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TABLE OF AUTHORITIES Cases

Addington v. Texas, 441 U.S. 418 (1979) ........................................................................................... 8, 10 DeMarco v. Sadiker, 897 F.Supp. 693 (1995) ...............................................................................9, 10, 11 Glass v. Mayas, 984 F.2d 55 (1993) ...................................................................................................... 11 Graham v. Connor, 490 U.S. 386 (1989) ............................................................................................... 11 Harlow v. Fitzgerald, 457 U.S. 800 (1982) ............................................................................................ 11 Humphrey v. Cady, 405 U.S. 504 (1972) ................................................................................................. 8 In re Hernandez, 46 N.C. App. 265 (1980) .............................................................................................. 8 OConnor v. Donaldson, 422 U.S. 563 (1975) ................................................................................... 9, 10 Project Release v. Prevost, 722 F.2d 960 (1983).................................................................................... 10 Rodriguez v. City of New York, 861 F.Supp. 1173 (1994) ....................................................................... 10 Vitek v. Jones, 445 U.S. 480 (1980) ......................................................................................................... 9 Wetherhorn v. Alaska Psychiatric Institute, 156 P.3d 371 (2007). ..................................................... 8, 10

Statutes
42 U.S.C. 1983 ................................................................................................................................... 11 N.C.G.S. 122C-2 .................................................................................................................................. 9 N.C.G.S. 122C-210.1 .......................................................................................................................... 11 N.C.G.S. 122C-262............................................................................................................................... 8 N.C.G.S. 122C-268(j) ........................................................................................................................... 8 N.C.G.S. 122C-3(11)(a)........................................................................................................................... 7 N.C.G.S. 122C-3(11)(b) .......................................................................................................................... 8

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SUMMARY OF ARGUMENT The states power to involuntarily commit an individual resides within two legitimate interests: first, its parens patriae power to provide care for an individual who is unable to care for themselves; and second, its police power to protect (in this case) society from the individual by limiting their contact with the public. At the same time, however, involuntarily committing an individual constitutes a significant deprivation of liberty that requires due process protection. Addington v. Texas, 441 U.S. 418, 425 (1979). The Supreme Court has repeatedly acknowledged that such a massive curtailment of liberty, Humphrey v. Cady, 405 U.S. 504, 512 (1972), requires that the state bear the burden of justifying the necessity for commitment, as the infringement of the respondents liberty rightsbegins [at] the moment the respondent is detained involuntarily. Wetherhorn v. Alaska Psychiatric Institute, 156 P.3d 371, 381 (2007). That burden can only be met when the criteria for involuntary commitment are metand sufficient findings exist to support the commitment order. In my situation, the states burden rested on the actions of petitioning physicians (as state actors), who were required to prove that clear, cogent, and convincing evidence existed, demonstrating that I was mentally ill and (emphasis mine) a danger to self1 or dangerous to others,2 as specifically required by N.C.G.S. 122C-268(j) (2007). Since the doctors were convinced3 that any delay caused by utilizing the normal procedure would create a danger of harm to [myself] and that I required immediate hospitalization to prevent [this] harm, I was committed under a special emergency procedure, as defined in N.C.G.S. 122C-262. This emergency procedure required the doctor(s) to submit a sworn affidavit that established the facts upon which [their] opinion [was] based, and that the facts must be sufficient to establishthat [I] was imminently dangerous to [myself[ at the time of the commitment. In re Hernandez, 46 N.C. App. 265 (1980). The state failed to meet its burden. Due to the fact that the states findings were insufficient to support a commitment order, the involuntary commitment that followed was unconstitutional and produced significant liberty violations. Consequently, the manner in which my liberties were violated was directly related to the behavior/actions of the staff physicians; their conduct substantially deviates from professional standards, whichat the very leastplaces their immunity from liability4 and/or potential entitlement(s) to qualified immunity5 in serious jeopardy. A The involuntary commitment of an individual is a deprivation of liberty that requires due process protection. The loss of liberty produced by an involuntary commitment is more (emphasis mine) than a loss of freedom from confinement. Vitek v. Jones, 445 U.S. 480, 492 (1980). The states power to involuntarily commit a person exists within the confines of procedural and
1 2

