In re Aiden R.
| Docket Number | S-17931 |
| Decision Date | 07 June 2023 |
| Parties | In the Matter of the Necessity for Hospitalization of AIDEN R. |
| Court | Alaska Supreme Court |
UNPUBLISHED See Alaska Appellate Rule 214(d)
Appeal from the Superior Court No. 3AN-20-02045 PR of the State of Alaska, Third Judicial District, Anchorage, Herman G. Walker Judge.
Appearances: Claire F. DeWitte, Assistant Public Defender and Samantha Cherot, Public Defender, Anchorage, for Appellant.
Ryan A. Schmidt, Assistant Attorney General, Anchorage, and Treg R. Taylor, Attorney General, Juneau, for Appellee.
Before: Winfree, Chief Justice, Maassen, Carney, Borghesan, and Henderson, Justices.
A man was arrested and detained in jail. Two days later the criminal charges were dropped but the man remained in jail awaiting a court-ordered mental health evaluation. He remained jailed for 12 days awaiting transport to an evaluation facility. At no point did he request a review hearing. Following an evaluation at Alaska Psychiatric Institute (API), mental health professionals petitioned for his involuntary 30-day commitment at API to treat his mental illness. After a hearing the superior court authorized that commitment.
The man appeals, arguing that the superior court plainly erred by not sua sponte ordering review hearings to monitor the legality of his continued pre-evaluation detention, and by not considering the effect of his extended pre-evaluation detention on his mental health when ordering that he be committed for treatment for 30 days. We hold that the court did not plainly err, and we affirm the superior court's orders.
On September 21, 2020, Aiden R.[1] was arrested on robbery and assault charges and brought to the Anchorage Correctional Complex. Two days later a mental health professional on behalf of the Department of Corrections (DOC) simultaneously filed both a notice of emergency detention and application for evaluation, and a petition for an order authorizing Aiden's involuntary hospitalization for a mental health evaluation.[2] The petition for hospitalization for evaluation noted that Aiden was in custody for an evaluation and that a mental health professional had interviewed Aiden that morning.[3] In an email to the superior court master presiding over these filings, DOC also represented that the criminal charges against Aiden had been dismissed and that he "would be released today if the petition were denied."
DOC's petition for hospitalization for evaluation alleged that Aiden was "refusing all meals and medications," was "defecating on the floor," had "persecutory and grandiose delusions," and was "explosive" with DOC staff. It further alleged that Aiden was "diagnosed with schizoaffective disorder, antisocial personality disorder, and polysubstance use disorder." The petition asserted that Aiden was likely to cause serious harm to others due to his "persecutory delusions," his aggressive responses, and his statement that he would "[hurt] anyone who gets in [his] way." According to the petition, Aiden was gravely disabled due to his refusal of food and medications, lack of sleep, disorientation, delusions, and aggression. The detention notice made similar though less detailed assertions.
In response to these filings the master recommended that the petition for hospitalization for evaluation be granted. The master noted that a mental health professional had already screened Aiden.[4] The master determined there was probable cause to believe that Aiden was likely to cause serious harm to others due to delusions, aggression toward DOC staff, and threats of violence. She further concluded there was probable cause to believe that Aiden was gravely disabled because of his refusal of meals and medication, his defecating on the floor, and his inability to sleep.[5]
The superior court approved the master's recommendation, appointed an attorney for Aiden, and ordered his immediate delivery to the first available evaluation facility. The order further required DOC to file a status report if Aiden was not transported within 24 hours and to file additional updates every 24 hours until he was transported.
