Opinion
NOT TO BE PUBLISHED
APPEAL from a judgment of the Superior Court of San Diego County No. MH101136, Gale E. Kaneshiro, Judge.
HUFFMAN, J.
Janet G. (Janet) appeals from a judgment imposing a Lanterman-Petris-Short Act (LPS) conservatorship on her person pursuant to Welfare and Institutions Code section 5350. Janet contends the judgment is not supported by sufficient evidence, and the trial court erred by denying her motion to exclude expert testimony relating to the ultimate issue of grave disability, and relating to her ability to obtain housing. We find no prejudicial evidentiary error, and that the judgment is sufficiently supported by substantial evidence. We affirm.
All further statutory references are to the Welfare and Institutions Code unless otherwise specified.
FACTUAL AND PROCEDURAL HISTORY
On May 10, 2007, the San Diego County Health and Human Services Agency (Public Conservator) petitioned for temporary conservatorship of the person of Janet. At that time, she was 60 years old and had been placed in a residential long term care facility, Monterey Day, after being hospitalized several times about six months previously.
Janet was earlier the subject of permanent conservatorships from 1991 to 1994, and from 2004 to 2006. She has suffered from mental illness from the time she was a teenager and has been hospitalized over 20 times for mental problems in the past. However, upon being placed for treatment this time, she explained that she did not believe she was mentally ill and planned to leave the facility. The temporary conservatorship was granted and Janet demanded a jury trial on this matter.
In preparation for trial, Janet's appointed counsel filed several motions in limine. These sought, among other things, to prevent the Public Conservator's expert witness, Dr. David Naimark, from using the legal conclusion, "gravely disabled," during trial, and to foreclose the expert witness from speculating upon Janet's ability to provide food, shelter, and clothing for herself in the future. (§ 5008, subd. (h)(1)(A).)
A person is gravely disabled when, as a result of a mental disorder, he or she is unable to provide for basic needs of food, clothing or shelter. (§ 5008, subd. (h)(1)(A).)
The Public Conservator, through the County Counsel's office, filed opposition, contending that expert opinion was appropriate on such subjects to assist the jury, because it was beyond common experience for jury members to determine whether Janet met the definition of gravely disabled, based upon her mental illness and symptoms and their effect on her behavior and her ability to provide for her own basic personal needs. The court denied Janet's motions.
During the trial, Janet testified about her understanding of her disability, and stated that she has back problems and is somewhat manic. She stated that she is not mentally ill, but has high energy that tends to make her not sleep a lot. She explained that she was being held against her will and had been poisoned. When asked if she could take care of her own food, clothing, and shelter, she answered that at the present time she could, although a few years ago, she had been found lying by the side of the freeway in the ice plant "because there was no ants that would crawl over me," and at that time she was taken by police and "incarcerated" (hospitalized), for about two and one-half years. After this trial, she intended to obtain housing through the section 8 program, although she did not want to go into details.
Janet testified that she obtains Social Security disability benefits of $800 per month, which were presently being deposited with the Public Conservator's office, and although she did not currently have a bank account, she planned to get one at Bank of America. She thought that she might have an apartment or house waiting. She planned to eat at a religious charity in Oceanside and to buy groceries. She can make her own clothes.
Janet testified that she is divorced and has not seen any family members for at least a year and a half. She believes her 92-year-old father is still alive, although her son had told her caregivers that he was dead. She said that she was taking medicine against her will, including Zyprexa, Abilify and Depakote. If she were released, she would not take them, but would instead take Klonopan for sleep assistance.
Dr. Naimark, who worked with the County forensic medicine department as a psychiatrist, testified that he had reviewed Janet's medical records, including a recent forensic psychiatry clinic report by another psychiatrist on whether she had a grave disability, and he had interviewed her for about 50 minutes. When asked how many evaluations for grave disability that he had done over the course of his career, he answered "hundreds." He stated that in conducting such exams, he did not always conclude that the person he had evaluated in a mental exam was gravely disabled, because often they were not.
