Civil Damages in Pennsylvania
Be aware - if you sue for civil damages in Pennsylvania and if you know or should know that your mental health will be an issue, even though you are not seeking compensation for mental health injury, your confidential involuntary mental health records are no longer deemed privileged or protected.
This past October, the Pennsylvania Supreme Court, in Octave v. Walker, held that a patient waives his confidentiality protections under the Mental Health Procedures Act where, judged by an objective standard, he knew or reasonably should have known his involuntary admission mental health would be placed directly at issue by filing the lawsuit.
The pertinent facts:
On June 21, 2007, plaintiff's decedent, James Octave, was struck and killed by a tractor-trailer driven by defendant, Walker. Based on eyewitness reports, the Pennsylvania state police concluded Mr. Octave attempted to commit suicide by jumping under the truck’s trailer. The decedent's wife later sued multiple defendants claiming their individual and collective negligence in causing her husband's death. Because the state police concluded Mr. Octave was attempting to commit suicide, defendants sought discovery information regarding the decedent's mental health history and access to his mental health records, which plaintiff refused to produce.
The Pennsylvania Mental Health Procedures Act (MHPA), 50 P.S. § 7111 provides, in pertinent part:
(a) All documents concerning persons in treatment shall be kept confidential and, without the person’s written consent, may not be released or their contents disclosed to anyone except ***
In no event, however, shall privileged communications, whether written or oral, be disclosed to anyone without such written consent.
The MHPA protection, once held absolute, provides incentive for a narrow class of citizens requiring involuntary mental health treatment to be honest and completely transparent in their complaints and health history. Honest and transparent patient reports are necessary for proper diagnoses and treatment. Historically, mental health professionals have used the MHPA's confidentiality provisions as incentive for patients to be truthful and complete so they can put themselves in the best position for a long-term cure.
Over the years, Pennsylvania courts have limited the application of the MHPA confidentiality provisions. First, courts have ruled that the MHPA protects from disclosure only involuntary mental health treatment - the MHPA does not protect from disclosure records surrounding voluntary outpatient mental health treatment. Courts have also refused to uphold the MHPA privilege when a plaintiff has sought compensation for alleged "mental health" injuries, e.g. anxiety and depression. In those cases, the courts have held that when the plaintiff places his/her mental health care at issue in the case, they waive the MHPA protection. In the Octave case however, the plaintiff did not place any mental health claims at issue. Nonetheless, because there was "objective" evidence, i.e. eyewitness statements, placing Mr. Octave's mental health at issue, the MHPA protections afforded to Mr. Octave were waived when the lawsuit was filed.
It should be noted that the dissent thought that the Pennsylvania Supreme Court majority was wrong in degrading the privilege since there were less intrusive means for the defendants to defend themselves, i.e. through eyewitness statements, the Pennsylvania state police observations, experts and the decedent's voluntary outpatient mental health records. The majority of the Supreme Court did not find that the "less intrusive means" axiom applied because the patient died and therefore his state of mind could not be examined.
Some believe that this is just another example of an intrusion into one's civil liberties. An individual's involuntary inpatient treatment record was once held sacred and completely immune from discovery. Now, mental health professionals will need to modify their discussions with patients since the MHPA protections are not absolute. Hopefully, this holding will not have a deleterious affect on those individuals so desperately requiring mental health treatment; and, will not increase the risk of harm to Pennsylvania citizens.
