Green v. Commissioner of Mental Health
Case Date: 01/01/2000
Court: Supreme Court
Docket No: 2000 ME 92
Green v. Commissioner of Mental Health Back to the Opinions page MAINE SUPREME JUDICIAL COURT Reporter of Decisions Decision: 2000 ME 92 Docket: Ken-99-335 Argued: January 5, 2000 Decided: May 17, 2000 Panel:WATHEN, C.J., and CLIFFORD, RUDMAN, DANA, SAUFLEY, ALEXANDER, and CALKINS, JJ. VIRGINIA GREEN v. COMMISSIONER OF MENTAL HEALTH AND MENTAL RETARDATION DANA, J. [¶1] Virginia Green appeals from the denial by the Superior Court (Kennebec County, Atwood, J.) of her petition for release from the Augusta Mental Health Institute (AMHI) and from the denial of her motion to alter or amend the court's judgment. Green was committed to AMHI on July 10, 1997, after she was found to be not criminally responsible by reason of mental disease or defect for the killing of her mother. On appeal, Green argues that the allocation of the burden of proof by clear and convincing evidence to insanity acquittees in release proceedings violates her right to substantive and procedural due process, as well as her right to equal protection. She also argues that the court erred as a matter of law when it applied the statutory criteria for release and that the court's findings of fact are clearly erroneous. Because we find that the allocation of the burden of proof passes constitutional muster and because we find no error in the court's judgment, we affirm. I. FACTS [¶2] On November 27, 1996, Virginia Green killed her mother while in a psychotic and delusional state. She was placed in AMHI in February 1997 pending the outcome of her trial. In July 1997, she was found not criminally responsible by reason of insanity and was automatically committed to AMHI pursuant to 15 M.R.S.A. § 103 (Supp. 1999). In October 1997, Green filed a petition for release to a residential treatment program. A hearing was not held on her petition, however, until November 1998 because of various delays. [¶3] Prior to the hearing, Green filed a trial memorandum challenging the placement of the burden of proof on her as a petitioner and requested that the burden be placed on the State to justify her continued commitment. The court denied her request citing our decision in Taylor v. Commissioner of Mental Health and Mental Ret., 481 A.2d 139 (Me. 1984), and ruled that the burden of proof rested with Green to show by clear and convincing evidence her eligibility for release. [¶4] In addition to the testimony of Green herself, the evidence at the hearing consisted almost exclusively of testimony by experts regarding Green's mental health and her potential for dangerousness if released to a program like the one she proposed in her petition for release. It is undisputed that Green suffers from bipolar disorder, also known as manic depressive illness, and poly-substance abuse, which together are referred to as a dual diagnosis condition. It is also undisputed that her illness is incurable and will last a lifetime. [¶5] Her treating psychiatrist at AMHI, Dr. Walter Christie, testified that she will always suffer from mental illness, but that she is currently asymptomatic. It was Dr. Christie who developed the transition plan that Green proposed to the court, as well as additional "steps" to the transition plan that were later provided at the court's request. Dr. Christie also testified that Green had a pattern of relapses and hospitalizations, indicating that she had been hospitalized fifteen to twenty times since 1972. [¶6] Nevertheless, Dr. Christie opined that Green could safely be returned to the community without a likelihood of harm to herself or others as long as the proposed treatment plan was followed strictly. He was confident that Green could safely make the jump from being restricted to the grounds of AMHI to a residential treatment program. Dr. Christie observed that the combination of Green's substance abuse and her bipolar illness precipitated her mania that eventually evolved in psychosis and delusion. He testified that the events leading up to the death of her mother represented an extreme state for Green that could have been avoided with proper treatment and oversight like that provided for in the plan. [¶7] Green testified that in the past she had used drugs and alcohol in an effort to self-medicate despite her awareness that they precipitated psychotic and delusional episodes, but that she would never again resort to those tactics because they had led to the death of her mother. Green did acknowledge, however, that her illnesses are prone to relapse. [¶8] Dr. Prudence Baxter, a forensic psychiatrist, prepared an independent psychiatric examination of Green at AMHI's request and conducted a general review of Green's case. She concluded that Green was not an appropriate candidate for release from the hospital, even in a supervised living situation like the one proposed. She expressed concerns that much of Green's treatment at AMHI had been focussed on gaining discharge from the hospital and had not sufficiently explored why Green's most recent episode of psychosis had resulted in such an extreme outcome. She was also concerned about Green's anti-anxiety medication that