the person involved and whether or not probable cause exists to believe that person is likely to injure himself or herself or others if not immediately detained. At that point in the process, a defect in the application itself should be taken into account insofar as it may bear upon the reliability and integrity of the application and the information therein, but should not be treated as a per se cause for immediate termination of the proceedings and release of the person involved no matter how dangerous to self or others. Particularly in light of other, expressly-created statutory and common-law mechanisms designed to protect against unauthorized and unwarranted applications, we are unwilling to read into the statute an unexpressed congressional intent that any defect in the application should without more invalidate the entire process of emergency hospitalization.
I
A
Appellant is a sixty-eight-year-old woman with a history of mental illness, including psychiatric hospitalizations over the past thirty years. In February 1990 she arrived in the District of Columbia, where she took up residence in the shelter operated by the Community for Creative Nonviolence, located at 2nd and D Streets, N.W. As time went on, the shelter staff became increasingly concerned about appellant’s behavior, and invoked the aid of Priscilla Porter, a social worker assigned to work with female residents at the shelter who had become familiar with appellant during her stay *960there. Appellant refused to speak with Ms. Porter or any other clinician about her situation or to accept any medical help at the shelter. A crisis mental health team from the Emergency Psychiatric Response Division (“EPRD”) did make an hour-long assessment of appellant on June 7, 1990, but did not refer her for emergency hospitalization at that time.
On June 8, 1990, Ms. Porter requested that Jannelle Goetcheus, M.D., the medical director of the Health Care for the Homeless clinic, examine appellant at the shelter. Ms. Porter suggested to Dr. Goetcheus that she remove her stethoscope and not identify herself as a doctor because of appellant’s unwillingness to speak with health care professionals. According to Ms. Porter, who witnessed the interview, appellant did speak briefly with Dr. Goetcheus “for several minutes,2 until she [appellant] realized, I think, that she [Dr. Goetcheus] was a doctor ... And then she [appellant] got up and walked away.” Dr. Goetcheus then spoke with several staff members who had observed appellant’s behavior. She also discussed the situation with Dr. Keesling, the psychiatrist who is the head of the EPRD, and he advised her to make the necessary application for involuntary hospitalization.
Dr. Goetcheus thereupon filled out the application required by § 21-521. She erroneously checked the box identifying herself as a “physician employed by the United States or the District of Columbia.” She also failed to check the box that related to compliance with the requirements of § 582.3
The form, signed by Dr. Goetcheus, did state, in its printed text, that the applicant has “reason to believe” that the person to be hospitalized “is mentally ill and, because of such illness, is likely to injure self and/or others if not immediately detained.” Furthermore, in her own handwriting, Dr. Goetcheus explained the bases for this conclusion: “67 year old homeless woman whose behavior has deteriorated in last 2 months. Noted by shelter staff to defecate in her bed & smear feces on bathroom walls, floor, her clothes and her body. Patient talking this a.m. of White House trying to contact her, the President trying to call her, and her husband is attempting to murder her. Daughter of patient states [patient] has had multiple psychiatric admissions w/ diagnosis of paranoid schizophrenia. Staff has [observed] patient trying to light cigarette butts, at times almost catching her clothing on fire and concern about mattress catching fire. Patient is danger to herself and others.”
On the basis of this application, appellant was taken into custody and presented for admission to St. Elizabeths Hospital for purposes of emergency observation and diagnosis. Thereafter, all the steps prescribed by statute for emergency hospitalization were taken within the allotted time periods. Pursuant to § 522, a psychiatrist on duty at the hospital examined appellant, tentatively diagnosed her as suffering from “atypical psychosis,” and concluded that she was “likely to injure herself and/or others unless immediately hospitalized.” Pursuant to § 523, the hospital within 48 hours filed a petition with the Superior Court seeking appellant’s detention for an additional seven days of emergency observation and diagnosis, which was granted the same day pursuant to § 524.
