Opinion
No. 05-10-00479-CR
08-03-2011
LONNIE OWENS, Appellant v. THE STATE OF TEXAS, Appellee
On Appeal from the 204th Judicial District Court
Dallas County, Texas
Trial Court Cause No. F06-87560-MQ
MEMORANDUM OPINION
Before Justices Richter, Lang, and Fillmore
Opinion By Justice Lang
After finding Lonnie Owens not guilty by reason of insanity of aggravated assault with a deadly weapon, the trial court committed him to a state hospital for in-patient mental health treatment for a period not to exceed 181 days. In two issues, appellant argues the evidence is legally and factually insufficient to support the commitment order. We affirm.
Appellant was charged with aggravated assault with a deadly weapon in connection with an incident involving his mother in 2006. After he was indicted, appellant was determined to be incompetent to stand trial, and trial court ordered in-patient mental health services. The trial court extended the services in 2008 and 2009. On April 6, 2010, the trial court found appellant was competent to stand trial. On that day, appellant waived his right to a jury trial and pleaded not guilty by reason of insanity.
Appellant's mother, Jessie Jackson, testified appellant was at her house on May 29, 2006 and complained his jeans had a hole in them. Mrs. Jackson, who was seventy-five years old at the time, suggested appellant "work a little" so that he could buy new jeans, and appellant went "crazy." Mrs. Jackson said appellant, who was holding a jar of gasoline and a lighter, threatened to throw the gasoline in her face and set her on fire. He also threatened to throw the gasoline on her if she said anything. Mrs. Jackson was seated in a chair on the porch at the time, and appellant was standing nearby. When she started to get up from her chair, appellant told her to sit down and told her if she called the police, he would "throw it on me." Mrs. Jackson said she was very frightened and did as appellant said. Mrs. Jackson's neighbor called the police, but appellant left before they arrived. The next day, appellant called his mother and threatened to kill her. Appellant, who was homeless, was arrested several weeks later.
Mrs. Jackson said appellant had a history of acting crazy, but to the best of her recollection, had never had any treatment. On one occasion, he beat her refrigerator with a hammer. On at least three occasions, she said the police had been called to her residence on appellant.
Appellant's sister, Lola Faye Owens, testified appellant had a history of mental illness for twenty years and said she did not believe he had ever received help. She testified he is estranged from the family because of his actions, and that she and her mother were both afraid of him. She recalled an incident where appellant cut up her mother's sofa and another where he threatened to burn down their mother's house. She also testified that appellant had delusions that she and her sister were conspiring to cheat him out of his inheritance, although she said her mother had no money and only a small house. Owens, who is a registered nurse, believed he needed psychiatric help for his safety and the safety of others.
The trial court also heard conflicting testimony from medical experts as to whether appellant was insane at the time of the offense. Dr. David Self, a forensic psychiatrist and clinical director at Rusk State Hospital, evaluated appellant on two occasions about four months before the trial. He testified appellant suffered schizophrenia, undifferentiated type, and characterized is as a severe and persistent mental illness. Based upon his examination of appellant, reports from five other medical professionals, and appellant's jail and clinical records, he opined that appellant did not know the wrongfulness of his conduct on the day he threatened his mother. In contrast, Dr. Kelly Goodness testified she believed appellant was legally sane at the time of the incident, primarily because appellant attempted to prevent his mother from calling the police, which she said suggested an understanding that what he was doing was wrong. She did believe, however, that appellant suffered schizophrenia, a serious mental illness, and was psychotic at the time of the offense.
After hearing the evidence, the trial court found appellant not guilty by reason of insanity. Pursuant to statute, the trial court ordered appellant committed to the maximum security unit of North Texas State Hospital, Vernon Campus, for a period not to exceed thirty days so that an examination could be conducted of his present mental state. After appellant arrived at NTSH, two staff psychiatrists evaluated him, and both recommended appellant be recommitted for further evaluation and treatment. Following a disposition hearing, the trial court found by clear and convincing evidence that Owens is severely mentally ill, and as a result of his mental illness, is likely to cause serious bodily injury to another if not provided with treatment and supervision. The trial court also found appellant is suffering severe and abnormal mental, emotional, and physical distress, is experiencing substantial mental and physical deterioration of his ability to function independently, and is unable to make a rational and informed decision as to whether to submit to treatment. Finally, the trial court found inpatient treatment was necessary to protect the safety of others, and there was no indication appellant would follow a regimen of outpatient treatment if available. The trial court ordered appellant committed for in-patient mental health services for a period not to exceed 181 days.
In two issues, argued together, appellant asserts the evidence is legally and factually insufficient to support his commitment.
