In the Matter of the Involuntary Commitment of R.T.

Pursuant to Ind.Appellate Rule 65(D),
this Memorandum Decision shall not be
regarded as precedent or cited before FILED
Jul 10 2012, 9:35 am
any court except for the purpose of
establishing the defense of res judicata,
collateral estoppel, or the law of the case. CLERK
of the supreme court,
court of appeals and
tax court
ATTORNEY FOR APPELLANT: ATTORNEYS FOR APPELLEE:
MATTHEW G. GRANTHAM GREGORY F. ZOELLER
Bowers, Brewer, Garrett & Wiley, LLP Attorney General of Indiana
Huntington, Indiana
STEPHANIE ROTHENBERG
Deputy Attorney General
Indianapolis, Indiana
IN THE
COURT OF APPEALS OF INDIANA
)
)
IN THE MATTER OF THE INVOLUNTARY )
COMMITMENT OF R.T. ) No. 35A02-1110-MH-1088
)
)
APPEAL FROM THE HUNTINGTON CIRCUIT COURT
The Honorable Thomas M. Hakes, Judge
Cause No. 35C01-9903-MH-127
July 10, 2012
MEMORANDUM DECISION - NOT FOR PUBLICATION
BAILEY, Judge
Case Summary
R.T. appeals the trial court’s order continuing his regular commitment1 to Logansport
State Hospital (“Logansport”).
We affirm.
Issue
The sole issue presented is whether sufficient evidence supports the trial court’s
decision to continue R.T.’s involuntary commitment.
Facts and Procedural History
While in sixth grade, R.T. was placed in the Gibault School for Boys after three
incidents of sexually abusing children. Three and one-half years later, R.T. was placed in
juvenile detention due to an allegation that he had sodomized a fifteen-year-old male resident
of Gibault.
In March of 1999, the State petitioned for R.T.’s involuntary commitment. The
attached psychological evaluation showed that R.T. exhibited “significant predatory
capabilities” and “clearly represent[ed] a threat to society.” (App. at 28.) The
recommendation was for placement in the long-term inpatient facility at Logansport that
focuses on treatment of violent predatory sexual offenders. On April 7, 1999, the trial court
granted the petition for involuntary commitment. Since May of 1999, R.T. has been
hospitalized at Logansport. Each year from 2001 through 2009, Logansport filed an annual
1
The most restrictive form of involuntary treatment, a regular commitment is appropriate when an
individual’s commitment is reasonably expected to require custody, care or treatment in a facility for more
than ninety days. Ind. Code § 12-26-7-1; J.S. v. Ctr. For Behavioral Health, 846 N.E.2d 1106, 1111 (Ind.
Ct. App. 2006), trans. denied.
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report with a treatment plan summary and each year the trial court ordered continued regular
commitment without a hearing.2
In March of 2010, R.T. filed a request for review or dismissal of his commitment.
Counsel was appointed and, after a hearing, the trial court ordered an evaluation of R.T. Dr.
Douglas Morris, the attending physician, submitted an amended periodic report listing
eighteen recent incidents of “inappropriate behaviors” evidencing dangerousness to others
and/or grave disability. (App. at 16-18.) On June 15, 2010, the trial court ordered R.T.’s
continued commitment.
On March 11, 2011, Logansport again filed its Periodic Report on Regularly
Committed Patient and Treatment Plan Summary with a recommendation that R.T. remain in
the facility. The report lists R.T.’s mental condition as “Narcissistic Personality Disorder and
History of Pedophilia.” (App. at 12.) Dr. Morris opined that R.T. “[p]resents a substantial
risk that [he] is dangerous to others” and that he is “gravely disabled.” (App. at 12.) On
March 14, 2011, the trial court issued an order continuing regular commitment. On April 19,
2011, R.T. filed a request for dismissal of his commitment. The trial court appointed counsel
to represent R.T. and ordered evaluation reports to be submitted to the court prior to the
2
Pursuant to Indiana Code Section 12-26-15-1(a), the superintendent or attending physician must file with
the court, at least annually or more often if directed, a review of the patient’s care and treatment, including
a statement regarding the individual’s mental condition, whether the individual is dangerous or gravely
disabled, and whether the individual needs to remain in the facility or may be cared for under a
guardianship. In re Commitment of J.W.B., 921 N.E.2d 513, 516 (Ind. Ct. App. 2010). Upon receipt of
the report, the court shall do one of the following: (1) order the individual’s continued custody, care and
treatment in the appropriate facility or therapy program; (2) terminate the commitment or release the
individual from the therapy program; or (3) conduct a hearing under IC 12-26-12 [“Notice of Discharge of
an Individual”]. I.C. § 12-26-15-2(a); Commitment of J.W.B., 921 N.E.2d at 516.
