Opinion
F079535
01-24-2022
THE PEOPLE, Plaintiff and Respondent, v. HARVEY LEE WILLIAMSON, Defendant and Appellant.
Rachel Lederman, under appointment by the Court of Appeal, for Defendant and Appellant. Xavier Becerra, Attorney General, Lance E. Winters, Chief Assistant Attorney General, Michael P. Farrell, Assistant Attorney General, Darren K. Indermill and Melissa Lipon, Deputy Attorneys General, for Plaintiff and Respondent.
NOT TO BE PUBLISHED
APPEAL from an order of the Superior Court of Merced County Nos. MF48825, MF39700. Carol K. Ash, Judge.
Rachel Lederman, under appointment by the Court of Appeal, for Defendant and Appellant.
Xavier Becerra, Attorney General, Lance E. Winters, Chief Assistant Attorney General, Michael P. Farrell, Assistant Attorney General, Darren K. Indermill and Melissa Lipon, Deputy Attorneys General, for Plaintiff and Respondent.
OPINION
DE SANTOS, J.
Appellant Harvey Lee Williamson is a mentally disordered offender (MDO) committed to a state hospital. On August 28, 2018, the People filed a petition to extend his commitment to March 2020 pursuant to Penal Code sections 2970 and 2972. In June 2019, a jury trial was conducted, and the jury found the petition true on June 19, 2019. Appellant appeals the order extending his commitment, contending (1) insufficient evidence supported the jury's finding he represented a substantial danger of physical harm to others due to his mental disorder at the time of trial and (2) his fair trial and due process rights were violated by the trial court's failure to "sanitize" references to sex offender treatment, one of appellant's recommended treatment groups. Finding no error, we affirm.
All further undesignated statutory references are to the Penal Code.
FACTS
The hospital at which appellant is committed is a structured environment where patients have a treatment team, including a psychologist, psychiatrist, social worker, and a psychiatric technician case manager, who work together to make and assess individualized treatment recommendations for the patients and work with them to meet treatment goals. The treatment recommendations are designed to help the patient in various ways, including looking at repetitive and problematic patterns of behavior, addressing the reason why they are hospitalized, and working on social skills. Patients are also assisted with every-day tasks such as hygiene, eating meals, and taking medication. Medication is administered to patients at set times, and patients do not need to worry about whether the dosage is right or whether they have the correct medication.
Appellant was initially committed as an MDO based on qualifying offenses of false imprisonment and making a false bomb threat. He suffers from schizophrenia or schizoaffective disorder, bipolar type. Schizophrenia is a "formal thought disorder, " which causes those who suffer from it to have trouble thinking logically. People with schizophrenia show "loose associations," meaning to join together ideas in a way which "ignore[s] reality." They also suffer from delusions and hallucinations. Schizoaffective disorder means that in addition to the thought disorder of schizophrenia, the person also has a mood disorder. State hospital consulting psychologist Robert Wagner testified he performed an MDO evaluation of appellant in July 2018 and that appellant's diagnosis qualified as a "severe mental disorder" within the meaning of the MDO statutory scheme.
Wagner had been conducting MDO evaluations of appellant since 2013.
According to appellant's treating psychiatrist, Zahida Azam, schizophrenia is a "very chronic illness," and is treated with medication and therapy, but medication is the "cornerstone of treatment of Schizophrenia." Appellant was taking Olanzapine, an antipsychotic, and lithium, a mood stabilizer. Olanzapine helps with hallucinations, delusional thinking, and the patient's thought process. Lithium helps calm the patient down, and in appellant's case, serves a second purpose of "boost[ing] the effect of anti-psychotics."
Azam treated appellant from the end of 2017 to either the end of 2018 or the beginning of 2019.
Appellant was compliant with taking his medications though he was prompted to do so by the psychiatric technician who worked in appellant's housing unit. Appellant could identify the medications he was prescribed to take but not the dosages. He was unable to state what his medications were for and had told Azam on one occasion his medication was for his blood pressure. As recently as August 2018, appellant told Azam, in response to her question about whether his medications were helping him, that the medications were "not harmful." Appellant needed "constant education" about his medications and what they were for. Azam explained the medications were effective for appellant as he did not experience side effects or instability and that if appellant stopped taking his medication, his "chances of decompensation [we]re very high and likely" and his symptoms would worsen.
