When can defendants access victims' mental health records in Utah sexual abuse cases? State v. Worthen Explained

In State v. Worthen, the Utah Court of Appeals addressed the challenging intersection of victims’ privacy rights and defendants’ constitutional rights to a fair trial when seeking access to privileged mental health records in sexual abuse prosecutions.

Background and Facts

Defendant Leroy Worthen was charged with ten counts of aggravated sexual abuse of his adopted child, B.W. The allegations arose after B.W. attempted suicide and was hospitalized at the University of Utah Neuropsychiatric Institute for 19 days. During therapy, B.W. initially denied any abuse but later disclosed to her therapist that Worthen had sexually abused her. However, B.W.’s journal entries revealed significant animosity toward her parents, including violent threats against her mother.

Key Legal Issues

The central issue was whether Defendant could obtain in camera review of B.W.’s mental health records under Utah Rule of Evidence 506(d)(1), which creates an exception to the physician-patient privilege when a patient’s mental or emotional condition is relevant to “an element of [a] claim or defense.” The State argued that Defendant’s request was merely for impeachment evidence that didn’t constitute an element of his defense.

Court’s Analysis and Holding

The court applied the reasonable certainty test established in State v. Cardall, requiring defendants to show with reasonable certainty that sought-after records contain exculpatory evidence favorable to their defense. The court distinguished this case from State v. Gonzales, noting that Defendant wasn’t seeking general impeachment evidence but specific evidence of B.W.’s bias and motive to fabricate. The court found that evidence of B.W.’s animosity toward her parents supported an element of Defendant’s defense—that B.W. falsely accused him to be removed from their home.

Practice Implications

This decision provides crucial guidance for practitioners handling sexual abuse cases. Defense attorneys must present specific factual bases rather than general requests, including calendars of therapy sessions, references to particular sessions, and supporting documentation. The court emphasized that materiality determinations occur during in camera review, not at the initial request stage. Importantly, the court affirmed that trial judges, not law clerks, must personally conduct in camera reviews due to the sensitive nature of mental health records.