Supreme Court: Holding mental health patients without timely due process is illegal

  • A security officer stands by while medical staff works with mental health patients in a make-shift care area in a Concord Hospital Emergency Room hallway. In recent months, hospitals have experienced a backlog of patients waiting to be admitted to New Hampshire State Hospital. Elodie Reed

Monitor staff
Published: 5/11/2021 2:40:32 PM

Patients in a mental health crisis can no longer be involuntarily committed in emergency rooms without being offered a probable cause hearing within three days of their confinement, according in an opinion issued Tuesday by the New Hampshire Supreme Court. 

The court ruled on a lawsuit filed against the N.H Department of Health and Human Services that claims the state has not been prompt enough in providing judicial hearings for patients that have been involuntarily held for mental health reasons. 

Often in New Hampshire, people deemed to be in crisis must wait days or weeks in the emergency rooms for a bed in one of the state’s psychiatric facilities to open up without an opportunity to challenge the involuntary admission.

Lawyers for the Department of Health and Human Services argued that a ruling of this nature could unwind the current mental health system. They said this requirement would either force probable cause hearings to be held in private hospitals or prematurely release people who may be a danger to themselves or others if this three day time limit cannot be met. 

How exactly the state will comply with the ruling will be up to Department of Health and Human Services or to the legislature if lawmakers want to change the law, the opinion said.

The waiting list for psychiatric care has only grown during the pandemic— last week, 44 adults and 5 children were waiting for a bed to open up at the state-run New Hampshire Hospital or a contracted facility for youth in Hampstead. 

The plaintiff in this case, a woman identified by the pseudonym Jane Doe, says she was involuntarily held at the emergency department of Dartmouth Hitchcock Medical Center for two weeks before she was transferred to the New Hampshire Hospital in Concord and received a probable cause hearing after 17 days of confinement, not including weekends or holidays. Under New Hampshire law, involuntarily committed patients are entitled to a hearing within three days of being admitted. 

The case rested on whether the three-day countdown starts when the patient reaches New Hampshire Hospital, as the state argued, or when they are confined in an emergency room and enter the “state mental health services system.” Jane Doe already received a favorable ruling from a lower court judge, who agreed that the clock should start when a patient is first involuntarily committed.    

The state’s lawyers contend that “involuntary emergency admission,” a term that appears in the legislation governing the three day wait time, only applies when a person is admitted to a treatment facility. Emergency rooms, they argued, are not treatment facilities. 

This interpretation, the opinion said, loses sight of the purpose of the policy, which is to ensure involuntarily committed people receive due process. 

“The defendant’s interpretation rests upon construing certain words in isolation, instead of in context, which is contrary to our statutory interpretation principles,” it read. 

Advocacy groups saw this as a historic moment for the rights of people living with mental illness. 

“It recognizes that those being boarded in hospital emergency rooms are human beings entitled to prompt due process,” read a statement from the N.H American Civil Liberty Union. 

Ken Norton, the executive director of NAMI NH said the state should see this opinion as a call to action to rapidly address the deeper need for more mental health treatment resources. 

“When justice is denied to one person, it is denied to all,” he said. “Today’s decision on behalf of Jane Doe is a decision in favor of all Granite Staters.” 

State officials are weighing their next steps.

“We are currently reviewing the ruling and working with our legal counsel to determine how to comply with the court’s opinion,” the Department of Health and Human Services said in a statement.

Teddy Rosenbluth bio photo

Teddy Rosenbluth is a Report for America corps member covering health care issues for the Concord Monitor since spring 2020. She has covered science and health care for Los Angeles Magazine, the Santa Monica Daily Press and UCLA's Daily Bruin, where she was a health editor and later magazine director. Her investigative reporting has brought her everywhere from the streets of Los Angeles to the hospitals of New Delhi. Her work garnered first place for Best Enterprise News Story from the California Journalism Awards, and she was a national finalist for the Society of Professional Journalists Best Magazine Article. She graduated from UCLA with a bachelor’s degree in psychobiology.

Concord Monitor Office

1 Monitor Drive
Concord,NH 03301


© 2021 Concord Monitor
Terms & Conditions - Privacy Policy