Opinion
No. 05-04-00647-CV
Opinion Issued January 31, 2005.
On Appeal from the Probate Court No. 3 Dallas County, Texas, Trial Court Cause No. 04-0556-Mi
Affirmed.
Before Justices MOSELEY, FRANCIS, and MAZZANT.
MEMORANDUM OPINION
In a single point of error, M.T. argues the evidence is factually insufficient to support her court-ordered commitment to Terrell State Hospital for a period of no more than ninety days. The background of the case and the evidence adduced at trial are well known to the parties; thus, we do not recite them here in detail. Because all dispositive issues are settled in law, we issue this memorandum opinion. Tex.R.App.P. 47.2(a), 47.4. We affirm the trial court's judgment.
A trial court may order temporary inpatient mental health services if it finds by clear and convincing evidence that the patient is mentally ill and that at least one of three criteria set forth in the mental health statute results from that mental illness. See Tex. Health Safety Code Ann. § 574.034(a) (Vernon 2003). In this case, the hearing was conducted without a jury and the trial court found that M.T. was likely to cause serious harm to herself and that she suffered severe mental, emotional, or physical distress, deterioration in her ability to function independently, and inability to make a rational and informed decision about treatment. Id. § 574.034(a)(2)(A), (C).
To be clear and convincing under the statute, 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 either (1) the likelihood of serious harm to the proposed patient or others or (2) the proposed patient's distress and the deterioration of the proposed patient's ability to function. Id. § 574.034(d). 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. Addington, 588 S.W.2d 569, 570 (Tex. 1979) (per curiam).
Because the State's burden of proof is clear and convincing evidence, we apply a heightened standard of review. See In re C.H., 89 S.W.3d 17, 25 (Tex. 2002). We must determine whether the evidence is such that a fact finder could reasonably form a firm belief or conviction about the truth of the matter required to be established by clear and convincing evidence. In re J.F.C., 96 S.W.3d 256, 265-66 (Tex. 2002); In re C.H., 89 S.W.3d at 25. When reviewing factual sufficiency, we must give due consideration to evidence that the fact finder could reasonably have found to be clear and convincing and then determine whether, based on the entire record, a fact finder could reasonably form a firm conviction or belief that the allegations in the petition were proven. In re J.F.C., 96 S.W.3d at 266.
The record indicates that police found M.T. wandering in traffic, and she had been sleeping on people's porches in the area. She told police she needed help and had not slept in over two days. Police took her into custody, and the State obtained an order for protective custody. She was disheveled, malodorous, very confused, and uncooperative. Dr. Goen, a psychiatrist at Terrell, testified as the State's expert witness. He diagnosed M.T. with paranoid schizophrenia. He testified that when she came to Terrell, she refused to eat, drink, bathe, or change her clothes. After two days, she was transferred to the medical floor and told that a feeding tube would be used if she continued to refuse to eat and drink. She began eating and drinking and after a few days was transferred back to the main floor. Observation confirmed she was not sleeping well and was very confused.
M.T. also refused to talk with the medical staff and either referred them to her lawyer or to her outpatient psychiatrist. However, she repeatedly refused to sign a release to allow them to talk with her psychiatrist. She indicated she had been taking an anti-psychotic medication for her condition and requested the medication on several occasions only to refuse it once it was offered to her. Her family reported M.T. did not see her outpatient doctor regularly or take her medication and had a thirty-year history of failed treatment for her mental illness. Goen testified that it was difficult to determine if M.T. was suicidal because she refused to communicate. However, M.T.'s behavior, history, and staff's observations of her confirmed the diagnosis.
Several witnesses testified that M.T. did well when she took her medications. M.T.'s mother confirmed her history of mental illness and that she had been hospitalized at least twice. M.T. had a pattern of not taking her medication and not following up with her outpatient doctor. She refused help from available sources. There was testimony that she had been living with a friend but would not agree to the condition that she look for work during the day and stay there only at night. M.T.'s mother had not seen her refuse to eat or bathe in the past. Goen concluded that if M.T. were released without further treatment, she would return to living on the street, wander in traffic, not take her medication or see her doctor, and become more paranoid, which would lead her to stop eating and to starve. Based on the entire record, including this and other evidence, a reasonable fact finder could resolve the disputed evidence in favor of the trial court's findings and could reasonably form a firm belief or conviction that M.T. is mentally ill and as a result of that illness, as confirmed by her recent overt acts and continuing pattern of behavior, there is a likelihood of serious harm to herself and she is in distress and deteriorating in her ability to function independently. The evidence is factually sufficient to support the trial court's order. We overrule M.T.'s only point of error.
We affirm the trial court's judgment.