Commitment of J.B. v. Midtown Mental Health Center

• Citation: 581 N.E.2d 448
• Decision Date: 19 November 1991
• Docket Number: No. 49A02-9102-CV-60,49A02-9102-CV-60
• Parties: 2 NDLR P 149 In the Matter of the COMMITMENT of J.B., Appellant-Respondent, v. MIDTOWN MENTAL HEALTH CENTER, Appellee-Petitioner. 1 .
• Court: Court of Appeals of Indiana

Page 448

581 N.E.2d 448

2 NDLR P 149

In the Matter of the COMMITMENT of J.B., Appellant-Respondent, v. MIDTOWN MENTAL HEALTH CENTER, Appellee-Petitioner.

No. 49A02-9102-CV-60 ¹.

Court of Appeals of Indiana,

Fifth District.

Nov. 19, 1991.

Katherine A. Cornelius, Bleecker Brodey & Andrews, Indianapolis, for appellant-respondent.

Peter H. Pogue, Locke Reynolds Boyd & Weisell, Indianapolis, for appellee-petitioner.

RUCKER, Judge.

J.B., a thirty-one year old female suffering from the mental disease of alcoholism, was involuntarily committed to Central State Hospital after the trial court determined she was dangerous to herself. On appeal J.B. challenges the commitment order arguing the trial court erred in its finding of dangerousness.

We reverse.

Since 1984, J.B. has undergone treatment for alcoholism. The treatment programs were not successful until 1987, when she underwent outpatient therapy. J.B. was demonstrating progress until the spring of 1990, when her ability to stay sober began to decline and her behavior became erratic.

By the summer of 1990, as a result of her alcohol abuse, J.B. had become unemployed, and had lost her apartment. Between June and October of 1990, J.B. was arrested on three separate occasions: once for driving while intoxicated, once for public intoxication, and once for public indecency.

During that same period, there were three instances in which J.B. was away from home and so intoxicated that her mother went out to retrieve her. On two of those occasions, J.B. initially appeared to acquiesce and went along with her mother's desire to take her home. On both of those occasions, however, J.B. waited until her mother had stopped the car at a busy intersection and then J.B. got out of the car and ran away through the traffic. On the third occasion, J.B. did not get into her mother's car but rather flagged down a car containing several young men and left in the car with them as her mother approached.

On October 16, 1990, J.B.'s mother submitted an application for J.B.'s emergency detention to Midtown Mental Health Center (Midtown). Midtown filed a physician's emergency statement with the trial court and on that date an emergency detention order was issued pursuant to Ind.Code Sec. 16-14-9.1-7. While at Midtown, J.B. was examined by Dr. Celestine Detrana, a psychiatric resident at the hospital. Midtown petitioned for regular commitment of J.B. and a hearing was held on November 1, 1990.

At the hearing, Dr. Detrana testified that J.B. was mentally ill in that she was suffering from severe alcohol dependency. Dr. Detrana also testified that J.B.'s recent conduct was a manifestation of that illness, and that those manifestations of mental illness made J.B. dangerous to herself. Detrana further testified J.B. was unlikely to make any progress with her illness without a structured program.

The trial court found that J.B. was mentally ill and dangerous to herself, and entered an order for J.B.'s regular commitment to Central State Hospital. This appeal ensued.

I.

A person may be involuntarily committed if the court finds by clear and convincing evidence that the person is mentally ill and either dangerous to herself or others or gravely disabled. Ind.Code Sec. 16-14-9.1-3 and Sec. 16-14-9.1-10; Jones v. State (1985), Ind.App., 477 N.E.2d 353, trans. denied.

Mental illness is defined as a "psychiatric disorder that substantially disturbs an individual's thinking, feeling, or behavior and impairs the individual's ability to function." Ind.Code Sec. 16-14-9.1-1(a). J.B. does not contest the court's finding that she is mentally ill. J.B. argues, however, the evidence is insufficient to justify the court's finding that she is dangerous to herself.

When reviewing a challenge to sufficiency of the evidence we look to the evidence most favorable to the trial court's decision and all reasonable inferences drawn therefrom. If the trial court's commitment order represents a conclusion that a reasonable person could have drawn, then the order must be affirmed even if other reasonable conclusions are possible. In re Mental Commitment of M.P. (1986), Ind.App., 500 N.E.2d 216, 219 reh. denied, modified, (1987), Ind., 510 N.E.2d 645.

"Dangerous" is defined by Ind.Code Sec. 16-14-9.1-1(c) as "a condition in which an individual as a result of mental illness presents a substantial risk that the individual will harm the individual or others." J.B. argues the evidence of leaving her mother's car while stopped at an intersection and hitchhiking is not the sort of conduct envisioned by the statute as a basis for a finding of dangerous to self. J.B. also argues such evidence is far from clear and convincing that she is at substantial risk of harming herself in the future.