had highly addictive properties given her diagnosis of poly-substance abuse. Lastly, she indicated that she had not seen a residential treatment plan like the one proposed implemented in a forensic setting in the absence of any data regarding a candidate's responses to more incremental increases in privileges. [¶9] Dr. Ann Bower, the clinical director for the Department of Mental Health, Mental Retardation and Substance Abuse Services, expressed similar concerns regarding the absence of demonstrable evidence that Green was ready for such a reduction in supervision. She indicated that such plans, known as "out-patient commitment plans," are rare in Maine because the State lacks an effective enforcement mechanism in the event of a breakdown in compliance. Dr. Bower also had concerns regarding analgesics that Green had been prescribed because of their addictive qualities. [¶10] Following the testimony, the court issued an order in which it denied Green's petition for release, but noted that a higher level of privileges might be appropriate for Green. Green then filed a motion to amend the judgment, seeking an order granting off-grounds privileges. The State opposed the motion and submitted an institutional report recommending off-grounds privileges of a more circumscribed nature. The court denied Green's motion to amend the judgment and accepted the report's recommendation, approving the increased privileges it outlined including the more limited off-grounds privileges. Green then filed a notice of appeal. II. THE BURDEN OF PROOF [¶11] If a defendant is determined to be not criminally responsible by reason of mental disease or defect pursuant to 17-A M.R.S.A. § 39 (Supp. 1999), the person is automatically committed to the custody of the Commissioner of Mental Health. See 15 M.R.S.A. § 103 (Supp. 1999). Generally, the State must carry the burden beyond a reasonable doubt that the defendant engaged in conduct constituting a crime after which the burden shifts to the defendant to prove lack of criminal responsibility by reason of mental disease or defect by a preponderance of the evidence.{1} See 17-A M.R.S.A. §§ 39 & 40 (1983 & Supp. 1999). The statute governing release of insanity acquittees, however, does not provide for a standard of proof, nor does it provide on whom the burden of proof rests. See 15 M.R.S.A. § 104-A (Supp. 1999). As a result, we have been forced to make that determination in the past. [¶12] In State v. Shackford, 262 A.2d 359 (Me. 1970), we determined that the trial court had correctly placed the burden on the insanity acquittee to prove beyond a reasonable doubt that he was qualified for release into the community in a proceeding on a petition for release. Id. at 365-66. In 1984, we reconsidered our decision in Shackford and determined that, while the burden should continue to rest with the insanity acquittee, see Taylor, 481 A.2d at 144 n.6, the degree of proof required should be clear and convincing evidence, see id. at 149. Compare 18 U.S.C.A. § 4243(d) (1985 & Supp. 1999) (placing burden on insanity acquittees by clear and convincing evidence when underlying offense involved serious bodily injury or serious damage to property). We explicitly elected not to decide, however, the constitutionality of the required degree of proof, as the parties did not have an opportunity to brief the issue. Id. at 154. Green now asks us to address, inter alia, the constitutionality of placing the burden of proof on insanity acquittees by clear and convincing evidence in proceedings regarding petitions for release and to reconsider our holding in Taylor. A. Substantive Due Process [¶13] Green argues that placing the burden on her to show by clear and convincing evidence that she is either no longer mentally ill or no longer harbors a potential for dangerousness violates her right to substantive due process provided by the Maine and United States Constitutions.{2} We conclude that placing such a burden on an insanity acquittee in release proceedings neither offends common concepts of ordered liberty, nor is such an arbitrary and wrongful government action that it violates either the Maine or United States constitutions. The United States Supreme Court has stated: Our established method of substantive-due-process analysis has two primary features: First, we have regularly observed that the Due Process Clause specially protects those fundamental rights and liberties which are, objectively, deeply rooted in this Nation's history and tradition, and implicit in the concept of ordered liberty, such that neither liberty nor justice would exist if they were sacrificed. Second, we have required in substantive- due-process cases a careful description of the asserted fundamental liberty interest. Our Nation's history, legal traditions, and practices thus provide the crucial guideposts for responsible decisionmaking that direct and restrain our exposition of the Due Process Clause. Washington v. Glucksberg, 521 U.S. 702, 720-721 (1997) (internal quotation marks and citations omitted). When a state infringes on one of these fundamental rights or liberties, the infringement must be narrowly tailored to serve a compelling government interest. See