Opinion
NOT TO BE PUBLISHED
Super. Ct. No. SCR1158546
HULL, J.In 1981, defendant Christopher John Thomas was charged with attempted murder. (Pen. Code, §§ 187, 664; unspecified statutory references that follow are to the Penal Code.) Defendant was found not guilty by reason of insanity because, at the time of the incident, defendant, acting under the delusion that his victim had killed defendant’s sister, struck his victim in the head with a hammer. Defendant was committed to the state hospital and that commitment has been extended on three occasions since his original commitment expired on June 24, 2000. This appeal follows an order entered in 2005 extending defendant’s commitment once again for an additional two years.
Defendant contends in the matter before us that the trial court failed to consider whether he has serious difficulty in controlling his dangerous behavior, a finding required on recommitment. We agree, but, under the circumstances, we find the error harmless beyond a reasonable doubt and affirm the judgment.
Facts and Proceedings
In 1980, defendant struck a co-worker on the head with a hammer because defendant believed the co-worker had killed defendant’s sister. The court found defendant not guilty by reason of insanity and committed him to a state hospital. Over the next 19 years, defendant was placed on community outpatient status three times. Each time, however, his outpatient status was revoked and he was returned to a state hospital (once for a positive drug test and twice for going absent without leave). In 1999, after another revocation, defendant was committed to Patton State Hospital. Since the original commitment’s expiration in 2000, defendant has been recommitted three times.
In 2005, the Placer County District Attorney’s Office filed a petition to extend defendant’s commitment under section 1026.5.
The petition was tried to a judge sitting without a jury in June 2006. Defendant waived his right to be present at the trial and his right to a trial by jury.
The trial court admitted into evidence four Department of Mental Health Evaluation Reports dated October 5, 2004, April 26, 2005, October 18, 2005, and April 24, 2006. Each of the reports notes that defendant’s current Diagnostic and Statistical Manual of Mental Disorders (4th ed. 2000) (DSM-IV) diagnosis is “Schizophrenia, Paranoid Type” (see DSM-IV, category 295.30, Paranoid Type, p. 313) and “Alcohol Dependence in partial remission” (see DSM-IV, category 303.90, Alcohol Dependence, p. 213).
The most recent report, that of April 2006, discusses defendant’s progress in dealing with his mental disease. It states that, during the reporting period, defendant continued to experience symptoms of a severe mental disorder, that he continued to lack insight regarding his mental illness and had not made the connection between, or taken the responsibility for, his mental illness and his crime. According to the report, defendant does not believe he has a mental illness and becomes agitated and evasive when he is confronted with the fact of his mental illness or his crime.
The April 2006 report refers to an “Interdisciplinary Note” dated November 6, 2005, that reflects that defendant said he did not understand why he was being kept in a mental institution, that he stated his belief that his legal records were erroneous, and that he thought the hospital staff was indifferent to his legal status. The report also refers to a Social Work Monthly Report dated April 4, 2006, that says that defendant remains “to some degree” paranoid of staff and peers and will refuse to sign or permit paperwork for Medicare to be copied because he is afraid his signature will be misused. While not a “management problem,” defendant’s interaction with staff and peers is minimal and he is “socially isolative and apprehensive about his engagement with staff.”
The April 2006 report also refers to an interdisciplinary note dated January 15, 2006, stating that defendant had said he had been in the hospital too long and did not know why. It also notes that defendant continued to be “paranoid, isolative and guarded” towards staff, that he had been attending “AA/NA” meetings, and that there had been no symptoms of illicit drug or alcohol use.
According to the April 2006 report, defendant met with the “Interdisciplinary Treatment Team” on April 28, 2006, and was cooperative and polite. He had, at the time, been working on his “Industrial Therapy” assignment for four months and was attending substance abuse meetings, but he continued his “isolative” behavior. The team reiterated that it was important for defendant to increase his involvement in the treatment process and his insight into the connection between his mental illness and his crime. The interdisciplinary treatment team determined that defendant remained mentally ill, that he was a danger to the health and safety of others and would remain so even if he was given supervision and treatment in the community. The team concluded that defendant was “not a candidate for a less restrictive environment” as of April 28, 2006.
Finally, the April 2006 report recommended to the court that defendant “should be considered for an extension of commitment as provided in PC 1026.5(b).” The three earlier reports admitted into evidence were consistent with the report of April 2006.
At trial, the People called Ai-Li Arias, M.D. She had reviewed and agreed with the report dated April 24, 2006, summarized above and she prepared and agreed with the report dated October 18, 2005.
On cross-examination, Dr. Arias testified that defendant had a discharge plan which is a plan that, if met, would help insure that defendant had his mental illness under control with medication and which helps him recognize the “triggers” for his mental illness. If he met the criteria set forth in the plan, he would be considered for release into the community.