N.C.G.S. 122C-3(11)(a) N.C.G.S. 122C-3(11)(b) 3 based on their findings listed in the statutorily-required commitment documents 4 N.C. Gen. Stat. 122C-210.1 5 42 U.S.C. 1983

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substantive due process. Procedural due process essentially requires that the same standard is adhered to in the assessment of commitment criteria; that one has been given the benefit of procedural safeguards to reduce the chance of erroneous commitment. DeMarco v. Sadiker, 897 F.Supp. 693, 699 (1995). The medical staffsa initial assessment and following reassessments failed to determineand much less evaluatethat I was a danger to myself or others. The states incorporation of the dangerousness standard into their own statutory languages only adds to blurred line of distinction that attempts to designate the point(s) at which an individuals liberty interest is unreachable by the all-encompassing interests of the state. Moreover--at no point did the doctors even try to meet the constitutional minimum, where the loss of liberty calls for a showing that the individual suffers from something more serious than is demonstrated by idiosyncratic behavior. In re Addington, supra. Additionally, the doctors determination of mental illness was based largely on my self-reported patient history. b In 2004, I was diagnosed with Bipolar II Disorder and Attention-Deficit Hyperactivity Disorder (ADHD) by Dr. Andrew Proffer. c I also suffer from Trichotillomania. The medical staff concluded that my initial complaint of a severe skin rash upon arrival to the ERcoupled with my statement that I hadnt slept for two dayswas best explained by delusions and/or psychoses associated with a manic episode.6 The following additional facts7 were known, but not considered:
1. Manic Episodes occur only in the context of Bipolar I Disorder. The presence of a Manic or Mixed Episode precludes the diagnosis of Bipolar II Disorder. DSM-IVTR, 296.89(c). 2. I have had no previous onsets of a Manic Episode with Psychotic Features. 8 3. I was misdiagnosed with Scabies (133.0, ICD-9-CM, under the category of Infectious and Parasitic Diseases) twice, approximately two months prior. 4. I lived by myself in a house that I paid rent for every month. 5. I worked full-time.9 6. I went to school full-time at the University of North Carolina at Greensboro.d 7. I have no prior history of inpatient psychiatric hospitalization. 8. I came to the ER at Wesley Long Hospital on my own (by choice).

The required existence of dangerousness set forth in OConnor v. Donaldson, 422 U.S. 563, 575 (1975), outlines the constitutional minimum requisite for satisfying procedural due process: that a finding of mental illness alone cannot justifycustodial confinement. The doctors failure to conduct an examination and/or assessment of my dangerous to self in accordance with the statute* constituted a violation of my procedural due process rights. With regard to involuntary commitment statutes, the need for state actors to take the time to tediously follow the statutory language is tantamount to preventing any arbitrary deprivation of liberty. The mentally ill10 are in danger of being confined merely because theyexhibit some abnormal behavior
6 7

see definitions page relevant criteria to the legally-required assessment in Form No. DMH 5-72-01 8 In Bipolar II Disorder, only a Major Depressive Episode can manifest in psychotic features 9 as a server at Bravo! Cucina Italiana, located at the Friendly Shopping Center in Greensboro, NC 10 anyone with a DSM-IV-TR diagnosis; additionally, the term is very easily stretched to encompass a wide range of individuals

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which might be perceived by some as symptomatic of a mental or emotional disorder, but which is in fact within a range of conduct that is generally acceptable. Wetherhorn v. Alaska Psychiatric Institute, supra, at 378 (citing Addington, 441 U.S. at 426-427). In addition, the doctors failure to conduct an examination and/or assessment in accordance with the statute violates procedural due process on the grounds that they did not consider alternative forms of care and treatment besides involuntary hospitalization. Project Release v. Prevost, 722 F.2d 960 (1983). Additionally, the doctors actions goes against North Carolinas mental health policy, as defined in N.C.G.S. 122C-2, which states that the policy of the state is to assist individuals with needs for mental healththrough a system designed to meet the[ir] needsin the least restrictive, therapeutically most appropriate setting available.
*On Form No. DMH 5-72-01, it states that: Included in the examination was an assessment of the respondents: (1) current and previous mental illnessincluding, if available, previous treatment history; (2) dangerousness to self or others as defined in G.S. 122C-3(11); (3) ability to survive safely without inpatient commitment, including the availability of supervision from family, friends, or others; and (4) the capacity to make an informed decision concerning treatment.