id. at 721 (citation omitted). Additionally, the Court has stated, "the Due Process Clause contains a substantive component that bars certain arbitrary, wrongful government actions regardless of the fairness of the procedures used to implement them." Foucha v. Louisiana, 504 U.S. 71, 80 (1992) (internal quotation marks and citations omitted). [¶14] Green relies heavily on Foucha for her proposition that the allocation and degree of proof in a release proceeding violates substantive due process. However, as the United States Supreme Court has admonished, we first must have a careful description of the asserted fundamental interest. In Foucha, an insanity acquittee challenged a Louisiana statute that allowed for the indefinite commitment of individuals who although dangerous, were no longer mentally ill. Id. at 73. The Court determined that a statute that allowed for the indefinite confinement of an individual who the State conceded was no longer mentally ill simply because he could not prove that he was no longer a danger to society was the kind of arbitrary and wrongful government conduct that substantive due process protection guards against. See id. at 80-83. In other words, individuals who are not mentally ill and who have not been found guilty of any crime have a fundamental interest in being free from indefinite confinement by the government and simply showing that they pose a danger to society is not a constitutionally sufficient justification for impinging on that fundamental interest. In this case, Green is merely challenging the allocation and standard of proof in a release proceeding, not the basis for her confinement. [¶15] It is well established that the State may confine someone who is both mentally ill and who poses a danger to society. See Jones v. United States, 463 U.S. 354, 370 (1983) ("when a criminal defendant establishes by a preponderance of the evidence that he is not guilty of a crime by reason of insanity, the Constitution permits the government, on the basis of the insanity judgment, to confine him to a mental institution until such time as he has regained his sanity or is no longer a danger to himself or society"). Green does not dispute that she may continue to be confined on that basis, rather she argues that placing the burden on her in a release proceeding to prove by clear and convincing evidence that one of these two requirements is no longer met violates a fundamental liberty interest. [¶16] Green cites no authority, and we find none, that stands for the proposition that once an individual has been properly committed, that individual possesses a substantive due process right to be free from bearing the burden of proof in subsequent release proceedings. Again, we stress that Green is not arguing that her continued confinement is an arbitrary and wrongful governmental action; as someone who has been adjudged both mentally ill and dangerous, she does not possess a fundamental right to be free from confinement. Rather, she merely argues that the allocation of the burden of proof is arbitrary and wrongful government action. We do not agree, however, that placing the burden on an insanity acquittee in a release proceeding is somehow repugnant to our notion of ordered liberty; therefore, doing so does not violate Green's right to substantive due process.{3} B. Procedural Due Process [¶17] Green also argues that the placement of the burden and degree of proof in release proceedings does not comport with her right to procedural due process. The first step in procedural due process analysis is to identify whether there is an interest to be protected. See Matthews v. Eldridge, 424 U.S. 319, 335 (1976). Courts have generally determined that release proceedings implicate a liberty interest on the part of insanity acquittees. See, e.g., United States v. Phelps, 955 F.2d 1258, 1266 (9th Cir. 1992) (holding that federal statute placing burden on insanity acquittees to prove eligibility for release did not violate due process), cert. denied, 504 U.S. 989 (1992); United States v. Wallace, 845 F.2d 1471, 1473 (8th Cir. 1988) (also holding statute did not violate procedural due process), cert. denied, 488 U.S. 845 (1988). [¶18] Once a protected interest is established, that interest receives constitutionally required procedural protection. See Vitek v. Jones, 445 U.S. 480, 492 (1980). To determine whether a certain procedure comports with due process, courts look to three factors: the private interest affected, the risk of error inhering in the procedure, and the government interest in the given procedure. See Matthews, 424 U.S. at 335. While courts have recognized the liberty interest at stake for the acquittee, i.e., avoiding continued confinement, see Wallace, 845 F.2d at 1474, the United States Supreme Court noted in Jones that insanity acquittees experience a diminished deprivation of liberty when compared to civil committees because they have already assumed the social stigma associated with commitment by raising the insanity defense themselves. Jones, 463 U.S. at 367, n.16. [¶19] The Court also noted that, for purposes of initial automatic commitment of insanity acquittees, the finding beyond a reasonable