State ( 2007 )

                                                NO. 12-06-00316-CV

IN THE COURT OF APPEALS

TWELFTH COURT OF APPEALS DISTRICT

TYLER, TEXAS

THE STATE OF TEXAS FOR        §                      APPEAL FROM THE

THE BEST INTEREST AND          §                      COUNTY COURT AT LAW

PROTECTION OF C.L.       §                      CHEROKEE COUNTY, TEXAS

MEMORANDUM OPINION

            C.L. appeals from an order for temporary inpatient mental health services.  In his sole issue on appeal, C.L. asserts that the evidence presented was legally and factually insufficient to support the order.  We affirm.

Background

            On August 4, 2006, an application for court ordered temporary mental health services was filed requesting that the trial court commit C.L. to Rusk State Hospital (“RSH”) for a period not to exceed ninety days.  At the time the application was filed, C.L. was a patient at RSH.  The application was supported by two physicians’ certificates of medical examination for mental illness.  The first certificate stated that, on August 3, 2006, Dr. Catir Cuellar evaluated and examined C.L. and diagnosed him with schizo-affective disorder. According to Dr. Cuellar, C.L. was mentally ill and, as a result, was likely to cause serious harm to himself. Dr. Cuellar reached these conclusions because C.L. said that the United States was in a civil war, believed that computers were sending deadly missiles against his dog, and had been living in filth and neglecting himself.  Dr. Cuellar also stated in his certificate that C.L. presented a substantial risk of serious harm to himself or others if not immediately restrained, which was demonstrated by C.L.’s behavior and by evidence of severe emotional distress and deterioration in C.L.’s mental condition.       

            The second certificate stated that, on August 4, 2006, Dr. Larry Hawkins evaluated and examined C.L. and diagnosed him with schizo-affective disorder.  Dr. Hawkins stated that C.L. had been receiving medications under his direction. According to Dr. Hawkins, C.L. was mentally ill and was likely to cause serious harm to others.  Dr. Hawkins reached these conclusions because C.L. exhibited pressured speech and flight of ideas, was very paranoid about the government, exhibited grandiose behavior saying “I am the chosen one,” was found swimming (allegedly naked) in a public ditch, had failed to care for himself, and had maintained his residence in an unsanitary living condition.  In regard to C.L.’s residence, Dr. Hawkins stated that someone reported there were “maggots all over [C.L.’s] house.” 

            The hearing on the application was held on August 22, 2006.  Both physicians’ certificates were offered into evidence.  At the hearing, Dr. Jon Guidry testified as an expert in mental health care.  He testified that he had reviewed C.L.’s medical records and that he had last examined C.L. during the week prior to the hearing.  He testified that C.L. suffered from schizo-affective disorder, bipolar type; was likely to cause serious harm to himself; and  was experiencing a substantial mental deterioration of his ability to function independently.  He reached these conclusions because C.L. believed people were looking for him in an attempt to harm him and force him to give them money, had purposely changed the condition of his home in an attempt to conceal his whereabouts,¹ and had been swimming in a ditch.

            Dr. Guidry testified that C.L. was an extremely delusional individual and would regress to a manic state if prematurely released.  He stated that C.L.’s medication had temporarily relieved C.L.’s manic symptoms, but continued medication was necessary to prevent a regression.  Dr. Guidry stated that this was so because C.L. was still delusional and would be free to explore and build upon these delusions if released from RSH.  He stated that C.L. was responding to treatment, and he anticipated that C.L would require only an additional two weeks at RSH to reach the maximum possible benefit. 

         During cross examination, Dr. Guidry admitted that he did not know of any overt act committed by C.L. by which he attempted to harm himself.  Dr. Guidry admitted that C.L. was currently able to obtain food and feed himself and obtain clothes and clothe himself.  He admitted that C.L. would know to seek treatment for a broken arm.  He also admitted that C.L. would know to remove his foot from a fire ant hill and to exit a burning building.  Nonetheless, Dr. Guidry testified that C.L. would not be able to take care of his personal safety if prematurely released.

            C.L.’s sister, Teresa, testified that C.L. told her he had been swimming in a ditch in his underwear.  She also said that she saw C.L. afterward and that he had been bitten by mosquitos and other bugs “from head to toe.”  As a result, she had to take him to a hospital emergency room. She further testified that C.L. had “completely destroyed” his home. 

