Opinion
DOCKET NO. A-4248-13T2
03-04-2016
IN THE MATTER OF THE CIVIL COMMITMENT OF B.V.
Lorraine H. Hoilien, Deputy Public Defender, argued the cause for appellant B.V. (Joseph E. Krakora, Public Defender, attorney; Ms. Hoilien, and Stanley Shur, Assistant Deputy Public Defender, of counsel and on the brief). M. Lou Garty argued the cause for respondent State of New Jersey (The Garty Law Firm, L.L.C., attorneys; Mr. Garty, on the brief).
RECORD IMPOUNDED
NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION Before Judges Fasciale, Nugent and Higbee. On appeal from Superior Court of New Jersey, Law Division, Cumberland County, Docket No. CUCC-272-14. Lorraine H. Hoilien, Deputy Public Defender, argued the cause for appellant B.V. (Joseph E. Krakora, Public Defender, attorney; Ms. Hoilien, and Stanley Shur, Assistant Deputy Public Defender, of counsel and on the brief). M. Lou Garty argued the cause for respondent State of New Jersey (The Garty Law Firm, L.L.C., attorneys; Mr. Garty, on the brief). PER CURIAM
Appellant B.V. appeals from an April 10, 2014 final order of involuntary commitment. A court is authorized by statute to continue a person's involuntary commitment if it determines by clear and convincing evidence the person suffers from a mental illness that causes the person to be dangerous to himself or herself, others, or property. Following our review of the record, we conclude there is sufficient evidence to support the trial judge's finding B.V. was a danger to himself. Accordingly, we affirm.
B.V. was temporarily involuntarily committed to Inspira Health Network Bridgeton (Inspira) after police responded to a complaint that B.V. was creating a disruption in his college classroom. The disruption arose from B.V.'s disagreement with his teacher regarding the Book of Genesis.
Upon being admitted to Inspira, he was evaluated by Dr. Raj Prewitt. At B.V.'s civil commitment hearing that occurred a few days after B.V.'s arrival, Dr. Prewitt explained B.V. suffered from schizoaffective disorder, bipolar type. Dr. Prewitt testified B.V. was delusional, reluctant to believe he had a mental health issue, and remained in denial as to why he had been admitted to the hospital. Dr. Prewitt acknowledged B.V. had been taking his medication and was improving; however, Dr. Prewitt opined within a reasonable degree of medical certainty B.V. was a danger to himself and others. Dr. Prewitt testified he believed if B.V. were released, he would stop taking his medication and decompensate.
Although B.V. wished to be conditionally discharged to the apartment in which he was living before his commitment, Dr. Prewitt opined B.V. was delusional and did not have any understanding of why that could not happen. Dr. Prewitt learned from B.V.'s social worker that he could not return to his previous living arrangement, something B.V. did not understand or accept. B.V. also stated he could stay with friends, but he proposed no names or alternative locations.
The trial judge found by clear and convincing evidence: B.V. suffered from a mental illness; if released, B.V. would be a danger to himself and others; and there were no less restrictive facilities available to provide the necessary treatment for B.V. The trial judge described B.V.'s lack of understanding of his future housing options as evidence of B.V.'s danger to himself, stating B.V.'s belief he could stay with a friend was unsupported, and B.V. remained confused about why he could not return to his old apartment. The trial judge determined B.V. required continued care and entered a final order of involuntary commitment on April 10, 2014, scheduling another hearing in two weeks. Subsequently, B.V. was administratively discharged from Inspira on April 16, 2014, into his mother's care.
On appeal, B.V. argues the State failed to prove by clear and convincing evidence he was a danger to himself or others. In addition, B.V. argues he should have been placed on Conditional Extension Pending Placement (CEPP) rather than continuing his involuntary commitment. B.V. also contends Dr. Prewitt's opinion was a net opinion lacking factual support. The State argues B.V.'s appeal is moot because he was discharged a few days after being committed.
We first address the State's contention B.V.'s appeal is moot. An appeal in an involuntary commitment case is not moot if collateral legal consequences result from the commitment order. In re R.B., 158 N.J. Super. 542, 545 (App. Div. 1978).
It is well settled in New Jersey that an appeal in [involuntary commitment] cases is not moot, even if the patient is no longer confined, when the patient remains liable for his or her hospital bill, and a finding in the patient's favor will entitle the patient to a credit for any period of illegal commitment.However, "even if appellants were not responsible for their hospital costs, 'we should nevertheless decide the issue because it implicates a committee's constitutional right to liberty, and by its nature, will continually become moot before judicial review.'" Ibid. (quoting In re G.G., 272 N.J. Super. 597, 600 n.1 (App. Div. 1994)).
[In re B.L., 346 N.J. Super. 285, 292 (App. Div. 2002).]
Civil commitments by their nature often evade review because the patients are discharged before their appeal is heard. For this reason, we conclude appellant's case is not moot because it implicates his constitutional right to liberty.
We next turn to B.V.'s arguments challenging the continuation of his commitment. The court is authorized to continue an individual's temporary involuntary commitment if it finds by clear and convincing evidence:
(1) the person is mentally ill, as that term is defined in N.J.S.A. 30:4-27.2(r); (2) the mental illness causes the person to be dangerous (a) to self or (b) to others or property, as those terms are defined in N.J.S.A. 30:4-27.2(h), (i); (3) the person is unwilling to be admitted to a facility for voluntary care; and (4) the patient needs care at a psychiatric facility or hospital because other available services will not meet the patient's needs.See also N.J.S.A. 30:4-27.15(a); R. 4:74-7(f)(1).
