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    01-15-00784-CV
    FIRST COURT OF APPEALS
    HOUSTON, TEXAS
    11/13/2015 12:10:03 PM
    CHRISTOPHER PRINE
    CLERK
    No. 01-15-00784-CV
    IN THE FIRST COURT OF APPEALS FOR     FILED IN
    1st COURT OF APPEALS
    HOUSTON TEXAS             HOUSTON, TEXAS
    11/13/2015 12:10:03 PM
    CHRISTOPHER A. PRINE
    IN THE INTEREST OF E.S.R.                    Clerk
    On Appeal from the Probate Court No. 4, Harris County, Texas
    Trial Court Cause No. I218340
    BRIEF FOR APPELLANT
    Michael Scott Thomas
    State Bar No. 19861200
    Thomas & Williams, L.L.P.
    2626 S. Loop West, Suite 561
    Houston, Texas 77054
    Telephone: (713) 665-8558
    Facsimile: (713) 665-8562
    Email: mstlawyer@aol.com
    ATTORNEYS FOR APPELLANT
    ORAL ARGUMENT WAIVED
    IDENTITY OF PARTIES AND COUNSEL
    APPELLANT:   E.S.R.
    COUNSEL:     Michael Scott Thomas
    State Bar No. 19861200
    THOMAS & WILLIAMS, L.L.P.
    2626 S. Loop West, Suite 561
    Houston, Texas 77054
    Telephone: (713) 665-8558
    Facsimile: (713) 665-8562
    Email: mstlawyer@aol.com
    APPELLEE:    Harris County
    COUNSEL:     Keith Toler
    State Bar No. 24088541
    Assistant County Attorney
    1019 Congress, 15th Floor
    Houston, Texas 7702
    Telephone: (713) 274-5265
    Facsimile: (713) 755-8924
    Email: Keith.Toler@cao.hctx.net
    JUDGE:       The Honorable Christine Butts
    Probate Court No. 4, Harris County, Texas
    -ii-
    TABLE OF CONTENTS
    Identity of Parties and Counsel ................................................................................. ii
    Table of Contents ..................................................................................................... iii
    Index of Authorities ..................................................................................................iv
    Statement of the Case................................................................................................. 1
    Issues Presented ......................................................................................................... 2
    Statement of Facts ...................................................................................................... 2-6
    Summary of Argument .............................................................................................. 6-7
    Argument.................................................................................................................... 7
    I.       The Evidence is Legally and Factually Insufficient to Support the
    Trial Court’s Order of Involuntary Commitment ............................................ 7
    A.        Standard of Review. .............................................................................. 7-8
    B.        Involuntary Commitment. ..................................................................... 8-10
    C.        Mental Illness ................................................................................... 11
    D.        Harm to Others .................................................................................11-13
    E.        Experiencing Substantial Mental or Physical Deterioration ..............13-15
    II.      The Evidence is Legally Insufficient to Support the Trial Court’s
    Order to Administer Psychoactive Medication. ............................................ 15
    A.        Standard of Review. ............................................................................ 15
    B.        Psychoactive Medication Order. .........................................................15-16
    Conclusion and Prayer ............................................................................................. 16
    Certificate of Compliance ........................................................................................ 16
    Certificate of Service ............................................................................................... 17
    -iii-
    INDEX OF AUTHORITIES
    Cases
    Armstrong v. State, 
    190 S.W.3d 246
    (Tex. App.--Houston [1st Dist.] 2006,
    no pet.) ...........................................................................................................14
    In re C.O., 
    65 S.W.3d 175
    (Tex. App.--Tyler 2001, no pet.) ..................................13
    In re F.M., 
    183 S.W.3d 489
    (Tex.App.-- Houston [14th Dist.] 2005, no pet.) ........14
    Johnstone v. State, 
    22 S.W.3d 408
    (Tex. 2000) ........................................................9
    J.M. v. The State of Texas, 
    178 S.W.3d 185
    (Tex.App.--Houston [1st Dist.]
