In Re the Mental Health of K.G.F.

Montana Supreme Court8/2/2001
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Full Opinion

*2JUSTICE NELSON

delivered the Opinion of the Court.

¶1 K.G.F1. appeals the order entered by the First Judicial District Court, Lewis and Clark County, that involuntarily committed her to a mental health facility. K.G.F. contends that she was denied effective assistance of counsel during the course of the commitment proceedings.

¶2 We reverse and remand for further proceedings.

¶3 K.G.F. raises the following issue:

Did her counsel render ineffective assistance of counsel in violation of her rights guaranteed under the Sixth Amendment to the United States Constitution and Article II, Section 24, of the Montana Constitution?

FACTUAL AND PROCEDURAL BACKGROUND

¶4 It is undisputed that the condition of KG.F.’s mental health in October of 1999, reached a critical point that led her to voluntarily seek treatment at St. Peter’s Community Hospital in Helena, Montana. She was admitted into the hospital on October 21, 1999.

¶5 K.G.F. is afflicted with bipolar disorder or what is oftentimes referred to as manic-depressive illness. The disorder is a biochemical imbalance that causes gross mood changes from the high reaches of mania to the lows of severe depression. K.G.F.’s disorder has been diagnosed as “mixed rapid cycling.” The term “mixed” identifies a particular kind of bipolar episode that features both mania and depression. The term “rapid cycling” generally refers to frequent severe episodes of depression and mania.

¶6 Up until her hospitalization, K.G.F. controlled her disorder with medication and was under psychiatric care. At the time she entered the hospital, K.G.F. had apparently “fired” her treating psychiatrist and was suicidal, which is not an uncommon symptom of a person afflicted with her kind and degree of bipolar disorder. She has a medical history of prior hospitalizations and episodes of suicidal behavior. Testimony herein indicates that K.G.F. did not take any affirmative steps in attempting suicide beyond threatening to do so while voluntarily committed at the hospital.. Although not entirely clear, hearing testimony as well as a medical “professional person’s” report indicate that there were actual suicide attempts in the past, one as recent as June of 1999.

¶7 After her admission, K.G.F. disagreed with the medications prescribed for her and refused to take those medications. It is undisputed that she is intelligent, and quite adept at understanding the medications she takes in relation to managing her disorder. Against medical advice, she requested that she be released from the hospital. By the time of her commitment hearing, however, she was apparently willing to take her medication and apparently willing to undergo further voluntary commitment if necessary. *3¶8 On October 26, 1999, a deputy county attorney filed a petition with the District Court “alleging mental disorder that requires commitment.” The petition relied on the findings and request made by a case coordinator, Nancy McVean, at St. Peter’s who was also a certified “professional person” under § 53-21-106, MCA. The primary focus and concern was that K.G.F. planned to commit suicide, and that once released from the hospital she would implement her plan. The petition also reported that K.G.F. was indigent and therefore unable to afford an attorney, and that she was “presently detained” at the hospital. The petition requested that K.G.F. be held at the hospital for further evaluation and treatment until a commitment hearing took place.

¶9 That same day, the District Court issued an order finding probable cause that K.G.F. had a mental disorder requiring commitment. Counsel was appointed pursuant to this order. An initial appearance took place later that same day some time in the afternoon, according to a court reporter minute entry. At that time, with counsel present, KG.F.’s constitutional rights were explained to her as well as the substantive effects of the petition. A hearing was set for the next morning, on October 27, 1999, at 11:30 a.m.

¶10 Two medical professionals were called to testify at the hearing the next day, one by the State and one by counsel for K.G.F. Both experts had interviewed K.G.F. and reviewed her records. K.G.F. was also called to testify. Although present at the hearing, K.G.F.’s husband was not called to testify.

¶11 McVean, the case coordinator who had requested the petition and who in turn served as a “professional person” as required by law, recommended that based on her interview with K.G.F., K.G.F. should be committed to a community facility, as opposed to the State Hospital at Warm Springs.

¶12 Nancy Adams, who had spent approximately one hour with K.G.F. the day before, recommended that K.G.F. remain in the hospital for a few days, so that a community-based treatment plan in Bozeman-nearer to where K.G.F. lived-could be arranged. She testified that “being pulled away from her closest support, her husband, and staying in a strange place might do more harm than good.”

