Opinion
24A-MH-2336
10-24-2024
In the Matter of the Civil Commitment of K.C., Appellant-Respondent v. St. Vincent Hospital and Health Care Center, Inc. d/b/a St. Vincent Stress Center, Appellee-Petitioner
ATTORNEY FOR APPELLANT Deborah Marisohn Marion County Public Defender Agency Indianapolis, Indiana ATTORNEYS FOR APPELLEE Andrew B. Howk Matthew M. Schappa Kathryn M. Daggett Hall, Render, Killian, Heath, &Lyman, P.C. Indianapolis, Indiana
Pursuant to Ind. Appellate Rule 65(D), this Memorandum Decision is not binding precedent for any court and may be cited only for persuasive value or to establish res judicata, collateral estoppel, or law of the case.
Appeal from the Marion Superior Court The Honorable David J. Certo, Judge Trial Court Cause No. 49D08-2409-MH-40676
ATTORNEY FOR APPELLANT Deborah Marisohn Marion County Public Defender Agency Indianapolis, Indiana
ATTORNEYS FOR APPELLEE Andrew B. Howk Matthew M. Schappa Kathryn M. Daggett Hall, Render, Killian, Heath, &Lyman, P.C. Indianapolis, Indiana
MEMORANDUM DECISION
Weissmann, Judge.
[¶1] K.C. appeals her temporary involuntary civil commitment, claiming it is not supported by sufficient evidence. As the record contains clear and convincing evidence that K.C. is mentally ill, gravely disabled, and in need of the commitment to ensure her treatment, we affirm the trial court's authorization of her temporary involuntary commitment. But we agree with K.C. and the Hospital that the trial court's restrictions on K.C.'s drug and alcohol use during outpatient therapy had no evidentiary foundation, so we reverse that restriction.
Facts
[¶2] K.C. is a 29-year-old registered nurse and mother of a 9-year-old son. She underwent temporary involuntary civil commitments in November and December 2021, during which she was diagnosed with bipolar disorder type one. K.C. also claimed to have been hospitalized on other occasions as well.
[¶3] In late August 2024, K.C. left her son in her mother's care while K.C. worked her normal 12-hour nursing shift. During this time, K.C. did not call her son as expected, and she ultimately did not respond to calls and texts from her mother and other relatives. K.C.'s mother went to K.C.'s home to check on her, but K.C. did not answer the door. Eleven days after K.C. began limiting contact with her family, her mother went to K.C.'s home again and rang the doorbell. She could see K.C. pacing inside, seemingly oblivious to her mother's presence. Mother called 911. Police ultimately responded and took K.C. to the St. Vincent Stress Center (Hospital).
The record is unclear as to whether K.C. reported to work during this period or if she cared for her son during any part of it.
[¶4] Dr. Erika Cornett-the same psychiatrist who treated K.C. during her two prior commitments-treated her during this latest hospitalization. Upon her admission to Hospital, K.C. was exhibiting "acute symptoms of mania," including irritability, rapid speech, paranoia, and disorganized, illogical thoughts. Tr. Vol. II, p. 6. She was speaking in rhymes and "in tongues," making inappropriate sexual and racial comments, and engaging in other unusual behaviors. Id. at 6, 11.
[¶5] For instance, while speaking to Dr. Cornett, K.C. made unusual hand gestures that were not consistent with American Sign Language. But she told Dr. Cornett that the gestures were "sign language that she had suddenly been given the power or the ability to do." Id. at 7. K.C. accused Dr. Cornett of lying and of not being a doctor. K.C. also accused hospital staff of sleeping with her fiancee and placing her in hospital scrubs so that her private body parts could be inappropriately viewed. K.C. became so angry with one hospital worker that she pulled back her fist as if preparing to strike the worker, although K.C. did not follow through.
[¶6] At the time of her hospitalization, K.C. also had not been caring for herself. Dr. Cornett concluded that this latest manic episode, in which K.C. displayed "very severe symptoms," had "psychotic features." Id. at 6, 8. Although K.C. was taking her oral medication as prescribed during her hospitalization, she showed "minimal" insight into her illness. Id. at 7. She conceded that she might have a "mild form of bipolar" but denied that her hospitalization was related to her illness. Id. Instead, K.C. reported that "everything was going fine" before her hospitalization and that her family's jealousy-not her illness-prompted them to call police. Id.
