Opinion
No. 5-971 / 05-1114
Filed February 1, 2006
Appeal from the Iowa District Court for Johnson County, Kristin L. Hibbs, Judge.
Respondent appeals the order of the district court, which affirmed the hospitalization referee's finding that she was seriously mentally impaired. AFFIRMED.
Paul D. Miller of Miller Law Office, Iowa City, for appellant.
J. Patrick White, County Attorney, Anne M. Lahey, Assistant County Attorney, for appellee State.
Considered by Sackett, C.J., and Eisenhauer, J. and Brown, S.J.
Senior Judge assigned by order pursuant to Iowa Code section 602.9206 (2005).
I. Background Facts Proceedings
Elizabeth moved to Iowa in September 2004, and shortly after that her husband asked for a divorce. Elizabeth became depressed and began seeing Dr. Kimberly Sheff, a psychiatrist. Elizabeth was hospitalized for suicidal ideation in November 2004 and April 2005. She was placed on medication for her mental condition.
In May 2005, Elizabeth told her dissolution attorney that she wanted to shoot her husband and his attorney. Elizabeth's attorney took this threat very seriously and called Dr. Sheff. Dr. Sheff believed Elizabeth was actively homicidal and contacted law enforcement personnel, asking that Elizabeth be subject to emergency hospitalization. Police officers found a hunting rifle in a storage shed rented by Elizabeth.
In the emergency room, Dr. Harlow Hove certified that he was unable to find any serious mental illness. Elizabeth was then examined by Dr. Sarah Adlakha, who determined Elizabeth was suffering from a delusional disorder. She believed her husband and daughter were in a conspiracy to take everything she had. Dr. Adlakha testified that delusional patients had a higher risk than other patients of actually acting out on suicidal or homicidal ideations. Elizabeth was reluctant to take medication. Dr. Adlakha recommended that Elizabeth be placed in out-patient commitment in order to monitor her medication, and whether she was having suicidal or homicidal thoughts.
The judicial hospitalization referee determined Elizabeth was seriously mentally impaired, and that she should have a complete psychiatric evaluation and appropriate treatment. Elizabeth appealed to the district court. The court affirmed the ruling of the hospitalization referee. Elizabeth appeals.
II. Standard of Review
An involuntary commitment proceeding is a special action triable to the court as an ordinary action at law, and our review is for the correction of errors at law. In re J.P., 574 N.W.2d 340, 342 (Iowa 1998). The elements of serious mental impairment must be established by clear and convincing evidence. Id. The district court's findings of fact are binding on us if supported by substantial evidence. Id.
III. Merits
A person who is seriously mentally impaired may be subject to involuntary hospitalization. See Iowa Code § 229.6 (2005). The term "seriously mentally impaired" is defined as:
[T]he condition of a person with mental illness and because of that illness lacks sufficient judgment to make responsible decisions with respect to the person's hospitalization or treatment, and who because of that illness meets any of the following criteria:
a. Is likely to physically injury the person's self or others if allowed to remain at liberty without treatment.
b. Is likely to inflict serious emotional injury on members of the person's family or others who lack reasonable opportunity to avoid contact with the person with mental illness if the person with mental illness is allowed to remain at liberty without treatment.
c. Is unable to satisfy the person's needs for nourishment, clothing, essential medical care, or shelter so that it is likely that the person will suffer physical injury, physical debilitation, or death.
The existence of a mental illness, by itself, does not establish the grounds for commitment. In re Oseing, 296 N.W.2d 797, 801 (Iowa 1980). There must also be evidence that the person lacks sufficient judgment to make responsible decisions as to treatment. J.P., 574 N.W.2d at 343. Furthermore, the court must make a predictive judgment about whether the respondent poses a danger to herself or others. In re Foster, 426 N.W.2d 374, 377 (Iowa 1988). This judgment must be supported by evidence of a recent overt act, attempt, or threat. Id.
We find there is substantial evidence in the record to support the district court's decision in this case. Dr. Adlakha testified Elizabeth suffered from a delusional disorder, which is a mental illness. There was evidence that Elizabeth was reluctant to take the prescribed amount of medication for her condition. In addition, Elizabeth had made a recent overt threat to injure her husband and his attorney, and this supports a finding that she posed a threat to herself or others.
Elizabeth's challenge to the district court's decision is based principally on her evaluation of the weight to be assigned the evidence presented. Elizabeth concedes there is evidence supporting each of the elements to be established, but asserts it is conflicting. We note two psychiatrists supported the district court's conclusion, opposed largely only by Elizabeth's own testimony.
We affirm the decision of the district court and the judicial hospitalization referee.