Appellant then requested a probable cause hearing pursuant to § 525. Although scheduled for the following day, the hearing was postponed for one week because appellant fired her originally appointed attorney. At the outset of the rescheduled hearing, appellant moved to dismiss the case on the basis of the allegedly improper application. The trial court postponed ruling on the motion at that time, *961and proceeded to hear the hospital’s three witnesses. The first of these witnesses was appellant’s daughter, who recounted appellant’s history of mental illness. Next, Ms. Porter testified that she had learned from shelter staff that appellant smoked cigarettes while in bed and that she had defecated in her bed and had smeared feces in the bathroom. Ms. Porter had personally observed similar behavior, and she testified that she had seen what appeared to be feces on appellant’s arms and under her fingernails, and had noticed that appellant “constantly” flicked lit matches. Finally, Robert Brown, M.D., a psychiatrist at the hospital, testified that he had diagnosed appellant’s condition as “paranoid schizophrenia” based on his own personal observations, those of other hospital staff who had observed appellant during the nearly 18 days she had spent at St. Elizabeths prior to the hearing, and on the testimony at the hearing.4 Appellant testified on her own behalf, as did an investigator for the Public Defender Service.
Following the close of the government’s case, the trial court addressed again the question of the assertedly deficient application and found that the subsequent proceedings had cured any such deficiencies. At the end of all proceedings, the court found, based on the testimony at the hearing, that there was probable cause to believe that appellant was mentally ill and that as a consequence, she was a danger to herself if allowed to remain at liberty.5 Accordingly, he ordered that she continue to be hospitalized for emergency observation and diagnosis pursuant to § 524(a)(1).6
B
Of primary relevance to this case are two of the sections of the District of Columbia Hospitalization of the Mentally Ill Act (also known as the Ervin Act), D.C.Code §§ 21-501 et seq. (1989), dealing with the involuntary emergency hospitalization of persons believed to be dangerously mentally ill. Under § 521, such hospitalization can be initiated only as follows:
An accredited officer or agent of the Department of Human Services of the District of Columbia, or an officer authorized to make arrests in the District of Columbia, or a physician or qualified psychologist of the person in question, who has reason to believe that a person is mentally ill and, because of the illness, is likely to injure himself or others if he is not immediately detained may, without a warrant, take the person into custody, transport him to a public or private hospital, and make application for his admission thereto for purposes of emergency observation and diagnosis. The application shall reveal the circumstances under which the person was taken into custody and the reasons therefor.
Thus, only three categories of individuals— certain employees of the Department of Human Services, police officers, and physicians and qualified psychologists “of the person in question” — are authorized to make the necessary initial application to a hospital for the admission of the affected *962individual for purposes of emergency observation and diagnosis.
A further limitation on such applications insofar as physicians and qualified psychologists are concerned is found in § 582 (contained in the subchapter on “Miscellaneous Provisions”). Its subsection (b)7 provides that:
A petition, application, or certificate of a physician or qualified psychologist may not be considered unless it is based on personal observation and examination of the alleged mentally ill person made by the physician or qualified psychologist not more than 72 hours prior to the making of the petition, application, or certificate. The certificate shall set forth in detail the facts and reasons on which the physician or qualified psychologist based his opinions and conclusions.
As its starting point, the panel assumed, as had the trial court, that the physician who signed the application for emergency hospitalization of appellant was not the “physician of the person” as required by § 521.8 Drawing on a line of cases beginning with Williams v. Meredith, 407 A.2d 569 (D.C.1979), which held that certain defects in applications made pursuant to § 521, including an application completed by one found not to be in fact the “physician of the person,” were “remedied” by a trial court’s subsequent finding of probable cause in a § 524 order or after a § 525 hearing,9 the panel concluded that the trial court properly ordered the continued emergency hospitalization of appellant.10 With respect to the alleged § 582(b) violation, the panel concluded that by conversing with appellant, shelter staff, and the head of the EPRD before providing in the application a “detailed report” of the reasons for applying for emergency hospitalization, the physician, “having involved herself personally in the process of determining appellant’s need for emergency hospitalization and faced with a refusal of appellant to cooperate, did all that the statute required.” Herman, supra, 594 A.2d at 537-38. The panel noted that while excusing defective applications raised “significant concern,” ordering the release of appellant would ignore the fact that the trial court had determined, after a full evidentiary hearing, that probable cause existed to believe that she was “ ‘mentally ill and, because of that illness ... likely to injure herself or others’ unless immediately hospitalized for observation and diagnosis not to exceed the limited maximum period allowed by the Act.” Id. at 539 (quoting Rosell, supra, 547 A.2d at 183).