B Substantive due process analysis requires the balancing of state interests against the liberty interests of the individual. Applied to involuntary commitment laws, the state maintains the burden of constitutionally justify[ing] the deprivation of a persons physical liberty. OConnor v. Donaldson, supra, at 563. The doctors failure to give me the benefit of procedural safeguards significantly increased the likelihood of erroneous commitment. DeMarco v. Sadiker, supra, at 699. Attributed heavily to the violation of procedural due process, the doctors decision to involuntarily commit me without requisite findings ofOR requisite attempts to determinedangerousness constitutes a violation of my substantive due process. Thus, the violation of substantive due processas applied to my situationbecame inevitable pursuant to the procedural violations. However, if the doctors had followed the statutorilymandated process in determining the dangerousness standard, a substantive element would still exist. The question then turns to the issue of whether or not my behavior with the relevant past11 renders me a danger to myself. Consequently, an impartial factfinder, guided by medical documentation, should be [able] to determine that mental illness [was] present and danger likelywithout [having] to wait for [my] conduct to make serious harm all but inevitable. Rodriguez v. City of New York, 861 F.Supp. 1173 (1994). If such a factfinder was applied to this case, they would also find my conduct12 was not conducive to a finding of dangerousness to self. The courts taskis to examine the undisputed facts of a plaintiffs behavior and the defendants responses and decide whether the record permits a determination as a matter of law that the defendants finding of dangerousness was objectively reasonable. DeMarco v. Sadiker, supra, at 707. C
11 12

Id. at 1. Id. at 8.

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The Supreme Court has stated, a seizure, triggering the Fourth Amendments protections occurs only when government actors have, by means of physical forces or show of authority,in some way restrained the liberty of a citizen. Glass v. Mayas, 984 F.2d 55 (1993) (citing Graham v. Connor, 490 U.S. 386, at 395 n. 10 (1989). Following, the Glass court concluded that the Fourth Amendment applies to involuntary commitment. Id. Pursuant to the conclusion that the doctors involuntary commitment violated my due process rights, it seems logical to conclude that my Fourth Amendment rights were also violated. D In my own assessment as to whether the doctors in my case are entitled to qualified immunity, I relied mainly onand followedthe courts reasoning in DeMarco v. Sadiker (1995): "The availability of qualified immunity turns on whether it was objectively reasonable for the defendants to believe, at the time they examined the plaintiff and in light of the information they possessed, that plaintiff was dangerous." The standard of assessment for determining the existence of qualified immunity in substantive due process claims is a two-step analysis: first, whether the right allegedly violated was clearly established at the time; second, whether it was objectively reasonable for the [doctors] to believe that his or her actions did not violate that right.13 Considering the potential liberty infringements posed by an involuntary commitment (as previously discussed), the doctors knew that my constitutional rights were clearly established at the time they decided to initiate the order for commitment. As for whether or not it was objectively reasonable for the doctors to believe that their actions violated my constitutional rights of which a reasonable person would have known, Harlow v. Fitzgerald, 457 U.S. 800, 818 (1982), the distinction rests on whether or not other physicians who follow acceptedstandards14 would find their actions reasonable. So, was it objectively reasonable for the doctors in DeMarco to conclude that the plaintiff was in fact a danger to himself? The court thought so; their agreement can mainly be attributed to the following information about Brian DeMarcos (plaintiff) background:
"Because of his earlier visits, doctors and nurses at the [hospital] were familiar with plaintiff, his complaints, his history of drug use and previous hospitalization in a psychiatric institution."

Following the courts reasoning in this caseas well as additional case law, statutes, etc.it was not objectively reasonable for the doctors in my situation to conclude that I was a danger to myself.
13 14

42 U.S.C. 1983 N.C.G.S. 122C-210.1

a refers to each member of the medical staff that aided in my assessment (according to the Patient Assessment Sheet) b registration history as patient of Wesley Long Hospital; *see attached document(s) c information on Dr. Proffers diagnoses; *see attached document d where I pursued a double-major in English and Psychology, and a minor in Political Science; I graduated in May (2009); a copy of my Degree Evaluation is provided; *see attached document

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