Opinion
NOT TO BE PUBLISHED
APPEAL from a judgment of the Superior Court of San Diego County No. MH102-314, Jeffrey B. Barton, Judge.
McConnell, P. J.
T.H. appeals a judgment establishing a conservatorship of the person for her under the Lanterman-Petris-Short Act (LPS Act). (Welf. & Inst. Code, § 5000 et seq.) T.H. challenges the court's admittance of certain evidence, and the sufficiency of the evidence to support the jury's finding she was gravely disabled within the meaning of the LPS Act. We affirm the judgment.
Further statutory references are to the Welfare and Institutions Code.
FACTUAL AND PROCEDURAL BACKGROUND
In March 2008 the public conservator of the County of San Diego filed a petition for the appointment of a conservator of the person of T.H. under the LPS Act on the ground she is gravely disabled. The petition also sought the appointment of a temporary conservator pending the outcome of the conservatorship proceeding, on the ground T.H. is "paranoid, grandiose and insightless," she is "in need of acute hospital care," and she is "incapable of accepting treatment voluntarily." The court appointed a temporary conservator.
In April 2008 the court appointed a cousin of T.H. to be a conservator over her person. T.H. demanded a jury trial on the issue of whether she is gravely disabled, and it was held between June 4 and 6.
T.H. is in her early 50s. The evidence pertaining to her background shows she has suffered from mental illness for about 30 years. She lived in Hawaii for many years before moving back to California in 2000 or 2001 to care for her mother, who had suffered a stroke. Her mother had a home on several acres of property in Crest. She died in 2002, and T.H. remained in her home. In 2003, however, the home burned down in the Cedar Fire. After the mother's death, T.H. had let the insurance on the home lapse, and it was not rebuilt. A couple took T.H. in, but she was abusive and the arrangement was short lived. T.H. then lived on the property in various structures, including a tent, a VW bus and a camper, none of which had a toilet, electricity, running water, heat or refrigeration. Several people in the Crest area tried to help her obtain mental health care, but she was uncooperative. In 2006 she spent two weeks in the psychiatric unit of Las Colinas jail after an altercation on the Crest property.
Dan Funkenstein, a psychiatrist, had been treating T.H. for about three months, since the sheriff's department brought her to the county's psychiatric hospital on a 72-hour involuntary commitment. For the first month of T.H.'s hospitalization, staff feared her and felt she was both an assault and an elopement risk. Dr. Funkenstein diagnosed T.H.'s condition as "chronic paranoid schizophrenia," which "tends to be a life-long disorder that rarely simply disappears" but "can be managed quite well with medication." T.H. refused to take her prescribed medication, however, and the hospital obtained a court order allowing it to administer medication by injection. After she received a few injections she began voluntarily taking medication orally, and her behavior had improved.
Dr. Funkenstein believed T.H. had never previously taken medication for her mental illness, and he was "quite sure" she would not take medication if she were on her own, because she believes "all medicine is poison and dangerous to her body" and "every day she... asks me about discontinuing her medication in the hospital." He also believed she would not voluntarily accept treatment, noting she had recently "provided me with a written letter that basically stated: I have no mental condition; I do not have psychiatric problems." Rather, she "still believes she doesn't have any mental illness, that all of her psychiatric problems or all of her current environmental and social problems are simply the result of a strained neck that she has." He explained it is important for a person with a mental illness to understand his or her condition, because otherwise "it's very unlikely we're going to be able to go forward."
Additionally, Dr. Funkenstein testified T.H. cannot satisfy her basic needs for food, shelter and clothing. He elaborated as follows: "She has told me repeatedly that she was living [on the Crest property] after the fire, and there was no longer a home on that property. She then began living in a trailer which she brought onto the property. The trailer, at the time of her admission to the hospital, had a leak in the roof. The bedding was wet and moldy. She was wet and moldy.... [T]here was no hot water. There was no electricity. I understand since her coming to the hospital the trailer has been additionally vandalized and [is] less suitable for habitation." T.H. had told Dr. Funkenstein the morning of his testimony that she "wants to go to a shelter downtown and then..., each day, take a taxi cab from the shelter downtown, out to Crest to live on the property and take care of it." Dr. Funkenstein explained that T.H. "has told me that she has the belief that her mother will be coming back to life and that part of her need to maintain this property in Crest and to maintain her mother, who is buried in a crypt above ground, is so that everyone will be prepared for her mother's return. I don't mean that in a religious sense that there will be some kind of second coming and the dead will be raised, I mean that in a literal, concrete sense, that at some point the crypt will open and mother will be returned to her."
