In the Matter of the Necessity for the Hospitalization of PAIGE M.
Appeal
from the Superior Court No. 1SI-16-00074 PR of the State of
Alaska, First Judicial District, Sitka, Leonard Devaney,
Judge pro tem.
Michael Jude Pate and Rachel E. Cella, Assistant Public
Defenders, and Quinlan Steiner, Public Defender, Anchorage,
for Paige M.
Anna
Jay, Assistant Attorney General, Anchorage, and Jahna
Lindemuth, Attorney General, Juneau, for State of Alaska and
Department of Health and Social Services.
Before: Bolger, Chief Justice, Winfree, Stowers, Maassen, and
Carney, Justices.
OPINION
BOLGER, Chief Justice.
I.
INTRODUCTION
A
psychologist at a mental health clinic petitioned to have a
patient involuntarily hospitalized. The superior court held a
hearing on the petition at which only the psychologist gave
substantive testimony. The court granted the petition, and
the patient was hospitalized. The patient now appeals the
court's denial of her motion to vacate the involuntary
hospitalization order. Because the superior court failed to
conduct a screening investigation that met statutory
requirements, and because this failure was not harmless
error, we reverse the superior court's denial of the
patient's motion to vacate.
II.
FACTS AND PROCEEDINGS
In
November 2016 a psychologist at Neurobehavioral Consultants,
LLC filed a "Petition for Order Authorizing
Hospitalization" of Paige M., [1] an individual the clinic had
been treating for approximately one year.[2] The psychologist
indicated on the petition form that she had interviewed Paige
one week prior. The psychologist also indicated that she
believed Paige was mentally ill and "gravely disabled or
likely to cause serious harm to []herself or others" as
a result of her mental illness.[3] The psychologist explained that
"[t]he risk(s) of self-neglect and self-harm are
discussed in detail" in clinic notes she had attached to
the petition and alleged that "[m]ost recently, [Paige]
admitted needing 'safety checks' by S[itka] P[olice]
D[epartment], due to medical and suicidal concerns, then hung
a note on her door, refusing to answer the door for [the
police]."
The
Sitka superior court held a hearing on the petition that
evening. The only people in attendance were the psychologist
and a representative of Sitka Counseling and Prevention
Services (SCPS), which arranges for transportation and
coordination with hospitals after a hospitalization petition
is granted. The court confirmed that the SCPS representative
had no additional information related to the petition and
conducted a voir dire examination of the psychologist, who
testified to Paige's behavior over the last month. The
court observed that although it was "clear that [Paige]
has many mental health diagnoses," the court
"wasn't getting the information [it] felt like [it]
needed" to make a finding necessary to grant the
petition.[4] The court accordingly requested "a
little bit more information about whether... in [the
psychologist's] opinion [Paige was] likely to cause
serious harm to herself right now."
The
psychologist replied that there were multiple reasons for
believing Paige was likely to cause serious harm to herself;
one was Paige's "very recent lack of compliance in
her own treatment plan and self-care," which the
psychologist stated was particularly significant in light of
Paige's ailments, including her propensity to suddenly
lose consciousness. The psychologist added that Paige's
conduct four days prior, when she arrived at the clinic and
then abruptly left, was especially concerning "knowing
that she's been suicidal, that she's been actively
entertaining the thought of suicide, [and] that she has a
history of doing this with several different means available
to her." The court questioned the psychologist whether
Paige would have persisted in this "state of mind"
if the psychologist had seen her over the weekend, but the
psychologist was unable to answer the question. The court
also asked if Paige had a legal guardian who could check in
on her, but the psychologist said that she did not and that
she was also "estranged from her nuclear family"
and "[v]ery isolated." Ultimately the court asked
the psychologist: "Based on your education, training,
and experience, . . . [and] given all these warning signs and
the decompensation that you're seeing, do you believe
that [Paige is] likely to cause serious harm to
herself?" When the psychologist replied in the
affirmative, the court stated that it would grant the order.