According to the discharge plan, defendant needs to understand he has a mental illness and be aware of its symptoms. He needs to know what triggers his mental illness such as not taking his medications and know what his medications are, what they treat, how his mental illness contributed to his crime, and he needs to be able to abide by the rules that would be set for him for his continued treatment in an outpatient setting.
Dr. Arias agrees that the April 2006 report notes that defendant was consistently attending alcoholics anonymous and narcotic addicts anonymous meetings which he began in October 2005, which attendance is a sign of improving mental health. The report also says defendant “indicated” that he had no desire or craving for illicit substances or alcohol and no symptoms of the use of those substances.
Even with the above, Dr. Arias does not think defendant has met his discharge criteria because, although he is taking medications, he consistently had refused to have his blood taken until recently when they found he suffered from hypothyroidism for which he refuses medication. Hypothyroidism can result in psychotic symptoms. Under the circumstances, Dr. Arias does not know whether defendant is psychotic or an addict or medically ill. While she has reduced his prescription for Zyprexa, that does not mean his mental health is improved although he has remained stable.
During the period covered by the April 2006 report, defendant was, for the most part compliant with rules and staff direction, but he is not compliant with his treatment program for his hypothyroidism. This causes Dr. Arias to question whether defendant would be compliant with his treatment plan for his mental health issues if he were released to the community.
Defendant continues to deny he has a mental illness and says he does not know why he is in a mental hospital. He has not been able to admit that his mental disorder along with his alcohol and cocaine intoxication led to the commission of his crime. He does not understand the “precursor[s] to decompensation.”
The fact that defendant has not been aggressive or assaultive suggests improved mental health, although he remains “isolative” which, under the circumstances at the hospital, could be fairly normal behavior. Although defendant had been refusing to meet with the interdisciplinary team, he agreed to meet with the team when Dr. Arias became his treating psychiatrist and, at the time of trial, defendant had attended two such meetings. In addition, at the time of trial, defendant had been working as a janitor in the industrial therapy program for four months and had been doing very well.
Dr. Arias thinks that defendant’s concerns about signing his Medicare benefit forms and thinking that his signature is going to be used for an unintended purpose is “a little outrageous.”
Defendant is improving, but is not ready to be released into the community.
At the conclusion of the trial, the court found the petition’s allegations to be true, concluding that by reason of mental disease, defect or disorder, defendant represented a substantial danger of physical harm to others. As a result, the trial court issued an order extending defendant’s commitment for an additional two years.
Defendant appeals.
Discussion
Defendant contends that the judgment must be reversed because the trial court made no findings on an essential element required for recommitment, namely, that defendant, by reason of his mental deficiency, disorder or abnormality, has serious difficulty in controlling his dangerous behavior. We do not agree that the judgment must be reversed.
Section 1026.5, subdivision (b)(1), provides: “A person may be committed beyond the term prescribed . . . only under the procedure set forth in this subdivision and only if the person has been committed under Section 1026 for a felony and by reason of a mental disease, defect, or disorder represents a substantial danger of physical harm to others.”
In People v. Galindo (2006) 142 Cal.App.4th 531 (Galindo), this court concluded that recommitment also requires proof “that a person under commitment has serious difficulty in controlling [his] dangerous behavior.” (Id. at p. 536.) We held that such a requirement was mandated by In re Howard N. (2005) 35 Cal.4th 117 (Howard N.), which had applied the identical requirement to a juvenile offender under Welfare and Institutions Code section 1800 et seq. (Galindo, supra, at p. 536.)
Here, the trial court ruled that defendant, “by reason of mental disease, defect or disorder . . . represents a substantial danger of physical harm to others.” The record is silent as to whether the trial judge, as the trier of fact, decided there was evidence sufficient to prove that defendant also has serious difficulty in controlling his dangerous behavior, as required under Galindo and Howard N.
We first consider the principle that a trial judge is presumed to know and follow the law. (See People v. Coddington (2000) 23 Cal.4th 529, 588, overruled on other grounds in Price v. Superior Court (2001) 25 Cal.4th 1046, 1069, fn. 13; People v. Martin (2005) 127 Cal.App.4th 970, 977.) We note, however, that Galindo was decided in August 2006 and that the court’s recommitment order in this matter was filed in early July 2006 after an evidentiary hearing in June 2006. Thus, at the time of trial, there was no case specifically holding that proof of serious difficulty in controlling behavior was required in a proceeding brought under section 1026.5. We recognize that Howard N. was decided in February 2005, but that case dealt with the elements of proof on a petition to extend a commitment to the Youth Authority pursuant to section 1800 et seq. Even though an extension of Howard N. to a proceeding on a petition filed pursuant to section 1026.5 might arguably have been predictable, the question had not yet been decided. Under the circumstances, we think that a presumption that the trial court thought such proof was necessary in this proceeding is unwarranted. And we note that no mention was made of such proof in the assessment reports or by the witnesses, the attorneys, or the trial court.