Though appellant was taking his medication, Wagner opined appellant's disorder was not in remission. Wagner explained to the jury that remission meant "that the major symptoms … have been suppressed or controlled to the effect that they no longer affect thinking or behavior." Wagner explained that remission "does happen" for some patients if they find the correct medication but that had not happened in appellant's case. Wagner testified that appellant still manifested symptoms of schizophrenia, including delusions that were "rather fixed" or "unchanging." Wagner, Azam, and several other members of appellant's treatment team testified they had observed him "responding to internal stimuli" such as talking to himself, which Wagner described as symptomatic of appellant's disorder. Appellant's social worker described appellant as guarded and difficult to engage, which Wagner explained demonstrated appellant suffered from paranoia, another symptom. In Wagner's opinion, the symptoms suffered by appellant substantially impaired his rational thinking, his perception of reality, his emotional process, his judgment, and his behavior.
Wagner further opined that appellant presently represented a substantial danger of physical harm to others as a result of his mental disorder. Wagner based his opinion on his review of appellant's records, including appellant's qualifying offenses and diagnosis, and Wagner's interview with him. Wagner explained that at the time appellant committed his qualifying offenses he was not medicated and in a psychotic state. Wagner further explained that appellant told Wagner his medications were not doing anything for him and that he did not think he had a mental illness and mentioned that appellant had told Azam that his medications were for high blood pressure. Wagner opined that appellant demonstrated a lack of insight into his mental illness, which indicated appellant would stop taking his medication in an unmonitored setting. Wagner explained that if appellant failed to take his medication, he would "deteriorate mentally and become psychotic" and his dangerousness would increase.
One major concern of appellant's treatment team was appellant's attitude towards alcohol. Appellant had a history of drinking alcohol and substance abuse, and had told Wagner a version of his qualifying offenses where he had been drinking. As such, he was recommended to participate in substance abuse treatment to help him "increase his knowledge and awareness of what drives him to drink … and to begin to take steps to … find other ways to cope with those problems." When appellant's treatment team tried to discuss appellant's substance abuse with him, appellant did not demonstrate insight into his substance abuse history and consistently expressed over the course of several years he did not see anything wrong with drinking alcohol and planned to drink if he were to be released from the hospital.
Wagner testified substance abuse treatment was an important factor in treating appellant because "substance abuse either magnifies the emotions that you're experiencing at the moment, say, anger or fear, and it also affects judgment profoundly." Wagner was concerned that appellant said he did not see a problem with drinking alcohol upon release from the hospital because it would affect appellant's judgment and if he were also to stop taking his medication, "his behavior would be unpredictable," which could exacerbate his symptoms. Wagner believed that if appellant were to use substances or alcohol, it would elevate his risk for future violent behavior. Azam explained that drinking alcohol with appellant's medication could affect appellant's impulsivity, dangerousness, and poor insight. She further explained it could increase dangerous behaviors toward himself or others.
After resisting substance abuse treatment, appellant eventually enrolled in June 2018, though, according to Wagner, his attendance was "shaky." Shortly before trial, it appeared appellant's attitude toward drinking may have been beginning to change.
Appellant's art therapist who had worked with him from 2014 through the time of the trial testified that his insight into his mental illness in general had improved over the years. In a recent conversation with appellant, he expressed to her that" 'it's not a good idea'" to drink alcohol. She did testify, however, that if he was released from the hospital, she believed he would relapse and start drinking. Appellant's social worker also testified that even though appellant had recently stated he did not want to drink if he were to be released, the social worker was still concerned appellant would drink alcohol in an uncontrolled setting.
Another one of appellant's treatment recommendations was the sex offender treatment program. He had been encouraged to enroll for years but had not done so, though recently he had become more open to it. His social worker opined he had not enrolled because he was focused on "tr[ying] to relitigate his past" as much of his time was spent working on legal paperwork.
In general, appellant's treatment team described him as pleasant and polite and denied that he displayed aggression.
DISCUSSION
I. Sufficiency of the Evidence
To obtain a one-year extension of an MDO commitment, the People must prove beyond a reasonable doubt: (1) the defendant continues to have a severe mental disorder; (2) the defendant's severe mental disorder is not in remission or cannot be kept in remission without treatment; and (3) because of his or her severe mental disorder, the defendant continues to represent a substantial danger of physical harm to others. (§ 2972, subd. (c).)