doubt that the acquittee committed a crime is a sufficient indication of dangerousness and that an insanity acquittal supported an inference of continuing mental illness. See id. at 365-66. The Court noted that this mitigated the risk of error generally, as compared to civil commitment proceedings, and that it eliminated altogether the risk that an individual was being confined merely for idiosyncratic behavior, a legitimate concern in the civil commitment context. See id. at 367. Furthermore, continuing to place the burden on the acquittee regarding issues of mental health at release proceedings subsequent to commitment places the burden on the individual with the best ability to collect and present evidence on those matters. In addition, although an insanity acquittee certainly has an interest in avoiding erroneous continuation of confinement, the acquittee also has an interest in avoiding an erroneous release that may lead to personal harm and harm to others. [¶20] Furthermore, the State clearly has an interest, for reasons of public safety, in avoiding erroneous release. See Wallace, 845 F.2d at 1474 ("[T]he government's interest in preventing the premature release of persons who have already proven their dangerousness to society . . . outweighs the interest in avoiding continued confinement of an acquittee."). This interest merits a heightened degree of proof for release. The State also has an interest in avoiding duplicative hearings in which issues established during the criminal phase leading up to commitment are relitigated, see Jones, 463 U.S. at 366, and insanity acquittees have already gathered much of the relevant information by virtue of their carrying the original burden in the criminal proceedings. Placing the risk of error with the acquittee in release proceedings does not appear to strike an improper balance among these competing interests. Cf. Benham v. Ledbetter, 785 F.2d 1480, 1491- 92 (11th Cir. 1986). Therefore, the placement and the degree of the burden of proof does not violate procedural due process. C. Equal Protection [¶21] Green argues that the disparity in the allocation and degree of proof at release proceedings for civil committees and those for insanity acquittees violates her right to equal protection guaranteed by the Maine and United States Constitutions.{4} We have noted previously, "[i]f a challenged statute involves neither a fundamental right nor a suspect class, different treatment accorded to similarly situated persons need only be rationally related to a legitimate state interest." See School Admin. Dist. No. 1, 659 A.2d at 857; see also FCC v. Beach Communications, Inc., 508 U.S. 307, 313 (1993) (noting that in areas of social policy, if neither a fundamental right nor suspect class is involved, a classification must be upheld if there is "any reasonably conceivable state of facts that could provide a rational basis for the classification"). [¶22] Allocating the burden of proof to insanity acquittees by clear and convincing evidence in release proceedings, while not doing so to civil committees, does not impinge on a fundamental right, nor are insanity acquittees considered members of a suspect classification, therefore, strict scrutiny does not apply. Rather, we must determine whether similarly situated individuals are being treated differently and whether there is a rational basis for it. See City of Cleburne, Texas v. Cleburne Living Center, 473 U.S. 432, 439 (1985). There is a good argument that insanity acquittees and individuals civilly committed are not similarly situated for purposes of equal protection analysis because of the difference in circumstances giving rise to their commitment, see, e.g., Glatz v. Kort, 807 F.2d 1514, 1522 (10th Cir. 1986); Hartman v. Summers, 878 F. Supp. 1335, 1346 (D.C. Cal. 1995). As the United States Supreme Court noted in Jones, there is a "widely and reasonably held view that insanity acquittees constitute a special class that should be treated differently . . . ." Jones, 463 U.S. at 370. Even if we assume, however, that they are similarly situated there is a rational basis to justify the differing procedures at their respective release proceedings. [¶23] Insanity acquittees have previously demonstrated their dangerousness to the community. The danger posed by civil committees is more speculative. This distinction does not change once commitment has taken place. As a result, insanity acquittees pose an increased risk to society once they are released and this provides a rational basis for the disparity in treatment. Cf. Francis S. v. Stone, 995 F. Supp. 368, 385 (S.D.N.Y. 1998). Therefore, the release procedures for insanity acquittees do not violate their right to the equal protection of the law. [¶24] Because the placement and the degree of the burden of proof in release proceedings do not violate insanity acquittees' rights to due process and equal protection, we conclude that our ruling in Taylor is constitutionally sound. Therefore, our decision in that case will remain undisturbed. The Superior Court properly adhered to Taylor in the hearing on Green's petition for release. On to the rest of this opinion. Back to the Opinions page. |