The above notwithstanding, we may affirm the trial court’s order if we decide that, given the evidence presented at trial, any rational trier of fact would have found beyond a reasonable doubt that defendant “harbored” a mental disorder that made it seriously difficult for him to control his impulses. (Howard N., supra, 35 Cal.4th at p. 138; see also Galindo, supra, 142 Cal.App.4th at p. 538.) For the reasons that follow, we find that to be the case here.
Defendant was found not guilty by reason of insanity when he proved at trial that, when he attempted to murder his victim, he was operating under the delusion that the victim had killed his sister. In this context, the Oxford English Dictionary defines “delusion” as “[a]nything that deceives the mind with a false impression; a deception; a fixed false opinion or belief with regard to objective things, esp. as a form of mental derangement.” (Oxford English Dict. (2d ed. 1989) [as of Sept. 17, 2007] “delusion,” No. 3.) It is apparent that behavior driven by delusions, that is, behavior that is undertaken while the mind is deceived, is behavior that is controlled by the delusion and not by the person suffering from it. It is equally apparent that such a person has, at least, serious difficulty controlling his impulses since he acts on the delusion and not in conformance with facts based on reality. That is the very reason why the criminal law excuses his crime; fundamentally, due to his mental disease, defendant could not help committing his crime, that is, it was impossible for him to control the impulses that drove him to commit it.
Of course, the question before us is not the state of defendant’s mental health in 1980, but the state of his mental health in June 2006. Is there evidence that would require a rational fact finder to decide that, due to a mental disorder, defendant continued to have serious difficulty controlling his behavior?
As noted earlier, defendant’s psychiatric diagnosis was, and at least back to October 2004 had been, “Schizophrenia, Paranoid Type,” within the meaning of DSM-IV category 295.30. This evidence was before the trial court.
We take judicial notice of the DSM-IV. (Evid. Code, §§ 452, subd. (h), 454, subd. (a)(1), 459, subd. (a).) The manual explains this diagnosis, in part, as follows: “The essential feature of the Paranoid Type of Schizophrenia is the presence of prominent delusions or auditory hallucinations in the context of a relative preservation of cognitive functioning and affect . . . . Delusions are typically persecutory or grandiose, or both, but delusions with other themes (e.g., jealousy, religiosity, or somatization) may also occur. The delusions may be multiple, but are usually organized around a coherent theme. Hallucinations are also typically related to the content of the delusional theme. Associated features include anxiety, anger, aloofness, and argumentativeness. The individual may have a superior and patronizing manner and either a stilted, formal quality or extreme intensity in interpersonal interactions. The persecutory themes may predispose the individual to suicidal behavior, and the combination of persecutory and grandiose delusions with anger may predispose the individual to violence.” (DSM-IV, category 295.30, Paranoid Type, pp. 313-314.)
While we recognize that the witnesses at trial did not discuss in any detail why they continued this diagnosis of defendant’s mental illness, the point is that his continued diagnosis was one having as its “essential feature” the “presence of prominent delusions or auditory hallucinations.” (DSM-IV, supra, at p. 313.) One can only read the diagnosis as finding that defendant continued to suffer from delusions and that his mental illness caused him to act based on those delusions and not through his own volitional behavior.
There is evidence in the record to support the diagnosis. The report of April 24, 2006, noted that defendant continued to become agitated and evasive when asked to discuss his mental illness, which in any event he denies. He does not know why he is being kept in the hospital and believes that his legal records are erroneous. He remains to some degree paranoid of hospital staff and may refuse to sign or permit Medicare paperwork to be copied because of his fear his signature will be misused. He was found to interact with staff and peers “minimally” and continued to be “paranoid, isolative and guarded toward staff.” Significantly, defendant continued to deny his mental illness and was unable to realize the connection between his mental illness and his crime. The interdisciplinary team concluded that defendant remained mentally ill and was a danger to the health and safety of others.
Dr. Arias’s testimony was consistent with the reports. Even though she found some improvement in defendant’s condition, she remained of the opinion that he should remain institutionalized.
In all, and especially in light of the fact that defendant continued to suffer from a mental illness characterized by delusions and continued to act on at least some of them, we hold that any rational trier of fact would have found that defendant continued to suffer from a mental disorder that made it seriously difficult for him to control his violent impulses. The error at trial in not specifically considering this element of proof necessary to an extended commitment pursuant to section 1026.5 was harmless beyond a reasonable doubt. (Cf. People v. Zapisek (2007) 147 Cal.App.4th 1151; People v. Bowers (2006) 145 Cal.App.4th 870.)
Finally, defendant’s reliance on Galindo and In re Anthony C. (2006) 138 Cal.App.4th 1493 is misplaced. In neither of those cases was the defendant suffering from a mental illness marked by delusions, a fact in the case before us that makes all the difference.
Disposition
The judgment is affirmed.
We concur: DAVIS, Acting P.J. MORRISON , J.