¶13 K.G.F. was called to testify on her own behalf. She agreed that the Bozeman option would be best for her, and explained that she had private financial and insurance resources to cover the expenses. She further testified that “my husband is there and he is with me every night and every morning.” She indicated that she would voluntarily remain at the St. Peter’s facility until such arrangements could be worked out.

¶14 The court issued its findings of fact, conclusions of law, and order that day following the hearing. The court then issued an amended findings of fact, conclusions of law, and order on November 2, 1999. The latter struck one finding, and was otherwise identical to the prior order.

*4¶15 The court found that K.G.F., while at St. Peter’s Hospital, “began to refuse medications and desired to sign out against medical advice.” Upon finding that K.G.F. suffered from bipolar disorder “mixed” and that she was an “imminent threat of injury to herself,” the court ordered that she be committed to Golden Triangle Mental Health, in Helena, for a period of 90 days for “care, treatment and evaluation of the respondent’s mental health needs ...”

¶16 K.G.F. appeals the findings of fact, conclusions of law, and order on the grounds she received ineffective assistance of counsel at the hearing.

STANDARD OF REVIEW

¶17 Our review of the constitutional issues of due process and right to counsel involves questions of law and our review of such questions is plenary. See Pickens v. Shelton-Thompson, 2000 MT 131, ¶¶ 7-8, 300 Mont. 16, ¶¶ 7-8, 3 P.3d 603, ¶¶ 7-8; State v. Okland (1997), 283 Mont. 10, 14, 941 P.2d 431, 433.

DISCUSSION

¶18 As a preliminary matter, we agree with KG.F.’s contention that this controversy is not moot, even though K.G.F. is no longer subject to the 90-day commitment order. Although the issue of mootness was not contested by the State, we nevertheless emphasize that the issue was resolved by this Court some time ago, in In re N.B. (1980), 190 Mont. 319, 620 P.2d 1228 (superseded in part by statute as stated in In re J.M. (1985), 217 Mont. 300, 304-05, 704 P.2d 1037, 1040).

¶19 Our reasoning there, as here, was that this Court “reserves to itself the power to examine constitutional issues that involve the broad public concerns to avoid future litigation on a point of law.” In re N.B., 190 Mont. at 322-23, 620 P.2d at 1230-31 (concluding important constitutional questions were not rendered moot by patient’s release from Warm Springs mental health facility and observing that approximately 100 Montanans each year are involuntarily committed for three months of treatment and evaluation in that facility).

¶20 Thus, we conclude that the claimed constitutional right to effective assistance of counsel in civil involuntary commitment proceedings is “capable of repetition, yet evading review.” Heisler v. Hines Motor Co. (1997), 282 Mont. 270, 275-76, 937 P.2d 45, 48 (setting forth mootness standard). Accordingly, we proceed to the issue raised.

ISSUE PRESENTED

Did K.G.F.’s counsel render ineffective assistance of counsel in violation of her rights guaranteed under the Sixth Amendment to the United States Constitution and Article II, Section 24, of the Montana Constitution?

¶21 K.G.F. argues that although she was appointed counsel by the District Court, her constitutional right to effective assistance of counsel was denied during the course of her involuntary commitment proceedings.

¶22 K.G.F. reasons that this claimed right exists because the involuntary civil commitment process may deprive an individual of his or her liberty, and therefore should be likened to criminal custody and *5incarceration. She contends, therefore, that her constitutional right to effective assistance of counsel flows from both the Sixth Amendment to the U.S. Constitution and Article II, Section 24, of the Montana Constitution, and must be scrutinized pursuant to this Court’s application of the Strickland test.

¶23 The State and Amicus2 contend that the foregoing constitutional protections afforded individuals in criminal proceedings are not appropriate for the “unique legal undertaking” of a civil commitment proceeding. K.G.F., as an alternative position, concurs with this due process argument.

