Parham v. J.R

Brief Fact Summary.

Appellees, juveniles committed to state mental hospitals, brought a class action suit claiming that Georgia’s voluntary commitment procedures for children under 18 violated the Due Process Clause of the Fourteenth Amendment.

Synopsis of Rule of Law.

A factfinding hearing prior to commitment is not required because it is unlikely that such a hearing would be more reliable than the findings of a mental health professional.

Facts.

Appellee J.R., a plaintiff in this class action suit, was a child being treated in a Georgia state mental hospital. Appellants are the State’s Commissioner of the Department of Human Resources, the Director of the Mental Health Division of the Department of Human Resources, and the Chief Medical Officer at the hospital where appellee was being treated. Appellee sought a declaratory judgment that Georgia’s voluntary commitment procedures for children under 18 violated the Due Process Clause of the Fourteenth Amendment. Two other plaintiffs included J.L., whose mother requested his indefinite commitment at the hospital and J.R., a neglected child who was removed from his parents by the state and eventually admitted to the hospital.

Issue.

What process is constitutionally due a minor child whose parents or guardian seek state administered institutional health care?

Held.

Periodic review is required for continued commitment, but an initial factfinding hearing is not required.
Georgia Code provides for the voluntary admission to such hospitals to begin with an application for hospitalization signed by a parent or guardian. The superintendent of each hospital is then given the power to admit temporarily any child for observation and diagnosis. If the superintendent then finds evidence of mental illness, the child may be admitted for such period and under such conditions as may be authorized by law. The mental health statute also provides or the discharge of voluntary parents, and provides that each superintendent has an affirmative duty to release any child who has recovered.

The District Court held the statutory voluntary commitment of juveniles unconstitutional based on the finding that because commitment involved a severe deprivation of a child’s liberty, the process due required at least the right after notice to be heard before an impartial tribunal. The court feared that some parents still looked upon mental hospitals as a dumping ground. The court also rejected the argument that review by the superintendents of the hospitals and their staffs was sufficient to protect the child’s liberty interest.

Assuming the existence of a protectible interest, the Court has required a balancing of a number of factors. These considerations include the child’s interest in not being committed, the combination of the child’s and parents’ concerns, and the State’s interest in the procedures. It is undisputed that a child has a substantial liberty interest in not being unnecessarily confined, and that the confinement procedure constitutes state action under the Fourteenth Amendment.

Appellees argue the constitutional rights of the child and the likelihood of parental abuse is so great that the parent’s traditional interests in upbringing their child must be subordinated at least to the extent of providing a formal adversary hearing prior to voluntary commitment. Precedent and history has demonstrated that parents in Western Society have broad parental authority, including a high duty to recognize symptoms of illness and to seek and follow medical advice. Nonetheless, a state is not without constitutional control over parental discretion in dealing with children when their physical or mental health is jeopardized. Here, there was no finding by the court of a single instance of bad faith by any parent.

The State has a significant interest in confining its costly mental health facilities to cases of genuine need, and in not imposing unnecessary procedural obstacles that may discourage individuals from seeking needed psychiatric assistance. The parens patriae interest in helping parents cannot be fulfilled if they are unwilling to take advantage of the opportunities because the admission process is too onerous, embarrassing, or contentious.

The risk of error in the parental decision to have a child institutionalized is sufficiently great that some kind of inquiry should be made by a neutral factfinder to determine if the statutory requirements for admission are satisfied. A staff physician will suffice, so long as they are free to evaluate independently the child’s mental and emotion condition and need for treatment.

A factfinding hearing also posses the danger of providing for a significant intrusion into the parent-child relationship. It is unrealistic to believe that trained psychiatrists will often be deceived about the family situation surrounding a child’s emotional disturbance. It is unlikely that a lay, or even a law-trained factfinder would be more skilled in this process than a professional. The periodic reviews reduce the risk of error in the initial admission, and are thus necessary. On remand the District Court must determine if they are sufficient to justify continuing voluntary commitment.

Discussion.

The Court found that a factfinding hearing prior to commitment was constitutionally unrequired, but that periodic review was necessary. The Court remanded for the District Court tot determine if the periodic review was sufficient, suggesting that more rigorous review may be necessary for wards of the state.