As in the panel opinion, we will assume without deciding that Dr. Goetcheus was not the “physician of the person,” and hence that the application for appellant’s emergency hospitalization violated § 521 in that regard. With respect to the alleged § 582(b) violation, we will further assume, again entirely without deciding, that the extent of personal observation was insufficient to strictly meet the requirement of § 582(b). Therefore, we turn directly to the issue whether the alleged failure to meet these requirements barred the trial court from going on to consider whether in *963fact there was probable cause that appellant was likely to injure herself unless she was immediately hospitalized and from ordering appellant’s continued emergency hospitalization based on that finding.
II
A
Our starting point is the text of the Ervin Act itself, particularly the subchap-ter dealing with emergency hospitalization procedures. No provision of this subchap-ter or any other provision of the Ervin Act explicitly provides that a trial court at a post-admission hearing should impose as the sanction for defects in the original application the immediate release of the person detained, even where there is sufficient evidence for the trial court to conclude that probable cause exists to believe that the person is mentally ill and is likely to injure himself or others if released.11 See In re Barnard, 147 U.S.App.D.C. 302, 455 F.2d 1370 (1971) (applying probable cause standard to § 525 hearing and outlining respective burdens on parties). Therefore, a finding that Congress intended such a result must be somehow gleaned from the structure and operation of the Act. We think such an inquiry leads to a quite opposite conclusion.
To begin with, the involvement of the trial court does not come with the filing of the application. Rather, court involvement begins with a petition from the hospital administrator, and that, not the initial application, is the impetus of the proceeding. The hospital’s petition must be filed within 48 hours from the time of admission if the administrator determines that the emergency observation and diagnosis requires detention beyond that period. § 523. Thus, by the time the matter reaches the trial court, a psychiatrist or qualified psychologist on duty at the hospital — that is, a professional specially trained in mental health — has examined the person and concluded that the person “has symptoms of a mental illness and, as a result thereof, is likely to injure himself [or herself] or others unless he [or she] is immediately hospitalized.” § 522. In addition, the administrator has determined to admit the person for purposes of emergency observation and diagnosis, and notice of such admission has been given to the spouse, parent, or legal guardian of the person and to the Commission on Mental Health. Id.
As a result oí these statutorily-required procedures, the trial court has before it at the time of the § 524 determination,12 and is required to consider, not only the application but the certificate of the hospital’s examining psychiatrist or psychologist and “any other relevant information.” Such information can include the hospital’s experience with the person over the days elapsed since admission. In short, the petition, not the initial application, is now the key operative document.
The trial court’s task, then, is to focus upon the present mental state of the person and the probability of injury to the person or others, taking into account all relevant and available information. Nothing in § 524 suggests that the trial court should focus upon the processes whereby the person came to be admitted to the hospital to the exclusion of other considerations. To the contrary, § 524 appears to contemplate a substantive review, based on all of the information available to the trial court, of the mental condition of the hospi*964talized person at the time the petition is filed with the court. Immediate release based on a defective application is nowhere mentioned in the section. In the absence of textual support for the proposition that the trial court is not to consider all of the relevant information, as § 524 provides, whenever there is a formal defect in the application, we are disinclined to construe the section in this manner.
The same considerations warrant a like construction of § 525. Section 525 provides that when continued hospitalization is ordered under § 524, the trial court must hold a hearing within 24 hours of its request. Essentially, § 525 ensures that the person can have a full evidentiary hearing in which he or she can participate to challenge the correctness of the trial court’s determination under § 524. In the absence of any evidence that Congress intended different considerations to apply to § 525 hearings than to § 524 determinations, we conclude that the trial court’s focus at § 525 hearings also should be on the hospitalized person’s present condition.