¶24 Although clearly not agreeing as to what should constitute a standard of “effectiveness,” K.G.F., the State, and Amicus urge this Court to turn to the foundation of the due process clause under either the federal or our state constitution, and construct an appropriate standard for ensuring the “fundamental fairness” of civil commitment proceedings. See In re W.M. (1992), 252 Mont. 225, 229, 828 P.2d 378, 381 (stating that civil commitment for any purpose constitutes a significant deprivation of liberty that requires due process protection, and citing Addington v. Texas (1979), 441 U.S. 418, 425, 99 S.Ct. 1804, 1809, 60 L.Ed.2d 323, 330-31); In re Shennum (1984), 210 Mont. 442, 450-51, 684 P.2d 1073, 1078 (stating that procedural safeguards in commitment cases were “inserted by the Legislature because of the calamitous effect of a commitment: a deprivation of a person’s liberty for up to three months ... and the inevitable damage to a person’s reputation”). See also Foucha v. Louisiana (1992), 504 U.S. 71, 80, 112 S.Ct. 1780, 1785, 118 L.Ed.2d 437 (stating that freedom from bodily restraint has always been at the core of the liberty protected by the due process clause from arbitrary governmental action); Mathews v. Eldridge (1976), 424 U.S. 319, 334, 96 S.Ct. 893, 902, 47 L.Ed.2d 18 (stating that due process is “flexible and calls for such procedural protections as the particular situation demands”).

¶25 This Court has not previously addressed whether a person subjected to an involuntary commitment proceeding has a constitutional right to effective assistance of counsel, and, if so, how such effectiveness should be measured3.

*6 A. The right to effective assistance of counsel

¶26 Involuntary civil commitments in Montana are governed by Title 53, Chapter 21, MCA (codified in 1975). Our initial review of this matter is guided by § 53-21-101(4), MCA, which expressly provides that one purpose of our laws governing the treatment of “seriously mentally ill” persons is to “ensure that due process of law is accorded any person coming under the provisions of this part.” Further, under § 53-21-115, MCA, a person who is involuntarily detained or against whom a commitment petition is filed is expressly afforded numerous due process rights including the right to be represented by counsel. See § 53-21-115(5), MCA; § 53-21-116, MCA (judge shall appoint attorney if person has no attorney).* **4 See also § 53-21-119(1), MCA (right to counsel may not be waived).

¶27 In turn, the foregoing statutory rights explicitly and implicitly garner protection under both the federal and the Montana constitutions. We disagree with K.G.F., however, that the protection of those rights flows from the express constitutional provisions addressing persons subject to criminal prosecution.

¶28 The Sixth Amendment to the U.S. Constitution provides that in all criminal prosecutions, the accused shall have the assistance of counsel. Similarly, under Article II, Section 24, of the Montana Constitution, the accused in all “criminal prosecutions” shall have the right to appear and defend in person and by counsel. Where a criminal defendant claims his or her constitutional right to effective counsel has been violated, this Court applies the two-part Strickland test, derived from the U.S. Supreme Court decision in Strickland v. Washington (1984), 466 U.S. 668, 104 S.Ct. 2052, 80 L.Ed.2d 674. See, e.g., State v. Berg, 1999 MT 282, ¶ 28, 296 Mont. 546, ¶ 28, 991 P.2d 428, ¶ 28 (identifying two-prong Strickland ineffective assistance of counsel test as (1) whether counsel acted within the range of competence demanded of attorneys in criminal cases and (2) whether counsel’s deficient *7performance prejudiced the defense so as to deny the defendant a fair trial).

¶29 As argued by K.G.F., at least one other state appellate court has adopted and applied Strickland to the involuntary civil commitment process in order to secure an individual’s rights to due process. See In re Carmody (Ill.App.Ct. 1995), 653 N.E.2d 977.

¶30 We agree with the Carmody court to the extent it reasoned that where a state statute affords an individual subject to involuntary commitment with the right to counsel, the legislature could not have intended that counsel could be prejudicially ineffective. See Carmody, 653 N.E.2d at 983 (holding that the State’s statutorily providing a respondent in an involuntary commitment proceeding with the right to counsel implicitly includes the right to the effective assistance of that counsel, and citing to Strickland). See also In re Commitment of Hutchinson (Penn. 1982), 454 A.2d 1008, 1011 (holding that an alleged mental incompetent is entitled to effective representation by competent counsel).

