Opinion
No. 05-14-01051-CV
12-02-2014
THE STATE OF TEXAS FOR THE BEST INTEREST AND PROTECTION OF R.O.
On Appeal from the County Court at Law No. 2 Kaufman County, Texas
Trial Court Cause No. 14M-149
MEMORANDUM OPINION
Before Justices O'Neill, Fillmore, and Chief Justice Thomas, Ret.
Opinion by Justice Fillmore
The Hon. Linda Thomas, Chief Justice of the Court of Appeals for the Fifth District of Texas—Dallas, Retired, sitting by assignment.
R.O. appeals the trial court's judgment of commitment ordering temporary inpatient mental health services. In three issues, R.O. challenges the legal and factual sufficiency of the evidence to support the trial court's affirmative findings on each of the statutory criteria for court-ordered mental commitment set out in section 574.034(a)(2) of the health and safety code. We affirm the trial court's judgment.
Background
R.O. had a "conversation" with his mother and, believing she was lying to him, flipped over a table and went to his grandmother's house. The sheriff was called, and R.O. was detained. On July 16, 2014, R.O. was examined by Dr. Zahoor Ahmed at ETMC Pittsburg. After examining R.O., Dr. Ahmed completed a physician's certificate of medical examination for mental illness, diagnosing R.O. as delusional and having homicidal ideation. It was Dr. Ahmed's opinion that R.O. was mentally ill and, as a result of that illness, was likely to cause serious harm to himself or others and was suffering severe and abnormal mental, emotional or physical distress, was experiencing substantial mental or physical deterioration, and was not able to make a rational and informed decision as to whether to submit to treatment. Dr. Ahmed further opined, based on R.O.'s behavior, that R.O. presented a substantial risk of serious harm to himself or others if he was not immediately restrained. On July 18, 2014, a magistrate judge granted the State's motion for order of protective custody and ordered R.O. detained, pending a probable cause hearing, in Terrell State Hospital.
The record is not clear as to the date R.O was detained.
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Dr. Louis Deere, a staff psychiatrist at Terrell State Hospital, examined R.O. on July 23, 2014 and completed a physician's certificate of medical examination for mental illness. Dr. Deere diagnosed R.O. as schizophrenic, paranoid, and suffering from delusional disorder. In Dr. Deere's opinion, R.O. was mentally ill, likely to cause serious harm to others, and would, if not treated, continue to suffer severe and abnormal mental, emotional, or physical distress, would continue to experience deterioration of his ability to function independently, and was unable to make a rational and informed decision as to whether to submit to treatment. Dr. Deere's opinion was based on R.O. threatening to kill his family, becoming angry during an argument with his mother and flipping over a table, killing his pet, and believing both his father and his boss had "pulled a gun on him."
On July 30, 2014, the trial court held a commitment hearing, at which both Dr. Deere and R.O. testified. Dr. Deere testified R.O. was suffering from "schizoaffective disorder versus schizophrenia paranoid." In his opinion, R.O. was mentally ill and, as a result of that mental illness, was likely to cause serious harm to others and might cause harm to himself. Dr. Deere also believed that, if R.O. was not treated, he would continue to suffer abnormal mental, emotional, or physical distress and his ability to function independently would deteriorate, and that R.O. was unable to make a rational, informed decision about submitting to treatment. In Dr. Deere's opinion, the hospital was the least restrictive, appropriate, and available setting for R.O.'s treatment. Dr. Deere's opinions were based on R.O. threatening to kill his parents, purchasing a gun and using it to kill a dog and, on the day of the hearing, throwing a chair against the telephone after he became angry while talking with his mother. Further, R.O. claimed he woke up one morning and saw his father holding a shotgun in his face and that his boss shot a gun behind him. R.O. admitted he thought people were "out to get him."
R.O. testified he came to the hospital after he had a conversation with his mother in which she told him that he had not planted 18,000 trees in South Texas and was not in a lawsuit with Clay Construction and Development. R.O. believed his mother was lying to him and "wasn't recognizing [him] at all as a person," so he "expressed" himself by flipping the table.
R.O. admitted there had been an incident earlier on the day of the hearing in which he threw a chair while he was talking to his mother on the telephone. He testified he was trying to express himself. R.O. admitted his actions might not be the "best expression," but that sometimes he felt he was in a fight all the time. He stated that, "It's been four years of stuff like this, similar."
