Should a Physician Consider Patient's Behavior In Community After Discharge In Determining His Dangerousness ?

In Matter of Seltzer v. Hogue (187 AD2d 230 [2d Dept 1993]) the Second Department was presented with a civil committee whose behavior improved in the hospital, yet who, upon discharge, would not comply with treatment and quickly deteriorated into substance abuse and dangerousness. (Id., at 238.) The Court found that physicians could take into account the patient's behavior in the community, after discharge, in making a determination of dangerousness. (Id., at 238.) The Court authorized retention of the patient, pursuant to Mental Hygiene Law 9.33, holding that (at 237-238) "The unrebutted evidence adduced from Dr. Kathpalia's expert psychiatric testimony, Hogue's medical records, and the personal observations of Lisa Lehr, depicts an individual who is presently suffering from mental illness and who has had a long history of mental illness and dangerous behavior dating back almost 30 years. This evidence also indicates that although Hogue's external behavior has improved somewhat in Creedmoor (a structured setting in which he takes certain seizure medication), he has a history of noncompliance with any treatment program upon his release from psychiatric hospitals. Indeed, once he is released from these institutions, his mental illness invariably deteriorates to the point that he engages in substance abuse and activities which are dangerous to himself and others."