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Lake v. Cameron - 124 U.S. App. D.C. 264, 364 F.2d 657 (1966)


The District of Columbia Hospitalization of the Mentally Ill Act, D.C. Code §§ 21-501 to 21-591 (Supp. V, 1966) provides that if the court or jury finds that a person is mentally ill and, because of that illness, is likely to injure himself or other persons if allowed to remain at liberty, the court may order his hospitalization for an indeterminate period, or order any other alternative course of treatment which the court believes will be in the best interests of the person or of the public. D.C. Code § 21-545(b) (Supp. V, 1966). This confirms the view of the Department of Health, Education and Welfare that the entire spectrum of services should be made available, including outpatient treatment, foster care, halfway houses, day hospitals, nursing homes, etc. The alternative course of treatment or care should be fashioned as the interests of the person and of the public require in the particular case. Deprivations of liberty solely because of dangers to the ill persons themselves should not go beyond what is necessary for their protection.


When appellant Catherine Lake was sixty years old, a policeman found her wandering about and took her to the D.C. General Hospital. Thereafter, she filed in a federal district court a petition for a writ of habeas corpus. The court transferred her to St. Elizabeths Hospital for observation in connection with pending commitment proceedings, allowed her to amend her petition by naming the Superintendent of Saint Elizabeths as defendant, and on November 2, 1962, dismissed her petition without holding a hearing or requiring a return. After she filed her appeal from the denial of habeas corpus, she was adjudged "of unsound mind" and committed to Saint Elizabeths. At the commitment hearing, two psychiatrists testified that she was mentally ill, and one of them testified that she was suffering from a "chronic brain syndrome" associated with aging and "demonstrated very frequently difficulty with her memory." Both psychiatrists testified to the effect that she could not care for herself adequately. The case was subsequently remanded to the district court, and during the commitment hearing and the habeas corpus hearing on remand, Lake testified that she felt able to be at liberty. The district court denied Lake's petition, asserting that she was in need of care and supervision, that there was no member of the family able to give her the necessary care and supervision, and that the family was without sufficient funds to employ a competent person to do so. The district court noted Lake's right to make further application if she was able to show that there was an alternate facility available. Lake thereafter challenged this decision, arguing that remand to the district court was required for a consideration of suitable alternatives to confinement in the mental hospital in light of the new District of Columbia Hospitalization of the Mentally Ill Act.


Where a patient was said to be suffering from a mental disorder, was it the patient's burden to show that there was an alternate facility available aside from the hospital?




The federal appellate court held that an indigent patient could not be required to carry the burden of showing the availability of alternatives. According to the court, because the government had the means to find alternatives, an earnest effort should have been made to review and exhaust available resources of the community in order to provide care reasonably suited to her needs. The court remanded the matter to the district court for an inquiry into other alternative courses of treatment for Lake.

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