B
Appellant quite properly raises the concern, which we share, that provision for emergency hospitalization can create a potential for erroneous commitments and unlawful detention. We do not doubt that while the emergency provisions were not the exclusive subject of the Ervin Act,13 Congress was well aware of this concern over their operation.14 The Ervin Act’s emergency admissions procedures represent one part of a broader effort “to revise the procedures for the hospitalization of the mentally ill in the District of Columbia and to guarantee to those hospitalized certain civil rights.” Senate Comm, on the JUDICIARY, PROTECTING THE CONSTITUTIONAL Rights of the Mentally III, S.Rep. No. 925, 88th Cong., 2d Sess. 9 (1964), U.S.Code Cong. & Admin.News, 1964,1078 (hereinafter Senate Report). One of the concerns to the drafters of the Act was to give appropriate and timely attention to those mentally ill persons who were likely to injure themselves or others unless immediately hospitalized. Id. at 3. Thus, the procedures for emergency admission provided fewer protections than did the procedures for longer-term judicial hospitalization, the rationale being that “it is necessary to give the individual immediate attention.” Id. at 17.
As a consequence, the Ervin Act explicitly provides for certain precise safeguards for preventing abuses of the emergency hospitalization procedures. First, as already mentioned, the statute commands that a hospital may not admit for purposes of emergency diagnosis and observation a person for whom application is made under *965§ 521 unless a psychiatrist or qualified psychologist on duty at that very hospital examines the person and concludes that the person will present a danger if not hospitalized. “The statute thus contemplates that the psychiatrist’s certificate rather than the physician’s application, will determine whether the patient will be confined for emergency observation and diagnosis.” Johnson v. United States, 178 U.S.App.D.C. 391, 396, 547 F.2d 688, 693 (D.C.Cir.1976) (per curiam). Indeed, in considering a claim of wrongdoing by the physician executing the application, the Johnson court concluded that “the intervening action of the hospital psychiatrist was an independent efficient cause, and thus legally the proximate cause, of appellant’s confinement.” Id. at 397-98, 547 F.2d at 694-95. In the case of a private hospital, even with such a determination, the hospital administrator may nonetheless refuse admission. While a public hospital must admit the person, the second determination of dangerousness is there made by a government employee presumably sheltered from conflicting considerations. In either ease, internal discipline procedures may provide an additional check on examinations that do not comply with the requirements of § 522.
The statute also requires that particular scrutiny be given to applications under § 521 made by physicians or qualified psychologists. Under § 582, an application by a physician or qualified psychologist “may not be considered” by the hospital unless the person making the application meets a number of requirements, including the requirement that his application is based on the personal observation and examination of the mentally ill person not more than 72 hours prior to making the application.15 By providing that hospitals may not consider applications that do not meet the prerequisites of § 582,16 and by requiring hospital psychiatrists to conduct their own independent evaluations of persons for whom applications are made, the Act established *966one procedure for ferreting out abusive or unwarranted applications.
Nor is review by the admitting hospital the only safeguard against unwarranted or erroneous emergency hospitalizations: the Ervin Act’s strict time limits governing the process of emergency hospitalization provide a second tier of protections against extended deprivations of liberty. As described above, § 522 of the Act provides that a hospital that admits a person under the emergency hospitalization procedures shall serve notice of the admission on the spouse, parent, or legal guardian of the person not later than 24 hours after the admission. Section 523 provides that a person admitted under § 522 may not be detained for more than 48 hours unless the administrator of the hospital has filed a written petition with the court for an order authorizing the continued hospitalization of the person for emergency observation and diagnosis for not more than seven days from the time the order is entered. Under §' 524, the court must rule on the petition within 24 hours of its receipt, and, if the court orders continuing hospitalization and the person requests a hearing on the matter, the court must hold the hearing within 24 hours of receipt of. the request. See In re DeLoatch, 532 A.2d 1343, 1345 (D.C.1987) (section 525 requires trial court to hold hearing within 24 hours of request, and failure to do so results in release of detainee). Finally, we have read § 528, which deals with the detention of persons hospitalized under the emergency procedures during the course of judicial proceedings, to require that a hospital file a judicial hospitalization petition within the seven-day period established in § 523. See In re Strickland, 597 A.2d 869 (D.C.1991); In re Reed, 571 A.2d 801 (D.C.1990).