Based on his evaluation of Janet and his review of her medical records, Dr. Naimark diagnosed her as having a mental disorder, which her records showed had previously been evaluated three different ways, although he believed the correct diagnosis under the DSM professional manual, schizo-affective disorder, would also be consistent with those. Specifically, she has some features of psychotic illness, which is a disorder of thoughts or thinking, and some features of affective or mood disorders. The symptoms of these disorders that he noticed during their interview were her problems with thinking and her problems with her emotional state. However, Janet does not believe she is mentally ill.
Dr. Naimark explained to the jury that the DSM-IV T-R (diagnostic statistical manual) documents different categories of mental illness and sets forth the signs and symptoms consistent with those mental illnesses. At the trial court's request, he explained to the jury in lay terms the definitions of the diagnostic criteria of psychosis, delusions, hallucinations, and agitation.
Specifically, Janet showed delusional thinking in the following respects: She believed she would be receiving a big inheritance, had a high paying job or two waiting for her in several different places, and was planning to work in the capacity of managing money and trusts for other people. Regarding her emotional state, Dr. Naimark noticed that she was "on edge" and became upset and agitated when he asked her about her housing plans, which he felt was consistent with her history of emotional instability. The information he reviewed in her records supported those diagnoses, i.e., her medical history prepared by the Public Conservator's office, and the month-old forensic evaluation by another psychiatrist. Based on his evaluation, he believed that she would be unable to maintain herself independently in the community at this point, due to her difficulties in remaining compliant with treatment. When she was out of treatment, her records showed that she often began to demonstrate characteristics such as agitation, aggression, psychotic thinking with delusions, or hallucinations, all of which led to placement problems, homelessness, jail stays, or rehospitalization.
Dr. Naimark testified that schizo-affective disorder is not a curable illness. One of the usual symptoms of a severe mental illness is that the person who suffers from it does not understand or appreciate that they do have an illness. Janet experiences some of the symptoms of her illness even when she is properly medicated, and she told him she is not willing to continue on her medication as presently prescribed if left to her own devices. The medicine she was currently taking, Haldol, Zyprexa and Abilify, are treatments for the psychotic part of the illness. For the mood disorder component, she is on a mood stabilizing medication called Depakote. She believes she should be on a different medication, Klonopan.
When asked if Janet's schizo-affective disorder would make it difficult for her to secure housing if she were on her own, Dr. Naimark answered: "Well, it's not specifically that her--that the illness would make it difficult for her to obtain housing. It's the behavior that could be a result or the thinking that could be a result of that illness that could make it difficult for her to obtain housing. [¶] For instance, you know, if she had presented to, let's say, a landlord to negotiate let's say rent for an apartment and was as on edge and easily agitated and argumentative as she was, number one, as is reflected in the records many times and as when I met with her, it would be very unlikely that that would be successful." When he asked her if she could provide her own shelter if released from her facility, she became testy and refused to consider how she would handle it if there were a delay in obtaining section 8 housing. Although he was not sure, he believed that she received disability income, but he did not believe she would be able to put a budget into effect in order to allocate her funds for food or clothing, for example.
Further testimony was provided by the assigned case manager for Janet in her present care facility, Janet Rodriguez (the case manager). She testified that she had met with Janet five times in the last 11 months, and Janet was always well groomed. Janet's behavior characteristics over those visits remained the same, in that she could be very irritable, aggressive, intimidating, and loud, such as when she screamed and cursed to tell other residents to stop talking to themselves. At other times she is isolated and tends to keep to herself. At times, Janet is aggressive toward the case manager or refuses to talk to her, and the nursing staff had to intervene on at least one occasion when they met.
Janet told the case manager during an interview that she had a boyfriend and would be obtaining section 8 housing upon release, but when asked for details such as telephone numbers and documents, Janet was unable to provide them and became confused and agitated. She then told the case manager she was incompetent and she wanted a different case manager. Because of the lack of detail, the case manager was unable to investigate whether Janet had a job waiting for her or section 8 housing or a boyfriend. Section 8 housing is not available to persons who are in a conservatorship. Janet's disability benefits are paid to the County, which then pays for her care.
