In the Interest of: R.D.

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NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37
IN THE INTEREST OF: : IN THE SUPERIOR COURT OF
: PENNSYLVANIA
:
:
R.D., :
:
Appellant :
: No. 944 MDA 2014
Appeal from the Order Entered May 14, 2014
In the Court of Common Pleas of Centre County
Civil Division No(s).: 2002-1621
BEFORE: FORD ELLIOTT, P.J.E., PANELLA, and FITZGERALD,* JJ.
MEMORANDUM BY FITZGERALD, J.: FILED DECEMBER 18, 2014
Appellant, R.D.,1 appeals from the order entered in the Centre County
Court of Common Pleas committing him to inpatient treatment at the
Meadows Psychiatric Center with subsequent transfer to Danville State
Hospital or another facility approved by his treatment team and Centre
County Mental Health and Intellectual Disabilities (“MH/ID”) for a period not
to exceed 180 days.2 Appellant contends the evidence presented at the
*
Former Justice specially assigned to the Superior Court.
1
Appellant is represented in this appeal by the Public Defender’s Office.
2
Appellant purported to appeal from both the May 14, 2014 order
involuntarily committing him for impatient treatment and from the May 16,
2014 order denying his petition for review of certification to involuntary
inpatient treatment. We note that the appeal properly lies from the May
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mental health commitment hearing was insufficient to compel his involuntary
commitment for psychiatric treatment. We affirm.
Appellant has a history of prior commitments in Centre County. On
July 5, 2002, Appellant was committed to a psychiatric facility for a period
not to exceed ninety days. Order, 7/5/02. On December 13, 2010,
following a Section 73033 hearing, Appellant was committed to inpatient
14th order and have amended the caption accordingly. See In re W.A., 91
A.3d 702, 703-04 (Pa. Super. 2014).
Although Appellant’s commitment pursuant to the instant order
expired on October 1, 2014,
we note that this case presents a live controversy . . . .
This is so “because involuntary commitment affects an
important liberty interest, and because by their nature
most involuntary commitment orders expire before
appellate review is possible.” “[W]ere we to dismiss such
appeals as moot, the challenged procedure could continue
yet its propriety would evade our review.”
See In re Woodside, 699 A.2d 1293, 1296 (Pa. Super. 1997). Thus, the
instant appeal is properly before us. Id.3
Section 7303 provides:
Extended involuntary emergency treatment certified
by a judge or mental health review officer─not to
exceed twenty days
(a) Persons Subject to Extended Involuntary
Emergency Treatment.─Application for extended
involuntary emergency treatment may be made for any
person who is being treated pursuant to section 302
whenever the facility determines that the need for
emergency treatment is likely to extend beyond 120 hours.
The application shall be filed forthwith in the court of
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treatment for a period not to exceed twenty days. Order, 12/13/10. On
March 4, 2013, following a Section 73044 hearing, the court ordered
Appellant to be committed to inpatient treatment for a period not to exceed
ninety days. Order, 3/4/13. On January 29, 2014, following a Section 7303
hearing, the court ordered Appellant to be committed to inpatient treatment
for a period not to exceed twenty days. Order, 1/29/14. On February 24,
common pleas, and shall state the grounds on which
extended emergency treatment is believed to be
necessary. The application shall state the name of any
examining physician and the substance of his opinion
regarding the mental condition of the person.
50 P.S. § 7303 (footnote omitted).
4
Section 7304 provides:
Court-ordered involuntary treatment not to exceed
ninety days
(a) Persons for Whom Application May be Made.─(1)
A person who is severely mentally disabled and in need of
treatment, as defined in section 301(a), may be made
subject to court-ordered involuntary treatment upon a
determination of clear and present danger under section
301(b)(1) (serious bodily harm to others), or section
301(b)(2)(i) (inability to care for himself, creating a
danger of death or serious harm to himself), or
301(b)(2)(ii) (attempted suicide), or 301(b)(2)(iii) (self-
mutilation).
50 P.S. § 7304(a). Section 7301(a) provides: “A person is severely mentally
disabled when, as a result of mental illness, his capacity to exercise self-
control, judgment and discretion in the conduct of his affairs and social
relations or to care for his own personal needs is so lessened that he poses a
clear and present danger of harm to others or to himself.” 50 P.S. §
7301(a).
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2014, following a Section 7304 hearing, the court ordered Appellant to be
committed for a period not to exceed ninety days. Order, 2/24/14.
On May 8, 2014, Meadows Psychiatric Centre filed a petition for an
additional period of court-ordered involuntary treatment pursuant to
Section 7305 of the Mental Health Procedures Act (“MHPA”) for 180 days.5
A hearing was held on May 9, 2014. Muhammad Qamar, M.D., a staff
psychiatrist for The Meadows and treating psychiatrist for Appellant,
testified as an expert in the field of psychiatry. N.T., 5/9/14, at 5-6. Dr.