"A defendant's condition a year earlier is relevant but not dispositive of these questions." (People v. Cobb (2010) 48 Cal.4th 243, 252.) At a recommitment hearing, the issue is whether the defendant's "current condition justifie[s] extension of his commitment." (Id. at p. 243.) A mental health professional "may and should take into account the prisoner's entire history in making an MDO evaluation." (People v. Pace (1994) 27 Cal.App.4th 795, 799.) "[S]ubstantial danger of physical harm" within the meaning of the MDO statutory scheme "does not require proof of a recent overt act." (§ 2962, subd. (g).)
We review the judgment for substantial evidence, reviewing "the record in the light most favorable to the judgment to determine whether it discloses substantial evidence-'evidence that is reasonable, credible, and of solid value'-such that a reasonable trier of fact could find beyond a reasonable doubt" that the elements of the MDO statute have been met. (People v. Labelle (2010) 190 Cal.App.4th 149, 151.)
Appellant contends insufficient evidence supported the jury's finding as to the third element because the prosecution did not present evidence to support that "currently, at the time of trial" appellant represented a substantial danger of physical harm to others as a result of his mental disorder. We disagree. The jury could have reasonably concluded that appellant represented a substantial danger of physical harm to others as a result of his mental disorder at the time of trial and, therefore, that his mental disorder caused him serious difficulty in controlling dangerous behavior.
Here, the jury was instructed they were required to find whether appellant had a severe mental disorder defined as "an illness or disease that substantially impairs the person's thought, perception of reality, emotional process, or judgment; or that grossly impairs his or her behavior; or that demonstrates evidence of an acute brain syndrome for which prompt remission, in the absence of treatment, is unlikely." The jury was further instructed in order to find the disorder was not in remission, they had to find "the external signs and symptoms of the severe mental disorder" were not under control. Finally, the jury was instructed to find whether appellant represented a substantial danger of physical harm to others because of the disorder. (CALCRIM No. 3457.) These instructions were sufficient to satisfy the federal due process requirement that a civil committee must be found to have "serious difficulty in controlling [dangerous] behavior" under Kansas v. Crane, supra, 534 U.S. 407. In People v. Putnam (2004) 115 Cal.App.4th 575, the appellate court rejected the appellant's argument that due process required the court to instruct the jury that it needed to find "serious difficulty in controlling [dangerous] behavior" in an MDO extension trial. (Id. at p. 579.) The appellate court held that the standard instructions as those given here "which tracked the language of the MDO statute, necessarily encompassed a determination that [the] appellant had serious difficulty in controlling his violent criminal behavior, and thus … separate instructions on that issue were not constitutionally required." (Id. at p. 582.) To the extent appellant argues the jury was required to make a separate finding, we reject his argument, and find that, for the same reasons that substantial evidence supports the jury's finding appellant represented a substantial danger of physical harm to others as a result of his mental disorder, substantial evidence also supports a finding that appellant's mental disorder caused serious difficulty in controlling dangerous behavior at the time of trial as required by due process. Appellant also argues the evidence does not support a finding that appellant's "mental disorder caused serious difficulty controlling dangerous behavior," suggesting this was a separate finding the jury was required to make to protect appellant's due process rights. (Kansas v. Crane (2002) 534 U.S. 407, 412‒413; People v. Williams (2003) 31 Cal.4th 757.)
The jury could reasonably rely on Wagner's opinion that appellant represented a substantial danger to others as a result of his mental disorder, as it was supported by Wagner's July 2018 MDO evaluation and further corroborated by other evidence presented to the jury. Though there is little evidence appellant showed violent tendencies while in the controlled, structured environment of the hospital, this was due, in large part, to appellant's medication compliance. Appellant posed a substantial danger to others because of the likelihood he would cease taking his medications and drink alcohol upon release. Both Wagner and Azam testified as to the effects of appellant not taking his medication and/or drinking alcohol, which would seriously deteriorate his mental state and increase his dangerousness to others. In addition, appellant committed his qualifying offenses while not medicated and perhaps while under the influence of alcohol. The totality of these circumstances constituted substantial evidence supporting the jury's finding as to the third element.