Although the correctness of our prior decisions interpreting certain of these time limitations rigidly to require the release of a person detained in violation of them is not squarely before us, this line of cases necessarily is implicated by the question whether we have properly distinguished between violations of the statutory timetables and violations in the application process. The basis for such a distinction is derived from the statute itself. We think that the DeLoatch court correctly concluded that these timetables “evince[] the intention of Congress to permit emergency confinement for only short and precisely circumscribed durations.” 532 A.2d at 1345. Not only do §§ 522, 523, and 525 use the mandatory “shall,” which we have said “creates ‘a duty, not an option,’ ” id. at 1344 (quoting DuPont Circle Citizens Ass’n v. District of Columbia Bd. of Zoning Adjustment, 530 A.2d 1163, 1170 (D.C.1987)),17 the entire statutory scheme postulates independent judicial review as the cornerstone of the protections against erroneous deprivations of liberty. See generally Senate REPORT, supra; see also Morris, supra note [9], 482 A.2d at 373. Since such review is at the heart of due process, we have treated failures to comply with those time limits for invoking such judicial review as implicating a core concern of the Act.
It is true that however well these subsequent safeguards may work, a defective application may result in a brief period of unauthorized involuntary detention. The statute itself shows that Congress was not unmindful of the problem. In addition to § 582, the statute imposes specific criminal penalties for certain abuses of the emergency hospitalization procedures. Section 591(1) of the Act provides for a fine of not more than $5,000 or imprisonment for a maximum of three years, or both, of any person who executes a petition, application or certificate or causes or assists another to cause the hospitalization of a third person without probable cause for believing that person to be mentally ill. The same penalties apply specifically to any physician, psychiatrist, or qualified psychologist who.knowingly makes a false certificate or *967application as to the mental condition of a person. § 591(3).
Furthermore, long existing case law opened the possibility of civil liability in tort. In Jillson v. Caprio, 86 U.S.App.D.C. 168, 181 F.2d 523 (1950) the plaintiff had brought a claim of false imprisonment against a physician specializing in psychiatry who, it was alleged, had caused a police officer to transport the plaintiff to a mental hospital by providing that officer with a written statement that he believed the person was mentally ill and in need of hospitalization. In reversing a directed verdict for the physician, the court noted that the then existing statute authorized an arrest other than in a public place18 only upon affidavits of “two or more responsible residents” that they believed for specified reasons the person was unfit to be at large and, in addition, upon certificates of at least two physicians that they had examined the person and that “such person should not be allowed to remain at liberty and go unrestrained, and that such person is a fit subject for treatment on account of his or her mental condition.” D.C.Code § 21-327 (1940). The court noted:
In providing protection for persons whose relatives think or pretend to think they require restraint because of mental illness, Congress necessarily struck a balance between individual liberty and public safety. A policeman or a psychiatrist may think Congress should have drawn the line in a different place but may not make arrests on that theory. Some insane and some sane persons may well be thought dangerous, but even the most reasonable belief that they will do harm in the future does not justify doctor or layman in arresting them without statutory authorization and without a warrant. Appellee’s calling neither defeats appellant’s claim to damages nor reduces its amount.
Jillson, supra, 86 U.S.App.D.C. at 169-70, 181 F.2d at 524-25. The concurring judge cautioned against too broad a reading of the holding. Id. at 170-71, 181 F.2d at 525-26. He noted that the common law recognized the power to restrain, summarily and without court process, an insane person who was dangerous at the moment. He would apply that rule in this jurisdiction while stressing that “the defendant must plead and prove that the emergency was real and immediate, and that the measures taken were reasonable under all the circumstances.” He would further permit a defendant to prove in reduction of damages “that he was acting in good faith, that the patient was in fact in need of hospitalization, and that the hospitalization was beneficial.” Id. at 170, 181 F.2d at 525.