    2005, no pet.) .............................................................................. 7-8, 12-13, 15
    K.E.W. v. State, 
    315 S.W.3d 16
    (Tex. 2010) ...........................................................10
    K.T. v. State, 
    68 S.W.3d 887
    (Tex.App.--Houston [1st Dist.] 2002, no pet.)...........16
    M.S. v. State, 
    137 S.W.3d 131
    (Tex.App.--Houston [1st Dist.] 2004, no pet.) ........11
    Mezick v. State, 
    920 S.W.2d 427
    (Tex.App.--Houston [1st Dist.] 1996, no
    writ)................................................................................................................12
    State v. Addington, 
    588 S.W.2d 569
    (Tex. 1979) ..................................................... 7
    State v. Lodge, 
    608 S.W.2d 910
    (Tex. 1980) .............................................................8
    State ex rel E.R., 
    287 S.W.3d 297
    (Tex.App.--Texarkana 2013, no pet.) ... 12-13, 15
    T. G. v. State, 
    7 S.W.3d 248
    (Tex. App.--Dallas 1999, no pet.) ....................... 10, 13
    Statutes
    Tex. Health & Safety Code § 574.034(a) .......................................... 2, 7, 8, 9-11, 14
    Tex. Health & Safety Code § 574.034(d) ..................................................... 8, 10, 14
    Tex. Health & Safety Code § 574.106(a)(1)…………………………………2, 15
    -iii-
    No. 01-15-00784-CV
    IN THE FIRST COURT OF APPEALS FOR
    HOUSTON TEXAS
    IN THE INTEREST OF E.S.R.
    On Appeal from the Probate Court No. 4, Harris County, Texas
    Trial Court Cause No. I218340
    BRIEF FOR APPELLANT
    TO THE HONORABLE FIRST COURT OF APPEALS:
    COMES NOW Michael Scott Thomas, Attorney for Appellant E.S.R., and
    files this Brief for Appellant. The Clerk’s Record will be referred to as CR, the
    Supplemental Clerk’s Record will be referred to as Supp. CR, and the Reporter’s
    Record will be Referred to as RR.
    STATEMENT OF THE CASE
    This is an appeal from an involuntary mental health commitment (order for
    temporary inpatient mental health services)(CR 27) and from an order to
    administer psychoactive medications (CR 26). These lower court orders were
    entered on September 3, 2015.
    -1-
    ISSUES PRESENTED
    1. Whether the evidence is legally and factually insufficient to support the trial
    court’s order for temporary involuntary mental health services in violation of
    Texas Health & Safety Code Section 574.034 ?
    2. Whether the evidence is legally and factually insufficient to support the trial
    court’s order for psychoactive medication in violation of Texas Health &
    Safety Code Section 574.106?
    STATEMENT OF FACTS
    Appellant is a 59 year old male (CR 8). On or about August 25, 2015,
    Appellant’s father completed a sworn Application for Temporary Mental Health
    Services (CR 8), an Affidavit of Applicant, wherein he alleged that Appellant had
    made a verbal threat to kill his parents (CR 10), and Application for Emergency
    Detention (CR 14). An Order of Emergency Apprehension and Detention was
    signed on August 25, 2015 (CR 13), as well as an Emergency Apprehension and
    Detention Warrant that issued on August 25, 2015, which was received, executed
    and the Officer’s Return filed on that same date (CR 12).
    On August 26, 2015, E.S.R. was examined at Methodist Hospital in
    Houston, Texas by a Dr. Ashley Smith, M.D. The Certificate of Medical
    Examination from Dr. Smith states E.S.R. was examined on August 26, 2015, with
    an Axis I diagnosis of “unspecified, psychosis” (CR 15). Dr. Smith writes that
    E.S.R. was mentally ill and met all three requirements for involuntary commitment
    and that he was likely to cause harm to himself, likely to cause harm to others, or is
    -2-
    suffering from severe and abnormal mental, emotional or physical distress (CR
    15).
