The Supreme Court of Connecticut Denies Defendant's Request for In Camera Review of Privileged Psychiatric Records of Homicide Victim
In State v. Fay, 167 A.3d 897 (Conn. 2017), the Supreme Court of Connecticut ruled that privileged psychiatric records of a homicide victim are subject to in camera review for the trial court to determine whether the defendant's constitutional right of confrontation affords him the records. In the instant case, however, the defendant failed to make sufficient showing of his compelling need for the records based on criteria outlined by the court.
Facts of the Case
On July 8, 2010, William Fay shot his brother (who was also his roommate) twice with the victim's firearm in their shared apartment. The victim later died as a result of his injuries, and Mr. Fay did not deny shooting him. He was convicted of manslaughter, although he claimed self-defense. He presented evidence that the victim had problems with depression and alcoholism that had caused previous violent confrontations between them. Mr. Fay alleged that the victim's mental state had worsened significantly in the months preceding the homicide. The victim had been under the care of a psychiatrist, and Mr. Fay sought to strengthen his self-defense claim by showcasing the victim's mental state at the time of the crime. Mr. Fay's legal team filed multiple motions seeking medical records as well as testimony from the victim's psychiatrist concerning the victim's behavior and the potential effects of prescribed psychotropics on the victim's behavior and temperament at the time of the shooting.
On February 1, 2013, the trial court held a hearing to address the defense motions. Ultimately, the court granted the defendant's motion to subpoena the victim's psychiatric records with the proviso that an expert would ultimately have to present testimony as to whether any information contained therein was exculpatory. Before the evidentiary portion of the trial, the defense also filed a motion to present testimony by the victim's treating psychiatrist. The defense argued that the defendant's Sixth Amendment right to confrontation trumped the psychiatrist–patient privilege and that the duty to guard the privacy of psychiatric records is vitiated if the patient is deceased. In rebuttal, the state noted that without a waiver of the privilege by the victim's authorized representative, even an in camera review of the documents would not be allowed. The state also noted that the deceased would not be able to testify and information regarding bottles of prescription medications found at the apartment would be irrelevant without testimony from his psychiatrist or records. Ultimately, the trial court prohibited the victim's privileged mental health records from being reviewed.
Mr. Fay appealed under the premise that the trial court erred in not following the holding in State v. Esposito, 471 A.2d 949 (Conn. 1984). In Esposito, the Connecticut Supreme Court held that in some situations the privileged psychiatric records of a witness testifying for the state are subject to an in camera review, so that it can be determined whether the defendant's constitutional right of confrontation entitles him to such access. If the witness refuses said review, his or her testimony may be stricken from the record. Mr. Fay asserted that access to the victim's psychiatric records might support his claim of self-defense. The trial court ultimately agreed with the state's contention that the victim's psychiatric records were protected by statute. Furthermore, the trial court noted it lacked the authority to create an extrastatutory exception to the statutory psychiatrist–patient privilege “in the absence of express consent by the patient, courts have no authority to create nonstatutory exceptions to general rule of nondisclosure” (Fay, p 903, citing State v. Kemah, 957 A.2d 852, (Conn. 2008)863). Finally, the trial court noted that while witnesses' testimony had been stricken from the record under Esposito, to protect the defendant's constitutional right of confrontation, the Esposito holding does not authorize access to a patient's privileged psychiatric records without the patient's consent.
Ruling and Reasoning
The Connecticut Supreme Court held that, in certain circumstances, a defendant can have an in camera review of a homicide victim's privileged psychiatric records, but in Fay, the court held that the defense had to show a “compelling need for the privileged records, a showing predicated on the relevance of the records to the claim of self-defense, the potential significance of the records in establishing that defense, and the unavailability of alternative sources of similar information” (Fay, p 904). The court weighed the statutory psychiatrist–patient privilege of the patient against the right of the defendant to “a meaningful opportunity to present a complete defense” (Fay p 906, citing State v. Cerreta, 260 Conn. 251, 260 (Conn. 2002)).
The court noted that very few prior cases had addressed the question of this appeal. Most notably, in United States v. Hansen, 955 F.Supp. 1225 (D. Mont. 1997), a federal district court held that a victim's privilege may be superseded by a defendant's right to support a claim of self-defense, but only if the emotional state of the deceased is a vital element of the defense. The Hansen court also emphasized the critical nature of safeguarding an accused's constitutional rights in something as pivotal as a murder trial.
The Connecticut Supreme Court found that Mr. Fay did not demonstrate a compelling need for the deceased's privileged psychiatric records, and thus his motion did not qualify as an exception to the general rule of nondisclosure. The court noted that, although Mr. Fay testified that the victim had mental health problems, the “mere existence of a mental condition, without any showing of relevance, will not suffice to justify intrusion into the victim's privileged medical records” (Fay, p 914). Although the court had allowed Mr. Fay to testify that the victim “was taking certain medications, including Risperdal and Librium, and that those medications were being used to treat the victim's depression,” they pointed out that Mr. Fay had failed “to move to introduce expert testimony on the potential effects of those medications” (Fay, p 915). The court held that Mr. Fay had failed to make the required preliminary showing that he was not entitled to an in camera review of the victim's psychiatric records.
Discussion
In Jaffee v. Redmond, 518 U.S. 1 (1996), the United States Supreme Court upheld the psychiatrist–patient privilege of a police officer in a wrongful-death civil action. Certainly, the right to have one's most personal information kept private has been zealously guarded by the courts. In Fay, the privacy right is preserved in the face of a criminal defendant's attempt to prove his innocence. The denial of in camera review in Fay appears to rest more on the putative inadequacy of his counsel than on an actual determination of whether the psychiatric records contained evidence that might have supported Mr. Fay's self-defense claim. The court dismissed the claim based on a lack of sufficient showing to justify intrusion into a patient's private psychiatric records. However, there are troubling details in this case. For instance, the victim was prescribed Risperdal and Librium (Fay, p 915). Treatment with an antipsychotic (Risperdal) would at least suggest fairly serious target symptoms. In addition, the Connecticut Supreme Court acknowledged that during the appeal process, Mr. Fay submitted a brief that suggested that the victim was using alcohol and marijuana, while prescribed a benzodiazepine (Librium). The potential for significant disinhibition from the admixture of these various substances would warrant concern. Possibly, the outcome in this case could be attributed to defense counsel errors, such as the failure to introduce “expert testimony on the potential effects” of Risperdal and Librium (Fay, p 915). However, because the defendant was facing a homicide-related charge, an independent mental health review might have better resolved problems such as those raised in this case.
Footnotes
Disclosures of financial or other potential conflicts of interest: None.
- © 2018 American Academy of Psychiatry and the Law
