Man acting up in the psych area of a large emergency room wasn't engaged in disorderly conduct, court rules

The Supreme Judicial Court today tossed out a man's disorderly-conduct conviction for acting up in a room in a hospital ER, even though it took several canisters of pepper stray to bring him under control, saying it would be wrong to criminalize behavior a large psych unit should be equipped to handle.

On June 5, 2011, Richie Accime was brought, against his wishes, to the Boston Medical Center for an emergency psychiatric exam and brought to a room in the psych area of the ER. Once there, and after being told he might have to spend two or three days in the hospital, he resisted efforts to make him take any medication and demanded to be let go, to the point of threatening to break the arms of anybody who tried to restrain him - a threat security guards took seriously since he was 6'4" and about 270 lbs.

A tussle broke out - although he never actually struck anybody - three to six guards sprayed him and he wound up in a corner after which he agreed to be quiet. Guards agreed to wash the spray off him after he consented to being handcuffed. In 2014, he was tried in Boston Municipal Court on charges of assault, threatening to commit a crime and disorderly conduct. The jury acquitted him on the assault charge, couldn't reach a verdict on the threat one and convicted him of disorderly conduct, after which the judge fined him $150.

In its ruling today, the Supreme Judicial Court said the disorderly-conduct verdict was a mistake, because of the way state law defines disorderly conduct and because a room meant for a psych patient is far different than a place where the public congregates.

To start, the court said the law requires evidence that nearby people were alarmed and that the person being disorderly was doing something reckless enough to alarm bystanders.

It bears emphasis that at the time of this incident, according to the Commonwealth, the defendant had been brought to and was detained in the hospital's emergency department because he was thought to be dangerous to himself or to others by reason of mental illness. See G. L. c. 123, § 12. We do not decide that a person detained in such circumstances can never satisfy the intent element of the crime of disorderly conduct, but in the circumstances presented here, without any evidence showing or even suggesting that the defendant was at all aware that his conduct had any impact on anyone in the hospital outside his room, the Commonwealth has failed to prove that the defendant acted with the requisite conscious disregard of an "unjustifiable risk" of public annoyance or alarm created by his conduct. His behavior in the emergency department did not attract the crowd of onlookers that typifies public disturbance under our law. ... All the evidence shows is that the behavior was witnessed and experienced by the hospital's treating staff attending the defendant and the security officers called in by the staff. The evidence would permit a finding that unquantified "other" patients may have observed the defendant's loud and aggressive behavior in his room; "other" patients looking in on a patient arguably out of control in a small hospital room does not qualify as the kind of public disturbance that § 53 is intended to address.

And, the court continued, there's a difference between what might be alarming in, say, a courthouse, and a unit designed for people facing possible hospitalization for psychiatric issues:

Indeed, far from going "way beyond" a hospital's day-to-day "hurly-burly," a patient's resistance to detention and medication would seem to be the kind of disruption a psychiatric area in the hospital's emergency department is designed to absorb. The responding officers, moreover, were not leaving their posts, but carrying out an assignment that fit squarely within their job to provide security to the hospital community. Where the inquiry is setting-specific, Sholley, 432 Mass. at 730 n.11, criminal charges of disorderly conduct in the context of mental health treatment in the emergency department of a large urban hospital, although not per se unavailable, should be rare. To decide otherwise risks criminalizing mental illness in the very treatment centers where help must be available.

The justices continued they are not trying to minimize the challenges faced by workers in a large hospital psych unit:

This would be a very different case if the defendant had actually struck a member of the hospital staff or had intentionally or recklessly caused a substantial disruption to other patients or hospital operations. Here, however, the jury found the defendant not guilty of assault and reached no verdict on the charge of threatening to commit a crime. The defendant's belligerent actions, given their context and location, do not rise to the level of disorderly conduct. In sum, considering all the evidence in this case in the light most favorable to the Commonwealth, we conclude that it was not sufficient to permit a reasonable jury to find beyond a reasonable doubt that the defendant consciously disregarded a "substantial and unjustifiable risk of public inconvenience, annoyance, or alarm." The defendant's conviction of disorderly conduct must be reversed.