Opinion
No. C1-02-1456.
Filed February 18, 2003.
Appeal from the Rice County District Court, File No. P3-00-1792.
Raymond F. Schmitz, Olmsted County Attorney, Geoffrey A. Hjerleid, (for respondent)
Jeff D. Bagniefski, Bagniefski Murakami, P.A., (for appellant)
Considered and decided by Randall, Presiding Judge, Shumaker, Judge, and Wright, Judge.
This opinion will be unpublished and may not be cited except as provided by Minn. Stat. § 480A.08, subd. 3 (2002).
UNPUBLISHED OPINION
The district court found that appellant was unable to care for himself, that he was chemically dependent and mentally ill, and that he was a danger to himself and ordered him committed to a state hospital. He appeals from that judgment. We affirm.
FACTS
Appellant Mikeal Odell is 34 years old. He was diagnosed with bipolar disorder at age 18. Since his diagnosis, Odell has been hospitalized or sought care for his illness at least five times, but he has never been committed. Odell's work history is sporadic due to his mental illness and chemical dependency. For the past ten years, Odell has received social security disability payments, which his father manages for him. Odell has lived with his sister and with his parents, but his father stated that he recently had to ask his son to leave because of his behavior. His father also stated that Odell's behavior worsened after a head injury Odell suffered while working at a carnival and that Odell was recently seen walking along the highway drawing on himself, talking to himself, and carrying a hubcap.
The record indicates that Odell has a history of consuming alcohol to excess and using marijuana and cocaine. He used these substances both while taking and after he stopped taking medications for the bipolar disorder. His substance abuse contributed to and exacerbated his behavior problems. On one occasion while he was drinking, he tore the faucet out of the sink in his apartment. As a result, he was evicted.
This proceeding began after friends brought Odell to the emergency room at St. Mary's Hospital in Rochester. He had been drinking and was unkempt, agitated, erratic, and threatening. His speech was incoherent. Consequently, the staff at St. Mary's put Odell in four-point restraints. The record indicates that while at St. Mary's, Odell urinated and defecated in the quiet room and was very uncooperative with the psychiatric examiners.
Two court-appointed psychologists examined Odell. At the first evaluation, Odell was apparently upset that the psychologist, Dr. Linda Marshall, was not his dietician and stated, "I'm pleading the 5th, talk to my lawyer." Dr. Marshall based her report on hospital records and family reports gathered for the pre-petition screening. Dr. Marshall diagnosed Odell as having bipolar I disorder, manic episode, with psychotic features and polysubstance dependence.
The second evaluation was similar to the first. Dr. Paul Reitman, the second evaluator, found that Odell manifests gross impairment of thought, is prone to outbursts and agitation, and has no real insight to his mental illness. Both evaluators found that Odell cannot provide food, clothing, or shelter for himself and that he cannot meet his medical needs. Also, both evaluators found that commitment is the least-restrictive alternative for Odell.
At the commitment hearing, Odell denied any erratic behavior, testified that he went to St. Mary's for a blood check, and testified that if he said he had been drinking it was just that he was playing a "little game." At the hearing, Odell rambled, seemed to have disjointed thoughts, and was ultimately removed from the courtroom. The district court found that Odell was mentally ill and chemically dependent and that commitment was the least-restrictive alternative.
DECISION
The district court must find a person mentally ill by clear and convincing evidence. Minn. Stat. § 253B.09, subd. 1(a) (2002). Upon reviewing a commitment order, this court is limited to an examination of whether the trial court complied with the statutory requirements. In re Duvick, 497 N.W.2d 312 (Minn.App. 1993). This court will not set aside the district court's findings unless they are clearly erroneous. Minn.R.Civ.P. 52.01.
I.
Odell first argues that the district court did not establish that he was mentally ill. To civilly commit a person, the district court must find that the person is "mentally ill" under the Minnesota Commitment Act. Minn. Stat. § 253B.02, subd. 13(a) (2002). The district court determines whether a person is mentally ill by applying a two-part test. First, the district court must find that a person has an organic or psychiatric disorder. Id. Second, the district court must find that the person "poses a substantial likelihood of physical harm to self or others." Id. (emphasis added); see also In re Schaefer, 498 N.W.2d 298, 300 (Minn.App. 1993) (holding that the statute only requires that the failure to obtain the necessities demonstrates "a substantial likelihood of physical harm"); In re Burmeister, 391 N.W.2d 89, 91 (Minn.App. 1986) (holding that threat of harm is all that is required).
Odell testified that he was diagnosed with bipolar disorder at age 18, and he concedes that the district court found that he has an organic brain disorder. Odell appeals the district court's finding that he poses a substantial risk of harm to himself.