R.O. also admitted that he killed his dog. He went looking for some hog heads to use in training his other dogs when he found two puppies in a pipe. He gave one of the puppies away. He treated the remaining puppy for fluid under its chin, gave it a seven-in-one shot, wormed it, gave it pyrethrin, and fed it for three or four months. He tried to give the puppy away, but could not find anyone who wanted it. His parents would not allow the puppy at the house, so he moved it to another place with his other dog and allowed it to run around the chicken houses. He decided to shoot the dog and did it "humanely."
When asked if he had ever threatened to kill a member of his family, R.O. responded, "All I know on threats is that it's an intent to do something. And that there's a couple different ways you can speak, figuratively and literally." When asked what he had literally said to his mother, R.O. responded he told her she "might die blind and dumb." He also admitted that when his cousin asked him "what are you going to do," he "went like this: Like I had a machine gun or a tommy gun." However, R.O. claimed he never intended to do anything or to harm anybody and did not believe he was a danger to others.
At the conclusion of the hearing, the trial court found, after considering the evidence and the physician certificates filed by Drs. Ahmed and Deere, that R.O. was mentally ill, see TEX. HEALTH & SAFETY CODE ANN. § 574.034(a)(1) (West Supp. 2014), and as a result of that mental illness, was likely to cause serious harm to himself, was likely to cause serious harm to others, and would, if not treated, continue to suffer severe and abnormal mental, emotional or physical distress, would continue to experience deterioration of his ability to function independently, and was unable to make a rational and informed decision as to whether to submit to treatment. See id. § 574.034(a)(2)(A), (B), (C). The trial court ordered R.O. committed to Terrell State Hospital for a period of time not to exceed ninety days.
Analysis
R.O. does not contest the trial court's finding that he suffers from mental illness, but contends, in three issues, that the evidence is legally and factually insufficient to support the trial court's findings that, as a result of mental illness, (1) he was likely to harm himself; (2) he was likely to harm others; and (3) if not treated, he would continue to suffer severe and abnormal mental, emotional, or physical distress, would continue to experience deterioration of his ability to function independently, and was unable to make a rational and informed decision as to whether to submit to treatment.
When seeking a court-ordered mental commitment, the State has the burden of proving by clear and convincing evidence that the patient is mentally ill and, as a result of that mental illness, the patient is likely to cause serious harm to himself; is likely to cause serious harm to others; or is (i) suffering severe and abnormal mental, emotional, or physical distress, (ii) experiencing substantial mental or physical deterioration in his ability to function independently, and (iii) unable to make a rational and informed decision as to whether to submit to treatment. TEX. HEALTH & SAFETY CODE ANN. § 574.034(a). "Clear and convincing evidence is 'that measure or degree of proof which will 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.'" State v. K.E.W., 315 S.W.3d 16, 20 (Tex. 2010) (quoting State v. Addington, 588 S.W.2d 569, 570 (Tex. 1979) (per curiam)). To constitute clear and convincing evidence, the evidence must include expert testimony and, unless waived, evidence of a recent, overt act or a continuing pattern of behavior that tends to confirm (1) the likelihood of serious harm to the proposed patient or others, or (2) the proposed patient's distress and the deterioration of his ability to function. TEX. HEALTH & SAFETY CODE ANN. § 574.034(d); K.E.W., 315 S.W.3d at 20. "[A] recent overt act by a proposed patient 'tends to confirm' that the patient poses a likelihood of serious harm to others. . . if the overt act is to some degree probative of a finding that serious harm is probable, even though the overt act itself may not be dangerous." K.E.W., 315 S.W.3d at 24. Further, words can constitute an overt act. Id. at 22. The recent overt act or continuing pattern of behavior must relate to the criteria on which the judgment is based. State ex rel. T.M., 362 S.W.3d 850, 852 (Tex. App.—Dallas 2012, no pet.); see also State ex rel. E.M., No. 05-14-00769-CV, 2014 WL 5474800, at *2 (Tex. App.—Dallas Oct. 29, 2014, no pet. h.) (mem. op.).