After a person is acquitted by reason of insanity of an offense involving dangerous conduct, the trial court is required to commit the person for no more than thirty days for an evaluation of his present mental condition and treatment. Tex. Code Crim. Proc. Ann. art. 46C.251(a) (West 2006). A hearing to determine the proper disposition of the acquitted person must be held no more than thirty days after the date of acquittal. Tex. Code Crim. Proc. Ann. art. 46C.251(d). The acquitted person shall be committed to a mental hospital or other appropriate facility for inpatient treatment or residential care if the State establishes by clear and convincing evidence that (1) the person has a severe mental illness or mental retardation; (2) the person, as a result of that mental illness or mental retardation, is likely to cause serious bodily injury to another if the person is not provided with treatment and supervision; and (3) inpatient treatment or residential care is necessary to protect the safety of others. Tex. Code Crim. Proc. Ann. art. 46C.256(a)(1)-(3). In determining whether inpatient treatment has been proved necessary, the court shall consider whether the evidence shows both that (1) an adequate regimen of outpatient or community-based treatment will be available to the person and (2) the person will follow that regimen. Tex. Code Crim. Proc. Ann. art. 46C.256(b)(1)-(2).
Clear and convincing evidence is that measure or degree of proof that will produce in the mind of the trier of fact a firm belief or conviction about the truth of the allegations sought to be established. State v. Addington, 588 S.W.2d 569, 570 (Tex. 1979). In a case where the burden of proof at trial was by clear and convincing evidence, we review a challenge to the legal sufficiency of the evidence by considering all the evidence in the light most favorable to the finding. In re J.F.C., 96 S.W.3d 256, 266 (Tex. 2002). We must assume the trier of fact resolved disputed facts in favor of its findings if a reasonable trier of fact could do so, and we must disregard all contrary evidence that a reasonable trier of fact could have disbelieved or found to be incredible. Id. In a challenge to the factual sufficiency of the evidence, we must give due consideration to evidence that the factfinder reasonably could have found to be clear and convincing. Id. The ultimate inquiry is whether the evidence is such that a factfinder could reaonsably form a firm belief or conviction about the truth of the allegations. Id.
At the disposition hearing, the trial court had before it the hospital's report as well as the physicians' certificates of medical examination for mental illness from two staff psychiatrists, Drs. Gail Johnson and Calvin Gerke. Both Drs. Johnson and Gerke examined appellant and diagnosed his condition as schizophrena, undifferentiated type, and antisocial personality disorder. Both were of the opinion that appellant was mentally ill and, as a result of his mental illness, was likely to cause serious harm to others. Attached to the certificates were affidavits setting out facts to support the opinions. In her affidavit, Dr. Johnson relied on statements of appellant that he was "glad to be in a hospital," had "no problems," and had "nothing to say" about his crime. She noted appellant had been examined by multiple forensic staff since his arrest in 2006 and had changed his recollection of the event. Additionally, appellant had made comments blaming his family for his actions to her and other examiners.
Dr. Johnson also opined that appellant is suffering severe and abnormal mental, emotional, or physical distress; experiencing substantial mental or physical deterioration of his ability to function independently, which is exhibited by the proposed patient's inability, except for reasons of indigence, to provide for the proposed patient's needs, including food, clothing, health, or safety, and is not able to make a rational and informed decision as to whether to submit to treatment.
She relied on the following acts of appellant: his "behavioral choices" that led to his arrest; a report in January 2008 that he was stockpiling his medications while in jail; his transfer to a less restrictive setting during a prevision admission after he passed the NTSH Dangerousness Review Board; and acts during the interview where she noted he was calm, but demonstrated limited insight into the aggravated assault.
As for the mental status evaluation, she noted, among other things, that appellant was calm and cooperative, did not appear to "attend to unseen others," and denied hallucinations. He also denied thoughts of wanting to harm himself or others.
Dr. Gerke's affidavit providing similar supporting facts. Dr. Gerke asserted appellant denied the offense happened, denied committing the offense, and denied ever harming or injuring anyone. Dr. Gerke stated appellant said he pleaded guilty because his lawyer told him to. Appellant also said, "Tell the judge to have a nice day."
Like Dr. Johnson, Dr. Gerke noted that appellant was reported to have stockpiled his medications while in jail and also noted that appellant's mental status deteriorated as a result. He also noted that appellant, since his admission two days earlier, had not committed acts of aggression against his self or others requiring the use of restraints or seclusion and had "cooperatively came to my office and answered all questions posed." With respect to the mental status examination, Dr. Gerke said appellant was well groomed, awake, alert, and oriented. He said appellant maintained fair eye contact and engaged "moderately well." Among other things, he said appellant's thought process was linear and goal oriented and his thought content was without suicidal or homicidal ideation and without auditory or visual hallucinations. He was not delusional, but his insight and judgment were poor.