We reject appellant's contention that the evidence did not support Wagner's opinion appellant would stop taking medication outside of the hospital setting. Wagner based his opinion on appellant's demonstrated lack of insight into his mental illness and the importance and function of his medication. This was corroborated by testimony from members of appellant's treatment team detailing first-hand observations of appellant's lack of insight into his mental illness and Azam's testimony regarding appellant's neutral attitude toward his medication. It was further corroborated by appellant's social worker's testimony that he was concerned appellant would not be able to stay medication compliant outside of the hospital setting based on his own observations of appellant's inability to communicate his needs.
We also reject appellant's contention that Wagner's opinion that appellant would drink alcohol outside of the hospital setting was too "speculative" in nature to rise to the level of substantial evidence. There was abundant testimony from multiple members of appellant's treatment team about appellant's history with alcohol abuse, his lack of insight into how drinking alcohol could negatively affect his mental state and the effectiveness of his medication, and his years of consistent statements that he planned on drinking alcohol were he to be released. We acknowledge appellant's recently made comment that he did not think it was a good idea to drink alcohol; however, within context of appellant's history, Wagner's opinion that this comment was too recent to represent a substantive change was reasonable.
We acknowledge appellant's argument that Wagner's evaluation was completed almost a year before trial and as such it was "outdated" and could not support a finding of current dangerousness. Wagner, however, testified he had reviewed appellant's medical records, which postdated his evaluation prior to trial, and saw nothing that changed his opinion. Appellant's counsel cross-examined Wagner about appellant's recent comment suggesting he would not drink alcohol if released, and Wagner testified the comment was too recent for Wagner to opine appellant had had any real change of attitude toward alcohol use. Finally, as we have explained, Wagner's opinion was corroborated by testimony of appellant's treatment team who had more recently worked with appellant.
The totality of the evidence substantiated the jury's finding that appellant represented a substantial danger to others at the time of trial.
II. Alleged Violations of Rights to Due Process and a Fair Trial By the Reference to "Sex Offender" Treatment
Prior to trial, appellant sought to "sanitize" the reference to "sex offender" treatment, arguing it was "highly prejudicial" and irrelevant. Appellant argued the relevant detail was that appellant had not participated in the treatment group, not what kind of treatment it was. In denying appellant's request, the court noted that one of the issues the jury was to consider was whether appellant voluntarily followed the treatment plan and whether appellant had acted as a reasonable person in following the treatment plan. The court concluded the type of treatment was relevant for the jury to make a determination if appellant was acting reasonably or not. The court noted the reference to "sex offender" treatment resulted in "some" prejudice but the prejudice was outweighed by the probative value.
On appeal, appellant contends the court erred by allowing the prosecution to refer to the treatment group as "sex offender" treatment and that his rights to due process and a fair trial were violated as a result. We disagree.
Evidence Code section 352 provides that the court in its discretion may exclude evidence if its probative value is substantially outweighed by the probability that its admission will (a) necessitate undue consumption of time or (b) create substantial danger of undue prejudice, of confusing the issues, or of misleading the jury. (Evid. Code, § 352.)
"Prejudicial" in the Evidence Code section 352 context is not synonymous with "damaging." (People v. Dejourney (2011) 192 Cal.App.4th 1091, 1105.)"' [E]vidence should be excluded as unduly prejudicial when it is of such nature as to inflame the emotions of the jury, motivating them to use the information, not to logically evaluate the point upon which it is relevant, but to reward or punish one side because of the jurors' emotional reaction. In such a circumstance, the evidence is unduly prejudicial because of the substantial likelihood the jury will use it for an illegitimate purpose.'" (People v. Doolin (2009) 45 Cal.4th 390, 439.)
On appeal, we presume the trial court's evidentiary ruling was correct, and appellant bears the burden of demonstrating error. (People v. Giordano (2007) 42 Cal.4th 644, 666.) Trial courts have broad discretion in determining the admissibility of evidence and we review challenges to the admission of evidence for abuse of discretion. (People v. Jackson (2016) 1 Cal.5th 269, 320‒321.) Under this standard, the court's ruling"' "will not be disturbed, and reversal of the judgment is not required, unless the trial court exercised its discretion in an arbitrary, capricious, or patently absurd manner that resulted in a manifest miscarriage of justice." '" (People v. Lewis (2009) 46 Cal.4th 1255, 1286.)
