In re J.S.

586 A.2d 909, 526 Pa. 418, 1991 Pa. LEXIS 34
Supreme Court of Pennsylvania·Decided February 6, 1991·No. No. 6 E.D. Appeal Dkt. 1990·Published·Cited by 22 cases

Opinion

OPINION

McDERMOTT, Justice.

In this appeal, we must address, for the first time, the interplay between the provisions of the Mental Health Pro[420] cedures Act1 which provide procedures for voluntary inpatient treatment for mental illness, and those procedures which apply to involuntary inpatient treatment. In enacting the Mental Health Procedures Act, the General Assembly expressly recognized that “[i]t is the policy of the Commonwealth of Pennsylvania to seek to assure the availability of adequate treatment to persons who are mentally ill, and it is the purpose of this act to establish procedures whereby this policy can be effected. The provisions of this act shall be interpreted in conformity with the principles of due process to make voluntary and involuntary treatment available where the need is great and its absence could result in serious harm to the mentally ill person or to others. Treatment on a voluntary basis shall be preferred to involuntary treatment and in every case, the least restrictions consistent with adequate treatment shall be employed.” 50 P.S. § 7102. It is only with these intentions firmly in mind that we may properly resolve the question of statutory construction now before us.

On September 29, 1987, R.S. petitioned the Philadelphia County Office of Mental Health and Mental Retardation, appellant herein, seeking the involuntary commitment of her mother, J.S., for an emergency examination and inpatient treatment for mental illness. An involuntary commitment became unnecessary, however, when J.S., on September 30, 1987, consented to voluntary inpatient treatment at the Thomas Jefferson University Hospital. J.S. consented to the inpatient treatment by signing a consent form. In this form, J.S. agreed that if she chose to withdraw from voluntary inpatient treatment at any time, her release from the hospital could be delayed for a period not to exceed 72 hours from the time she provided notice of her decision to withdraw from treatment:

Before a person is accepted for voluntary inpatient treatment, an explanation shall be made to him of such treatment, including the types of treatment in which he may be involved, and any restraints or restrictions to which he [421] may be subject, together with a statement of his rights under this act. Consent shall be given in writing upon a form adopted by the department. The consent shall include the following representations: That the person understands his treatment will involve inpatient status; that he is willing to be admitted to a designated facility for the purpose of such examination and treatment; and that he consents to such admission voluntarily without coercion or duress; and, if applicable, that he has voluntarily agreed to remain in treatment for a specified period of no longer than 72 hours after having given written notice of his intent to withdraw from treatment. The consent shall be part of the person’s record.

50 P.S. § 7203. A patient presumably may choose any amount of delay between the written notice and release which does not exceed 72 hours. Thus, in the event that an individual decides to withdraw from voluntary inpatient treatment, but has not previously agreed to any delay in his release, then he will be immediately released from voluntary treatment upon submitting the written notice. See 50 P.S. § 7206(a).

On October 1, 1987, J.S. indicated to the staff at Jefferson Hospital that she wished to withdraw from voluntary inpatient treatment. As a result, on that day, a psychiatrist at the hospital completed the documents which were necessary to effect an involuntary commitment of J.S., the procedure originally pursued but abandoned when J.S. decided to consent to the voluntary inpatient treatment. In accordance with 50 P.S. § 7302(b)2, the psychiatrist determined, [422] based upon his examination of J.S., that she was severely mentally disabled and in need of immediate inpatient treatment. J.S. thus became an involuntary inpatient on October 1, 1987.

Severe mental disability is precisely defined in the Mental Health Procedures Act, and it relates to certainly the most serious of mental illnesses. “A person is severely mentally disabled when, as a result of mental illness, his capacity to exercise self-control, judgment and discretion in the conduct of his affairs and social relations or to care for his own personal needs is so lessened that he poses a clear and present danger of harm to others or to himself.” 50 P.S. § 7301(a). If a person has made threats of harm and has committed acts in furtherance of the threat to commit harm, this may demonstrate that he or she is a clear and present danger of harm to others. See 50 P.S. § 7301(b). Further, a person represents a clear and present danger to himself if, within the past 30 days, it is established that:

(i) the person has acted in such manner as to evidence that he would be unable, without care, supervision and the continued assistance of others, to satisfy his need for nourishment, personal or medical care, shelter, or self-protection and safety, and that there is a reasonable probability that death, serious bodily injury or serious physical debilitation would ensue within 30 days unless adequate treatment were afforded under this act; or
(ii) the person has attempted suicide and that there is the reasonable probability of suicide unless adequate treatment is afforded under the act. For the purposes of this subsection, a clear and present danger may be demonstrated by the proof that the person has made threats [423] to commit suicide and has committed acts which are in furtherance of the threat to commit suicide; or
(iii) the person has substantially mutilated himself or attempted to mutilate himself substantially and that there is the reasonable probability of mutilation unless adequate treatment is afforded under this act. For the purposes of this subsection, a clear and present danger shall be established by proof that the person has made threats to commit mutilation and has committed acts which are in furtherance of the threat to commit mutilation.

50 P.S. § 7301(b)(2).

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In re J.S., 586 A.2d 909, 526 Pa. 418, 1991 Pa. LEXIS 34 (Pa. 1991).

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