Under the Minnesota Commitment Act, one of the ways in which a substantial likelihood of harm is demonstrated is "a failure to obtain necessary food, clothing, shelter, or medical care as a result of the impairment." Minn. Stat. § 253B.02, subd. 13(a)(1) (2002); see also In re McGaughey, 536 N.W.2d 621, 624 (Minn. 1995) (finding that there was no evidence that McGaughey was not able to obtain necessities and that he was therefore not "mentally ill" under the statute); In re Perkins, 404 N.W.2d 307, 309 (Minn.App. 1987) (affirming district court's determination that Perkins was "mentally ill" where evidence showed he had no permanent address, no employment, was having difficulty finding food, and was not taking medication).
In McGaughey, none of the witnesses who testified at the commitment hearing indicated that McGaughey was unable to obtain necessary food, clothing, shelter, or medical care. In addition, McGaughey's case manager testified that "she had no reason to believe that McGaughey would refuse to take his medications outside of a hospital environment." Id. The Minnesota Supreme Court reversed the commitment, stating that mere speculation that McGaughey might not be able to care for himself, without a prior history of an inability to do so, was not enough to meet the statutory definition. Id.
We find the instant case distinguishable from McGaughey. Unlike McGaughey, the district court here was not speculating. At the commitment hearing, Dr. Marshall testified that, based on her review of Odell's records and based on an attempted interview with him, Odell meets the statutory criteria for commitment as mentally ill. She further testified that Odell does not attend to his personal hygiene and is homeless. In Dr. Marshall's opinion, Odell would be "at imminent risk of harming himself because of not being able to care for himself." Similarly, the other examiner, Dr. Reitman, testified that Odell cannot provide food, clothing, or shelter for himself and that Odell cannot meet his medical needs.
Odell's inability to care for himself was supported by other evidence. For example, Odell's father stated that two years ago Odell lived successfully on his own for a short period, but he has since started abusing alcohol and has not taken his medication. As a result, Odell is unable to find work or a place to live or stay with family members.
The danger to Odell is that he is unable to care for himself or meet his basic needs. Under the statute, this is sufficient to find that, if not committed, Odell poses a substantial risk of harm to himself. Minn. Stat. § 253B.02, subd. 13(a)(1).
Odell argues that the state bases the commitment solely on Odell's mental illness, thereby eliminating the "separate harm" requirement in the Minnesota statutes. See Minn. Stat. § 253B.02, subd. 13 (2002). Here, the record shows that Odell has a sporadic work history due to medication noncompliance and that he is homeless and chemically dependent. The record, therefore, supports the district court's findings that Odell is unable to care for himself, and the court did not base the harm analysis solely on Odell's mental illness.
Odell also argues that the tone of his voice should not be considered sufficient to show a substantial likelihood of physical harm to himself or others. The record indicates concern that others may perceive Odell's behavior as threatening to them because of his loud voice, pressured speech, and agitation and that as a result people may retaliate against him. However, the district court did not find this factor supported commitment.
II.
Odell argues that there is not clear and convincing evidence that he is chemically dependent. The Minnesota Civil Commitment Act defines chemical dependency in much the same way as it defines mental illness and sets forth a similar two-part test. Minn. Stat. § 253B.02, subd. 2 (2002). To find a person chemically dependent, a district court must first determine that a person is "incapable of self-management or management of personal affairs" because of excessive alcohol or drug use. Id. Next, the court must determine that the person poses a "substantial likelihood of physical harm to self or others." Id. The district court determined, and the record shows, that Odell has a history of alcohol and substance abuse that not only interferes with his taking necessary medication but also interferes with his otherwise handling his personal affairs and providing for his basic needs. We conclude that the district court's finding that Odell is chemically dependent is supported by clear and convincing evidence.
III.
Finally, Odell argues that even if the district court was correct in ordering the commitment, the evidence does not support a finding that commitment to a state hospital is the least-restrictive alternative that can meet Odell's treatment needs. Under Minnesota's Civil Commitment Act, the district court must "commit the patient to the least restrictive treatment program or alternative programs which can meet the patient's treatment needs." Minn. Stat. § 253B.09, subd. 1(a) (2002). In addition, the court must make specific findings as to these less-restrictive alternatives and its reasons for rejecting them. Minn. Stat. § 253B.09, subd. 2 (2002).
Here, the court considered less-restrictive alternatives and stated reasons for rejecting them. The court stated that dismissal was rejected because Odell has a history of chemical dependency and mental illness. Similarly, voluntary outpatient and inpatient care, appointment of a guardian or conservator, and release before commitment were rejected because Odell is not willing to follow recommended care. The record supports these findings. Both court-appointed examiners found that commitment was the least-restrictive alternative due to Odell's lack of insight into his mental condition, his inability to care for himself, his chemical dependency, and his history of medication noncompliance. In addition, the record indicates a long history of mental illness and erratic behavior. We hold that Odell's behavior during these times and his recent behavior is such that the district court did not err in finding that Odell requires a structured setting to address his treatment needs. Therefore, commitment is the least-restrictive alternative that can meet Odell's treatment needs.
The record shows that Odell poses a substantial likelihood of physical harm to himself, that he is chemically dependant, and that commitment is the least-restrictive alternative that can meet Odell's treatment needs. Because the district court based its decision to commit Odell on clear and convincing evidence, we affirm.