    Finally, Dr. Smith wrote that E.S.R. committed the following overt acts:
    1.   Patient has attempted to get gun and threatened to kill his parents
    2.   Patient owns gun and threatened to use it to kill parents
    3.   Patient is uncooperative with poor insight and judgment
    4.   Patient is likely to deteriorate further w/o treatment and hospitalization
    
    Id. E.S.R. was
    also examined by Dr. Alric D. Hawkins, M.D. on August 26,
    2015. The Certificate of Medical Examination from Dr. Hawkins states E.S.R. was
    examined on August 26, 2015, with an Axis I diagnosis of “schizophrenia” (CR 9).
    Dr. Hawkins writes that E.S.R. was mentally ill and met two of the three
    requirements for involuntary commitment and that he was likely to cause harm to
    others, or is suffering from severe and abnormal mental, emotional or physical
    distress. 
    Id. Finally, Dr.
    Hawkins wrote that E.S.R. committed the following overt acts:
    1. Patient has threatened to kill parents
    2. Also, has threatened to kill his parents
    
    Id. An Order
    for Protective Custody and Notice of Hearing (“OPC”) was
    entered on Thursday, August 27, 2015, and was received, executed and the
    Officer’s Return filed on the same date (CR 16). The OPC set a probable cause
    -3-
    hearing on Monday, August 31, 2015. The probable cause hearing was held on
    August 31, 2015, wherein the Hearing Officer found that there was probable cause
    that E.S.R. presented a substantial risk of serious harm to himself or to others (CR
    18). On August 26, 2015, Dr. Alric Hawkins filed a Petition for Order to
    Administer Psychoactive Medication (CR 19-20).
    Aside from Appellant, Dr. Alric Hawkins was the only person to testify at
    the involuntary commitment hearing held on September 3, 2015. At the
    commitment hearing, Dr. Hawkins testified that he had been working with E.S.R.
    for just over a week (RR Vol. 1, pp. 6:8-10). Dr. Hawkins further testified that
    E.S.R.’s diagnosis for his present medical condition was either schizophrenia or
    schizoaffective disorder (RR Vol. 1, pp. 6:16-23). Dr. Hawkins testified that
    E.S.R.’s behaviors were disorganized and outside the norm; that he was suffering
    from paranoid delusions; that per his family, he’s concerned that folks are shooting
    from him (sic); that the family became concerned after he requested a firearm (RR
    Vol. 1, pp. 7:15-25; pp. 8:1-6); that E.S.R. typically pleads the Fifth and refuses to
    cooperate (RR Vol. 1, pp. 8:10-22); that E.S.R. has refused the medication and
    some of the work (RR Vol. 1, pp. 9:13-16); that in the hospital, E.S.R. is pretty
    irritable, agitated, very argumentative (RR Vol. 1, pp. 9:17-23); that without
    further treatment or intervention, E.S.R. is likely to cause serious harm either to
    himself or to others (RR Vol. 1, pp. 10:13-18); and that Dr. Hawkins’ “primary
    -4-
    concern” was “harm to others” and “ability to care of himself” (RR Vol. 1, pp.
    10:19-25).
    Dr. Hawkins also testified that E.S.R. will experience substantial mental and
    physical deterioration without treatment; that E.S.R. would not be able to make
    decisions regarding his health and safety; and that E.S.R. would not be able to
    make rational and informed decisions as to whether to commit to treatment (RR
    Vol. 1, pp. 6:6-14). The trial court found that E.S.R. was mentally ill; furthermore,
    the trial court found by clear and convincing evidence that as a result of mental
    illness, E.S.R. met the second and third criteria for commitment:
    is likely to cause serious harm to others;
    is suffering severe and abnormal mental, emotional or physical distress;
    is experiencing substantial mental or physical deterioration of [her] ability to
    function independently, which is exhibited by the proposed patient’s
    inability, except for reasons of indigence, to provide for [her] basic needs;
    including food, clothing, health or safety; and
    is not able to make rational and informed decisions as to whether to submit
    to treatment.
    (CR 27; RR Vol. 1, pp. 23:2-10).