In contrast, Midtown contends J.B. exposed herself to substantial risk by running out into traffic at a busy intersection and flagging down a car containing several men. Midtown argues the demands of I.C. Sec. 16-14-9.1-1(c) have been satisfied by the testimony of Dr. Detrana that the foregoing conduct is a manifestation of J.B.'s mental illness and that because of these manifestations J.B. is thereby a danger to herself.

Proceedings for an involuntary commitment are subject to federal due process requirements:

We have recognized that for the ordinary citizen commitment to a mental hospital produces 'a massive curtailment of liberty' Humphrey v. Cady, 405 U.S. 504, 509, 92 S.Ct. 1048, 1052, 31 L.Ed.2d 394 (1972), and in consequence 'requires due process protection.' Addington v. Texas, 441 U.S. 418, 425, 99 S.Ct. 1804, 1809, 60 L.Ed.2d 323 (1979); O'Connor v. Donaldson, 422 U.S. 563, 580, 95 S.Ct. 2486, 2496, 45 L.Ed.2d 396 (BURGER, C.J., concurring). The loss of liberty produced by an involuntary commitment is more than a loss of freedom from confinement. It is indisputable that commitment to a mental hospital 'can engender adverse social consequences to the individual' and that '[w]hether we label this phenomena "stigma" or choose to call it something else ... we recognize that it can occur and that it can have a very significant impact on the individual.' Addington v. Texas, supra, [441 U.S.] at 425-426, 99 S.Ct., at 1809. See also Parham v. J.R., 442 U.S. 584, 600, 99 S.Ct. 2493, 2503, 61 L.Ed.2d 101 (1979). Also '[a]mong the historic liberties' protected by the Due Process Clause is the 'right to be free from, and to obtain judicial relief for, unjustified intrusions on personal security.' Ingraham v. Wright, 430 U.S. 651, 673, 97 S.Ct. 1401, 1413, 51 L.Ed.2d 711 (1977).

Vitek v. Jones (1980), 445 U.S. 480, 491-492, 100 S.Ct. 1254, 1263, 63 L.Ed.2d 552, 564, quoted in Matter of Tedesco (1981), Ind.App., 421 N.E.2d 726, 729, trans. denied.

To satisfy the requirements of due process the State must prove the facts justifying an involuntary commitment by clear and convincing evidence. In Re Turner (1982), Ind.App., 439 N.E.2d 201; Matter of Commitment of Linderman (1981), Ind.App., 417 N.E.2d 1140. This standard of proof not only communicates the relative importance our legal system attaches to a decision ordering an involuntary commitment, but it also has the function of reducing the chance of inappropriate commitments.

In Addington v. Texas (1979), 441 U.S. 418, 99 S.Ct. 1804, 60 L.Ed.2d 323, the United States Supreme Court expressed a strong concern that a decision ordering an involuntary commitment might be made on the basis of a few isolated instances of unusual conduct which occurred within a range of conduct which is generally acceptable. The Court opined that since everyone exhibits some abnormal conduct at one time or another, "loss of liberty calls for a showing that the individual suffers from something more serious than is demonstrated by idiosyncratic behavior." Id., 441 U.S. at 427, 99 S.Ct. at 1810.

The concern expressed in Addington is well taken and applies equally to the inherently problematic determination of future dangerousness. It is beyond dispute that everyone exposes himself to risk now and again, and therefore a court must approach the determination of a mentally ill person's dangerousness with some circumspection. Otherwise, the danger is strong, that a mentally ill person might be inappropriately committed. Addington, supra. There is no constitutional basis for confining a mentally ill person who is not dangerous and can live safely in freedom. Linderman, supra.

II.

No Indiana case has elaborated on the parameters of "dangerous" as that term is defined in I.C. Sec. 16-14-9.1-1(c). ² However, involuntary commitment cases from foreign jurisdictions are instructive to our analysis. Those cases which have found clear and convincing evidence that a mentally ill person is dangerous to self have a unifying thread running through the underlying facts. Namely, the facts used to justify the commitment discount on their face the possibility that the conduct is an instance of everyday risk-taking behavior. Matter of Gatson (1979), 3 Kan.App.2d 265, 593 P.2d 423 (Individual went out into cold weather wearing no clothes or shoes.); Matter of Wilson (1983), Ala.Civ.App., 431 So.2d 552 (Individual would not eat or sleep for periods of up to 36 hours and lost 50 lbs. in 8 months.); Matter of Samuels (1986), D.C.App., 507 A.2d 150 (Individual would wander aimlessly through traffic on freeway ramp.); Matter of Chey (1985), Minn.App., 374 N.W.2d 778 (Individual would often fall while climbing out of windows and ran repeatedly into traffic.); Matter of A.G. (1984), Mont., 677 P.2d 592 (Individual jumped out of moving car.).

To put the matter another way, we believe that the factual circumstances of the foregoing cases lead inevitably to a conclusion that the conduct which is predictive of future dangerousness would not occur but for the individual's mental illness. For reasons that we now elaborate, we believe this is the relevant inquiry to our review of the present issue.

III.

In making a determination of...