The Department of Health and Social Services (DHSS)[6] filed three status reports advising that evaluation facilities did "not have capacity" to accept Aiden. DHSS's next status report stated that Aiden had not been transported because he was "refusing COVID-19 screening" and that API was "working with DOC to plan for a safe admit as respondent had potential COVID-19 exposure." The status reports indicated that Aiden was expected to remain in jail "unless an appropriate less restrictive placement [was] identified." Neither Aiden nor his attorney objected or asked for a review hearing.[7]
On September 30, the day the original evaluation order was to expire, DOC moved to extend the order authorizing hospitalization for evaluation. DHSS also filed another status report noting that
The extension motion largely alleged the same facts as the original petition. It stated that Aiden was likely to cause serious harm to others because of his threat to "shoot the [people] in the head" that he believed were out to get him, including police officers and DOC staff. It also alleged that Aiden was gravely disabled because he could not "identify where he would stay or how he would obtain food" upon release. The superior court approved the master's recommendation to grant the motion, and extended the order for seven days. Neither Aiden nor his attorney objected to this order or requested reconsideration.
Aiden remained in jail the next two days, and DHSS filed status reports. Both reports stated that Aiden was still refusing COVID-19 screening, that DOC would continue to quarantine him at the jail due to COVID-19 exposure, and that he would be transported to API by October 6. Aiden was transported and admitted to API the morning of October 5, 12 days after the original order authorizing hospitalization for evaluation had been granted.
Upon arrival at API Aiden initially attempted to get away and "was subsequently placed in a brief manual restraint, and . . . became combative and resistive." Staff moved him into locked seclusion, at which point Aiden "became physically aggressive toward staff and punched a staff member in the head."
Following Aiden's evaluation API staff filed a petition for a 30-day commitment for treatment.[8] The petition alleged that Aiden was diagnosed with schizoaffective disorder, had delusional thoughts, and behaved aggressively toward staff. The petition asserted that Aiden was likely to seriously harm others as evidenced by verbal threats and physical aggression toward staff. It also asserted that Aiden was gravely disabled because without treatment he was "in danger of neglecting his basic needs."[9]
API also petitioned for court approval to involuntarily administer various psychotropic medications.[10] The API nurse practitioner who was treating Aiden stated in the petition that with these medications Aiden would "have continued improved impulse control, reduced aggression, and diminished agitation" as well as fewer delusions and a stabilized mood. The nurse practitioner asserted that no less intrusive options were available, that Aiden declined voluntary medications, that other methods had "not ameliorated [Aiden's] distressing symptoms," and that Aiden did "not appear to have the capacity to provide informed consent."
A 30-day commitment hearing was held on October 7.[11] Aiden's API nurse practitioner testified. He testified that Aiden's "current diagnosis [was] schizoaffective disorder," which "represents a combination of both psychotic symptoms as well as mood symptoms." The nurse practitioner described some of Aiden's delusions, including "suggestions that he is himself a god" and "that he reported finding . . . two one-million-dollar bills." According to the nurse practitioner, Aiden was "able to provide select linear responses to direct questioning, but prolonged interaction [led] to . . . tangential and disordered thoughts." When asked whether he thought Aiden's irritability was "specific to being at API," the nurse practitioner responded that although "being at API exacerbates his irritability" he also "engage[s] in aggressive and assaultive behavior" while in the community.
The nurse practitioner also testified about Aiden's aggression toward staff members, including both physical violence and verbal threats. He recounted Aiden's attempt to flee on admission, his subsequent restraint and combativeness, and his later attempt to hit an API staff member. According to the nurse practitioner, Aiden "had daily events involving brief manual restraints and emergency gurneys," but had not been violent toward any staff since the first instance. The nurse practitioner also testified about verbal threats Aiden made on the date of his admission, including that he was going to attack staff and that he would "[hurt] anyone who gets in his way or interrupts his spiritual journey." The nurse practitioner was not aware of any direct threats since that day.
The nurse practitioner explained that there had been some improvement in Aiden's condition while at API. He testified that he had "noticed an improvement in [Aiden's food] intake" since Aiden's arrival at API, and that Aiden had not defecated or urinated on the floor as he had while in jail. The nurse practitioner also said that Aiden had been able to shower and change himself after being prompted. The nurse practitioner attributed this improvement to ...
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