Because the State has a heightened burden of proof in commitment cases, we apply a heightened standard of review. State ex rel T.M., 362 S.W.3d at 852 (citing In re C.H., 89 S.W.3d 17, 25 (Tex. 2002)). In reviewing a legal sufficiency claim, we examine all the evidence in the light most favorable to the finding, resolving disputed facts in favor of the finding if a reasonable factfinder could do so and disregarding all contrary evidence unless a reasonable factfinder could not, to determine whether a reasonable factfinder could have formed a firm belief or conviction that the finding was true. K.E.W., 315 S.W.3d at 20. Likewise, in conducting a factual sufficiency review, we consider the evidence that the factfinder could reasonably have found to be clear and convincing and then determine, based on the entire record, whether the factfinder could have reasonably formed a firm belief or conviction that the allegations in the application were proven. State ex rel T.M., 362 S.W.3d at 852 (citing In re J.F.C., 96 S.W.3d 256, 266 (Tex. 2002)).
We first consider R.O.'s second issue in which he asserts the evidence is legally and factually insufficient to support the trial court's finding under section 574.034(a)(2)(B) of the health and safety code that, due to mental illness, R.O. was likely to cause serious harm to others. The trial court, relying on the evidence at the hearing and Dr. Ahmed's and Dr. Deere's certificates of medical examination for mental illness, found R.O. to be mentally ill and that all three statutory criteria for court-ordered commitment were met. In the certificates, Dr. Ahmed and Dr. Deere both specifically opined that, as a result of mental illness, R.O. was likely to cause serious harm to others. In both the certificate he prepared and during his testimony, Dr. Deere set out specific facts that supported his opinion. Further, evidence that R.O. flipped over a table during an argument with his mother, threatened his family, told his mother she might "die blind and dumb," made a motion like shooting a gun when asked by his cousin what he intended to do, shot his dog, and during a conversation with his mother on the day of trial, hit a telephone with a chair were overt acts that are probative of a finding that serious harm to others was likely if R.O. was not treated. See K.E.W., 315 S.W.3d at 22 (Legislature has permitted "the law's intervention to prevent serious injury to others" when person with a mental illness makes statements that foreshadow violence); G.H. v. State, No. 01-13-000422-CV, 2013 WL 5613457, at *6 (Tex. App.—Houston [1st Dist.] Oct. 10, 2013, no pet.) (evidence of patient's verbal threats to kill hospital staff and physical acts of throwing objects at home health care workers were overt acts sufficient to support finding patient was likely to cause serious harm to others); State ex rel M.D., No. 12-05-00425-CV, 2006 WL 1791661, at *4 (Tex. App.—Tyler June 30, 2006, no pet.) (mem. op.) (evidence of patient's threats and threatening actions toward his family and hospital staff sufficient to support finding patient was likely to cause serious harm to others).
Viewing the evidence in the light most favorable to the trial court's finding, we conclude there is legally sufficient evidence to support the finding, that as a result of mental illness, R.O. was likely to cause serious harm to others. Turning to R.O.'s complaint that the evidence was factually insufficient to support the finding, we note R.O.'s testimony that his actions were a means of expressing himself and he did not intend to harm anybody is contrary to the evidence that R.O. posed a risk of harm to his family. However, in light of the entire record, we conclude a reasonable factfinder could resolve the disputed evidence in favor of the trial court's finding and could reasonably form a firm belief or conviction that, as a result of mental illness, R.O. was likely to cause serious harm to others. See In re J.F.C., 96 S.W.3d at 266. We conclude the evidence is factually sufficient to support the trial court's finding that R.O. should be committed for treatment pursuant to section 547.034(a)(2)(B) of the health and safety code.
We resolve R.O.'s second issue against him. Having determined the evidence is legally and factually sufficient to support one of the statutory criteria, we need not consider R.O.'s first and third issues in which he attacks the sufficiency of the evidence to support the trial court's findings under sections 574.034(a)(2)(A) and (C) of the health and safety code. See TEX. R. APP. P. 47.1; In re A.H., No. 03-12-00496-CV, 2014 WL 1018083, at *3 (Tex. App.—Austin Mar. 14, 2014, no pet.) (mem. op.) (declining to address whether commitment was justified under section 574.034(a)(2)(A) because evidence was legally and factually sufficient to support commitment under section 574.034(a)(2)(C)). We affirm the trial court's judgment.
/Robert M. Fillmore/
ROBERT M. FILLMORE
JUSTICE
141051F.P05
JUDGMENT
On Appeal from the County Court at Law No. 2, Kaufman County, Texas,
Trial Court Cause No. 14M-149.
Opinion delivered by Justice Fillmore, Justices O'Neill and Chief Justice Thomas, Ret. participating.
In accordance with this Court's opinion of this date, the judgment of the trial court is AFFIRMED.