As for the provision of food, Dr. Funkenstein testified that T.H. told him the proper treatment for her condition "is a diet primarily consisting of citrus juices, and naturally occurring fruits and vegetables." He said he understood she "was taking taxi cabs from Crest to Pacific Beach in order to shop for pure natural vegetables. And this was an economic issue that came out in the discussions about how she was going to provide for her food in the future, because of the cost and efficiency of doing it that way." T.H. had given Dr. Funkenstein a budget that claimed she had $500 per month in income, and "$1,500 a month in savings," and "with that she would be able to live in a shelter downtown and take taxi cabs daily to Crest." He explained the budget "just doesn't add up as a logical way in order to be able to subsist," and "I also doubt those are correct numbers, because it sort of disregards any debts she may have."
Kandhy Franklin-Collins was a neighbor of T.H.'s mother, and she had known T.H. since she moved back to Crest. Franklin-Collins testified that T.H. revealed that while she was in Hawaii she lived in caves and "on farm areas." When T.H. began caring for her mother, she put her mother on a vegan diet consisting primarily of oranges and avocadoes, and she "removed a lot of medication that her mom was given after she had come home from the hospital, after the stroke." When T.H.'s mother died, she told Franklin-Collins she "felt that she was in a coma and that... she would be able to revive her." T.H. said she did not honor her mother's wish to be cremated because T.H. "felt that she still would have the opportunity to revive her, even weeks after the passing of her mother." T.H. did not allow her mother to be entombed for approximately 70 days.
Further, Franklin-Collins testified that T.H. received approximately $26,400 from the Federal Emergency Management Association (FEMA) after the fire, and she "used it very unwisely and did not make good decisions or make a prioritized list of some things that she really needed to do for herself to sustain herself." For instance, T.H. refused FEMA's offer of the use of various trailers because she believed they had odors or contained harmful chemicals, and instead purchased a 1960s VW van. Further, T.H. "frivolously" spent money on taxi rides. She "had designated markets... that she wanted to shop at and she did not want to take the public transportation or the trolley, the bus system, so she felt that she had more freedom with the taxi to take it wherever she wanted to go, including to a store to buy a $7 watermelon."
Further, Franklin-Collins testified that T.H. left the Crest property often, and when she got her check at the beginning of the month she would get a hotel room so she could have a shower. If "transportation did not work out, then she would sleep wherever before she could get herself back home." T.H. once got a ticket for sleeping on the beach. T.H. would call Franklin-Collins for a ride home, but when she appeared T.H. would sometimes refuse to get in the car. Toward the end of the month, when T.H.'s money was gone, Crest "residents saw [her] more often asking for us to take her places or to give her money to get food." If T.H. had insufficient funds, she would not eat for two or three days, and she told Franklin-Collins "she's [T.H.] capable of doing that." Franklin-Collins testified she had personally paid T.H.'s bills "for quite awhile," for such things as trash collection, food and clothing.
Ann H., T.H.'s sister, lives in northern California. She testified that when T.H. was in Hawaii she lived in caves and on beaches. When Ann visited her mother after the stroke, she saw T.H. feeding the mother primarily oranges and avocadoes, when the mother's diet previously included a lot of meat and fat. Each time Ann visited, her mother "appeared to be getting thinner and thinner." In her will, the mother requested cremation, but T.H. had her power of attorney and after she died T.H. did not believe she was actually dead. T.H. believed "we could just bring our mother back to the ranch and set her up under a tree in a chair, and if she could just smell some of the fresh air, that she would perhaps revive." After about six weeks, the mortuary filed a lawsuit and obtained an order for the placement of the body in a crypt. The judge refused T.H.'s request to have the hearse "swing by" the Crest property to allow the mother's body "to be set up... under an oak tree."