The case manager testified that Janet does not agree to a certain extent with her diagnosis of mental illness, specifically bipolar or schizophrenic conditions, but she acknowledges that at times she may be manic. Janet agrees to take some of her medications, but others have to be administered to her in another form, such as a shot. On the whole, she is able to function at the current placement because there is a lot of structure and experienced nursing staff there. At some times when she was not on a conservatorship, her chart showed that she had continued to take her medication.
At the close of the evidence, the jury was instructed with standard form instructions, including CACI No. 4002, providing in part: "The term 'gravely disabled' means that a person is presently unable to provide for her basic needs for food, clothing, or shelter because of a mental disorder." A standard verdict form in the language proposed by CACI was prepared. The jury returned a unanimous verdict that Janet is gravely disabled. Judgment was entered granting the petition to establish the conservatorship for one year from the judgment date, July 30, 2007, and standard terms and conditions regarding treatment and placement in a locked facility were imposed. Janet appealed, and we expedited the matter.
DISCUSSION
Before we can address Janet's argument that insufficient evidence supports the jury's verdict that she is gravely disabled, we must discuss her claims of evidentiary error, to determine the extent of the evidence properly provided on the ultimate issue of grave disability. Under the LPS Act, the courts are obligated to seek an optimal balance between the legitimate medical objectives of treating sick people without legal delays, and " ' "the equally valid legal aim of insuring that persons are not deprived of their liberties without due process of law." [Citation.]' [Citations.]" (Conservatorship of Kevin M. (1996) 49 Cal.App.4th 79, 89.)
I
EXPERT OPINION TESTIMONY IN LPS PROCEEDINGS
A. Introduction
In general, we review the rulings by the trial court on admissibility of evidence under an abuse of discretion standard, to determine if prejudicial error occurred. (City of Ripon v. Sweetin (2002) 100 Cal.App.4th 887, 900; Osborn v. Mission Ready Mix (1990) 224 Cal.App.3d 104, 112.) Expert opinion testimony "that is otherwise admissible is not objectionable because it embraces the ultimate issue to be decided by the trier of fact." (Evid. Code, § 805.) Under Evidence Code section 870, subdivision (c), an otherwise qualified expert witness, under Evidence Code sections 800 or 801, may state an opinion as to the sanity of a person.
This appeal challenges the court's rulings allowing Dr. Naimark, as Janet's evaluating doctor, to testify about his diagnosis and opinions as related to the subject of grave disability, including a reference to the number of other evaluations he had performed on that subject, and also allowing him to give opinions on her ability to maintain herself independently and to obtain housing. Dr. Naimark was qualified as an expert and was therefore authorized to offer opinions on subjects that are "sufficiently beyond common experience" in order to "assist the trier of fact." (People v. Cole (1956) 47 Cal.2d 99, 103.) Specifically, expert opinion is properly allowed on a proposed conservatee's inability to take care of his or her basic needs as affected by an illness, because a juror cannot determine from common experience whether the conservatee's inability to take care of the basic needs for food, clothing or shelter results from a mental disorder or from some other reason. (Conservatorship of Torres (1986) 180 Cal.App.3d 1159, 1163.) In Conservatorship of Scharles (1990) 220 Cal.App.3d 247, 255, this court relied on Torres for the proposition that expert psychiatric witnesses may base their opinions as to the proposed conservatee's mental capacity on statements made either by that person or third parties, including hearsay.
The jury was instructed in the language of CACI No. 219, about the usual standards for evaluating expert witness opinion: "The law allows an expert to state opinions about matters in his or her field of expertise even if he or she has not witnessed any of the events involved in the trial. [¶] You do not have to accept an expert's opinion. As with any other witness, it is up to you to decide whether you believe the expert's testimony and choose to use it as a basis for your decision. You may believe all, part, or none of an expert's testimony. In deciding whether to believe an expert's testimony, you should consider: [¶] 1. The expert's training and experience; [¶] 2. The facts the expert relied on; and [¶] 3. The reasons for the expert's opinion."