¶31 Therefore, we hold that the right to counsel, as provided under our Title 53, Chapter 21 statutes, provides an individual subject to an involuntary commitment proceeding the right to effective assistance of counsel. In turn, this right affords the individual with the right to raise the allegation of ineffective assistance of counsel in challenging a commitment order.

¶32 The fundamental question that must be resolved, as addressed by the parties and Amicus, is how effective counsel must be when representing an individual who is facing an involuntary commitment.

B. The Strickland standard is an inappropriate threshold

¶33 Although in numerous respects the procedural due process rights of an involuntary commitment patient-respondent are identical to those afforded an accused criminal defendant, we disagree with K.G.F. and the Carmody court that the application of the Strickland standard is appropriate in involuntary civil commitment proceedings. We conclude that the standard under Strickland simply does not go far enough to protect the liberty interests of individuals such as K.G.F., who may or may not have broken any law, but who, upon the expiration of a 90-day commitment, must indefinitely bear the badge of inferiority of a once “involuntarily committed” person with a proven mental disorder.5

¶34 The Strickland decision, for example, provides that a court “must indulge a strong presumption that counsel’s conduct falls within the wide range of reasonable professional assistance; that is, the defendant must overcome the presumption that, under the circumstances, the challenged action might be considered sound trial strategy.” See *8Strickland, 466 U.S. at 689, 104 S.Ct. at 2065 (citation and internal quotations omitted). See also State v. Hanson (1997), 283 Mont. 316, 327, 940 P.2d 1166, 1173 (quoting from Strickland, and observing U.S. Supreme Court’s warning that courts should be “highly deferential” when second guessing counsel’s assistance).

¶35 Even a cursory review of legal commentary reveals the flawed reasoning of applying the foregoing Strickland standard to involuntary civil commitment proceedings. Namely, “reasonable professional assistance” cannot be presumed in a proceeding that routinely accepts-and even requires-an unreasonably low standard of legal assistance and generally disdains zealous, adversarial confrontation. See generally Michael L. Perlin, Fatal Assumption: A Critical Evaluation of the Role of Counsel in Mental Disability Cases, 16 Law & Hum. Behav. 39, 53-54 (1992) (identifying Strickland standard as “sterile and perfunctory” where “reasonably effective assistance” is objectively measured by the “prevailing professional norms”) (hereinafter Perlin).

¶36 Further, we disagree with the Carmody court’s Strickland analysis indicating that in involuntary commitment proceedings “no issues are likely to arise regarding respondent’s counsel’s failure to adequately investigate or prepare for trial, or counsel’s failure to pursue defenses or witnesses as suggested by his client.” See Carmody, 653 N.E.2d at 984-85. To the contrary, the conduct of counsel during those few available hours prior to an involuntary commitment hearing or trial should be a key focal point of the inquiry as to whether the counsel’s representation was effective.

¶37 To this extent we disagree with K.G.F. that the “most startling evidence that counsel’s deficient performance prejudiced [K.G.F.] was counsel’s failure to object to hearsay testimony.” The weight of one missed objection to questionable testimony at a hearing is minuscule in comparison to the failure to fully investigate and comprehend a patient’s circumstances prior to an involuntary civil commitment hearing or trial, which may, in turn, lead to critical decision-making between counsel and client as to how best to proceed. Such pre-hearing matters, which shall be discussed infra, clearly involve effective preparation prior to a hearing or trial.

¶38 We also agree with Amicus that the Strickland burden of proving that counsel’s “deficient performance prejudiced the defense so as to deny the defendant a fair trial,” is contrary to our prior case law that mandates-that unless civil commitment laws are strictly followed, a commitment order must be revérsed. See, e.g., In re Morlock (1993), 261 Mont. 499, 501, 862 P.2d 415, 416 (citations omitted). This argument is also raised by K.G.F., in alternatively arguing that a non-Strickland due process analysis would find counsel ineffective here as well.

