Opinion
23A-MH-170
05-18-2023
In the Matter of the Commitment of S.A. Appellant-Respondent, v. Memorial Epworth, Appellee-Petitioner.
ATTORNEY FOR APPELLANT Ernest P. Galos South Bend, Indiana
Pursuant to Ind. Appellate Rule 65(D), this Memorandum Decision is not binding precedent for any court and may be cited only for persuasive value or to establish res judicata, collateral estoppel, or law of the case.
Appeal from the St. Joseph Superior Court The Honorable Mark P. Telloyan, Judge Trial Court Cause No. 71D04-2212-MH-1416
ATTORNEY FOR APPELLANT
Ernest P. Galos
South Bend, Indiana
MEMORANDUM DECISION
Riley, Judge.
STATEMENT OF THE CASE
[¶1] Appellant-Respondent, S.A., appeals the trial court's Order of temporary commitment following emergency detention.
[¶2] We affirm.
ISSUE
[¶3] S.A. presents this court with one issue on appeal, which we restate as: Whether the trial court's determination that S.A. was dangerous to herself or to others was supported by clear and convincing evidence.
FACTS AND PROCEDURAL HISTORY
[¶4] On December 16, 2022, S.A. arrived at the emergency room of St. Joseph Regional Medical Center in Mishawaka, St. Joseph County, Indiana. S.A. is fifty-six-years old and has a history of psychiatric treatment. She self-reported that she was being treated for post-traumatic stress disorder (PTSD), depression, anxiety, adjustment disorder, and severe trauma. S.A. claimed to be "the target of an organized crime ring in the east coast of the United States, [and] that she's being stalked and monitored[.]" (Transcript Vol. II, p. 2). S.A. left the emergency room but returned later that day and informed personnel that she wanted to overdose on her prescriptions. Hospital staff requested an emergency detention and S.A. was admitted to Memorial Epworth. On December 21, 2022, the trial court issued its order continuing the pre-hearing detention and set a hearing following its review of Dr. Julie Coyle's (Dr. Coyle) report of the emergency detention and her physician's statement. In her written physician's statement, Dr. Coyle opined that S.A. suffered from "PTSD as well as major depression, which is severe," and which is "recurrent with psychotic features." (Tr. Vol. II, p. 2; Appellant's App. Vol. II, p. 22). Dr. Coyle explained that S.A.'s paranoia amounted to being stalked by a crime family and that she repeatedly called the prosecutor's office and 911.
[¶5] At the December 28, 2022, evidentiary hearing, Dr. Coyle testified that although S.A. is compliant with the medication she has been prescribed by her psychiatrist, Dr. Coyle wanted to make some medication changes because "without medication she is a danger to herself because of the suicidal ideation" and "also a danger to others because of her extensive paranoia." (Tr. Vol. II, p. 3). Dr. Coyle clarified that S.A.'s suicidal ideations were ongoing during her time at Memorial Epworth and that she wanted to overdose on medication. S.A. believed so strongly that she was the target of an east coast organized crime ring that stalked and monitored her that she moved her hospital mattress into the bathroom, as she was convinced the cameras were monitoring her. S.A. refused to make any changes to her original medications.
[¶6] S.A. testified that she has been the victim of stalking, aggravated assault, and has incurred bruises on her body. She informed the trial court that her car had been vandalized six times, there is "continued theft in [her] apartment," and that she had been "assaulted in ten states." (Tr. Vol. II, p. 6). "[P]olice officers here locally" told her that she was the victim of "organized crime [] from the east coast." (Tr. Vol. II, p. 5). S.A. explained that she is "being stalked by crime, and it's a very serious crime, it's organized crime gang stalking. And [she] even went to the Department of Justice in D.C. and they have a specific department that is for civil rights [] crime, organized crime gang stalking, and tr[ied] to get their support." (Tr. Vol. II, p. 7). She testified that she "was drugged in jail when [she] was innocent. [] They took [her] nude body, threw [her] in the air, hit [her] down on the floor. [She] was drugged in there. [She] was tortured. [She] was laughed at about PTSD and bipolar with dementia." (Tr. Vol. II, p. 7). She informed the trial court that the "organized crime group that is after" her has "Italian affiliations out in Boston providence," but could not recall the exact name. (Tr. Vol. II, p. 9).
[¶7] At the close of the evidence, Dr. Coyle requested a ninety-day outpatient commitment with time to stabilize in the hospital first. Dr. Coyle estimated any hospitalization to be thirty days or less. That same day, the trial court issued an Order of temporary commitment following emergency detention. The trial court found S.A. to be suffering from a psychiatric disorder and concluded that she was dangerous to herself and others. S.A. was detained to Memorial Epworth.
[¶8] S.A. now appeals. Additional facts will be provided as necessary.