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hearing, which commenced on August 2, 2011, and concluded on August 9, 2011. On
October 11, 2011, the trial court ordered that R.T. “shall remain in the facility as he remains
gravely disabled and is a substantial risk of being dangerous to others.” (App. at 9.) This
appeal ensued.3
Discussion and Decision
Standard of Review
R.T. challenges the trial court’s order for continued involuntary commitment. When
reviewing the sufficiency of the evidence supporting an involuntary commitment, we look
only to the evidence most favorable to the trial court’s decision and all reasonable inferences
drawn therefrom. M.Z. v. Clarian Health Partners, 829 N.E.2d 634, 637 (Ind. Ct. App.
2005), trans. denied. We do not reweigh the evidence or judge the credibility of witnesses.
In re Involuntary Commitment of A.M., 959 N.E.2d 832, 835 (Ind. Ct. App. 2011). If the
trial court’s commitment order represents a conclusion that a reasonable person could have
drawn, we affirm the order even if other reasonable conclusions are possible. Id. (citations
omitted).
Civil commitment, however, is a significant deprivation of liberty and, thus, it requires
due process protections. Id. An individual may be involuntarily committed in Indiana only if
the petitioner proves by clear and convincing evidence that (1) the individual is mentally ill
and either dangerous or gravely disabled; and (2) detention or commitment of that individual
3
The State provides an updated Chronological Case Summary which shows that, on February 21, 2012,
Logansport filed another periodic report on R.T.’s commitment. On February 27, 2012, the court ordered
regular commitment without a hearing. (Supp. App. at 6.)
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is appropriate. Ind. Code § 12-26-2-5(e); In re Involuntary Commitment of A.M., 959
N.E.2d at 835. As a corollary, “[t]he court shall order the discharge of a committed
individual and terminate the commitment if the court finds that the individual is not mentally
ill and either dangerous or gravely disabled.” I.C. § 12-26-12-7.
Analysis
“Mental Illness” for purposes of Indiana Code Article 12-26, means “a psychiatric
disorder that: (A) substantially disturbs an individual’s thinking, feeling, or behavior; and
(B) impairs the individual’s ability to function. The term includes mental retardation,
alcoholism, and addiction to narcotics or dangerous drugs.” Ind. Code § 12-7-2-130. Here,
R.T. was diagnosed as having a Narcissistic Personality Disorder[4] and Pedophilia. R.T.
argues that, even if he has a mental illness, there is insufficient evidence to continue his
commitment on the basis that he is either dangerous or gravely disabled. We consider each in
turn.
1. Dangerous
“‘Dangerous” means “a condition in which an individual as a result of mental illness,
presents a substantial risk that the individual will harm the individual or others.” Ind. Code §
12-7-2-53. The trial court found that R.T. “remains violent” and “remains a predatory sexual
offender.” (App. at 9.)
4
Dr. Morris described narcissistic personality disorder as “a chronic personality style that deals with lack
of empathy towards others, a sense of self importance and grandiosity where he often feels what he wants
to do is more important than following rules, than . . . treating people with respect . . . .” (Tr. at 19.)
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The evidence favorable to the judgment shows that, in June of 2010, R.T. asked to be
placed into a more restrictive ward. He was moved there in August of that year. R.T.
testified that he requested the transfer due to his “verbal threats to staffs [sic] jobs” and
because he believed the more restrictive setting “was the best thing” for him at the time. (Tr.
at 70, 71.) Despite the more restrictive placement, in the months leading to the hearing, R.T.
had two restrictions for physical aggression. On one occasion he kicked a staff member in
the back of the leg, causing her to fall. The injury prevented the staff member from working
on active duty for a number of weeks. In another incident, R.T. required restraint because he
became combative with staff.
Although these incidents illustrate violence, R.T.’s dangerousness has “typically
revolved around his risk of . . . engaging in . . . pedophilia” and inappropriate sexual
behavior. (Tr. at 9.) R.T. admitted, “[W]hen I would have the feelings of loneliness,
boredom, I would sexually act out with other clients.” (Tr. at 79.) In addition R.T. had not
completed the hospital’s sexual responsibility program, designed to lessen problems related
to pedophilia. See Commitment of T.S. v. Logansport State Hosp., 959 N.E.2d 855, 856
(Ind. Ct. App. 2011) (affirming the denial of a patient’s request to be removed from the
sexual responsibility program), trans. denied. Although R.T. knows the general program
content, he does not practice those concepts and principles. For example, R.T. had recently
made an inappropriate phone call to a patient at another state hospital where there was a
sexually inappropriate discussion. He also admitted that, in April of 2011, he was “having
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issues” with an eighteen-year-old male who looked as if he were twelve or thirteen years old.