¶39 Finally, we agree with the State and Amicus that the 6th Amendment to the U.S. Constitution, and Article II, Section 24, pertain to criminal proceedings alone, and that although affording an individual with certain “criminal” due process rights, the involuntary *9commitment process does not invoke those constitutional provisions. See § 53-21-115(6), MCA (person has the right to remain silent) and compare with § 53-21-115(7), MCA (hearing governed by rules of evidence applicable to civil matters); § 53-21-126(3), MCA (proceedings governed by Montana Rules of Civil Procedure). See also § 53-21-126(2), MCA (providing hybrid standards of proof at civil commitment trials or hearings: “beyond a reasonable doubt” and “clear and convincing evidence”).

¶40 Thus, we turn as suggested by the State and Amicus, to the due process clause of the Montana Constitution.

C. Due process and fundamental rights

¶41 Under Article II, Section 17, the Montana Constitution provides that “No person shall be deprived of life, liberty, or property without due process of law.”

¶42 As a starting point, it is safe to say that in purportedly protecting the due process rights of an individual subject to an involuntary commitment proceeding-whereby counsel typically has less than 24 hours to prepare for a hearing on a State petition that seeks to sever or infringe upon the individual’s relations with family, friends, physicians, and employment for three months or longer6-our legal system of judges, lawyers, and clinicians has seemingly lost its way in vigilantly protecting the fundamental rights of such individuals. See In re Mental Health of L.C.B. (1992), 253 Mont. 1, 7, 830 P.2d 1299, 1303 (stating that courts must safeguard the due process rights of the individual involved at every stage of the proceedings); In re J.B. (1985), 217 Mont. 504, 511, 705 P.2d 598, 603 (stating that the discharge of judicial responsibility includes rigorous application of statutory mandates) (Morrison, J., dissenting).

¶43 In the case subjudice, for example, the public defender appointed to represent K.G.F. had, from the close of the initial appearance to the commencement of the commitment hearing, at best four or five working hours-amidst his usual case load of criminal matters-to prepare for what can only be described as a perfunctory process that lasted minutes.

¶44 Our Legislature has, however, expressly provided that an *10individual who may be suffering from a mental disorder and who, as a result, may be involuntarily committed must be afforded care and treatment that fully respects that person’s “dignity and personal integrity.” See § 53-21-101(1), MCA. Once admitted to a mental health facility, whether voluntarily or involuntarily, a patient has the right to “privacy and dignity,” under § 53-21-142(1), MCA. These legislative mandates, in turn, invoke fundamental rights under our state constitution.

¶45 Respect for a person’s dignity invokes Article II, Section 4, under this state’s constitution, which provides that “dignity of the human being is inviolable.” See Armstrong v. State, 1999 MT 261, ¶ 72, 296 Mont. 361, ¶ 72, 989 P.2d 364, ¶ 72 (stating that “[r]espect for the dignity of each individual--a fundamental right, protected by Article II, Section 4 of the Montana Constitution-demands that people have for themselves the moral right and moral responsibility to confront the most fundamental questions about the meaning and value of their own lives and the intrinsic value of life in general, answering to their own consciences and convictions”).

¶46 One example of respect for a patient-respondent’s dignity, as provided by the Legislature under Title 53, Chapter 21, is the requirement that the person has a right “to be dressed in the person’s own clothes at any hearing held pursuant to this part.” See § 53-21-115(10), MCA. Implicit under Title 53, Chapter 21, is also the notion that the hearing shall be conducted in court, not in a mental health facility, which enhances the dignity afforded to the individual. See §§ 53-21-115(2) and 116, MCA (respondent has the right to be present in any hearing or trial); § 53-21-119(2), MCA (affording respondent the right to waive presence at hearing and indicating an “alternative location” for a hearing in “surroundings familiar to the respondent” may be appropriate)7.

¶47 In Armstrong, this Court identified an individual’s medical decisions affecting “bodily integrity” as a fundamental right under the personal autonomy component of the constitutional right to privacy set out in Article II, Section 10, of the Montana Constitution. See Armstrong, ¶ 39. Respect for a patient-respondent’s medical-decision personal autonomy has likewise been expressed by our Legislature under § 53-21-115(11) and (12), MCA, which provide that a person has *11the right to either refuse or voluntarily take medications prior to any hearing, and the right to be examined by a professional person of the respondent’s choice, under §§ 53-21-115(9) and 53-21-124(3), MCA.