    The trial court then immediately started the medication hearing (RR Vol. 1,
    pp. 23:11-15). At the medication hearing, Dr. Hawkins again testified that he was
    still trying to “figure out” whether E.S.R.’s diagnosis was schizophrenia or
    schizoaffective disorder (RR, Vol. 1, pp. 23:19-23); that E.S.R. lacked the capacity
    to make decisions regarding medication (RR Vol. 1, pp. 24:16-19); that without
    -5-
    medication, E.S.R.’s prognosis would be poor (RR Vol. 1, pp. 24:20-24); and that
    there were no less restrictive alternatives (RR Vol. 1, pp. 24: 25; pp. 25:1-6).
    Dr. Hawkins admitted on cross-examination that he was not aware if E.S.R.
    had been on medication in the past, or what the potential results would be based on
    E.S.R.’s past history (RR Vol. 1, pp. 12:11-22). Dr. Hawkins further admitted on
    cross-examination that if E.S.R. did have an untreated seizure disorder, it could
    affect both his medical and psychiatric condition (RR Vol. 1, pp. 25:18-25). The
    trial court found that it would be in E.S.R.’s best interest to be treated with
    psychoactive medications, and that E.S.R. was incapable of making his own
    medical decisions (CR 26; Vo. 1, pp. 32:10-17).
    E.S.R. filed his notice of appeal (CR 6) and affidavit of indigence and
    inability to pay costs (CR 33) on September 8, 2015. On September 14, 2015, the
    trial court signed an order discharging Teresa Scardino as Attorney Ad Litem for
    E.S.R., and appointing Michael Scott Thomas as Attorney Ad Litem for E.S.R.
    (Supp. CR 6-7).
    SUMMARY OF ARGUMENT
    The State’s evidence at trial in support of court-ordered temporary and
    involuntary mental health services is insufficient. The expert witness had little
    knowledge of the facts attendant to the application for involuntary commitment.
    Dr. Hawkins testimony did not state sufficient facts of an overt act or continuing
    -6-
    pattern of behavior sufficient to support a finding of clear and convincing
    evidence.
    Because the evidence is legally insufficient to support the involuntary
    commitment order, the evidence is likewise insufficient to support the order to
    administer psychoactive medication.
    Based on the foregoing, E.S.R. requests that the judgment of the trial court
    be reversed in its entirety.
    ARGUMENT AND AUTHORITIES
    I.    The evidence is legally and factually insufficient to support the trial
    court’s order of involuntary commitment.
    A.     Standard of Review.
    Clear and convincing evidence is that “degree of proof which 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)(per curiam).
    The standard of review for legal sufficiency or factual sufficiency when the
    burden of proof is clear and convincing case is a heightened standard. J.M. v. The
    State of Texas, 
    178 S.W.3d 185
    , 191-192 (Tex.App.--Houston [1st Dist.] 2005, no
    pet.). The State of Texas is required to prove at least one of the prongs of Health
    & Safety 574.034(a) by clear and convincing evidence.
    -7-
    In a legal sufficiency review, a court should 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 its finding was true.
    To give appropriate deference to the factfinder’s conclusions and the role of
    a court conducting a legal sufficiency review, looking at the evidence in the
    light most favorable to the judgment means that a reviewing court must
    assume that the factfider resolved disputed facts in favor of its finding if a
    reasonable factfinder could have done so. A corollary to this requirement is
    that a court should disregard all evidence that a reasonable factfinder could
    have disbelieved or found to have been incredible. This does not mean that a
    court must disregard all evidence that does not support the finding.
    Disregarding undisputed facts that do support the finding could skew the
    analysis of whether there is clear and convincing evidence. If, after
    conducting its legal sufficiency review of the record evidence, a court
    determines that no reasonable factfinder could form a firm belief or
    conviction that the matter that must be proven true, then that court must
    conclude that the evidence is legally insufficient.
    
    Id. The standard
    of review for factual sufficiency is also a heightened one:
    In reviewing the evidence for factual sufficiency under the clear and
    convincing standard, we inquire “whether the evidence is such that a
    factfinder could reasonably form a firm belief or conviction about truth of
    the State’s allegations. In doing so, we must give due consideration to
    evidence that the factfinder reasonably could have fond to be clear and
    convincing. If, in light of the entire record, the disputed evidence that a
    reasonable factfinder could not reasonably have formed a firm belief or
    conviction, then the evidence is factually insufficient.
