Supreme Court: More Information Required On Release Of Potentially Dangerous Patients

May 9, 2016

A ruling by the Vermont Supreme Court could change the legal landscape for mental health care in Vermont. The high court ruled that mental health professionals should provide more information about potentially dangerous patients who are leaving treatment.

A divided court ruled in favor of a St. Johnsbury man who was severely beaten by a former Brattleboro Retreat patient.

In February 2011, Michael Kuligoski was working on a furnace in an apartment when he was attacked and seriously injured by Evan Rapoza.

Rapoza is a former patient at the Brattleboro Retreat and was receiving outpatient treatment from Northeast Kingdom Human Services.

Richard Cassidy is an attorney who represented the injured furnace technician. He says the Retreat should have provided more information to Rapoza's family to help protect the public.

"We think that the mental health care professions ought to take the public interest into account in terms of making decisions about those few patients who do present a risk to public safety," said Cassidy.

Cassidy argued that the Retreat should have recognized that Rapoza posed a threat to the public.

A lower court dismissed the case. But when the case reached the Supreme Court, the majority ruled that the Retreat knew the patient had a history of violence and should have provided better guidance for his care. But the court did not say the hospital had a duty to warn the general public.

Department of Mental Health Commissioner Frank Reed says he can't predict how the ruling will affect the mental health system.

"The majority of the justices have an opinion," Reed says. "The dissenting opinions are to the contrary, so I think many of the concerns voiced in the dissenting opinions would be those that would have potential implications for the service system. And yes, of course, we're concerned and we will follow it."

Ritchie Berger represented the Retreat and he says it's unclear how hospitals will be expected to provide that information about a patient to caregivers.

"We are very disappointed by the majority decision of the Vermont Supreme Court which creates a legal duty of care that never existed in Vermont, or anywhere else in the country, when the patient at issue is being cared for," said Berger.

AJ Ruben, supervising attorney at Disability Rights Vermont, says the ruling could have far-reaching effects on the mental health care system. He says doctors might be less willing to release psychiatric patients, while patients could fear that they would be held against their will in the absence of clear guidelines for release.

"If you say to your mental health provider, 'I'm going to go burn down my father's barn,' current law was that provider had to tell the police," Ruben explains. "Now, if the person says, 'Sometimes I have violent thoughts,' and it may not be anything more than that, the provider may have to be really worried about letting that person into the community, even though there's no reason to think anyone specific is about to be harmed. It just raises a lot of questions."

The attorney for the injured furnace worker says the Supreme Court ruling allows his client to seek financial compensation for the losses he suffered at the hands of the former Retreat patient.