We conclude the trial court's ruling was not an abuse of discretion. As the trial court stated, the probative value of the type of treatment was high. One of the questions the jury was asked to resolve in the context of whether appellant's disorder could be kept in remission was whether appellant voluntarily followed the treatment plan, which required the jury to determine whether he "acted as a reasonable person would in following the treatment plan." (CALCRIM No. 3457.) As there was evidence appellant's treatment team recommended that he participate in sex offender treatment, and he failed to enroll, the type of treatment was relevant to the question of whether appellant's resistance was reasonable.
The trial court was not unreasonable in determining the probative value was not outweighed by any prejudice arising from the reference to "sex offender." Appellant contends the use of the term "sex offender" raised an assumption appellant committed a sexual offense. We disagree the use of the term raises such an assumption in a hospital setting where multiple treatment groups are offered for a variety of therapeutic purposes. Even so, the prejudice of the use of the general term "sex offender" was low in light of the entire record. The jury was presented with no evidence appellant had committed any sexual crime or perpetrated any other serious sexual abuse. The only reference to any sexual misconduct was that appellant received counseling for making inappropriate sexual remarks to staff. There was general testimony that the treatment team felt he could "benefit" from the class. Based on the evidence presented, the jury likely would have concluded appellant was recommended to take the treatment because of conduct such as the inappropriate sexual comments. Further, the references to sex offender treatment throughout the trial were very brief. We do not agree the use of the term in the context of the entire record would have led the jury to assume appellant had committed a sexual crime or that it caused undue prejudice which outweighed the probative value of the evidence.
Appellant suggests the reason he was recommended to enroll in sex offender treatment was that he had suffered a juvenile adjudication for rape, which appellant suffered approximately 50 years before trial when he was 14 years old. He points out that when he sought to exclude any reference to the juvenile adjudication prior to trial, the prosecutor agreed not to bring it up. Appellant relies on this to argue it was "more prejudicial for the jury to hear 'sex offender treatment' without any explanation, because jurors would logically assume the sex offense was more recent." Appellant's argument is not well taken. Certainly, appellant could have sought to introduce evidence of the reason for the recommendation for sex offender treatment and cross-examine the witnesses on the effectiveness of the treatment based on such an old offense, as that information would have been relevant to the question of whether his resistance to treatment was reasonable. Appellant did not do so, and the issue was never before the trial court. Rather, appellant argued the prior juvenile adjudication should be excluded. This was a tactical decision which appellant cannot now argue resulted in error. (Norgart v. Upjohn Co. (1999) 21 Cal.4th 383, 403 [" 'Where a party by his conduct induces the commission of error, he is estopped from asserting it as a ground for reversal' on appeal."].)
We conclude the trial court acted within its discretion in allowing the prosecution to specify one of the treatment groups appellant failed to participate in was sex offender treatment. Further, we reject appellant's argument that the mention of sex offender treatment violated his due process rights and right to a fair trial.
The admission of evidence, even if erroneous under state law, results in a due process violation only if it makes the trial fundamentally unfair. (Estelle v. McGuire (1991) 502 U.S. 62, 70; People v. Falsetta (1999) 21 Cal.4th 903, 913 ["The admission of relevant evidence will not offend due process unless the evidence is so prejudicial as to render the defendant's trial fundamentally unfair."].)
Here, we find no fundamental unfairness. To support appellant's contention, he cites People v. Garcia (2014) 229 Cal.App.4th 302. In Garcia, the appellate court held evidence introduced in a sexual abuse trial that the defendant was homosexual was irrelevant but that the trial court did not abuse its discretion in denying her motions for mistrial "[g]iven … the state of the record at the time [the defendant] made her mistrial motions." (Id. at p. 312.) Nonetheless, the appellate court concluded appellant did not receive a fair trial because, subsequent to the court's denial of the mistrial motions, the prosecutor argued the defendant's sexual orientation was relevant to the issue of motive. According to the appellate court, the prosecutor "essentially told the jury the reason [the defendant] chose to victimize [the victim] [was] because she is gay." (Id. at p. 313.) The appellate court emphasized the evidence regarding the defendant's sexual orientation was not "relevant to [the] prosecution [of the defendant]. Period." (Id. at p. 314.)
Here, in contrast, as we have explained, the evidence was relevant. Garcia is inapposite, and we find no due process violation.
DISPOSITION
The order is affirmed.
WE CONCUR: LEVY, ACTING P. J., MEEHAN, J.