[In re M.M., 384 N.J. Super. 313, 337 (App. Div. 2006.]
Our scope of review is limited. We "give[] deference to civil commitment decisions and reverse[] only when there is clear error or mistake." In re M.M., supra, 384 N.J. Super. at 334. The reviewing court "must consider the adequacy of the evidence"; evidence is adequate if it is competent. Ibid. Clear and convincing evidence "should produce in the mind of the trier of fact a firm belief or conviction as to the truth of the allegations sought to be established." Liberty Mut. Ins. Co. v. Land, 186 N.J. 163, 169-70 (2006) (quoting In re Purrazzella, 134 N.J. 228, 240 (1993)). It has been defined as evidence that is "'so clear, direct and weighty and convincing' that the factfinder can 'come to a clear conviction' of the truth without hesitancy." In re Civil Commitment of R.F., 217 N.J. 152, 173 (2014) (quoting In re Jobes, 108 N.J. 394, 407 (1987)).
The review of whether civil commitment is necessary to protect a person alleged to be a danger to self or others is fact sensitive. "Dangerous to self" as defined by statute means:
that by reason of mental illness the person has threatened or attempted suicide or serious bodily harm, or has behaved in such a manner as to indicate that the person is unable to satisfy his need for nourishment, essential medical care or shelter, so that it is probable that substantial bodily injury, serious physical harm or death will result within the reasonably foreseeable future; however, no person shall be deemed to be unable to satisfy his need for nourishment, essential medical care or shelter if he is able to satisfy such needs with the supervision and assistance of others who are willing and available. This determination shall take into account a person's history, recent behavior and any recent act, threat or serious psychiatric deterioration.
[N. J.S.A. 30:4-27.2(h).]
The trial judge found B.V. was delusional and did not understand his lack of available shelter, which presented a danger to himself. We find the State presented adequate proof to establish by clear and convincing evidence B.V. was a danger to himself. B.V. had nowhere to live if he were released and no one willing to assist him. Being homeless by itself is not sufficient cause for commitment; however, when mental illness causes an individual not to recognize his lack of options for shelter, he is a danger to himself.
We recognize CEPP placement is appropriate where a patient understands his need for assistance and shelter but the State needs additional time to find a placement. CEPP as defined by R. 4:74-7(h)(2) states:
If a patient otherwise entitled to discharge from an inpatient facility cannot be immediately discharged due to the unavailability of an appropriate placement, the court shall enter an order conditionally extending the patient's hospitalization and scheduling a placement review hearing within 60 days thereafter. . . . At all placement review hearings the court shall inquire into and receive evidence of the patient's placement as is necessary to support the entry of an order conditionally extending the patient's hospitalization. . . . If the court is advised at a hearing that an appropriate placement is available, it shall forthwith order such placement. If an appropriate placement becomes available during the interval between scheduled hearings, the patient may be administratively discharged to said placement.
B.V. did not meet the criteria for CEPP because he remained delusional regarding his shelter options; he believed his apartment was a possible choice or that he could stay with friends, but he failed to understand these were not viable placements. Given the proofs presented, the decision to commit B.V. was adequately supported by competent evidence in the record.
We next address B.V.'s assertion Dr. Prewitt's opinion was a net opinion. An expert opinion is admitted into evidence if it relates to a relevant subject that is "beyond the ken of the average laymen." Boland v. Dolan, 140 N.J. 174, 188 (1995) (quoting Nesmith v. Walsh Trucking Co., 247 N.J. Super. 360, 369 (App. Div. 1989), rev'd on other grounds, 123 N.J. 547 (1991)).
The facts or data in the particular case upon which an expert bases an opinion or inference may be those perceived by or made known to the expert at or before the hearing. If of a type reasonably relied upon by experts in the particular field in forming opinions or inferences upon the subject, the facts or data need not be admissible in evidence.Under the "net opinion rule," expert opinions based on unfound speculation and unqualified possibilities are excluded. Vuocolo v. Diamond Shamrock Chems. Co., 240 N.J. Super. 289, 300 (App. Div.), certif. denied, 122 N.J. 333 (1990).
[N. J.R.E. 703.]
Dr. Prewitt's testimony regarding B.V.'s mental illness and inability to find shelter were grounded in fact. N.J.R.E. 703 allows expert opinions to be based on information "perceived by or made known to the expert at or before the hearing." Dr. Prewitt treated B.V. as a patient. She learned firsthand about his mental illness and his delusional thinking. Dr. Prewitt was also free to use information learned from a secondary source in forming her opinion. See Glowacki v. Underwood Mem'l Hosp., 270 N.J. Super. 1, 18 (App. Div. 1994) (stating the intent of N.J.R.E. 703 "is to permit an expert opinion to be corroborated, confirmed, or bolstered by hearsay, but not to rely exclusively or primarily on it").
As to B.V.'s contention the State failed to prove by clear and convincing evidence he was a danger to others, we agree. But this finding does not change the resulting order of involuntary commitment. See In re M.M., supra, 384 N.J. Super. at 337 (stating involuntary commitment requires a showing mental illness causes a "person to be dangerous (a) to self or (b) to others or property") (emphasis added). We therefore conclude his continued commitment was appropriate.
Affirmed. I hereby certify that the foregoing is a true copy of the original on file in my office.
CLERK OF THE APPELLATE DIVISION