Ann testified she was aware that T.H. did not want to take any medication for her mental condition. Ann recommended that T.H. obtain mental health care, but she denied having any problem and attributed her problems to others. According to Ann, T.H. receives approximately $600 per month from her mother's annuity, but T.H. is not good at budgeting her money, and she "will spend $250 on a shopping trip in an organic food store," and $40 to $60 on a taxi ride. Ann believes T.H. should be under a conservatorship.
Ian Hudson works in the county's parks and recreation department. He testified he first met T.H. about a year earlier in a park in Crest where he was working. She told him he was breaking the law by trimming trees and mowing the grass, and she was going to put him under citizen's arrest. Hudson described T.H. as dirty and "very skinny looking, unhealthy looking." Two or three months later Hudson had another interaction with T.H. at a park near the Crest property where he was using a chainsaw to remove eucalyptus tree "suckers," which grow from the base of the trunk. T.H. told him that "when we start the chainsaws we're releasing demons from the gates of hell," and "every time we fire up any kind of gas powered equipment in this part there's some kind of portal there that the noise and everything God can't hold the gate and it gets opened and somehow demons get released from there." T.H. appeared "very scared and unable to control herself," and she again was dirty and looked "very skinny and unhealthy." After this incident, Hudson learned the county had a restraining order against T.H. She yelled at him again in January or February 2008, and he threatened to call the police because of the restraining order. She still looked "very skinny, unhealthy."
T.H. testified in a rambling, largely incoherent manner. She believed she was in court because people wanted her ranch for nothing and there had been a "wrongful death." She disagreed with Dr. Funkenstein's diagnosis of chronic paranoid schizophrenia, and she did not believe she had any mental illness. She said "it's basically a fraud." She testified she was "very unhappy" about being on medication, because it had side effects and was not giving her any benefit, and she was "furious" over being locked up. She said "they need to release me immediately and give some kind of public apology for what they're doing because they're in serious criminal trouble for doing something like this to me." She denied telling Dr. Funkenstein or anyone else that she believed her dead mother would return. She also denied having told people that while in Hawaii she lived in caves and on beaches.
T.H. admitted that after the fire she "was desperate and I've never been that desperate in my life," and toward the end of the month she would ask neighbors for food. She also admitted she got a ticket for sleeping on the beach, and she did not feel safe sleeping there. She also said she had gained about 20 pounds since entering the hospital three months earlier.
Finally, William Coburn, a friend of T.H.'s, testified that she seemed happy, nourished and healthy living on her own.
After deliberating, the jurors unanimously found T.H. is presently gravely disabled because of a mental disorder. The court entered a judgment that establishes a conservatorship over T.H.'s person for one year, and found the least restrictive level of placement "necessary to achieve the purpose of treatment" for her was a closed, locked facility.
DISCUSSION
I
Overview of LPS Act
The LPS Act "governs the involuntary treatment of the mentally ill in California. Enacted by the Legislature in 1967, the act includes among its goals ending the inappropriate and indefinite commitment of the mentally ill, providing prompt evaluation and treatment of persons with serious mental disorders, guaranteeing and protecting public safety, safeguarding the rights of the involuntarily committed through judicial review, and providing individualized treatment, supervision, and placement services for the gravely disabled by means of a conservatorship program." (Conservatorship of Susan T. (1994) 8 Cal.4th 1005, 1008-1009.)
The LPS Act "authorizes the appointment of a conservator for up to one year for a person determined to be gravely disabled as a result of a mental disorder and unable or unwilling to accept voluntary treatment." (Conservatorship of Susan T., supra, 8 Cal.4th at p. 1009.) "To extend the commitment beyond one year, the petitioning party must again prove beyond a reasonable doubt the conservatee is, at the time, gravely disabled." (§ 5365.) The LPS Act defines the term "gravely disabled" as "unable to provide for... basic personal needs for food, clothing, or shelter." (§ 5008, subd. (h)(1)(A).) A person must be " 'presently' gravely disabled" for the imposition of a conservatorship of the person. (See Conservatorship of Murphy (1982) 134 Cal.App.3d 15, 19, italics added.)