[¶7] K.C.'s illness was negatively impacting K.C.'s employment and ability to parent her son, according to Dr. Cornett. The psychiatrist noted that K.C.'s pattern is to stop taking the medication for her bipolar disorder once she starts feeling better, given that K.C. does not believe she needs medication for her illness. With each successive episode of psychosis, however, K.C.'s hospitalizations lengthened because stabilization of her condition became more challenging.
[¶8] Hospital petitioned for an emergency detention of K.C., who it alleged had a psychiatric disorder and was gravely disabled. The court granted the emergency detention and ordered Hospital to file a request for hearing within seven days if it deemed a temporary or regular commitment necessary. Four days later, Hospital sought a temporary commitment hearing.
[¶9] After the hearing, at which K.C. testified, the trial court granted Hospital's petition and ordered K.C. involuntarily committed from that day, September 24, 2024, until December 24, 2024, absent earlier discharge. The court concluded that K.C.
"is gravely disabled in her judgment and reasoning. He[r] psychosis has improved, but she continues to underestimate and misapprehend the severity of her mental illness and her symptoms. Her safety and her child's safety require her to engage more fully in treatment than she has in the past and not with medication alone."App. Vol. II, p. 10.
[¶10] The court ordered K.C., upon attaining outpatient status, to: (1) take all medications as prescribed; (2) attend all clinic sessions as scheduled; (3) maintain her address and telephone number with the court and her treatment facility; (4) not harass or assault family members or others; and (5) refrain from use of alcohol or of any drugs not prescribed for her by a certified medical doctor. The court authorized Hospital to treat K.C. with medications through the end of her commitment unless she "does not substantially benefit from the medications." Id. K.C. appeals.
Discussion and Decision
[¶11] K.C. argues the evidence does not support her involuntary commitment. Indiana Code § 12-26-2-5(e) permits an individual to be involuntarily committed upon proof by clear and convincing evidence that: (1) "the individual is mentally ill and either dangerous or gravely disabled"; and (2) "detention or commitment of that individual is appropriate." Because the first element of the statute is written in the disjunctive, the petitioner need only prove that the individual is either dangerous or gravely disabled to carry the petitioner's burden of proof. A.P. v. Cmty. Health Network, Inc., 238 N.E.3d 704, 709 (Ind.Ct.App. 2024).
[¶12] In reviewing the sufficiency of the evidence to support an involuntary commitment, "an appellate court will affirm if, considering only the probative evidence and the reasonable inferences supporting it, without weighing evidence or assessing witness credibility, a reasonable trier of fact could find [the necessary elements] proven by clear and convincing evidence." Civ. Commitment of T.K. v. Dep't of Veterans Affs., 27 N.E.3d 271, 273 (Ind. 2015) (quoting Bud Wolf Chevrolet, Inc. v. Robertson, 519 N.E.2d 135, 137 (Ind. 1988). Clear and convincing evidence is an intermediate standard of proof that is greater than a preponderance of the evidence but less than proof beyond a reasonable doubt. T.D. v. Eskenazi Health Midtown Cmty. Mental Health Ctr., 40 N.E.3d 507, 510 (Ind.Ct.App. 2015)
[¶13] K.C. concedes that the trial court properly found that she is mentally ill, given her bipolar disorder type one diagnosis. Her challenge to the commitment order instead focuses on the trial court's findings that she is gravely disabled. She also challenges the court's special condition during outpatient treatment that she abstain from use of alcohol or certain drugs. We affirm in part and reverse in part, finding the evidence sufficient to support K.C.'s temporary involuntary commitment but insufficient to support the challenged special condition.