In Kotla v. Regents of University of California (2004) 115 Cal.App.4th 283, 293-294 (Kotla), the court applied the general rules restricting the proper subjects of expert opinion. With respect to an issue of common knowledge (in that case, a motive by a supervisor or employer to retaliate against an employee), the court held that expert testimony and opinions about the significance of such evidence "did not assist the jury in its factfinding process. Instead, that testimony created an unacceptable risk that the jury paid unwarranted deference to [the] purported expertise when in reality [the expert] was in no better position than they were to evaluate the evidence concerning retaliation." (Id. at p. 293.) Janet relies on this authority as mandating that jurors should be allowed to decide issues of common knowledge for themselves, without being told by an expert what finding on such issues are justified by the evidence. (Ibid.)
Janet therefore contends that as laypersons, the jury had enough information to evaluate all the evidence in light of what is ordinarily necessary to obtain one's own food, clothing, and shelter, and the expert went too far in giving an opinion about whether she would be able to sustain herself independently. She relies on cases such as Summers v. A.L. Gilbert Company (1999) 69 Cal.App.4th 1155, 1168 (Summers), to argue that Dr. Naimark's testimony addressing the legal terminology of grave disability served to usurp the function of the jury. In Summers, the court said: "Notwithstanding Evidence Code section 805, an 'expert must not usurp the function of the jury . . . .' [Citation.] [¶] . . . [W]hen an expert's opinion amounts to nothing more than an expression of his or her belief on how a case should be decided, it does not aid the juror, it supplants them." (Summers, supra, 69 Cal.App.4th at p. 1183.)
In Summers, supra, 69 Cal.App.4th 1155, the court found no basis for a lawyer, who was an expert in the field of transportation, to testify the defendant was liable for wrongful death under the doctrines of nondelegable duty, respondeat superior, or negligent hiring of an incompetent contractor. (Id. at p. 1185.) The court reasoned: " '[T]he calling of lawyers as "expert witnesses" to give opinions as to the application of the law to particular facts usurps the duty of the trial court to instruct the jury on the law as applicable to the facts . . . .' " (Id. at p. 1179.) The court also held the expert opinion usurped the jury's role in weighing the evidence and drawing the proper conclusions. (Id. at p. 1185.)
With this background, we address Janet's specific arguments that the expert testimony allowed here went beyond permissible standards for assisting the jury, in several respects.
B. Ultimate Issue of Grave Disability
The issues here center around the adequacy of the showing that Janet was presently gravely disabled, as opposed to only probably or likely to become so in the future, due in large part to her expressed unwillingness to continue prescribed medication. She contends she was prejudiced by Dr. Naimark's statement that he had conducted hundreds of evaluations of persons to determine if they had a grave disability. She also contends he did not present enough evidence about her diagnosis and symptoms in order to enable the jury to make a decision about the causal connection between her illness and any inability she had shown to provide for her own necessities of life, such that the jury's function was interfered with by this expert opinion.
Janet relies on cases in which appellate courts have found that no adequate basis to establish or continue a conservatorship was established, because in those cases, only a possibility or likelihood had been shown that grave disability would result in the future for those individuals. (E.g., Conservatorship of Benvenuto (1986) 180 Cal.App.3d 1030, and Conservatorship of Murphy (1982) 134 Cal.App.3d 15.) In those cases, the proposed conservatees were not found to be "gravely disabled" as of the time of trial, even though there was a known risk that they would later become so, due to various disabilities. However, no judgment imposing conservatorships could be upheld on that type of showing, which lacked any "present disability" evidence.