    
    Id. B. Involuntary
    Commitment.
    Appeals of orders for involuntary commitment do not violate the
    mootness doctrine. Tex. Health & Safety Code § 574.034(d); State v.
    Lodge, 
    608 S.W.2d 910
    , 912 (Tex. 1980). In cases such as these tried before
    -8-
    the court, a motion for new trial is not necessary to preserve a actual
    sufficiency challenge in an appeal of a temporary involuntary commitment
    order. Johnstone v. State, 22 SW.3d 408, 411 (Tex. 2000)(per curiam).
    The State must establish by clear and convincing evidence the following to
    support an order of temporary involuntary mental health services:
    ORDER FOR TEMPORAR MENTAL HEALTH SERVICES. (a) The judge
    may order a proposed patient to receive court-ordered temporary inpatient
    mental health services only if the judge or jury finds, from clear and
    convincing evidence, that:
    (1) the proposed patient is mentally ill; and
    (2) as a result of that mental illness the proposed patient:
    (A)   is likely to cause serious harm to himself;
    (B)   is likely to cause serious harm to others; or
    (C)   is:
    (i)     suffering severe and abnormal, mental, emotional
    or physical distress;
    (ii)    experiencing substantial mental or physical
    deterioration of the proposed patient’s ability to
    function independently, which is exhibited by the
    proposed patient’s inability, except for reasons of
    indigence, to provide for the proposed basic needs,
    including food, clothing’ health, or safety; and
    (iii)   unable to make a rational and informed decision as
    to whether or not to submit to treatment.
    -9-
    Tex. Health & Safety Code § 574.034(a).
    The State’s proof must include expert testimony. Tex. Health &
    Safety Code § 574.034(d). Further, unless waivd by the proposed patient, the
    State must introduce evidence of a recent overt at or a continuing pattern of
    behavior that tends to confirm either (1) the likelihood of a serious harm to
    the proposed patient or others, or (2) the proposed patient’s distress and
    deterioration of the proposed patient’s ability to function. 
    Id. The expert
    opinion must be supported by a showing of its factual basis, and the
    identified overt act or continuing pattern of behavior must be related to the
    criteria on which the judgment is based. T.G. v. State, 
    7 S.W.3d 248
    , 252
    (Tex.App.--Dallas 1999, no pet.). “[A] proposed patient’s words are overt
    acts within the meaning of Section 574.034(d).” K.E.W. v. State, 
    315 S.W.3d 16
    , 22 (Tex. 2010). The Supreme Court has summarized the State’s
    burden in these cases:
    The statute requires evidence of a recent act by the proposed patient, either
    physical or verbal, that can be objectively perceived and that is to some
    degree probative of a finding that serious harm to others is probable if the
    person is not treated. The overt act itself need not be of such character that it
    alone would support a finding of probable serious harm to others.
    
    Id. at 24.
    - 10 -
    C.    Mental Illness.
    The trial court found that E.R.S. was mentally ill (CR 27). E.S.R. does not
    contest that finding; however, an expert diagnosis of mental illness, standing alone,
    is not sufficient to confine a patient for treatment. M.S. v. State, 
    137 S.W.3d 131
    ,
    136 (Tex.App.--Houston [1st Dist.] 2004, no pet.).
    D.    Harm to Others.
    The trial court found that the State had shown by clear and convincing
    evidence, two of three criteria of Section 574.034(a)(2)(B)-(C)(CR 27). The overt
    act or continuing pattern of behavior must relate to the criterion on which the
    judgment is based. Appellant maintains that those two findings are in error.
    The initial medical examination dated August 26, 2015, by Dr. Hawkins that
    accompanied the application for temporary services list the following alleged overt
    acts:
    1.    Patient has threatened to kill parents
    2.    Also, has threatened to kill his parents
    (CR 9).
