Trial Court Finds Harvard Satisfied Suicide Prevention Duty
- In one of the few cases to apply the student suicide prevention duty first recognized by the Massachusetts Supreme Judicial Court in Nguyen v. MIT, a state trial court recently found that Harvard University fulfilled its legal obligations after learning that a first-year student had attempted suicide.
- Granting summary judgment to the university and two of its administrators, the court held that these defendants satisfied their suicide prevention duties under state law by implementing emergency protocols and arranging for clinical care by qualified medical professionals, and by doing so, these defendants did not voluntarily assume any legal duty to provide ongoing care, even when they required the student to enter into a "care contract" as a condition of continued enrollment.
- The ruling is significant because it provides much-needed guidance as to the limited nature of the suicide prevention duty, both in scope and duration.
In one of the few cases to apply the student suicide prevention duty first recognized by the Massachusetts Supreme Judicial Court in Nguyen v. MIT, 479 Mass. 436 (2018), a state trial court recently found that Harvard University and two administrators fulfilled their legal obligations after learning that a first-year student had attempted suicide. In granting summary judgment, the court held that these defendants satisfied their suicide prevention duties under state law by implementing emergency protocols and arranging for clinical care by qualified medical professionals. By doing so, these defendants did not voluntarily assume any legal duty to provide ongoing care, even when they required the student to enter into a "care contract" as a condition of continued enrollment.
The ruling is significant because it provides much-needed guidance as to the limited nature of the suicide prevention duty, both in scope and duration. The case is Tang v. President and Fellows of Harvard College, et al., Middlesex Superior Court, C.A. No. 1881CV02603 (Dec. 20, 2022) (Tingle, J.).
Student Suicide Prevention Duty
Massachusetts law holds that, under certain circumstances, institutions of higher education and their administrators have a legal duty to take "reasonable measures" to prevent student suicide. That duty is triggered only when the institution has actual knowledge that a student has attempted suicide while enrolled or shortly before matriculating, or that a student has stated plans or intentions to commit suicide. Knowledge of these emergency circumstances, and the corresponding foreseeable risk of harm to the student, can create a "special relationship" from which the suicide prevention duty arises. That duty can be fulfilled for the institutions and their administrators by implementing a suicide prevention protocol that includes assisting the student in obtaining clinical care from medical professionals or notifying the student's emergency contact if the student refuses medical care. See Tang at pp. 12-13.
What Happened in Tang
In his first year, Tang disclosed to employees of Harvard's health services that he had attempted suicide two weeks earlier and had considered jumping in front of a subway train. In response, Harvard activated its emergency procedures, and its health services evaluated Tang's mental health. A need for "intensive evaluation in a secure setting" was determined, and Harvard arranged for the student's admission to a nearby psychiatric hospital. After a seven-day stay, Tang was discharged. He denied being suicidal and was not prescribed any psychiatric medications. His treating physician recommended continued outpatient therapy. Id. at pp. 1-7.
Harvard assigned a case manager to monitor Tang's condition. Harvard reviewed his medical records and spoke with those providing his clinical care. Based on an individualized assessment, Harvard conditioned Tang's return to campus upon his agreement to a "care contract" by which he promised to follow the recommendations of his clinical team and continue outpatient therapy. Harvard also connected Tang with a pastoral counselor. Tang accepted these conditions, returned to campus, kept university officials apprised of his treatment and completed his first year with nearly perfect grades and substantial engagement in extracurricular activities. At no time after his hospitalization did Tang express to a Harvard employee any attempt, plan or intention to take his life. Id. at pp. 7-9.
Tang returned to Harvard to begin his sophomore year after spending part of the summer in China. His advisor reminded him of the terms of his care contract and his obligation to continue with his mental health care. Tang acknowledged the obligations and denied any suicidal ideations. Tragically, just a few days later, Tang took his own life in his campus residence. Id. at 11-12.
A lawsuit ensued in which the estate for Tang alleged, among other things, that Harvard and certain administrators failed to fulfill its obligations to prevent student suicide under Nguyen and under the duty of care that it voluntarily assumed when it enrolled Tang for his sophomore year under the care contract.
Limited Duty Fulfilled
Applying the Nguyen decision to Tang's circumstances, the trial court held that Harvard and two of its administrators owed Tang a limited duty of care arising from a special relationship created by their actual knowledge of his suicide attempt and suicide plans his first year. Consequently, these defendants had a legal obligation to take reasonable measures to help prevent a further suicide attempt. The court found that these defendants satisfied that limited duty by evaluating his condition and arranging for his admission to a mental health facility, where he could be treated by trained medical professionals. In addition, Harvard contacted Tang's emergency contact, his father. Id. at pp. 14-15.
The court rejected the plaintiff's argument that the scope of the university's suicide prevention duty should extend beyond arranging for treatment by medical professionals, explaining that the duty's limited scope was explicitly defined by the Nguyen court as a means of respecting the "privacy and autonomy" of adult students. Id. at pp. 15-16.
The court also rejected the plaintiff's argument that the duty should extend beyond the immediate emergency until either the student has graduated or a qualified medical professional has determined that the student no longer needs clinical care. The court explained that a university's limited suicide prevention duty is "time-bound," requiring reasonable measures in response to specified emergency conditions. Absent evidence that the institution had actual knowledge that Tang had attempted suicide or stated plans or intentions to commit suicide after being discharged from the hospital and after his treating psychiatrist determined it was safe for him to return to campus, Harvard had no legal obligation to undertake further measures to prevent another suicide attempt, although in this instance Harvard did take several steps to protect Tang when he returned to campus. Id. at pp. 16-17.
Lastly, the court rejected plaintiff's so-called "good Samaritan" argument that these defendants voluntarily assumed a duty of care beyond what Nguyen established when they required Tang to sign a care contract and remain in therapy. The court reasoned that the care contract in this case did not impose further legal duties on these defendants. They did not promise specific medical or other services; rather, the contract imposed obligations on the student as a condition of continued enrollment. Id. at pp. 20-21.
In light of the rulings in Tang and Nguyen, colleges and universities, particularly those in Massachusetts, are well advised to assess their suicide prevention programs and conduct training. The programs may include, for example, guidelines for individualized assessment of a student's risk of self-harm, processes for arranging clinical care from qualified medical professionals, protocols for emergency contacts and follow-up communications, and individualized assessment of conditions for return to campus life. Institutions should take care not to promise specific medical or clinical services except in emergencies or as directed by their own healthcare professionals.
If you have questions or would like further information, contact the author or your attorney contact at Holland & Knight.
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