That
evening the court issued an order authorizing Paige's
hospitalization under AS 47.30.700. The court found that
there was probable cause to believe that Paige was mentally
ill, that she was likely to cause serious harm to herself,
and that she was gravely disabled.[5] The court also indicated
that Paige had been interviewed by the psychologist "in
regard to the petition" one week earlier. The same
evening Sitka police removed Paige from her home and placed
her in a jail cell overnight. The following day she was
transported from Sitka to the Alaska Psychiatric Institute in
Anchorage, where she was hospitalized from November 2 to
November 7.[6]
On
November 30 Paige filed a motion to vacate the order
authorizing her hospitalization. She argued that the superior
court had violated AS 47.30.700 by failing to interview her
after the petition was filed, that her due process rights had
been violated, and that the evidence presented to the court
could not support the findings needed to order involuntary
hospitalization. After two hearings in April and June 2017,
the court issued an order denying Paige's motion to
vacate in July 2017. In rejecting Paige's arguments, the
court acknowledged AS 47.30.700's screening investigation
requirement but asserted that petitions filed by mental
health professionals "are usually complete and contain
the essence of the screening investigation." The court
concluded that neither AS 47.30.700 nor due process
principles had been violated, and that testimony from the
psychologist provided sufficient evidence to support the
court's probable cause finding. Paige moved for
reconsideration and for an opportunity to supplement the
record; this motion was also denied. Paige appeals the denial
of both her motion to vacate and her motion to supplement the
record.
III. DISCUSSION
Paige's
central arguments for reversal on appeal are: (1) that the
superior court violated AS 47.30.700 and (2) that the court
erred by concluding there was probable cause to order
temporary hospitalization.[7] In the alternative Paige argues that
the case should be remanded with instructions that the trial
court permit her to supplement the record. We reverse the
superior court's denial of Paige's motion to vacate
and thus do not address Paige's alternative argument. And
because we reverse on statutory grounds, we also do not
address her probable cause arguments.
Paige
argues that the trial court violated AS 47.30.700 by not
ensuring that a full screening investigation was conducted
before it issued the order for her involuntary
hospitalization. We agree. Alaska law provides two avenues
for initiating involuntary hospitalization for a mental
health evaluation - one for emergency situations and one for
non-emergency circumstances. The emergency detention statute,
AS 47.30.705, authorizes a peace officer or a mental health
professional granted authority by the statute to "cause
[a respondent] to be taken into custody" without first
petitioning a court. But the person who initiates this
emergency procedure must have "probable cause to believe
that [the respondent] is gravely disabled or is suffering
from mental illness and is likely to cause serious harm to
self or others of such immediate nature that considerations
of safety do not allow initiation of involuntary commitment
procedures."[8] In this case Paige was not in custody when
the petition for her involuntary hospitalization was filed,
so the emergency detention statute did not apply.
Alaska
Statute 47.30.700 provides the second, non-emergency, avenue
to initiate involuntary hospitalization for a mental health
evaluation. It allows any adult to petition for involuntary
hospitalization:
Upon petition of any adult, a judge shall immediately conduct
a screening investigation or direct a local mental health
professional... to conduct a screening investigation of the
person alleged to be mentally ill and, as a result of that
condition, alleged to be gravely disabled or to present a
likelihood of serious harm to self or others. Within 48 hours
after the completion of the screening investigation, a judge
may issue an ex parte order orally or in writing, stating
that there is probable cause to believe the respondent is
mentally ill and that condition causes the respondent to be
gravely disabled or to present a likelihood of serious harm
to self or others.[9]
The
statute identifies three key events that must occur before an
individual may be involuntarily hospitalized. First an adult
must petition a superior court for the respondent's
involuntary hospitalization. Second a judge or mental health
professional must conduct a screening investigation to
evaluate the allegations in the petition. Third the court
must find probable cause that the respondent is mentally ill
and that this mental illness causes the respondent to be
gravely disabled or to present a likelihood of serious harm
to self or others. Only then may a judge issue an ex parte
order for the respondent's involuntary hospitalization.
Applying
AS 47.30.700, the non-emergency statute, to this case, the
court conducted an inadequate screening investigation in
violation of that statute when, absent a finding that a
post-petition interview was not reasonably possible, it did
not require Paige to be interviewed as part of the
investigation. Because this was not harmless error, we
reverse.
A.
The Screening Investigation Statute Required A Post-Petition
Interview With Paige If Reasonably Possible.
We
first interpreted the "screening investigation"
language of AS 47.30.700 in In re Hospitalization of
Heather R.[10] In that case a patient appealed her
hospitalization order, arguing that the court had violated AS
47.30.700 by failing to conduct a complete screening
investigation before issuing the order.[11] The
court's screening investigation had included neither an
interview with the patient nor any attempt to ensure an
interview was conducted.[12] Relying on the language of AS
47.30.700 and AS 47.30.915, we held that "a screening
investigation should omit an interview with the respondent
only if such an interview would not be reasonably
possible" and vacated the order ...