The sole issue presented is whether this court should transfer a mentally ill patient, who admittedly is dangerous to either himself or others, from a maximum security mental hospital to a mental hospital with little or no security, while such patient has a detainer lodged against him. Without the detainer the transfer would undoubtedly be approved. The State opposes transfer and insists upon maximum security.
Patterson was sentenced in November 1968 to a term of 13 to 15 years for rape and assault with intent to rape. He has been confined to the Forensic Section at the Trenton Psychiatric Hospital (hereinafter the Vroom Building) on four occasions, with admission and discharge dates as follows:
December 6, 1968 November 26, 1969
February 24, 1970 November 12, 1974
May 27, 1975 November 25, 1975
March 23, 1976 Still at Vroom
Thus, Patterson has spent only 12 months at the Trenton State Prison and the remaining time, or approximately 375 months, at the Vroom Building. Patterson has had several parole hearings, all denied. Each Parole Board decision makes reference to his mental illness, one citing his "insight was lacking" and "judgment was defective." His present diagnosis is schizophrenia, chronic, and alcoholism. His is still psychotic, likely to act out his psychosis, and is, in the opinion of all psychiatrists who examined him, "dangerous" to himself and others.
Bohuk is serving a life sentence for murder. His incarceration began in 1950 at Trenton State Prison. He has been a patient in the Vroom Building on 13 separate occasions, the last admission being November 1976. Since January
1969 Bohuk has spent only five months at the New Jersey State Prison, the remaining time, about 95 months, at state mental hospitals, primarily Vroom. On one occasion he was transferred to the Marlboro Psychiatric Hospital, but he escaped for a short period and was returned to the New Jersey State Prison. He too has had many applications for parole, all denied. His present diagnosis is paranoid, schizophrenic, chronic undifferentiated type, and alcoholism. In the opinion of all psychiatrists who examined Bohuk, he is "dangerous" to himself and others.
Neither seeks release -- merely transfer to a less restrictive mental hospital -- Patterson to Ancora and Bohuk to Marlboro.
Dr. Seymour Kavin, a private psychiatrist, and Dr. Jochim Elizando, a staff psychiatrist at the New Jersey Psychiatric Hospital, testified that in their opinion neither of these two patients require maximum security confinement at the Vroom Building and both would benefit from a less restrictive environment elsewhere. They urged transfer to Marlboro or Ancora where, they say (and this is crucial) many patients are no more "dangerous" than Patterson or Bohuk.
The State offered a psychologist and a clinical psychologist from Marlboro and a psychologist from Ancora who testified that in their opinion these patients should not be transferred to their institution and should remain at the Vroom Building. They were of the opinion that neither Ancora nor Marlbor could probably provide these patients with any better care and treatment than they are presently receiving at the Vroom Building. Both testified that if transferred, these patients would be placed in open wards where escape would be easy and they would create a serious management problem. There is some suggestion that both hospitals may shortly create closed wards -- nothing more than a room with locked doors and windows with bars -- which may, indeed, turn out to be more restrictive to individual freedom than exists at Vroom.
All patients in our mental hospitals are either voluntary or involuntary commitments. As to voluntaries, there is no problem. As to involuntaries, the rules now require judicial reviews at the time of initial commitment, and periodically thereafter. The criterion for the commitment is whether the person is "a [probable] danger to himself or the community". R. 4:74-7(f). If so, he is confined to a mental hospital. Thus, all patients who have been involuntarily committed, whether in maximum security at Vroom or with little or no security at other hospitals for the mentally ill, have been judicially determined to be "dangerous." But the dangerousness envisaged by the rules in many cases means nothing more than that the patient is unable to cope in the outside world on his own; so he is deemed to be dangerous to himself if released. On the other hand, there are patients, such as these men, who are dangerous to others but who, if there were no detainers, would be ...