In Conservatorship of Walker (1989) 206 Cal.App.3d 1572, 1576-1577, the court analyzed similar arguments that the proposed conservatee before it had shown he was likewise not "presently" gravely disabled, even though there was some possibility or "likelihood" that he would refuse to take prescribed medication if released. The court explained that sufficient evidence in the record supported the judgment establishing his conservatorship, since properly admitted expert testimony had showed that the proposed conservatee "remained gravely disabled because he had no insight into his mental illness. He did not believe he was ill, nor did he believe he needed medication. The evidence was undisputed that without the medication, appellant could not provide for himself." (Id. at p. 1577.) In its analysis, the court found that the proposed conservatee had not, through his own testimony that he had sometimes taken his medicine before, adequately controverted the expert doctor's opinion that this person needed 24-hour supervision, in part because he would not take medication on a voluntary basis. The court accordingly found that substantial evidence of his present disability, including circumstantial evidence, had been presented. (Ibid.)
Also as explained in Conservatorship of Guerrero (1999) 69 Cal.App.4th 442, 446-447, where it can be established with psychiatric testimony that a conservatee lacks insight into his or her own mental illness, and does not believe in the need for medication to address the mental illness, this can support a substantial evidence showing that the conservatee cannot provide his or her own basic necessities without such medication. Further, if the person will not take such prescribed medication without supervision, this in turn supports a finding of present grave disability. (Ibid., citing Conservatorship of Walker, supra, 206 Cal.App.3d at p. 1577.) "In other words, but for the medication, which [the conservatee] would not take without supervision, [the conservatee] was presently gravely disabled." (Guerrero, supra, at p. 447.)
In Janet's case, Dr. Naimark originally testified, in response to questions about his decade of professional experience, that he had conducted several hundred examinations for grave disability. Janet argues that in giving this testimony, he impliedly adopted the term of grave disability and labeled Janet with it, thereby misleading the jury, and the Public Conservator's attorney did likewise in closing argument. However, those portions of the record must be read in light of the remainder of his testimony, in which he explained that he did not find every person he examined in that respect to be gravely disabled, because often they were not. Rather than labeling her without explanation, Dr. Naimark's testimony took care to address Janet's personal circumstances, and to give meaning to the definitions used in his diagnosis, schizo-affective disorder, and the symptoms of it, such as delusions and emotional instability, and how her behavior manifested them.
For example, the doctor explained that mentally ill people often do not believe that they are ill, and Janet's record shows that since she does not think she suffers from a mental health problem, she has often become noncompliant with treatment. This in turn has led her to develop psychoses with delusions, hallucinations, agitation, and aggression. When she develops these symptoms, the result historically has been that she was unable to maintain herself independently in the community at that point.
With respect to her unwillingness to take her medication, Dr. Naimark said that it would, in his medical opinion, lead to decreased control of her signs and symptoms. For example, her medication was intended to reduce delusions, to decrease agitation, and to allow her to develop insight into the fact of her mental illness. However, even when she was properly medicated, she still could experience some of the symptoms of her illness. Such a showing of ongoing mental illness despite appropriate medication can properly support a finding of grave disability, where it interferes with the ability to provide for basic necessities. (Conservatorship of Guerrero, supra, 69 Cal.App.4th at pp. 446-447.)
In testifying about Janet's illness, Dr. Naimark illustrated her symptoms with historical events disclosed in her case file, related them to her current mental status, and then concluded with his opinion that as a result of her emotional instability and her delusions, Janet was currently unable to maintain herself in the community without assistance. Such testimony bears upon the ultimate issue of grave disability, but in a permissible way that explains psychiatric subjects that are beyond common experience. (See, Kotla, supra, 115 Cal.App.4th at pp. 293-294.) Moreover, a proposed conservatee may seek to controvert such a showing with one's own expert or other evidence. (Conservatorship of Scharles, supra, 220 Cal.App.3d 247, 255.) This was not done here in terms of expert testimony, although funds were authorized for that purpose. In Janet's case manager's testimony, other evidence of her apparently ongoing mental illness, despite medical care, was presented.
