## Facts

- Project HELP, an emergency psychiatric service for homeless persons, observed Billie Boggs on New York City streets over several weeks and initiated involuntary commitment proceedings.
- Boggs, described as homeless and allegedly mentally ill, was admitted to Bellevue Hospital under New York Mental Hygiene Law (MHL) § 9.27 based on physicians’ certifications.
- At the commitment hearing, hospital- and Project HELP–affiliated witnesses (psychiatrists and a psychiatric social worker) testified that Boggs was mentally ill, required involuntary treatment, and—if discharged—was likely to return to the streets and suffer serious harm because she could not understand her need for food, clothing, or shelter or recognize obvious danger.
- Three psychiatrists testifying for Boggs opined that she did not meet commitment criteria; none had observed her outside the hospital setting.
- The trial court ordered Boggs released, relying heavily on her courtroom demeanor and apparent improvement after removal from the street environment.
- The hospital respondents appealed the release order.

## Issues

1. Whether the appeal was moot because the trial court had ordered Boggs released.
2. Whether the record contained clear and convincing evidence that Boggs was mentally ill and, if untreated, likely to suffer serious harm to herself, justifying involuntary hospitalization under MHL § 9.27 and due process.

## Decision

- The appeal was not moot.
- The Appellate Division reversed the release order.
- The court held that the evidence, viewed fairly, was clear and convincing that Boggs met the statutory and constitutional criteria for involuntary commitment.
- The court directed that Boggs’s involuntary hospitalization continue.

## Legal Principles

- Involuntary civil commitment is a significant deprivation of liberty and requires proof by clear and convincing evidence under due process.
- Under MHL § 9.27, involuntary hospitalization is permissible where a person is mentally ill, needs involuntary care and treatment, and presents a likelihood of serious harm to self or others.
- “Danger to self” may be shown by an inability or refusal to provide for basic needs (including food, clothing, and shelter) such that serious harm to the person’s well-being is likely if untreated.
- In evaluating risk and “serious harm,” courts may give greater weight to evidence of functioning in the environment to which the person will be released; behavior in a structured hospital setting may understate real-world danger.

## Conclusion

The Appellate Division held the controversy remained justiciable and that clear and convincing evidence established Boggs’s mental illness and likely serious self-harm if discharged, warranting continued involuntary hospitalization under New York’s civil commitment statute and due process standards.


Boggs v. N.Y.C. Health & Hosps. Corp., 132 A.D.2d 340, 523 N.Y.S.2d 71 (1st Dep’t 1987)