That the concurring opinion’s view was more likely to prevail is indicated by the subsequent holding in Orvis v. Brickman, 90 U.S.App.D.C. 266, 196 F.2d 762 (1952), involving a civil action against a police officer who transported a woman who had attempted suicide to a hospital where she was placed in a psychiatric ward. Although the ease was decided on other grounds, the court noted that “we could not find that Congress, in enacting these provision of the statute [referring to the provision summarized above for detention of persons believed insane] intended to supersede the common law power of emergency arrest to such an extent as to impose civil liability upon a person who, acting reasonably, detains or restrains a person temporarily, for the purpose of mental observation, in order to prevent immediate serious harm or injury to the person restrained or to others.” Id. at 272, 196 F.2d at 767.19
We have no occasion here to delve further into the intricacies of the civil law in this regard, other than to note the existence of such possibilities of relief. We note also, that as our case law indicates, a person who is improperly detained in the admission process may seek to have that *968admission expunged from the record. See Morris, supra note 9, 482 A.2d at 373-74.
C
Finally, we reiterate the proposition that defects in the application are not, in truth, “cured” or “remedied” by the subsequent judicial determination under §§ 524 and 525. The defects remain defects and we do not trivialize them. We echo and adopt the exhortation of the panel opinion in this case:
Excusal in certain circumstances of defects in applications for involuntary admission raises significant concern. It could encourage sloppiness in compliance with the statutory provisions, designed in part to protect the rights of those who may exhibit signs of mental illness but not in fact be in need of hospitalization. Although other remedies, such as liability in tort, may perhaps lie in cases where the statutory requirements have not been met, fairness in the overall operation of the statutory scheme depends upon a scrupulous attempt by all concerned to adhere to both the spirit and the letter of the law.
Herman, supra, 594 A.2d at 539. Furthermore, we reiterate the proposition that defects in the application are not irrelevant. The trial court quite properly should take such defects into account insofar as they bear upon the reliability and integrity of the application and the information therein. Reliance on a defective application must be taken with caution, if not discounted altogether. Here, as already indicated, that does not appear a concern. The trial court heard three separate witnesses and ample grounds existed for his conclusion apart from the application form itself.
Moreover, a realistic view of the specific defects should be taken. No direct conflict of interest appeared of the type set forth in § 582(a), and it would be groundless to speculate otherwise. Likewise, if Dr. Goet-cheus’s application was not based on a “personal observation and examination” of Ms. Herman sufficient to meet § 582(b), it certainly reflected a genuine personal involvement in the process and seemingly a far cry from the concern about “loose certificates which occasionally have been presented,” referred to by the federal judge who recommended the inclusion of that requirement in the Ervin Act. See note 15 supra.
Perhaps too easily, these mental health proceedings with their heavy involvement of the legal profession can slip into an adversarial posture, apparently pitting the abstract rights of the individual against those of the public. At times, this may indeed be so. But in truth, as this case may illustrate, the true interests of the individual can be more complex. The interests of a person who in fact is a danger to herself if not hospitalized would not necessarily seem well served by releasing her solely because of some procedural defect in the mechanism by which she has come to be hospitalized for emergency observation and diagnosis. Cf. In re Melton, 565 A.2d 635, 649-50 (D.C.1989) (Schwelb, J., dissenting) (characterizing as “pyrrhic” legal victories that established the right for a mentally ill person not to be required to take medication essential to his or her mental health), on reh’g, 597 A.2d 892 (D.C.1991) (en banc); Addington v. Texas, 441 U.S. 418, 430, 99 S.Ct. 1804, 1811, 60 L.Ed.2d 323 (1979) (rejecting standard of beyond a reasonable doubt as constitutionally required for civil commitment proceedings as potentially preventing commitment of patients desperately in need of institutional care; “[s]uch ‘freedom’ for a mentally ill person would be purchased at a high price”). We see no reason why the actions of those involved in the complicated mental health field, from application to treatment to final resolution, should not carry in general a presumption of good faith and devotion to the interests of the mentally ill as well as to the public who may be affected thereby.
In short, appellant would have us find an intent of Congress that any defect in the application process, no matter how small, should require the immediate judicial release of the person affected, no matter how dangerous to self or others. Absent a sig*969nificantly clearer declaration of such an intent, we must decline to do so.