Both recommended appellant be recommitted to the maximum security facility for further evaluation and treatment. Both explained appellant's mental illness is one that cannot be cured, only treated. Dr. Johnson said appellant's "mental illness, refractoriness to treatment, and past history of medication compliance strongly suggested the need for ongoing hospitalization in excess of 90 days." Dr. Gerke noted that appellant reported that he had been in psychiatric treatment with MHMR since childhood, although there were not records to confirm this. Assuming the validity of the report and "accounting for his decompensation off medication while incarcerated," Dr. Gerke opined appellant would continue to suffer from a psychotic disorder for more than ninety days and would require treatment for more than ninety days.
Appellant argues the medical certificates "did little more than set forth the conclusions required by the statute." He argues any facts offer "little insight into why [a]ppellant is likely to cause serious harm to others or how they generally affect [a]ppellant's ability to function on a day-to- day basis without imposing inpatient hospitalization." Further, he asserts the certificates fail to address whether appropriate treatment and supervision could be safely and effectively provided as outpatient or community-based treatment.
Texas courts have noted several relevant factors that may be considered in determining whether a patient who has been criminally violent while insane meets the criteria for court-ordered extended mental health services. Weller v. State, 184 S.W.3d 787, 790 (Tex. App.-Beaumont 2006, no pet.). For example, a patient's refusal to take medicine is evidence that, as a whole, tends to confirm the likelihood of serious harm to the patient and others. Id. at 790; Roland v. State, 989 S.W.2d 797, 802 (Tex. App.-Fort Worth 1999, no writ); see Niswanger v. State, 875 S.W.2d 796, 801 (Tex. App.-Waco 1994, no pet.) (concluding evidence that patient with history of not taking medication and who murdered husband during period when she was off her medication and delusional tends to confirm likelihood of serious harm to patient or others). The original crime may also be considered as additional background information to assess whether the patient has improved or is merely repeating past behavior. Weller, 184 S.W.3d at 790; see Campbell v. State, 118 S.W.3d 788, 793-94 (Tex. App.-Houston [14th Dist.] 2003, pet. denied). The original crime may also indicate the extent to which a patient can be a danger to others if he does not use various tools, such as medication and counseling, to control his mental illness. Weller, 184 S.W.3d at 790; Campbell, 118 S.W.3d at 796. Evidence that a patient denies various details of the crime may also be relevant. Weller, 184 S.W.3d at 790; Campbell, 118 S.W.3d at 796.
Here, Drs. Johnson and Gerke both diagnosed appellant's condition as schizophrenia, undifferentiated type. He was being treated with Haldol and Cogentin. Both noted that appellant had stockpiled his medication while in jail in 2008, which led to deterioration of his mental condition. The evidence also showed appellant had "changed his recall" of the assault and had made comments blaming other family members for his actions. When appellant spoke with Dr. Gerke, he denied committing the crime and said it "never happened."
In addition to this evidence, the trial court had conducted the trial only a month earlier. Trial evidence showed appellant threatened to kill his mother by throwing gasoline on her and setting her on fire after she suggested he get a job to replace the torn jeans he was wearing. Appellant's mother testified he acted "crazy" every time he visited her and the police had been called out to her home on at least three occasions because of appellant's conduct. In the past, he had beat her refrigerator with a hammer and had cut up a sofa. Appellant's mother had not seen him since the incident and told the court she did not feel safe around him.
Finally, Dr. Self also testified at trial. He noted appellant's prior history of violence towards others and said "there's no doubt there's a risk of future aggressive acts towards family members if he's not treated and managed properly." Like Drs. Johnson and Gerke, Dr. Self concluded appellant suffers schizophrenia. Dr. Self testified that as a rule, people suffering from schizophrenia do not take their medications, and a "levered position" is needed to keep them on their medications long enough for the medications to have sufficient effect for the patient to understand the benefits. Dr. Self testified he wanted to see appellant hospitalized for treatment, and then, once he was "stabilized and optimized" on medication, have a "very cautious trial of outpatient [treatment] with really close scrutiny and monitoring." Dr. Self noted that the "close monitoring in the outpatient world is the hard part" and Texas had not done "a very good job of funding these community mental health centers."
Having reviewed the evidence, we conclude it is legally and factually sufficient to establish, clearly and convincingly, that (1) appellant had a severe mental illness, schizophrenia, and as a result of his mental illness, is likely to cause serious bodily injury to another if he is not provided with treatment and supervision and (2) inpatient treatment was necessary to protect the safety of others. We decide both issues against appellant.
We affirm the trial court's order for in-patient mental health services.
DOUGLAS S. LANG
JUSTICE
Do Not Publish