DISCUSSION AND DECISION
[¶9] S.A. claims that insufficient evidence supported the trial court's Order temporarily committing her to the care of Memorial Epworth. The purpose of civil commitment proceedings is to protect the public and to ensure the rights of the person whose liberty is at stake. Civil Commitment of T.K. v. Dep't of Veterans Affairs, 27 N.E.3d 271, 273 (Ind. 2015). Given the liberty interest at stake, the serious stigma involved, and the adverse social consequences that accompany such physical confinement, a proceeding for an involuntary civil commitment is subject to due process requirements. Id. In order to protect the due process rights of a person subject to commitment, the facts justifying an involuntary commitment must be shown by clear and convincing evidence. Id. This standard of proof communicates the relative importance our legal system attaches to a decision ordering an involuntary commitment, and it also has the function of reducing the likelihood of inappropriate commitments. P.B. v. Evansville State Hosp., 90 N.E.3d 1199, 1202 (Ind.Ct.App. 2017). When we review the sufficiency of the evidence supporting an involuntary civil commitment, we will affirm if, after considering the probative evidence and reasonable inferences supporting the decision, a reasonable trier of fact could have found the necessary elements proven by clear and convincing evidence. Id. We do not reweigh the evidence, nor do we judge witness credibility. Id.
[¶10] In Indiana, "[a]n individual who is alleged to be mentally ill and either dangerous or gravely disabled may be committed to a facility for not more than ninety (90) days." Ind. Code § 12-26-6-1. S.A. does not challenge the trial court's finding that she is mentally ill, and the trial court did not conclude that S.A. was gravely disabled. Rather, S.A. contends that the evidence did not show by clear and convincing evidence that she was a danger to herself or to others. For purposes of civil commitment, dangerousness is defined as "a condition in which an individual as a result of mental illness, presents a substantial risk that the individual will harm [herself] or others." I.C. § 12-7-2-53. "Dangerousness must be shown by clear and convincing evidence indicating that the behavior used as an index of a person's dangerousness would not occur but for the person's mental illness." B.M. v. Ind. Univ. Health, 24 N.E.3d 969, 972 (Ind.Ct.App. 2015), trans. denied.
[¶11] "The determination of dangerousness under the involuntary commitment statute has always been a question of fact for the trial court to decide." Id.
Only the trial court sees the witnesses on the stand, their demeanor in testifying, their candor, or lack of candor, in disclosing facts about which they have knowledge. Juries and trial courts, quite often, properly, give more weight to the demeanor of witnesses than to the substance of their statements in the determination of truth. An [a]ppellate [c]ourt, considering only the statements, is denied the assistance of this necessary factor.Id.
[¶12] Here, the evidence at S.A.'s commitment hearing reflected that S.A. initially voluntarily arrived at the hospital, informing hospital personnel that she wanted to overdose on her prescribed medication. Dr. Coyle testified that S.A. suffered from "PTSD as well as major depression, which is severe," and which is "recurrent with psychotic features." (Tr. Vol. II, p. 2; Appellant's App. Vol. II, p. 22). Although S.A. was compliant with her medication regimen, Dr. Coyle wanted to make some medication changes because "without medication she is a danger to herself because of the suicidal ideation" and "also a danger to others because of her extensive paranoia" of being the target of an east coast organized crime family. (Tr. Vol. II, p. 3). S.A. refused to make any changes to her original medications. Dr. Coyle noted that during S.A.'s time in the hospital, she continued to be very disorganized and delusional. S.A. also reported suicidal thoughts with a plan to overdose on medications while committed on an emergency basis. Dr. Coyle concluded that without a change in medication, S.A. is "a danger to herself because of the suicidal ideation [] and also to others because of her extensive paranoia." (Tr. Vol. II, p. 3).
[¶13] S.A. argues that a mere refusal to change medication while being compliant with her prescribed medications is not a "justification" for a finding of dangerousness. (Appellant's Br. p. 11). S.A. points to T.K., where the respondent suffered from paranoia, was aggressive and disruptive, created fear in others, mentioned violence in communications, had ammunition experience, and refused to take medication. T.K., 27 N.E.3d at 276-77. Our supreme court determined that there was insufficient evidence of dangerousness because the expert witness acknowledged, "I personally did not believe that he would be a danger to self or others[.]" Id. at 276. We find T.K. to be distinguishable from the case before us, as Dr. Coyle unequivocally testified that without changes in her medication, S.A. was "a danger to herself because of the suicidal ideation" and "also a danger to others because of her extensive paranoia," as evidenced by S.A.'s trial testimony. (Tr. Vol. II, p. 3). While we agree with S.A. that she did not attempt suicide at any time while in detention, "a trial court is not required to wait until an individual commits a physical act before determining that the individual poses a substantial risk of harm to others." M.Z. v. Clarian Health Partners, 829 N.E.2d 634, 638 (Ind.Ct.App. 2005), trans. Denied. Accordingly, we conclude that clear and sufficient evidence supports that S.A. posed a "substantial risk of harm" to herself as shown through Dr. Coyle's testimony which included an assessment that S.A. continued to pose a threat to herself. See id. Therefore, we affirm the trial court's Order.
CONCLUSION
[¶14] Based on the foregoing, we hold that the trial court's determination that S.A. was dangerous to herself was supported by clear and convincing evidence.
[¶15] Affirmed.
Altice, C. J. and Pyle, J. concur