The expert opinion given in this case about the signs and symptoms of Janet's illness, and its effect upon her behavior, as shown by her history, did not amount to an attempt to impermissibly direct the jury to reach the ultimate legal conclusion that Janet was gravely disabled. For these reasons, the trial court did not err or abuse its discretion in admitting this testimony.
C. Housing Opinion
Janet objects that Dr. Naimark testified outside the scope of his expertise, with respect to housing opportunities, such that his opinion on the difficulties she could face was not sufficiently based on matters upon which he could reasonably rely. (Evid. Code, § 801.) "Conjecture and speculation provide no proper basis for an expert's opinion." (Smith v. ACandS, Inc. (1994) 31 Cal.App.4th 77, 93, disapproved on other grounds in Camargo v. Tjaarda Dairy (2001) 25 Cal.4th 1235, 1242.) If an expert's opinion " 'is not based upon facts otherwise proved, or assumes facts contrary to the only proof, it cannot rise to the dignity of substantial evidence.' " (Hyatt v. Sierra Boat Co. (1978) 79 Cal.App.3d 325, 338-339.) "The qualification of expert witnesses, including foundational requirements, rests in the sound discretion of the trial court." (People v. Ramos (1997) 15 Cal.4th 1133, 1175; Korsak v. Atlas Hotels, Inc. (1992) 2 Cal.App.4th 1516, 1523.) Absent a manifest abuse, the court's determination will not be disturbed on appeal. (Ramos, supra, at p. 1175.)
Janet has several objections to the court's ruling in this respect. First, she argues Dr. Naimark was not qualified as an expert in housing possibilities for persons in her position. Next, since he was allowed to give an opinion on her ability to seek and obtain housing, the jury might have incorrectly relied too heavily upon housing as a factor in determining whether she was gravely disabled, when it reached a general verdict that she was.
With respect to the first argument, the circumstances were that Janet testified to her belief she would be able to obtain section 8 housing immediately upon her release, or that she may have had an apartment or house waiting for her. Dr. Naimark testified about his efforts to discuss the issue of housing with her, and how they were unsuccessful because she became agitated and was unable to set forth her thoughts or a plan. Specifically, the doctor stated that based upon his experience with her behavior, both personally and as shown in her medical records, she could likely be unable to deal successfully with a landlord, such as negotiating rent. Janet objects that the concept of housing was too narrowly expressed by the doctor, regarding negotiation.
The problem with this argument is that the issue being addressed by the expert was not housing opportunity per se, but how the signs and symptoms of Janet's mental illness might affect her ability to provide for her own necessities. The process of obtaining housing involves a number of interpersonal skills that go beyond the actual rent negotiation process, and the doctor made it clear that his opinion on this topic was limited to his understanding of her behavior as affected by her illness. This understanding was based on his review of her medical records, and his examination of her, and it did not need to depend upon an academic study of housing issues. He also explained that she continues to suffer from emotional instability and delusions, even when medicated, and that could adversely affect her ability to provide for herself in this respect, among others.
The doctor's opinions on her prospects for obtaining housing were supported by other evidence in the record. For example, when Janet's caseworker sought to discuss housing plans with her, Janet became upset and refused to go into detail. The caseworker tried to investigate section 8 housing but did not obtain enough information from Janet, and the caseworker knew that section 8 housing was not available for persons under conservatorships and often took some time to obtain, such that other housing would be necessary, at least in the interim. In her testimony at trial, Janet did not want to go into detail about housing.
To the extent that Janet appears to object to the CACI verdict form, her arguments are without merit. The trial court did not abuse its discretion by utilizing this form, which inquires whether the proposed conservatee has the ability to provide for his or her own basic necessities of life, which are referred to in the disjunctive, i.e., whether, as a result of a mental disorder, she is unable to provide for the "basic personal needs for food, clothing, or shelter." (§ 5008, subd. (h)(1)(A).) Testimony from Janet was presented on all three topics, and on the entire record, the expert testimony on this subject did not unduly overemphasize housing. All the evidence was submitted for the jury's evaluation, under proper instructions. There was no evidentiary error in this respect.