Qamar opined that Appellant was a danger to himself and others. Id. at 7.
Appellant is loud, angry, and paranoid such that he refuses to speak with
staff members and does not want to take his medication. Id. Appellant
takes Risperdal and Lithium. Id. at 9. Dr. Qamar explained that Appellant
5
Section 7305 provides, in pertinent part:
At the expiration of a period of court-ordered involuntary
treatment under section 304(g) or this section, the court
may order treatment for an additional period upon the
application of the county administrator or the director of
the facility in which the person is receiving treatment.
Such order shall be entered upon hearing on findings as
required by sections 304(a) and (b), and the further
finding of a need for continuing involuntary treatment as
shown by conduct during the person’s most recent period
of court-ordered treatment. The additional period of
involuntary treatment shall not exceed 180 days . . . .
50 P.S. § 7305(a). Section 7304(g) provides, in pertinent part: “(g)
Duration of Court-ordered Involuntary Treatment.─(1) A person may
be made subject to court-ordered involuntary treatment under this section
for a period not to exceed 90 days . . . .” 50 P.S. § 7304(g).
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did not want to take any other medications and controls his treatment
himself. Id. Appellant does not have a place to live. Id. Dr. Qamar opined
Appellant’s “diagnosis is bipolar type 2.” Id. He responded in the
affirmative when asked whether there would be a reasonable probability if
Appellant did not have treatment, “it would lead to death, disability or
serious physical debilitation within 30 days[.]” Id. at 7-8. Appellant was
not cooperating at Meadows and Dr. Qamar opined that the only facility that
could help him was a state hospital and he would be transferred as soon as a
bed became available. Id. at 8. He opined that Appellant was “psychotic,
delusional, paranoid, unable to care for himself and risk (sic) of hurting
himself and others.” Id. at 14.
Appellant testified that he did not want to take any medications other
than Risperdal and Lithium and that he believed he could live independently.
Id. at 17.
On May 14, 2014, following a Section 7305 hearing, the court entered
an order directing that Appellant “be committed to inpatient treatment at
Meadows Psychiatric Center with subsequent transfer to Danville State
Hospital or other facility approved his treatment team and Centre County
MH/ID for a period not to exceed one hundred eighty (180) days.” Order,
5/14/14. On May 16th, Appellant filed a Petition for Review of Certification
to Involuntary Inpatient Mental Health Treatment. The court denied the
petition. Order, 5/16/14. This timely appeal followed. Appellant filed a
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court-ordered Pa.R.A.P. 1925(b) statement of errors complained of on
appeal and the trial court filed a responsive opinion.
Appellant raises the following issue for our review:
1. Whether the trial court lacked clear and convincing
evidence from which it could conclude that Appellant
suffered from a mental illness and presented a danger to
himself or others so as to compel his involuntary treatment
and loss of liberty under the [MHPA]?
Appellant’s Brief at 5.
Appellant contends that the evidence was insufficient to compel him to
undergo involuntary psychiatric treatment because the evidence did not
show that within the past 30 days he was a clear and present danger to
others or to himself, pursuant to Sections 7301(b)(1)6 and (b)(2).7 Id.
6
Section 7301(b)(1) provides, in pertinent part:
Clear and present danger to others shall be shown by
establishing that within the past 30 days the person has
inflicted or attempted to inflict serious bodily harm on
another and that there is a reasonable probability that
such conduct will be repeated. . . . For the purpose of this
section, a clear and present danger of harm to others may
be demonstrated by proof that the person has made
threats of harm and has committed acts in furtherance of
the threat to commit harm.
50 P.S. § 7301(b)(1).
7
Section 7301(b)(2) provides, in pertinent part:
[T]he person has acted in such manner as to evidence that
he would be unable, without care, supervision and the
continued assistance of others, to satisfy his need for
nourishment, personal or medical care, shelter, or self-
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at 13 (emphasis added). Appellant argues there was no clear and
convincing evidence that he was a danger to himself or others. He reasons,
“The doctor’s concerns that he might be homeless, might stop taking even
the Lithium (which is helping him, but also might be causing his hand
tremors)[8] and will not speak with psychiatric staff, does not establish that
he is such a danger to himself . . . .” Id. at 15-16.
