The Arizona Supreme Court ruled Wednesday that a social worker who conducted a brief crisis screening of a patient could testify at an involuntary treatment hearing, holding that the interaction did not create a confidential behavioral health professional-client relationship and therefore was not protected by privilege.

In a precedential opinion, the state's top court vacated a split Arizona Court of Appeals decision and affirmed a trial court's order for court-ordered mental health treatment, concluding that confidentiality rules did not bar testimony arising from a one-time evaluation tied to potential civil commitment proceedings.

The case, In re MH2023-004502, centers on Arizona's statutory process for involuntary mental health treatment, which allows a court to order evaluation and care if clear and convincing evidence shows a patient has a serious mental disorder and needs treatment.

At issue was whether a licensed social worker, identified as M.G., who assessed a patient identified as A.R. during a hospital visit could later testify as an "acquaintance witness" at a court-ordered treatment hearing and whether M.G. and A.R. had a confidential "behavioral health professional-client relationship."

A.R. argued that the assessment created a professional-client relationship, making any communications privileged and confidential under state law.

The trial court allowed the testimony and ordered treatment. The Court of Appeals reversed in a divided opinion, finding the interaction was protected by privilege.

The Arizona Supreme Court stepped in to resolve the dispute, even though the treatment order had expired, citing the recurring nature of the issue and the liberty interests at stake in involuntary commitment cases.

Writing for a unanimous court, Justice William G. Montgomery said the key question was whether the interaction established a behavioral health professional-client relationship — a prerequisite for privilege comparable to attorney-client confidentiality under Arizona law.

In the ruling, the court adopted a framework previously used in attorney-client privilege disputes, requiring the party asserting privilege to show that a professional relationship existed, that communications were made to obtain services, and that they were intended and treated as confidential.

Applying that test, the justices concluded that no such relationship existed between A.R. and the social worker. A.R. did not seek treatment voluntarily, had no prior relationship with M.G., and interacted with her only once for a short assessment designed to determine whether further evaluation was necessary. The social worker also warned him that their conversation could be disclosed in legal proceedings.

The court concluded that, under those circumstances, any belief that the interaction was confidential was not "objectively reasonable."

In deciding the case, the court found that communications made during preliminary screenings, especially when accompanied by warnings and conducted without a therapeutic relationship, will not automatically be shielded from testimony in civil commitment hearings.

In a footnote to the opinion, the justices said the ruling does not diminish due process protections in civil commitment cases.

"We remain cognizant of due process concerns in COT proceedings," the footnote said, using an acronym for court-ordered treatment and noting that involuntary treatment constitutes a "significant deprivation of liberty."

In 2025, Arizona's lawmakers tweaked existing law to clarify that licensed behavioral health professionals may testify as acquaintance witnesses, rendering the first issue moot.

A.R. is represented by Sherri McGuire Lawson and Robert S. Shipman of the Maricopa County Legal Defender's Office.

The state of Arizona is represented by Rachel H. Mitchell and Sean M. Moore of the Maricopa County Attorney's Office.

The case is In re MH2023-004502, case number CV-24-0275-PR, in the Supreme Court of the State of Arizona.

--Editing by Bruce Goldman.