            Teresa stated that she was worried for C.L.’s safety. She testified that C.L. was under the delusional belief that people were trying to poison him.  Teresa described other behavior exhibited by C.L. such as threatening her, spraying down pizza delivery men with a water hose, breaking out windows with his hands, using illegal drugs, and walking around his yard in his underwear.  She further testified that C.L. was not able to buy food for himself because he had decision making problems.  As an example, she cited an instance in which C.L. accepted a pizza from a pizza delivery man, but then closed the door in the man’s face without paying for the pizza.

            C.L. testified as the sole witness in support of his release from RSH.  C.L denied that he had been swimming in a ditch, but admitted that he was near the ditch while wearing only underwear.  C.L. agreed that he once had said the United States was in a civil war, but stated that he knew this was not true.  As to the missiles being fired at his dog, C.L. said that he had been told by his nephew that inmates at a jail were the ones firing the missiles.  C.L. also said that he had recently ridden in a van that had an ejection seat for the front passenger.

            When asked about why he purposely damaged his home, C.L. testified that people were trying to harm him and to make him “go crazy.” C.L stated that the people believed he had large sums of money that he inherited from his deceased father.  C.L. admitted that he did not have the money, but asserted that this was the belief of the people who were after him.  He testified that he had set up his home “as a trap” for the people.  He stated that the people were currently incarcerated and thus not a present threat to him.  He said that if he found out that some of the people were not incarcerated, his best course of action would be to set up his home as before.

            C.L. testified that he wished to be released from RSH so he could return to his home.  He said that he did not wish to harm himself or others and that he had never threatened to harm himself.  C.L. testified that, while living at his home, he had prepared his own food and bought his own clothes.      At the conclusion of the hearing, the trial court found that C.L. was mentally ill, and as a result was likely to cause serious harm to himself; suffering severe and abnormal mental, emotional, or physical distress; experiencing substantial mental or physical deterioration of his ability to function independently, which was exhibited by his inability, except for reasons of indigence, to provide for his basic needs, including food, clothing, health, or safety; and unable to make a rational and informed decision as to whether or not to submit to treatment.  The trial court entered an order for temporary inpatient mental health services committing C.L. to RSH for a period not to exceed ninety days.  This appeal followed.

Sufficiency of the Evidence

            C.L. argues that the evidence was neither legally nor factually sufficient to support the order of commitment.  More specifically, he contends that the evidence failed to show an overt act or continuing pattern of behavior tending to confirm the likelihood that he would cause serious harm to himself, that he was suffering from severe distress, or that his ability to function was deteriorating. Standard of Review

            In a legal sufficiency review where the burden of proof is clear and convincing evidence, we must look at all the evidence in the light most favorable to the finding to determine whether a reasonable trier of fact could have formed a firm belief or conviction that the finding was true.  In re J.F.C., 96 S.W.3d 256, 266 (Tex. 2002).  We must assume that the fact finder settled disputed facts in favor of the finding if a reasonable fact finder could do so and disregard all evidence that a reasonable fact finder could have disbelieved or found incredible. Id.  This does not mean that we are required to ignore all evidence not supporting the finding because that might bias a clear and convincing evidence analysis.  Id.

            The appropriate standard for reviewing this factual sufficiency challenge is whether the evidence is such that a fact finder could reasonably form a firm belief or conviction that the finding was true. In re C.H., 89 S.W.3d 17, 25 (Tex. 2002).  In determining whether the fact finder has met this standard, we consider all the evidence in the record, both that in support of and contrary to the finding.  Id. at 27-29.  Further, we must consider whether disputed evidence is such that a reasonable fact finder could not have reconciled that disputed evidence in favor of the finding.  In re J.F.C., 96 S.W.3d at 266.  If the disputed evidence is so significant that a fact finder could not reasonably have formed a firm belief or conviction, then the evidence is factually insufficient to support the finding. Id.

Applicable Law

            A trial judge may order a proposed patient to receive court ordered temporary inpatient mental health services if the judge, from clear and convincing evidence, finds that the proposed patient is mentally ill and, as a result of the mental illness, is likely to cause serious harm to himself, is likely to cause serious harm to others, or is (1) suffering severe and abnormal mental, emotional, or physical distress, (2) experiencing substantial mental or physical deterioration of his ability to function independently, which is exhibited by his inability, except for reasons of indigence, to provide for his basic needs, including food, clothing, health, or safety, and (3) unable to make a rational and informed decision as to whether or not to submit to treatment.  Tex. Health & Safety Code Ann. § 574.034(a) (Vernon 2003).