"The proposed conservatee is entitled to demand a jury trial on the issue of his or her grave disability, and has a right to counsel at trial, appointed if necessary. [Citations.] The party seeking imposition of the conservatorship must prove the proposed conservatee's grave disability beyond a reasonable doubt and the verdict must be issued by a unanimous jury." (Conservatorship of Susan T., supra, 8 Cal.4th at p. 1009.) In considering whether a person is presently gravely disabled, the jury may consider evidence of the person's past failure to take mental health medication when prescribed, and of the person's lack of insight into his or her mental condition. If the jury finds the person "will not take his [or her] medication unless required to do so and that a mental disorder makes him [or her] unable to provide for his [or her] basic personal needs for food, clothing or shelter without such medication," the jury may find the person is gravely disabled. (In re Guerrero (1999) 69 Cal.App.4th 442, 445; see also Conservatorship of Walker (1989) 206 Cal.App.3d 1572, 1577.)
Here, the court instructed the jury with the following modified version of CACI No. 4002: "The term 'gravely disabled' means that a person is presently unable to provide for his or her basic needs for food, clothing, or shelter because of a mental disorder. [¶] Psychosis/bizarre or eccentric behavior/delusions/hallucinations are not enough, by themselves, to find that [T.H.] is gravely disabled. She must be unable to provide for the basic needs of food, clothing, or shelter because of a mental disorder. [¶] If you find [T.H.] 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 [T.H.] is presently gravely disabled. [¶] In determining whether [T.H.] 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 [T.H.] is presently gravely disabled, you may not consider the likelihood of future deterioration or relapse of a condition."
II
Substantial Evidence
When the sufficiency of the evidence is at issue, we review the entire record in the light most favorable to the judgment to determine whether it discloses substantial evidence, meaning evidence that is reasonable, credible, and of solid value, to support the verdict. (Conservatorship of Walker, supra, 206 Cal.App.3d at p. 1577.) "Substantial evidence includes circumstantial evidence, meaning evidence that is reasonable, credible, and of solid value, to support the verdict. (Ibid.) "The focus is on the quality, rather than the quantity, of the evidence. 'Very little solid evidence may be "substantial," while a lot of extremely weak evidence may be "insubstantial." ' " (Roddenberry v. Roddenberry (1996) 44 Cal.App.4th 634, 651.)
We conclude substantial evidence supports the jury's finding on the elements of the jury instruction. There was ample evidence from Dr. Funkenstein that T.H. lacks insight into her mental illness. Indeed, she denies having any mental condition and rather attributes her problems to a strained neck or to third parties. Further, the evidence establishes that before the current hospitalization she never took medication for mental illness, and outside a confined setting she would likely discontinue taking prescribed medicine necessary to treat her chronic paranoid schizophrenia. She asked Dr. Funkenstein every day to take her off medication because she believed it was poisonous. Ann also testified she knew T.H. did not want to take medicine, and T.H. testified she was very unhappy being required to take medication.
Further, the evidence shows that without medication and treatment, T.H. cannot meet her needs for shelter and food. Since the 2003 fire she had been living in makeshift and unsanitary conditions on the Crest property, without any toilet, heat, electricity, refrigeration or hot water. The trailer she was living in immediately before her hospitalization leaked, and both she and her bedding were wet and moldy. Additionally, T.H. left the property frequently and did not always make it back home the same day, and thus she was required to find a public place to sleep, such as the beach. She could not adequately manage her finances, and she spent her meager funds on taxis to gather food from remote locations. Further, toward the end of the month she would run out of money and food, and would go for two or three days without any sustenance.
T.H. contends that the factors this court discussed in In re Guerrero, supra, 69 Cal.App.4th at page 445 — including the proposed conservatee's lack of insight into his or her condition and the unlikelihood of taking medication outside a controlled setting — "were merely suggested, not mandatory, for [the jury's] analysis of 'grave disability.' " Those factors, however, appear in CACI No. 4002, and T.H. ignores that the jury here was instructed with a modified version of that instruction. She does not challenge the jury instruction.