¶48 That these fundamental constitutional rights are at issue during all phases of the involuntary commitment process, including prior to a hearing when counsel is either appointed or obtained, is self evident. Thus, we agree that the “[qjuality counsel provides the most likely way-perhaps the only likely way” to ensure the due process protection of dignity and privacy interests in cases such as the one at bar. See Perlin, at 47.

¶49 Therefore, in reviewing the procedural circumstances set forth here for whether K.G.F. was afforded effective assistance of counsel, we must address the obvious systemic failure of the involuntary civil commitment hearing process itself. In doing so, we emphasize that what follows is not meant as a per se indictment of the individual counsel here or appointed counsel in these matters in general; nor is it a tacit censure of the individual professionals involved, who undoubtedly have sound therapeutic objectives in mind. Rather, our aim is on the failure of the system as a whole, one that through the ordinary course of the efficient administration of a legal process threatens to supplant an individual’s due process rights that serve to safeguard the fundamental liberty interests discussed thus far.

¶50 Accordingly, while we may draw from the collective jurisprudence of both federal and other state’s decisions and statutes, as well as an array of thoughtful commentary by scholars and practitioners, we must nevertheless articulate a guiding standard that comports with Montana’s unique constitutional and statutory framework, one that protects the fundamental rights of individuals whose liberty is placed at issue by State action.

D. Individual liberty and the parens patriae doctrine

¶51 In articulating a standard for effective counsel, it is necessary to recognize and dispel certain stereotypes that serve only to frustrate the legal process that purports to secure the skillful and humane care and treatment of individuals suffering from mental disorders.

¶52 In this regard, our citation to the California Supreme Court’s decision, Conservatorship of Roulet (Cal. 1979), 590 P.2d 1, in In re Shennum (1984), 210 Mont. 442, 451, 684 P.2d 1073, 1078, is significant. In Shennum, we voiced the same concerns addressed by the California court in its landmark decision. See In re Shennum, 210 Mont. at 450-51, 684 P.2d at 1078 (stating that the Roulet court “nailed it down” in addressing the detrimental deprivation of a person’s liberty and the inevitable damage to a person’s reputation that may result from a civil commitment).

¶53 Although decided more than 20 years ago, the Roulet court’s recognition that society “views the mentally ill with suspicion” is still relevant today. See Roulet, 590 P.2d at 6. Due to the potentially “socially debilitating” stigma that results from the “irrational fear of the mentally ill,” the court posited that “[i]t is implausible that a person labeled by the state as so totally ill could go about, after his *12release, seeking employment, applying to schools, or meeting old acquaintances with his reputation fully intact.” Roulet, 590 P.2d at 7. Thus, the “former mental patient is likely to be treated with distrust and even loathing; he may be socially ostracized and victimized by employment and educational discrimination ... the experience may cause him to lose self-confidence and self-esteem.” Roulet, 590 P.2d at 7.

¶54 Our review of current literature concerning the treatment of the mentally ill as presented by Amicus leads us to once again agree with the California court that “[i]n the ideal society, the mentally ill would be the subjects of understanding and compassion rather than ignorance and aversion.... [b]ut that enlightened view, unfortunately, does not yet prevail.” Roulet, 590 P.2d at 6.

¶55 Nevertheless, as suggested by Amicus, we are mindful that such ideals as understanding and compassion are expressed in the Montana Constitution’s Declaration of Rights, as well as under Title 53, Chapter 21, as discussed thus far. See, e.g., Matthew O. Clifford & Thomas P. Huff, Some Thoughts on the Meaning and Scope of the Montana Constitution’s “Dignity” Clause with Possible Applications, 61 Mont.L.Rev. 301, 330-32 (2000) (discussing application of the dignity clause to treatment of persons under State supervision: “[i]t is natural to speak of the inherent dignity of such... mentally ill persons, and to speak of the requirements that such vulnerable persons be treated with dignity”); Armstrong, ¶ 39 (discussing the right of each individual to make medical judgments affecting her or his bodily integrity and health in partnership with a chosen health care provider free from the interference of the government).