(Tr. at 73.)
Yet, R.T. asserts that the evidence reveals “no clearly illegal sexual behavior.”
Appellant’s Br. at 9. He also argues that extreme self-centeredness, standing alone, does not
make him a substantial risk to others, and he suggests that his behavior is no more than a
“rational and informed decision to engage in conduct entailing a risk of harm.” Appellant’s
Br. at 8 (quoting Commitment of J.B. v. Midtown Mental Health Ctr., 581 N.E.2d 448, 452
(Ind. Ct. App. 1991), trans. denied). In effect, R.T. asks that we reweigh the evidence, which
we may not do.
The record does indicate that R.T. has made progress and that Dr. Morris was
considering transitioning him to a less restrictive facility. See In re Commitment of J.W.B.,
921 N.E.2d 513, 516 (Ind. Ct. App. 2010) (holding that the authority to decide where an
individual should receive treatment and the responsibility for that decision rest with the
superintendent of the facility). One of the physician’s “chief concerns,” however, was that
R.T. not lose his civil commitment and be released into the community with no supervision
and no mental health treatment. (Tr. at 25.) Dr. Morris believed that sexual risks remain and
that R.T. still has an inappropriate attraction to young males, whom R.T. referred to as
“jailbait.” (Tr. at 17.) On this record, a reasonable person could have drawn the conclusion
that R.T. requires commitment because, as a result of mental illness, he presents a substantial
risk that he will harm others.
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2. Gravely Disabled
“Gravely disabled”, for purposes of IC 12–26, means a condition in which an
individual, as a result of mental illness, is in danger of coming to harm because
the individual:
(1) is unable to provide for that individual’s food, clothing, shelter, or other
essential human needs; or
(2) has a substantial impairment or an obvious deterioration of that individual’s
judgment, reasoning, or behavior that results in the individual’s inability to
function independently.
I.C. 12-7-2-96.
R.T. relies on K.F. v. St. Vincent Hospital & Health Care Center, 909 N.E.2d 1063(Ind. Ct. App. 2009), for the proposition that the mere potential for odd or offensive behavior
is insufficient to support a conclusion that an individual cannot independently function
because of mental illness. K.F. involved an active sixty-two-year-old woman who had been
married for more than forty years when she began exhibiting unusual behaviors, including
frequenting a local bar, maxing out a new credit card, and getting into multiple car accidents.
She was diagnosed with bipolar disorder but did not want to take her medication or avoid
alcohol. Id. at 1065. K.F. appealed the order for her involuntary regular commitment. A
review of the hearing record showed that relatives gave conflicting testimony regarding
K.F.’s ability to function independently; the physician’s testimony was equivocal on that
issue; and her husband testified that he was willing and able to support her outpatient
therapy. Id. at 1066-67. Thus, our Court reversed the order for commitment, finding
insufficient evidence that K.F. was gravely disabled. Id. at 1067.
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K.F. is distinguishable. First, although R.T. is capable of dressing and feeding
himself, there were questions about whether he could provide for other basic needs, i.e.,
procuring a house or entering into a rental contract. And, unlike in K.F., there is no evidence
to demonstrate that R.T. would have the necessary support system to meet those needs in the
community. R.T. testified that he would be “asking my mom” to live with her for a time and
he had a “couple of ideas of summer jobs like mowing.” (Tr. at 74, 76.) R.T.’s plans and
“ideas” for meeting essential human needs are tentative at best.
Further, unlike the physician in K.F., here, without equivocation, Dr. Morris testified
that R.T. met the commitment criteria based upon grave disability. Specifically, Dr. Morris
opined that R.T.’s judgment is impaired enough that he would have difficulty functioning
independently. He elaborated: “[R.T.’s] inappropriate comments, his emotional maturity and
his difficulty getting along with people, his difficulty following rules would leave me to have
concerns that he does not that . . . he has substantial impairments in his judgment that would
cause him to have difficulty functioning in the community.” (Tr. at 30.) A reasonable person
could have concluded that R.T.’s commitment should continue because, as the result of
mental illness, he was gravely disabled. Thus, we affirm the trial court’s commitment order.
Affirmed.
ROBB, C.J., and MATHIAS, J., concur.
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