    At the commitment hearing, Dr. Hawkins testified that he had been working
    with E.S.R. for just over a week (RR Vol. 1, pp. 6, 8-10). Dr. Hawkins further
    testified that E.S.R.’s diagnosis for his present medical condition was either
    schizophrenia or schizoaffective disorder (RR Vol. 1, pp. 6:16-23). Dr. Hawkins
    - 11 -
    explained neither of his alternate diagnosis, and was never asked to do so by the
    State, E.S.R.’s attorney, or the trial court. Expert diagnosis of mental illness alone
    is not sufficient to confine a patient. Mezick v. State, 
    920 S.W.2d 427
    , 430
    (Tex.App.--Houston [1st Dist.] 1996, no writ).
    Dr. Hawkins testified that per his family, E.S.R. is concerned that folks are
    shooting from him (sic); that the family became concerned after he requested they
    bring a firearm (RR Vol. 1, pp. 7:15-25; pp. 8:1-6); that Dr. Hawkins’ “primary
    concern” was “harm to others” and “ability to care of himself” (RR Vol. 1, pp.
    10:19-25); and that without further treatment or intervention, that E.S.R. is likely
    to cause serious harm either to himself or to others (RR Vol. 1, pp. 10:13-18).
    “[A] threat of harm to the patient or others (emphasis ours) must be
    substantial and based on actual dangerous behavior manifested by some overt act
    or threats in the recent past.” J.M., 178 S.W.3d a 193. Evidence that E.S.R.
    “might” cause harm to others is insufficient. State ex rel E.R., 
    287 S.W.3d 297
    ,
    305 (Tex.App.--Texarkana 2009, no pet). There was no testimony from Dr.
    Hawkins as to the date that E.S.R. allegedly threatened his family. There was no
    testimony from Dr. Hawkins that E.S.R. owned a gun or had a gun in his
    possession, custody or control. In point of fact, E.S.R. denies threatening to harm
    his parents (RR Vol. 1, pp. 14:12-14). In sum, there was no testimony from Dr.
    Hawkins regarding overt acts sufficient to support an involuntary commitment.
    - 12 -
    Dr. Hawkins further testified that E.S.R. typically pleads the Fifth and
    refuses to cooperate (RR Vol. 1, pp. 8:10-22); and that in the hospital, E.S.R. is
    pretty irritable, agitated, very argumentative (RR Vol. 1, pp. 9:17-23).
    E.      Experiencing Substantial Mental or Physical Deterioration.
    For evidence to meet the clear and convincing standard, it must show a
    recent overt act or a continuing pattern of behavior that tends to confirm E.S.R.’s
    distress and deterioration of E.S.R.’s ability to function. The State of Texas for the
    Best Interest and Protection of 
    E.R., 287 S.W.3d at 305
    . Dr. Hawkins testified
    that E.S.R. will experience substantial mental and physical deterioration without
    treatment, that E.S.R. would not be able to make decisions regarding his health and
    safety, and that E.S.R. would not be able to make rational and informed decisions
    as to whether to commit to treatment (RR Vol. 1, pp. 11:6-14).
    Dr. Hawkins testified that E.S.R.’s behaviors were disorganized and outside
    the norm; and that he was suffering from paranoid delusions (RR Vol. 1, pp. 7:15-
    25; pp. 8: 7-9). Evidence of psychosis or delusions merely confirms that a patient
    is mentally ill. It does not rise to the level of an overt act or continuing pattern of
    behavior necessary to support a commitment order. 
    J.M., 178 S.W.3d at 196
    , citing
    In re C.O., 
    65 S.W.3d 175
    , 181-182 (Tex.App.--Tyler 2001, no pet.); 
    T.G., 7 S.W.3d at 250-252
    .
    - 13 -
    Dr. Hawkins testified that E.S.R has refused medication and some of the
    work (RR Vol. 1, pp.9:13-16; however, Dr. Hawkins admitted on cross-
    examination that he was not aware if E.S.R. had be on medication in the past, or
    what the potential results would be based on E.S.R.’s past history (RR Vol. 1, pp.