Affirmed.

. Specifically, appellant asserted that the physician was not a "physician or qualified psychologist of the person in question” under § 521 and that the application was not based on "personal observation and examination of the alleged mentally ill person” by the physician under § 582(b). These and all future section references are to Title 21 of the D.C.Code.

. Ms. Porter subsequently estimated the time as "three to five minutes,” and characterized appellant as having "stormed out.”

. The unchecked box states: "that I am not related by blood or marriage to the alleged mentally ill person; that I am not financially interested in the hospital to which said person is to be detained; and that the statements made hereinafter are based on my personal observations and examination of said person not more than 72 hours prior to the making of this application.”

. The transcript thus appears to support the conclusion that Dr. Brown did not rely on Dr. Goetcheus’s application in any significant way, if at all, in formulating his opinion of appellant’s mental condition.

. Nothing in the transcript indicates that the trial court relied on the information in the application in reaching this conclusion. The trial court did not refer to the application, but instead explicitly rested his decision on the report of the admitting psychiatrist and the testimony of Ms. Porter and Dr. Brown.

. Even prior to the probable cause hearing, on June 14, 1990, the hospital had filed a petition for judicial hospitalization pursuant to § 541. The timely filing of the petition, coupled with the trial court's finding of probable cause at the § 525 hearing, permitted the continued detention of appellant beyond the seven day emergency period. D.C.Code § 21-528 (1989); see In re Reed, 571 A.2d 801 (D.C.1990). As a result of this petition, appellant was entitled to a prompt hearing before the Commission on Mental Health and the other procedures, including a jury trial, provided in cases of hospitalization under court order, §§ 541-51. However, appellant has chosen not to avail herself of these statutory opportunities for review of her condition, pending disposition of this appeal from the trial court’s refusal to order her release. Appellant’s appeal has been based on the sole ground that the original application was assertedly defective.

.Subsection (a) also contains limitations: "A petition, application, or certificate authorized under section 21-521 and subsection (a) of section 21-541 [dealing with “petitions” for the initiation of formal judicial hospitalization proceedings] may not be considered if made by a physician or qualified psychologist who is related by blood or marriage to the alleged mentally ill person, or who is financially interested in the hospital in which the alleged mentally ill person is to be detained, or, except in the case of physicians or qualified psychologists employed by the United States or the District of Columbia, who are professionally or officially connected with the hospital." While Dr. Goetcheus, by failing to check the proper box, did not affirmatively indicate on the form that she did not fall within subsection (a), the statute does not expressly require such an assertion in writing and it is not contested that she in fact did not fall within the limitations of subsection (a). Only an alleged failure to comply with subsection (b) is at issue.

. This point is not conceded by the government, which argues that the trial court had no occasion to develop the full facts.

. See also In re Rosell, 547 A.2d 180 (D.C.1988); In re Morris, 482 A.2d 369 (D.C.1984).

. Appellant has not challenged as such the sufficiency of the evidence at the probable cause hearing.

. In this regard, we note that where Congress intended to prescribe the release of a person, it knew how to do so explicitly. See, e.g., § 527 (“shall be immediately released”); § 544 ("shall immediately order his release”).

. Section 524 provides:
(a) Within a period of 24 hours after the court receives a petition for hospitalization of a person for emergency observation and diagnosis, filed by the administrator of a hospital pursuant to section 21-523, the court shall:
(1) order the hospitalization; or
(2) order the person's immediate release.
(b) The court, in making its determination under this section, shall consider the written reports of the agent, officer, physician or qualified psychologist who made the application under section 21-522, the certificate of the examining psychiatrist or examining qualified psychologist which accompanied it, and any other relevant information.

. Although Congress was no doubt concerned with the proper functioning of the emergency hospitalization procedures, its primary focus was on other aspects of the legislation. Thus, the principal sponsor of the legislation, Senator Sam Ervin, described the legislation in the following terms at the beginning of hearings to consider particular amendments to the Act: "Primarily, [the Ervin Act] was designed to encourage voluntary hospitalization; to define and protect the rights of a patient once he was in [a] hospital; and to ensure, as far as legally possible, that there is no stigma attached to the fact that a person has been hospitalized for a mental illness. The core of the law is a legal recognition of the right of civilly-admitted patients in public hospitals to medical and psychiatric care and treatment and to periodic review of their cases.” Constitutional Rights of the Mentally III: Hearings Before the Subcomm. on Constitutional Rights of the Senate Comm, on the Judiciary, 91st Cong., 1st Sess. 3 (1969) (Statement of Senator Sam Ervin).