¶56 Amicus addresses this very point in contending that because the fundamental rights attached to decisions within the “provider-patient relationship” may be overridden by the State’s parens patriae duties and police power authority, the role of counsel is all the more critical where a patient may be involuntarily committed. The threats to individual liberty posed by involuntary commitment, according to Amicus, arise at a time “when the individual with a mental illness is least able to defend against them-during a time of crisis, confusion, fatigue.” See also Brace J. Winick, Therapeutic Jurisprudence and the Civil Commitment Hearing, 10 J. Contem. Legal Issues 37, 44-45 (1999) (observing that “[p]erhaps nothing can threaten a person’s belief that he or she is an equal member of society as much as being subjected to a civil commitment hearing” and when “legal proceedings do not treat people with dignity, they feel devalued as members of society”) (hereinafter Winick).

¶57 We therefore question the State’s contentions regarding how much process is due to K.G.F. with regard to effective counsel.

¶58 According to the State, this Court should keep its sights clearly focussed on the balance between the State’s duties under the parens patriae doctrine-i.e., the “humanitarian” or benevolent obligation to protect those citizens unable to protect themselves-and the exercise of police power to protect the general public health, safety, welfare and *13morals from the “imminent threat” of injury from persons afflicted by mental disorders. See In re Sonsteng (1977), 175 Mont. 307, 314, 573 P.2d 1149, 1153-54. See also In re J.B. (1985), 217 Mont. 504, 509-10, 705 P.2d 598, 602 (stating that “the legislature never intended that blood of innocent people must first be shed before the statutory definition of‘overt act’ has been satisfied”).

¶59 The Sonsteng decision cited by the State in this regard is particularly instructive. In spite of scientific and social advances in our understanding and treatment of individuals with mental disorders in recent years-as expressed by the policy set forth under § 53-21-101, MCA-the Court in Sonsteng gave voice to the all-too-familiar common law notion that the State, in its sovereign role as “father of the country,” retains the authority to “act as the general guardian of all ... idiots and lunatics.” In re Sonsteng, 175 Mont. at 314, 573 P.2d at 1153 (citing and quoting Hawaii v. Standard Oil Co., 405 U.S. 251, 257, 92 S.Ct. 885, 888, 31 L.Ed.2d 184 (1972)).

¶60 The use of such stereotypical labels-which, as numerous commentators point out, helps create and reinforce an inferior second-class of citizens-is emblematic of the benign prejudice individuals with mental illnesses face, and which are, we conclude, repugnant to our state constitution.8 See generally Michael L. Perlin, On “Sanism,” 46 SMU L. Rev. 373, 374 (1992) (identifying prejudice toward the mentally ill among “well-meaning citizens” as the same “quality and character of other prevailing prejudices such as racism, sexism, heterosexism and ethnic bigotry,” which in turn is reflected in our legal system); Winick, at 45 (stating that because people with a mental illness “already have been marginalized and stigmatized by a variety of social mechanisms, self-respect and their sense of their value as members of society are of special importance to them” throughout legal proceedings).

¶61 Nevertheless, our concept of due process regarding state action involuntarily imposed on individuals with mental disorders has surely progressed since the U.S. Supreme Court’s decision in Buck v. Bell. In that case, Justice Holmes described a “feeble-minded white woman,” who was the daughter of a “feeble-minded mother” and the mother of an “illegitimate feeble-minded child.” The Court declared that the woman, who was committed to the “State Colony for Epileptics and Feeble Minded,” could be involuntarily sterilized in the “best interest of the patients and of society” because:

It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit *14from continuing their kind .... Three generations of imbeciles are enough.

Buck v. Bell (1927), 274 U.S. 200, 205-207, 47 S.Ct. 584, 584-85, 71 L.Ed. 1000 (Holmes, J.).9

¶62 However enlightened we, as a society, may have become in the intervening 75 years since Buck v. Bell, we must nevertheless be cautious and critical of signs of paternalism legitimized by the parens patriae doctrine, where State actors purport to have an absolute understanding of what is in the best interests of an individual, whose liberty, dignity and privacy are at issue, and whose voice is muted by the swift and overriding authority of court-appointed professionals. See generally In re J.B, 217 Mont. at 511, 705 P.2d at 603 (stating that although the evidence against J.B. proved him to

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