Zinermon v. Burch

494 U.S. 113 (1990)

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Nature of the Case

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Facts

P was found wandering along a Florida highway, hurt and disoriented. He was taken to Community Mental Health Services which is a private mental health care facility designated by the State to receive patients suffering from mental illness. P was hallucinating, confused, and psychotic and believed he was 'in heaven.' His face and chest were bruised and bloodied, suggesting that he had fallen or had been attacked. P was asked to sign forms giving his consent to admission and treatment. He did so. The facility's staff diagnosed his condition as paranoid schizophrenia and gave him psychotropic medication. P was 'in need of longer-term stabilization,' and they referred him to FSH, a public hospital owned and operated by the State as a mental health treatment facility. P signed forms requesting admission and authorizing treatment at FSH. He was then taken to FSH by a county sheriff. Upon his arrival, P signed other forms for voluntary admission and treatment. One form, entitled 'Request for Voluntary Admission,' recited that the patient requests admission for 'observation, diagnosis, care, and treatment of [my] mental condition,' and that the patient, if admitted, agrees 'to accept such treatment as may be prescribed by members of the medical and psychiatric staff in accordance with the provisions of expressed and informed consent.' P signed a form entitled 'Authorization for Treatment.' This form stated that he authorized 'the professional staff of [FSH] to administer treatment, except electroconvulsive treatment'; that he had been informed of 'the purpose of treatment; common side effects thereof; alternative treatment modalities; approximate length of care'; and of his power to revoke consent to treatment; and that he had read and fully understood the Authorization. P was 'refusing to cooperate,' would not answer questions, 'appears distressed and confused,' and 'related that medication has been helpful.' P remained at FSH until May 7, 1982, five months after his initial admission. During that time, no hearing was held regarding his hospitalization and treatment. P complained that he had been admitted inappropriately to FHS and did not remember signing a voluntary admission form. P filed a complaint against Ds. P was held for a period of 149 days, without the benefit of counsel and no hearing of any sort was held at which he could have challenged his “voluntary” admission and treatment at FSH. Florida provides for short-term emergency admission. If there is reason to believe that a person is mentally ill and likely 'to injure himself or others' or is in 'need of care or treatment and lacks sufficient capacity to make a responsible application on his own behalf,' he may immediately be detained for up to 48 hours. After 48 hours, the patient is to be released unless he 'voluntarily gives express and informed consent to evaluation or treatment,' or a proceeding for court-ordered evaluation or involuntary placement is initiated. Before involuntary placement, the patient has a right to notice, a judicial hearing, appointed counsel, access to medical records and personnel, and an independent expert examination. P claims that he was entitled to receive the procedural safeguards provided by Florida's involuntary placement procedure and that Ds violated his due process rights by failing to initiate this procedure. The district court granted Ds’ motion to dismiss. The court of appeals reversed. The Supreme Court granted certiorari.