II
SUFFICIENCY OF THE EVIDENCE
In Conservatorship of Walker, supra, 206 Cal.App.3d 1572, 1577, the applicable standards were adapted from criminal matters: "On appeal 'the court must review the whole record in the light most favorable to the judgment below to determine whether it discloses substantial evidence - that is, evidence which is reasonable, credible, and of solid value - such that a reasonable trier of fact could find the defendant guilty beyond a reasonable doubt.' [Citation.] Substantial evidence includes circumstantial evidence and the reasonable inferences flowing therefrom. [Citation.]"
In light of the conclusions reached above, about the admissibility of Dr. Naimark's expert testimony, this record properly includes his opinions that Janet lacks insight into her own mental illness, and continues to suffer from its symptoms even when she complies with prescribed treatment to address those symptoms. Although she believes that she will be able to provide for her own basic necessities without supervision or medication, the natures of her illness and symptoms were professionally evaluated as significantly interfering with any such ability, and the jury could consider this opinion. "In other words, but for the medication, which [the conservatee] would not take without supervision, [the conservatee] was presently gravely disabled." (Conservatorship of Guerrero, supra, 69 Cal.App.4th 442, 446-447.)
The jury received instructions correctly requiring it to evaluate not only the expert opinion, but also the basis and facts supporting it. (CACI No. 219.) Likewise, the jury received CACI No. 4002, to explain the meaning of the term "gravely disabled," as "presently unable to provide for her basic needs for food, clothing, or shelter because of a mental disorder." This instruction further told the jury that any showings that she suffered from psychosis, delusions or hallucinations were not enough, by themselves, to support a disability finding, and it was necessary to show further that she was unable to provide for her basic needs because of the mental disorder. With respect to the effect of her medication usage, the instruction provided that a finding of present grave disability would only be appropriate: "If you find [Janet] will not take her prescribed medication without supervision and that a mental disorder makes her unable to provide for her basic needs for food, clothing, or shelter without such medication, then you may conclude [Janet] is presently gravely disabled. [¶] In determining whether [Janet] is presently gravely disabled, you may consider evidence that she did not take prescribed medication in the past. You may also consider evidence of her lack of insight into her mental condition. [¶] In considering whether [Janet] is presently gravely disabled, you may not consider the likelihood of future deterioration or relapse of a condition."
In light of these instructions, the jury had the tools to evaluate this expert testimony, which provided more than legal conclusions, in the form of analysis of her various symptoms as demonstrated to him. The testimony also included more than mere speculation with respect to housing issues, because it was based upon his observations of her ability to interact with other people as shown to him personally and to others, as documented in her medical records, which were properly considered. (Conservatorship of Scharles, supra, 220 Cal.App.3d 247, 255.) Together with the testimony of the case manager and Janet herself, this evidence constitutes substantial evidence to support the jury's verdict.
Specifically, the Public Conservator provided admissible evidence that Janet's on-going schizo-affective disorder causes her to have problems with her thoughts and with her emotions, and that the disorder is unlikely to be cured in the near future. Although she is currently taking prescribed medicine, she does not want to continue to do so; even while in compliance with her treatment, she continues to have problems with emotional instability and delusions, and would in medical certainty be likely to continue to have these without her medicine. Such emotional instability and delusions currently prevent her from providing for her own basic needs. Moreover, there is no reasonable probability the jury would have reached a decision more favorable to Janet in the absence of Dr. Naimark's testimony (1) that he had performed many such examinations, with differing outcomes, (2) that she would have difficulty sustaining herself independently due to the behaviors caused by her disorder or (3) his opinion that, because of her characteristic behaviors, she could likely have difficulty in obtaining her own housing. (See Kotla, supra, 115 Cal.App.4th at p. 294.)
DISPOSITION
The judgment is affirmed.
WE CONCUR: BENKE, Acting P. J., O'ROURKE, J.