## Facts

- Georgia law permitted “voluntary” admission of minors to state mental hospitals based on a parent’s or guardian’s written application.
- Upon application, a hospital superintendent could temporarily admit the child for “observation and diagnosis.”
- After observation, the child could be kept for treatment if the superintendent found evidence of mental illness and that the child was suitable for treatment.
- The statute allowed discharge at a parent’s request after five days and required the superintendent to release a child who recovered or improved such that hospitalization was no longer desirable.
- Minor patients in a Georgia state mental hospital filed a federal class action seeking declaratory and injunctive relief, alleging the admission and confinement procedures violated the Fourteenth Amendment Due Process Clause.
- A three-judge federal district court held the statutory scheme unconstitutional and required, at minimum, notice and an adversary-type hearing before an impartial tribunal prior to commitment.
- The Supreme Court reversed.

## Issues

1. Whether due process requires a formal adversary hearing before a minor may be admitted to a state mental hospital on a parent’s or guardian’s application.
2. What due process requires to ensure that a minor’s continued confinement in a mental hospital is justified, including whether review must be conducted through an adversary hearing before a legally trained decisionmaker.

## Decision

- The Supreme Court reversed the district court in a 6–3 decision.
- The Court held Georgia’s statutory procedures were not unconstitutional on their face based on the record presented.
- The Court held due process does not require a preadmission adversary hearing before a judge or similar tribunal when a parent seeks admission of a child.
- The Court held due process does require review of the child’s need for continued hospitalization by a neutral factfinder, but that review need not be an adversary hearing and the factfinder need not be legally trained.
- The Court concluded that independent medical evaluation and existing discharge safeguards could satisfy due process when combined with the presumption that parents generally act in their child’s best interests.

## Legal Principles

- Minors have a substantial liberty interest in avoiding unnecessary confinement for medical treatment, protected by the Due Process Clause.
- In assessing required procedures, courts balance the private interest, the risk of error and value of added safeguards, and the government’s interests and administrative burdens.
- Parents are generally presumed to act in the best interests of their children; the Constitution does not treat children as creatures of the State.
- Parental authority is not absolute; the State may regulate when a child’s health is jeopardized, but due process does not automatically mandate judicialized procedures for parental treatment decisions.
- For a parent-initiated admission, due process can be satisfied by independent, professionally grounded medical factfinding so long as the evaluator is free to make an independent judgment.
- Continued confinement must be subject to meaningful, neutral review; due process does not require counsel, cross-examination, or a formal adversary format for that review.

## Conclusion

The Court upheld Georgia’s parent-initiated admission scheme for minors, rejecting a constitutional requirement for a precommitment adversary hearing, while requiring neutral review of the need for continued hospitalization through independent medical factfinding rather than formal judicial procedures.


Parham v. J. R., 442 U.S. 584 (1979)