On May 13, 2026, the Oregon Court of Appeals confirmed that licensed healthcare practitioners and hospitals have immunity under ORS 426.335(5) from claims that they were negligent in determining that person does not meet the criteria for an involuntary psychiatric hold under ORS 426.232, as long as the determination is made in good faith and with a substantial objective basis for their belief.

Quick Take:

In Mesch v. Unity Center for Behavioral Health, 349 Or App 463 (2026), a mother sued a psychiatric emergency room facility and medical group for wrongful death after her 18-year-old son committed suicide two days after he was allowed to voluntarily leave the facility. The healthcare professionals had determined that he did not meet the criteria for an involuntary hold under ORS 426.232.

In the lawsuit, Plaintiff claimed the practitioners were negligent in their assessment of her son “J” and in their decision not to involuntarily commit him. The trial court dismissed Plaintiff’s claims on summary judgment, finding that ORS 426.335(5) immunized the practitioners from liability on Plaintiff’s claims.

The Oregon Court of Appeals affirmed the trial court decision and held that a practitioner’s decision to detain, or not detain, a person involuntarily under ORS 426.232 is an action covered by the immunity provision of ORS 426.335(5) as long as the practitioner acted “in good faith, on probable cause.” Further, the Court held that the standard in ORS 426.335(5) is of “honest, subjective belief, based on substantial objective evidence” that, more likely than not, the person does, or does not, meet the statutory criteria for an involuntary hold.

Deeper Dive:

A. The Facts

This case arose from the tragic suicidal death of 18-year-old J two days after he was allowed to leave a psychiatric emergency room. He was brought to the facility after he contemplated suicide by jumping from a bridge but the practitioners determined he did not meet the ORS 426.335(5) criteria for an involuntary hold. J was initially assessed to have suicidal ideation and depression and he was noted to be intoxicated. During the ten hours he was at the facility, J was assessed multiple times and became increasingly more cooperative as he became more sober. He discussed why he did not want inpatient treatment or antidepressants with the practitioners who found his reasoning to be sound. The practitioners thought he was sincere in wanting treatment and discussed safety planning with him, including his triggers for feeling suicidal and who he could call for help. The practitioners ultimately determined that J’s acute phase of suicidality had passed and testified that they could have, and would have, placed him on an involuntary hold if they believed he was lying to them or was at imminent risk of harm to himself or others.

B. Plaintiff’s Claims in the Lawsuit

Plaintiff’s specifications of negligence all concerned the decision by the practitioners to voluntarily discharge J, rather than institute a medical hold. First Plaintiff argued that that the immunity provided by ORS 426.335(5), applies only to decisions to involuntarily hold a patient, but not to a practitioner’s decision to not hold a person for emergency care because though ORS 426.232 and ORS 426.234 describe when a person can be involuntarily held, neither statute explicitly refers to a practitioner’s decision to release a person prior to initiating a hold. Plaintiff attempted to bolster this position by arguing that the requirement in ORS 426.335(5) that a practitioner have “probable cause” only makes sense in the context of a decision to deprive a person of their liberty, not a decision to release them.

Plaintiff further argued that defendants did not establish as a matter of law either “good faith” or “probable cause” and thus were not entitled to summary judgment. Plaintiffs argued that defendants did not act in good faith because they had information that J would be a danger to himself if released. Plaintiffs argued that defendants lacked probable cause because there was not a substantial objective basis to conclude he was no longer danger to himself or others.

Finally, Plaintiff argued that an application of the immunity under ORS 426.335(5) would violate her right to a remedy under Article I, Section 10 of the Oregon Constitution.

C. The Court’s Analysis

Pursuant to ORS 426.335(5), states that an independent practitioner, hospital, or judge acting in “good faith, on probable cause and without malice” may not be held criminally or civilly liable for actions pursuant to ORS 426.228, ORS 426.231, ORS 426.232, ORS 426.234., or ORS 426.234. Involuntary holds are addressed by ORS 426.232, which provides that a person brought to a hospital or facility may be held if the licensed practitioner believes the person is a danger to themselves or others and is in need of emergency mental health treatment.

Applying the methodology for determining the meaning of a statute provided in the State v. Gaines case, 346 OR 160 (2009), the Court considered the text of ORS 426.335(5) and ORS 426.232, in context, and with consideration to any useful legislative history. The Court concluded that within the larger statutory framework, ORS 426.232 necessarily contemplates two paths—detaining if the person meets the criteria, or not detaining them if they do not meet the criteria for a hold. Further, the Court noted that because the evaluation of whether someone is a danger to themselves or others is a condition precedent to the authority to hold someone involuntarily, it would not make logical sense that the initiating action of making that evaluation is not an action under ORS 426.232 as Plaintiff asserted. The court also found that applying immunity to both the decision to detain and the decision to not detain is “in harmony” with the legislature’s intent to strike an appropriate balance in the civil commitment statutes between the need for involuntary commitment in some circumstances and the liberty interests of those in need of emergency mental health treatment. Further, an alternative reading would have the adverse effect of encouraging practitioners to err on the side of involuntary holds.

In considering the appropriate definition of probable cause in ORS 426.335(5), the Court looked to ORS 131.005(11), in Oregon’s criminal code, and held that probable cause means “a substantial objective basis for believing that more likely than not the person did not meet the criteria for an involuntary hold under ORS 426.232.” The Court concluded that “good faith” in ORS 426.335(5), is a subjective, state of mind standard. Put together, “in good faith, on probable cause” requires the subjective state of mind of an honest and lawful purpose, based on substantial evidence that the person more likely than not did, or did not, meet the criteria for ORS 426.232. Therefore, the question in this case was not whether the defendants’ evaluation fell below the standard of care, but instead whether defendants, in good faith, determined that, at the time of the evaluation, there was a substantial objective basis for believing, more likely than not, that J was not a danger to himself or others and in need of emergency treatment. Plaintiff’s identification of facts that she argued should have led the practitioners to conclude that that J was not sincere when he said he was not suicidal did not raise a question of fact according to the Court because this amounted merely to an argument that a practitioner could have weighed the facts differently.

The Court also rejected Plaintiff’s argument that the immunity provisions in ORS 426.335 violate Oregon’s constitutional remedy clause because there was no duty at common-law for hospitals or practitioners to hold a person involuntarily for mental health treatment. See Horton v. OHSU, 359 OR 168 (2016) (“in deciding whether the legislature’s actions impair a person’s right to a remedy under Article I, section 10, we must consider the extent to which the legislature has departed from the common-law model measured against its reasons for doing so.”).

How will the Mesch case affect healthcare organizations and mental health professionals in Oregon?

Licensed mental health practitioners should be immune under ORS 426.335(5) from criminal and civil liability for decisions both to hold a patient involuntarily and decisions not to initiate an involuntary hold, as long as their decision is made in good faith (with an honest and lawful purpose) and based on substantial evidence. In the Mesch case, there was substantial uncontroverted evidence that the practitioners honestly believed that J was no longer suicidal at the time of his voluntary discharge and that they found him to be credible and reasonable in his decision making. Further, the practitioners could identify concrete facts that supported their beliefs.

Therefore, utilization of best practices in charting all aspects of assessments and decision making related to medical holds could bolster a practitioner’s ability to invoke the immunity provisions in ORS 426.335(5).

We also acknowledge the contributions of Claire Malone, Law Clerk, in the development of this update.

This article summarizes aspects of the law and opinions that are solely those of the authors. This article does not constitute legal advice. For legal advice regarding your situation, you should contact an attorney.