G.H.'s refusal to take his medications or his desire to share his records with only certain people is legally insufficient evidence of an overt act or a continuing pattern of behavior that demonstrates either distress or a deterioration of his ability to function. See id.; see also State ex rel. E.R., 287 S.W.3d 297, 304 (Tex. App.—Texarkana 2009, no pet.) (patient's refusal to communicate with hospital staff is insufficient to support finding required to authorize court-ordered mental health services). G.H.'s previous hospitalizations are likewise insufficient to demonstrate that commitment is justified in the present case.
Unless waived, the evidence must also include a recent overt act or a continuing pattern of behavior that tends to confirm the likelihood of serious harm to self. TEX. HEALTH & SAFETY CODE ANN. § 574.034(d) (1); State ex rel. E.R., 287 S.W.3d 297, 299 (Tex. App.—Texarkana 2009, no pet.); see C.B., 2011 WL 3918686, at *3; E.E., 224 S.W.3d at 794. S.K. called the MHMR hotline to report thoughts of suicide.
The evidence does not support a finding that E.R. has placed her health in jeopardy by failing to eat or to show a risk of harm to E.R. Evidence that the proposed patient might cause serious harm to herself is insufficient to satisfy the statutory requirements. State ex rel. E.R., 287 S.W.3d 297, 304 (Tex. App.-Texarkana 2009, no pet.); see State ex rel. L.C.F., 96 S.W.3d 651, 657 (Tex. App.-El Paso 2003, no pet.). An order to detain E.R. and place her in the Hunt Regional Behavioral Hospital was issued October 27, 2010.
Unless waived, the evidence must also include a recent overt act or a continuing pattern of behavior that tends to confirm the likelihood of serious harm to others. Tex. Health & Safety Code Ann. § 574.034(d)(1) (West 2010); State ex rel. E.R., 287 S.W.3d 297, 299 (Tex.App.-Texarkana 2009, no pet.); E.E., 224 S.W.3d at 794. “A threat of harm ... must be substantial.”
It is true that an expert diagnosis of mental illness, standing alone, is not sufficient to confine a patient for treatment. See State ex rel. E.R., 287 S.W.3d 297, 302 (Tex. App.-Texarkana 2009, no pet.). But C.G. cites no authority, and we find none, for the proposition that a physician's diagnosis of a mental illness is not sufficient to establish that the proposed patient suffers from a mental illness.
Next, while appellant expressed a desire to stop taking medication and while Dr. Shupe expressed concern about what might occur if appellant did so, the possibility that appellant might not take medication does not qualify as a recent overt act or continuing pattern of behavior that shows a deterioration of his current ability to function.See State ex rel. E.R., 287 S.W.3d 297, 306 (Tex. App.—Texarkana 2009, no pet.) ("Evidence of refusal to take medication, alone, is not an overt act or continuing pattern of behavior tending to confirm a proposed patient's distress or a deterioration of the ability to function. We add that evidence that the proposed patient will experience substantial mental or physical deterioration in the future does not establish this element.
Even though B.A. refused to take her medications and refused to allow the facility to conduct routine medical testing, her refusal is legally insufficient evidence of an overt act or a continuing pattern of behavior that demonstrates her distress or a deterioration of her ability to function. See State ex rel. E.R., 287 S.W.3d 297, 306 (Tex. App.—Texarkana 2009, no pet.) ("Evidence of refusal to take medication, alone, is not an overt act or continuing pattern of behavior tending to confirm a proposed patient's distress or a deterioration of the ability to function."). Nor was there any testimony or evidence that B.A. was unable to provide for her basic needs, including food, clothing, health, or safety.
Cf. In re T.N., 180 S.W.3d at 382 (recognizing factfinder's right to draw reasonable inferences from evidence). Citing to State ex rel. E.R., 287 S.W.3d 297, 305 (Tex. App.—Texarkana 2009, no pet.), E.S.R. argues that evidence that he "might" cause harm to others is insufficient. State ex rel. E.R. is factually distinguishable.
Even though G.M.S. initially refused to take his medication, his refusal to take his medication is legally insufficient evidence of an overt act or continuing pattern that demonstrates his distress or a deterioration of his ability to function. See State ex rel. E.R., 287 S.W.3d 297, 306 (Tex. App.—Texarkana 2009, no pet.) ("Evidence of refusal to take medication, alone, is not an overt act or continuing pattern of behavior tending to confirm a proposed patient's distress or a deterioration of the ability to function."). Dr. Isachievici pointed to G.M.S.'s suicidal thoughts, depressed mood, and weight loss as evidence of deterioration of G.M.S.'s ability to function independently and care for himself.
Further, "[e]vidence of refusal to take medication, alone, is not an overt act or continuing pattern of behavior tending to confirm a proposed patient's distress or a deterioration of ability to function." State ex rel. E.R., 287 S.W.3d 297, 306 (Tex. App.—Texarkana 2009, no pet.). We conclude that the State failed to provide evidence to show that R.J.R. was experiencing deterioration of his ability to function independently—the question which was submitted to the jury.