            To be clear and convincing, the evidence must include expert testimony and, unless waived, evidence of a recent overt act or a continuing pattern of behavior that tends to confirm either the likelihood of serious harm to the proposed patient or others or the proposed patient’s distress and the deterioration of his ability to function.  Tex. Health & Safety Code Ann. § 574.034(d) (Vernon 2003).  Clear and convincing evidence means the measure or degree of proof that will produce in the mind of the trier of fact a firm belief or conviction as to the truth of the allegations sought to be established. State v. Addington, 588 S.W.2d 569, 570 (Tex. 1979).  The statutory requirements for an involuntary commitment are strict because it is a drastic measure.  In re C.O., 65 S.W.3d 175, 182 (Tex. App.–Tyler 2001, no pet.).

Legal Sufficiency

            Dr. Guidry testified at the hearing that C.L. believed people were looking for him to try to harm him and force him to give them money.  Dr. Guidry also said that, in an attempt to conceal himself from these people, C.L. changed the condition of his home.  According to Dr. Guidry, C.L. told him that he made his home “look like a deathtrap because people are after me.”  C.L.’s sister, Teresa, said that C.L. had “completely destroyed” his home.  This overt act, damaging his home, tends to confirm that C.L. was suffering severe and abnormal mental, emotional, or physical distress. A reasonable trier of fact could have formed a firm belief or conviction that C.L. was suffering severe and abnormal distress as a result of his mental illness.

            Dr. Guidry also testified that C.L. would not be able to care for his own personal safety if he were released prematurely from RSH.  He based his opinion on C.L.’s behaviors of swimming in a ditch, damaging his home, and living in unsanitary conditions.  Teresa confirmed that C.L. had been swimming in a ditch.  She testified that, when she saw him afterward, she took him to a hospital emergency room because he had been bitten by mosquitos and other bugs from “head to toe.”  Teresa also testified that C.L. had used illegal drugs and had used his hands to break out windows.  C.L. himself admitted purposely damaging the condition of his home.  This evidence shows a continuing pattern of behavior that tends to confirm C.L.’s inability to provide for his own personal safety. A reasonable trier of fact could have formed a firm belief or conviction that, as a result of C.L.’s mental illness, C.L. was experiencing a substantial mental deterioration of his ability to function independently.  Therefore, the evidence was legally sufficient to support the trial court’s findings of distress and deterioration.  See Tex. Health & Safety Code Ann. § 574.034.

Factual Sufficiency

            Having determined that the evidence was legally sufficient to support the trial court’s order, we address factual sufficiency and consider all of the evidence, both that in support of and contrary to the trial court’s findings.  See In re C.H., 89 S.W.3d at 27-29.

            Based upon our review of the record as a whole, we note that there is some evidence that is contrary to the trial court’s findings. Dr. Guidry testified that C.L. would seek medical attention for a broken arm, remove himself from an anthill, and evacuate himself from a burning building.  Also, C.L. testified that he had not been swimming in a ditch.  The trial court was entitled to disregard evidence contrary to its findings and to disbelieve C.L.’s testimony.  See id. at 27.  In light of the entire record, the evidence that the trial court could not have credited in favor of its findings is not so significant that it could not form a firm belief or conviction that C.L. was suffering severe and abnormal mental distress and experiencing a substantial mental deterioration of his ability to function independently.  See In re R.S.C., 921 S.W.2d 506, 509-11 (Tex. App–Fort Worth 1996, no writ). Therefore, the evidence is factually sufficient to support the trial court’s findings of distress and deterioration.  See Tex. Health & Safety Code Ann. § 574.034; In re J.F.C., 96 S.W.3d at 266.

            Having determined that the evidence is legally and factually sufficient to support one of the criteria for committing C.L. to RSH, we need not consider the additional criteria used to support the commitment. See Tex. Health & Safety Code Ann. § 574.034(a); Tex. R. App. P. 47.1.  We conclude that the trial court met the obligations imposed by section 574.034 of the Texas Health and Safety Code and overrule C.L.’s sole issue.

Disposition

            The judgment of the trial court is affirmed.

                                                                                                    SAM GRIFFITH   

                                                                                                               Justice

Opinion delivered January 31, 2007.

Panel consisted of Worthen, C.J., Griffith, J., and Hoyle, J.

(PUBLISH)

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¹ C.L. said “I made it look like a deathtrap because people are after me.”