In Commonwealth v. Romett, 538 A.2d 1339 (Pa. Super. 1988),
this Court addressed the issue of the sufficiency of the evidence to support a
period of additional involuntary psychiatric commitment pursuant to Section
7305. In Romett, the patient argued the evidence “was insufficient in that
it did not establish that [she] had, within thirty days before the hearing,
inflicted or attempted to inflict serious bodily injury on another” pursuant to
Section 7301(b). Id. at 1341 (emphasis added). This Court found the
patient’s reliance on Section 7301 was “misplaced.” Id.The Romett Court held the evidence was sufficient and opined:
Section 7305 provides that, at the expiration of a period
of court-ordered involuntary treatment, the court may
protection and safety, and that there is a reasonable
probability that death, serious bodily injury or serious
physical debilitation would ensue within 30 days unless
adequate treatment were afforded under this act[.]
50 P.S. § 7301(b)(2).
8
We note that Dr. Qamar testified he wanted to reduce Appellant’s Lithium
dosage because of the tremors, but Appellant did not agree to reduce the
dosage. N.T. at 10.
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order treatment for an additional period. This order must
be entered upon a hearing on the findings required by §
7304(a) and (b) and on the “further finding of a need for
continuing involuntary treatment as shown by conduct
during the person's most recent period of court-ordered
treatment.” [50 P.S. § 7305(a)]. The applicable
paragraph of § 7304(a) referred to in § 7305 provides as
follows:
“(2) Where a petition is filed for a person already
subject to involuntary treatment, it shall be sufficient to
represent, and upon hearing to reestablish, that [(1)]
the conduct originally required by section [7301] in fact
occurred, and that [(2)] his condition continues to
evidence a clear and present danger to himself or
others. In such an event, it shall not be necessary
to show the reoccurrence of dangerous conduct,
either harmful or debilitating, within the past 30
days.”
[50 P.S. § 7304(a)(2)] (emphasis added).
Thus, in order for a person to be recommitted for
an additional period of treatment, it need not be
established that the person has inflicted or
attempted to inflict serious bodily harm upon
another within the past thirty days, as required for the
original commitment. The Act specifically states that on
recommitment it is not necessary to show that the patient
committed an overt act within 30 days of the hearing. It
is necessary however for the court to find that within the
patient’s most recent period of institutionalization, the
patient’s conduct demonstrated the need for continuing
involuntary treatment, Section 7305(a); i.e. his condition
continues to evidence a clear and present danger to
himself or others, Section 7304(a).
Thus, under the Act, in order to assess the patient’s
condition, a patient’s overall conduct, diagnosis and
prognosis may be considered. Recommitment does not
require that the patient do specific acts within 30 days of
the hearing that show he was a danger to himself or to
others. The Act specifically provides, “it shall not be
necessary to show the reoccurrence of dangerous conduct
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...” section 7304(a). The proper question is not whether
appellant’s recent assaults involved an attempt to inflict
serious bodily harm. The proper question which the
trial court did address was whether appellant’s
condition continued to evidence clear and present
danger that such acts could occur.
The Act also requires that upon recommitment it “shall
be sufficient to represent, and upon hearing to reestablish,
that the conduct originally required, under Section [7301-
initial commitment] in fact occurred.” Section 7304(a).
We do not read this provision as requiring that the grounds
for the original commitment must be relitigated at each
recommitment hearing. Such a requirement would be an
enormous waste of resources and would create
redundancy. We find that this provision is satisfied as long
as the patient’s commitment history shows that the
requisite behavior occurred in the past . . . .
Id. at 1341-42 (citations omitted and some emphases added).
Instantly, the trial court opined:
The [c]ourt was required to determine “whether
[A]ppellant’s condition continued to evidence clear
and present danger that such acts could occur.” To
do so, the Court listened to the recording of the May 9,
2014 hearing held at The Meadows in Centre County,
Pennsylvania. The staff psychiatrist of The Meadows
testified credibly that he has been treating Appellant since
February 2014, and that since that time, Appellant has
continued to be a danger to himself and others. Further,
Appellant is paranoid, psychotic, and delusional. He
isolates himself, refuses to speak to others to take his
medication, refuses to cooperate with his treatment, and
cannot provide for his basic care without the help of
others. Appellant requires inpatient treatment as the least
restrictive possible form of treatment in order to prevent
him from harming himself or others.
Trial Ct. Op., 6/24/14, at 2 (citation omitted). We agree.
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Instantly, Appellant, like the appellant in Romett, argued the evidence
for his continued involuntary commitment was insufficient because Sections
7301(b)(1) and (2) were not satisfied. This is not the proper inquiry for
continued commitment under Section 7305. Romett, 538 A.2d at 1341-42.
The trial court addressed the proper inquiry and determined Appellant’s
conduct demonstrated the need for continuing involuntary treatment. See
id. Accordingly, we affirm the order of the trial court.
Order affirmed.
Judgment Entered.
Joseph D. Seletyn, Esq.
Prothonotary
Date: 12/18/2014
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