    12:11-22). Appellant argues that Dr. Hawkins’ testimony is not legally or factually
    sufficient to establish that E.S.R.’s refusal of     medication is an overt act or
    continuing pattern of behavior tending to confirm E.S.R.’s distress or a
    deterioration of the ability to function. Armstrong v. State, 
    190 S.W.3d 246
    , 252-
    254 (Tex.App.--Houston [1st Dist.] 2006, no pet.)(refusal to take medications for
    medical condition); In re 
    F.M., 183 S.W.3d at 499
    (a preponderance of Texas
    authority holding a patient’s refusal to take medication is insufficient evidence of a
    recent overt act or continuing pattern of behavior). Appellant argues that evidence
    of deterioration in the future does not establish an overt act or a continuing pattern
    of behavior. 
    Armstrong, 190 S.W.3d at 252-253
    (evidence showed only that
    patient was beginning to deteriorate, not that she was currently experiencing
    substantial deterioration of her ability to function independently). Expert opinions
    must be supported by a showing of the factual bases on which they are grounded
    and not simply recite the statutory criteria. In re 
    F.M., 183 S.W.3d at 499
    . Dr.
    Hawkins’ opinion did little more that testify to the conclusions required by
    Sections 574.034(a) and (d).
    - 14 -
    In sum, there was no testimony from Dr. Hawkins regarding any overt act or
    a continuing pattern of behavior that E.S.R.’s ability to function independently
    would continue to deteriorate or any evidence of E.S.R.’s ability to function on a
    day-to-day basis. 
    E.R., 287 S.W.3d at 306
    ; 
    J.M., 178 S.W.3d at 193
    .
    II.    The evidence is legally insufficient to support the trial court’s order to
    administer psychoactive medication.
    A.     Standard of Review.
    Appellant incorporates by reference all authorities cited in Paragraph II.A of
    this Brief.
    B.     Psychoactive Medication Order.
    The trial court found by clear and convincing evidence that E.S.R. lacked
    capacity to make a decision regarding administration of medication and that it was
    in E.S.R.’s best interest that medication be ordered (CR 26). A trial court may
    issue an order authorizing the administration of psychoactive medication only if
    the proposed patient is under a valid order for temporary or involuntary mental
    health services. Tex. Health & Safety Code Ann. Section 574.106(a)(1).
    Appellant incorporates by reference all averment of facts and authorities
    cited in Paragraph II.B-E of this Brief. Based on the above and foregoing,
    Appellant argues that because the evidence is legally insufficient to support the
    trial court’s order of temporary commitment, the evidence is also legally
    - 15 -
    insufficient to support the order to administer psychoactive medication. K.T. v.
    State, 
    68 S.W.3d 887
    , 894 (Tex.App.--Houston [1st Dist.] 2002, no pet.).
    CONCLUSION AND PRAYER
    WHEREFORE,         PREMISES       CONSIDERED,           Appellant   respectfully
    requests that the order of the Probate Court No. 4 for temporary mental health
    services, and the dependent order for the administration of psychoactive
    medication, be reversed, rendered, and set aside, and for such other and further
    relief to which Appellant may show himself justly entitled.
    Respectfully submitted,
    /s/ Michael Scott Thomas
    MICHAEL SCOTT THOMAS
    State Bar No. 19861200
    THOMAS & WILLIAMS, L.L.P.
    2626 S. Loop West, Suite 561
    Houston, Texas 77054
    Telephone: (713) 665-8558
    Facsimile: (713) 665-8562
    Email: mstlawyer@aol.com
    ATTORNEYS FOR APPELLANT
    CERTIFICATE OF COMPLIANCE
    I certify that pursuant to Tex.R.App.P. 9.4(i)(3), this document contains
    4,080 words.
    /s/ Michael Scott Thomas
    MICHAEL SCOTT THOMAS
    - 16 -
    CERTIFICATE OF SERVICE
    I certify that a true and correct copy of Appellant’s Brief was served via
    email at Keith.Toler@cao.hctx.net to Mr. Keith A. Toler, Assistant County
    Attorney, 1019 Congress, 15th Floor, Houston, Texas 77002 on the 16th day of
    November, 2016.
    /s/ Michael Scott Thomas
    MICHAEL SCOTT THOMAS
    - 17 -