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.