I. The Record Supports the Trial Court's Finding that K.C. Was Gravely Disabled
[¶14] In the involuntary commitment context, "gravely disabled" means:
a condition in which an individual, as a result of mental illness, is in danger of coming to harm because the individual . . . has a substantial impairment or an obvious deterioration of that individual's judgment, reasoning, or behavior that results in the individual's inability to function independently.Ind. Code § 12-7-2-96. Because the language of Indiana Code § 12-7-2-96 is in present tense, this Court has determined that this statute requires the patient be gravely disabled as of the time of the commitment hearing. Commitment of B.J. v. Eskenazi Hosp./Midtown CMHC, 67 N.E.3d 1034, 1040 (Ind.Ct.App. 2016).
[¶15] K.C. contends she was no longer gravely disabled by the time of the commitment hearing because her condition had improved during her emergency hospitalization. She notes that the psychotic symptoms she presented upon her admission to Hospital had subsided and that her testimony at the commitment hearing appeared lucid. Focusing on her testimony that she would take the prescribed medications and engage in ordered treatment voluntarily, K.C. claims the record does not support the trial court's finding that she was gravely disabled at the time of the commitment hearing.
[¶16] But Dr. Cornett testified that K.C. has a pattern of being medically compliant while hospitalized and then ceasing her medication as soon as her condition improves outside the hospital. This pattern has resulted in at least three emergency detentions and resulting temporary commitments of K.C. in the last four years. And although K.C. testified that she would take her mental health medications as prescribed and engage in treatment, the trial court did not find her testimony credible. See Thompson v. State, 804 N.E.2d 1146, 1149 (Ind. 2004) (noting that a trial court is not obligated to credit a witness's testimony). After all, K.C. had made clear during her three hospitalizations overseen by Dr. Cornett that she did not believe she needed medication.
[¶17] In finding K.C. gravely disabled, the trial court aptly noted the significant impact that K.C.'s untreated mental illness had on her life and ability to function:
[T]his is not as [K.C.] described today with a profound lack of insight, a problem with boundaries or miscommunication with her family who love and help her. In fact, it is a psychiatric crisis that lasted for a period described by her mom of at least 11 days where [K.C.] didn't know where her son was and today cannot recall the details of that psychiatric crisis.Tr. Vol. II, p. 37.
[¶18] "Where the evidence is in conflict, we are bound to view only that evidence that is most favorable to the trial court's judgment." Golub v. Giles, 814 N.E.2d 1034, 1038 (Ind.Ct.App. 2004). If the trial court's commitment order represents a conclusion that a reasonable person could have drawn, we will affirm the order even if other reasonable conclusions are possible. Id. That is the case here, as the evidence most favorable to the judgment supports the trial court's conclusion that K.C. was gravely disabled. See E.F. v. St. Vincent Hosp. &Health Care Ctr., 194 N.E.3d 1130 (Ind.Ct.App. 2022) (finding patient's grave disability proven in part by a "history of not taking her medications" and the possibility of future harm if patient ceased "taking all of her medications").
II. The Record Does Not Support the Trial Court's Requirement that K.C. Abstain from Alcohol and NonPrescribed Drugs
[¶19] A court may require "an individual ordered to enter an outpatient therapy program" to "comply with . . . conditions determined by the court." Ind. Code § 12-26-14-3(4). "Such special conditions 'must be reasonably designed to protect the individual as well as the general public.'" M.L. v. Eskenazi Health/Midtown Mental Health CMHC, 80 N.E.3d 219, 223 (Ind.Ct.App. 2017) (quoting Golub, 814 N.E.2d at 1041). The record must contain sufficient evidence from which the trial court may conclude that the special condition "bears a reasonable relationship" to the committed individual's treatment and to the protection of others. Golub, 814 N.E.2d at 1041.
[¶20] K.C. challenges the trial court's order imposing as a special condition of her outpatient treatment that she "not use alcohol or drugs other than those prescribed by a certified medical doctor." App. Vol. II, p. 10. She contends, and Hospital agrees, that the record contains no evidence suggesting that the special condition bears a reasonable relationship to K.C.'s treatment or anyone's protection. We agree. This special condition was not sought by Hospital, and the record contains no evidence revealing K.C.'s use of alcohol or non- prescribed drugs. Accordingly, this special condition should be stricken from the commitment order.
[¶21] We affirm in part, reverse in part, and remand for proceedings consistent with this opinion.
Tavitas, J., and Foley, J., concur.