T.H. also asserts the jury's finding was improper because there was no evidence she "was suffering from malnutrition, overexposure, or any other sign of poor health or neglect." The jury instruction, however, did not base a finding of present grave disability on any of those criteria.
Additionally, T.H. asserts she was able to provide food for herself. She admits, however, that she "might go two to three days of not eating if she did not have enough money," and she "asked neighbors to give her money and food from time to time." T.H. miscites the evidence when she states her trailer did not become moldy until after she entered the hospital, as Dr. Funkenstein testified that both T.H. and her bedding were moldy when she was hospitalized because of the leak. T.H. merely cites conflicting evidence from her own testimony and that of her friend, but it is not our province to reassess the credibility of witnesses or reweigh the evidence.
T.H.'s reliance on Conservatorship of Smith (1986) 187 Cal.App.3d 903, is misplaced. In Smith, the court found the evidence was insufficient to support a finding the proposed conservatee was gravely disabled despite evidence that she behaved bizarrely, and had no fixed income or home address. (Id. at p. 906.) There, however, a psychiatrist testified that despite a paranoid delusion disorder, "she could feed and clothe herself and provide for her own place to live." (Id. at p. 907.) Further, in Smith, the court noted the evidence was sparse and did not "disclose why appellant is considered to be gravely disabled." (Id. at p. 910.) Here, Dr. Funkenstein did not testify that despite T.H.'s mental illness, lack of insight into her disease and reticence to take medication, she is able to provide for her basic needs, and the evidence did support a finding to the contrary.
III
Evidentiary Ruling
T.H. also contends the court abused its discretion by admitting evidence that she fed her mother primarily avocadoes and oranges, and that her mother died while she was under T.H.'s care. T.H. asserts a new trial is required because the evidence "had the prejudicial effect of having the jury conclude [she] killed her mother." She seeks a new trial "with directions to exclude any evidence regarding the food choices she made in relation to the life, care, and death of her mother."
"In general, the trial court is vested with wide discretion in determining the relevance and in weighing the prejudicial effect of proffered evidence against its probative value. Its rulings will not be overturned on appeal absent an abuse of that discretion." (People v. Edwards (1991) 54 Cal.3d 787, 817.) A trial court will abuse its discretion by action that is arbitrary, whimsical or capricious. (People v. Zack (1986) 184 Cal.App.3d 409, 413.)
The court disallowed any statements pertaining to the cause of the mother's death, but found that evidence pertaining to "the history of [T.H.'s] mental disorder, the history of how she cares for others and herself, is fair game." Even if the court should not have admitted the evidence, reversal is not required because it was nonprejudicial.
When T.H. was asked how she fed her mother, she responded: "Well, we just ate a regular natural foods diet. We shopped at Henry's and we shopped at the Ocean Beach People's Food Co-op and Ranchos Natural Foods. We went to farmers markets. And then we started getting deliveries from local farms 'cause... I thought really we would get a whole large delivery of fruit,... oranges and avocadoes and also fresh fruits and vegetables. And we would get organic oats and brown rice and lentils and stuff like that, sunflower seeds in bulk,... and seaweed with soy sauce. And I would make fresh squeezed orange juice." T.H. also explained that when she was a child, her mother had "her kids on an organic food diet." This testimony belied the testimony of others that T.H. fed her mother only oranges and avocadoes, and shows T.H. had some knowledge of nutrition. Indeed, jurors may have felt a vegan diet was preferable to her mother's previous diet of mostly meat and fat, particularly since she had suffered a stroke. The inability of T.H. to provide food for herself derives not from what she chose to eat, but from her mental illness and resultant disorganized method of shopping, such as taking taxis many miles to obtain organic food from certain markets when she has limited funds, and from running out of food for several days toward the end of the month when her funds are depleted.
We have read the entire reporter's transcript, and the evidence of what T.H. fed her mother would not give jurors the impression she caused her mother's death. There is no suggestion the jury rendered its finding to punish T.H. for anything. This is not a criminal proceeding, but an LPS Act proceeding in which the object is not to punish but to provide needed assistance to the gravely disabled.
DISPOSITION
The judgment is affirmed.
WE CONCUR: Nares, J., McIntyre, J.