Department of Health & Mental Hygiene v. Bean

JOSEPH, F., MURPHY, JR., Judge of the Court of Appeals of Maryland, specially assigned. In the Circuit Court for Baltimore City, a jury decided that Linwood Bean, appellee, was eligible for conditional release from confinement in the custody of the Department of Health and Mental Hygiene (the “Department”), appellant, which now presents a single question for our review: Did the circuit court err in submitting to the jury the issue of Mr. Bean’s eligibility for release when he did not present any expert testimony? Appellee agrees that he did not present any expert testimony but argues that such testimony is not required under § 3-114 of the Criminal Procedure Article. 1 For the reasons that follow, we shall reverse the order releasing appellee, and remand for further proceedings not inconsistent with this opinion. ⁴²⁰ Background On December 3, 1985, appellee was found not criminally responsible for a charge of assault with intent to murder, 2 and was therefore committed to the Department for inpatient care and treatment. Appellee has since been conditionally released from inpatient treatment three times, the third of which was revoked on October 15, 2001, due to allegations that he had assaulted his landlady.

Since that date, appellee has been a patient at the Clifton T. Perkins Hospital Center (“Perkins Hospital”). In the words of the Department’s brief: On December 23, 2004, pursuant to section 3-119 of the Criminal Procedure Article, [appellee] filed a petition requesting conditional release or discharge from his inpatient commitment to the Department. On June 20, 2006, a jury trial was held to determine whether he was eligible for conditional release or discharge. During the jury trial, [appellee] presented the testimony of only two witnesses: himself, and his friend, Andrew Conwell.

Neither was qualified as an expert, and neither is a physician, psychiatrist, psychologist, licensed clinical social worker, or other mental health or medical professional. At the close of [appellee’s] presentation of evidence, the Department moved for judgment because [appellee], who had the burden of proof, failed to present any expert witness testimony concerning the issue in the case: whether a mental disorder renders him a danger to himself or the ⁴²¹ person or property of others if he were to be released from commitment with or without conditions. The circuit court denied the Department’s motion. The Department then presented the testimony of Lisa Sloat, M.D., [appellee’s] psychiatrist at Perkins Hospital.

After the court accepted her as an expert in forensic psychiatry, Dr. Sloat testified that her diagnosis for [appellee] is Schizoaffective Disorder, and that, because of that mental disorder, he would be a danger to himself or others if he were released from inpatient commitment with or without conditions. According to her testimony, with [appellee’s] continued lack of insight into his mental disorder, there is little assurance that his violent past behaviors would not be repeated. Dr. Sloat also testified that [appellee] has not shown that he understands the connection between his mental disorder and his violent behavior or that he would be able to control his behavior once his symptoms return. At the close of all the evidence, the Department again moved for judgment on the same grounds as before, [appellee’s] failure to present expert testimony.

Its motion was again denied. The case was then submitted to the jury, and the jury returned the verdict that [appellee] should be released from inpatient commitment with conditions. On July 26, 2006, the circuit court entered an Order for Conditional Release, (footnote omitted). The record shows that, when denying appellant’s motion for judgment, the circuit court stated: ...

I looked at the statute, I looked at the cases. And nowhere regarding hearings, whether it be administrative or judicial, is there any reference whatsoever to any requirement of expert testimony. In fact, at the release hearing, the statutory language talks about that they can consider any relevant evidence, and there certainly would have been an opportunity for the legislature in this judge’s humble opinion, if they meant that I had to be determined to a standard of expertise, in other words, a standard or require ⁴²² ment of an individual with medical or psychiatric training, they could have referenced that. The test that falls upon the petitioner pursuant to Durant versus Superintendent of Perkins, which is a 1968 case, tests for release of person committed to mental institution is, if the patient if released would be a danger to the welfare of himself or society as a whole.

That’s the issue that’s presented to the trier of fact. And in this case, at Petitioner’s request, a juror. There’s nothing that says that within that consideration that that has to be done to a reasonable degree of medical or psychiatric certainty, which would be the test for an expert opinion. So for those reasons I will deny the motion.

This appeal followed. 3 Discussion Section 3-114 of the Criminal Procedure Article provides: (a) In general.—A committed person may be released under the provisions of this section and §§ 3-115 through 3-122 of this title. (b) Discharge.—A committed person is eligible for discharge from commitment only if that person would not be a danger, as a result of mental disorder or mental retardation, to self or to the person or property of others if discharged. ⁴²³ (c) Conditional Release.—A committed person is eligible for conditional release from commitment only if that person would not be a danger, as a result of mental disorder or mental retardation, to self or to the person or property of others if released from confinement with conditions imposed by the court. (d) Burden of proof.—To be released, a committed person has the burden to establish by a preponderance of the evidence eligibility for discharge or eligibility for conditional release. The Court of Appeals has “held that reliance on lay testimony alone is not justified when the medical question involved is a complicated one, involving fact-finding which properly falls within the province of medical experts.” Jewel Tea Co. v. Blamble, 227 Md. 1, 7 , 174 A.2d 764 (1961); see also Wilhelm v. State Traffic Safety Commission, 230 Md. 91 , 185 A.2d 715 (1962)(holding that where a “complicated medical question” is the alleged cause of negligent acts, medical expert testimony is required to prove the causal relationship); Riggleman v. State, 33 Md.App. 344, 353 , 364 A.2d 1159 (1976)(“Proof sufficient to raise a doubt in the minds of reasonable men as to an accused’s sanity can only be adduced through competent medical evidence to the positive effect that the accused, as a result of mental disorder, lacks substantial capacity either to appreciate the criminality of his conduct or to conform his conduct to the requirements of law.”) It is well settled that the testimony of one expert staff psychiatrist at the mental institution where the defendant has been confined is “legally sufficient evidence for the jury to conclude [that the defendant] if released would be a danger to the welfare of himself or society as a whole.” Durant v. Superintendent, Clifton T. Perkins, 251 Md. 467, 473 , 248 A.2d 148 (1968).

The Durant Court also stated: In essence, the test for the release of a person committed to a mental institution is whether the patient if released would be a danger to the welfare of himself or society as a whole. In Salinger v. Superintendent of Spring Grove State Hospital, 206 Md. 623 , 112 A.2d 907 (1955) as well as in Keiner v. ⁴²⁴ Superintendent, (Spring Grove State Hospital) 240 Md. 608 , 214 A.2d 788 (1965) it was said that the test is whether the patient, as a free man, would by reason of a mental disease or condition be a danger to himself, his safety or the person or property of others. Id. at 472, 248 A.2d 148 (quoting Alexander v. Superintendent, Spring Grove State Hospital, 246 Md. 334 , 228 A.2d 236 (1967)); see also Gray v. Director, Patuxent Institution, 245 Md. 80, 84 , 224 A.2d 879 (1966)(holding that one doctor’s testimony, along with reports and recommendations of other staff, was legally sufficient to support a jury verdict that defendant remain committed); Washington v. Director, Patuxent Inst., 237 Md. 311 , 206 A.2d 244 (1965)(holding that a report recommending defendant as a defective delinquent was sufficient evidence to support the jury verdict despite testimony from defendant’s psychologist that he was not a defective delinquent). Unlike the Durant case, the jury here found that appellee would not pose a danger to society if he were released, even though (1) appellee had presented no expert testimony in support of that finding, and (2) the Department had presented expert testimony against his release.

Appellee argues that, because the Department presented expert witness testimony, there was no valid