. For example, after participating in an off-the-record colloquy with Senator Ervin about the potential for abuse of emergency procedures, Professor Weihofen of George Washington University Hospital stated that "I am sure this subcommittee and any careful draftsman, would want to steer a careful course, so that it isn’t too easy for a policeman to pick somebody up and have him locked up in a psychiatric ward or a hospital. You need pretty quick summary procedures for taking care of him, but you should then afford him a number of protections such as immediate examination when he gets into the hospital and a very limited period of emergency detention.” To Protect the Constitutional Rights of the Mentally III: Hearing on S. 935 Before the Subcomm. on Constitutional Rights of the Senate Comm, on the Judiciary, 88th Cong., 1st Sess. 160 (1963) (hereinafter Senate Hearings).

. Although § 582 speaks of petitions, applications, and certificates, a close reading of the section makes clear that it applies only to applications under the emergency hospitalization provisions. Specifically, § 582(a) applies to "[a] petition, application, or certificate authorized under section 21-521 and subsection (a) of section 21-541_” Section 521 relates only to emergency applications to public or private hospitals, and § 541(a) relates to petitions and certificates needed to commence formal proceedings for judicial hospitalization. If Congress had intended § 582 to apply to the petitions and certificates filed in the context of emergency hospitalization, it would have referred to sections 522 and 523 in § 582.
Although subsection (b) of § 582 does not also contain the words "authorized under section 21-521 and subsection (a) of section 21-541,” there is no reason to believe that Congress intended subsection (b) of § 582 to relate to different petitions, applications, and certificates than those referred to in subsection (a). In this regard, we note as well that Judge Alexander Holtzoff of the U.S. District Court for the District of Columbia, who recommended the personal observation requirement in order "to exclude some loose certificates which occasionally have been presented,” did not even recommend that this requirement apply at all to emergency hospitalization proceedings. Senate Hearings, supra note 14, at 17; see also Senate Report, supra, at 19. We conclude that a § 582(b) violation is not an absolute bar to judicial consideration of a hospital’s petition under §§ 524 and 525. Whether the subsection bars the trial court from receiving into evidence or otherwise using such a defective application in making its decision is an issue we need not now address, since here it is evident that the application played no significant role in the trial court hearing and determination. See notes 4 and 5, supra.

. An argument could be made that the process did not function properly in this case, since the box on the application certifying to compliance with § 582 was not checked. It seems fair to say, however, that in this case, the application reflected in the physician’s own handwriting both a considerable inquiry and her medical conclusions. Of course, applications may be defective in ways that are not apparent to the admitting hospital personnel, as reflected by the requirement that a psychiatrist or qualified psychologist on duty at the admitting hospital conduct an independent evaluation of the person.
Corporation Counsel in its brief correctly characterizes the form involved in this case as less than clear. It has subsequently been replaced by a new version. On the other hand, Dr. Goetcheus’s affirmative indication on the form that she was a physician "employed by the United States or the District of Columbia" is less explainable. Corporation Counsel suggests that the difficulty may have arisen because Dr. Goet-cheus was employed by Health Care for the Homeless, an organization funded in large part by the District of Columbia Department of Human Services.

. Although § 523 states that a person hospitalized pursuant to § 522 “may not be detained” for more than 48 hours unless a petition is filed with the court, the Senate Report makes clear that this provision is mandatory. Specifically, the S.enate Report explains that the section mean that such a person “shall not be detained” for more than 48 hours. Senate Report, supra, at 16.

. An officer could arrest without a warrant "any insane person or person of unsound mind” found in a street or other public place. D.C.Code § 21-326 (1940).

. The court then cited to the concurring opinion in Jillson v. Caprio, supra, and the New York case on which that opinion relied, Warner v. State, 297 N.Y. 395, 79 N.E.2d 459 (1948).