In re B.T.

• Decision Date: 15 February 2006
• Docket Number: No. 2004–570.,2004–570.
• Citation: 891 A.2d 1193,153 N.H. 255
• Court: New Hampshire Supreme Court
• Parties: In the Matter of B.T.

153 N.H. 255

891 A.2d 1193

In the Matter of B.T.

No. 2004–570.

Supreme Court of New Hampshire.

Argued: Jan. 11, 2006.

Opinion Issued: Feb. 15, 2006.

Disability Rights Center, Inc., of Concord (Cindy Robertson and James Fox on the brief, and Mr. Fox orally), for the respondent.

Craig, Wenners, Craig and Capuchino, of Manchester (Linda Capuchino on the brief and orally), for the petitioner.

GALWAY, J.

The respondent, B.T., appeals an order of the Hillsborough County Probate Court (Cassavechia, J.) ordering her involuntary admission to a hospital for purposes of conditional discharge pursuant to RSA chapter 135–C (2005). We reverse.

The record supports the following facts. In June 2004, the petitioner, Jennifer DeVoe of the Mental Health Center of Greater Manchester (MHC), filed a petition in the probate court for the involuntary admission of B.T. At the subsequent hearing, Dr. Timothy Breitholtz, the court-appointed psychiatrist, DeVoe, and B.T. testified; Dr. Breitholtz also filed a report with the court.

The following evidence was presented to the court. B.T. is a woman with a history of mental illness beginning in 1987, when she was first diagnosed with "Schizophreniform Disorder." In 1999, she overdosed on prescribed medications and was hospitalized. During this hospitalization, the probate court ordered her involuntarily admitted for a period not to exceed two years. It is unclear from the record exactly when B.T. was released from the hospital, but she was conditionally discharged prior to the expiration of her two-year admission. In 2001, she was involuntarily admitted again for a period not to exceed three years, expiring on June 4, 2004, but again received a conditional discharge. One condition of her conditional discharge was that she take the medications prescribed by the MHC staff psychiatrist.

In December 2002, B.T. discontinued her required medications on two occasions and experienced what the petition describes as "agitation, pressured speech, and preoccupation with side effects of the medications." Due to her violations of the conditional discharge, her conditional discharge was temporarily revoked. The revocation resulted in B.T.'s admission to New Hampshire Hospital for twenty days. Additionally, in June 2003, DeVoe was informed by B.T. that she had decided on her own to decrease her dosage of a prescribed medication. DeVoe warned B.T. that doing so would violate her conditional discharge and could result in another revocation, which dissuaded B.T. from lowering her medication level.

On May 13, 2004, DeVoe was notified that B.T.'s family members were concerned about her condition. Later that day, the Manchester Police found B.T. "wandering around Hanover Street in Manchester, NH in a confused state and complaining of chest pains." The police took B.T. to the Catholic Medical Center Emergency Room, where a physician examined her for chest pains and recommended a psychological assessment by MHC. At this assessment, B.T. stated that she was not taking Abilify, a medication prescribed to her by her MHC psychiatrist. This resulted in another temporary revocation of her conditional discharge.

On June 7, 2004, DeVoe filed the instant petition for B.T.'s involuntary commitment, which gave rise to a hearing on July 22, 2004, in the probate court. At the hearing, DeVoe described B.T.'s history of not taking her prescribed medications and testified that in early May 2004, DeVoe received a call from B.T. in which she stated that she planned to stop taking Abilify and planned to take St. John's Wort, prescribed by her homeopathic physician, instead.

Dr. Breitholtz examined B.T. in June 2004 and diagnosed her as having "schizoaffective disorder bipolar type" and "narcissistic personality disorder." His testimony and report state:

[B.T.] has a long and extensive history of noncompliance with her recommended treatment which has often resulted in rapid decompensation of her mental condition manifested by severe agitation, emotional lability, delusional thinking and paranoid ideation. She expresses minimal insight into her mental condition and I feel without a conditional discharge there is a very high risk of noncompliance with taking her medication .... It is my opinion that [B.T] remains in such a mental condition as a result of mental illness as to create a potentially serious likelihood of danger to herself or others.

The probate court ruled that B.T. was "of such mental condition as a result of mental illness to create a potential serious likelihood of danger to herself." The probate court ordered that B.T. be "admitted to New Hampshire Hospital for a period not to exceed three years for the express purpose of conditional discharge."

B.T. appeals the probate court's order, arguing that the petitioner presented insufficient evidence at the hearing to support an order of involuntary commitment for the purpose of conditional discharge pursuant to RSA 135–C:34 and RSA 135–C:45.

The petitioner responds that she proved by clear and convincing evidence that B.T. posed a danger to herself or others and therefore met the standard of proof under RSA 135–C:34. She also argues that she presented sufficient evidence for an extension of B.T.'s conditional discharge under RSA 135–C:45, III, which requires a lower standard of proof than an initial involuntary commitment.

An overview of the applicable statutory scheme provides a context for our analysis. RSA chapter 135–C, entitled "New Hampshire Mental Health Services System," establishes a system of mental health facilities in New Hampshire and provides for procedures used in the admission, maintenance, and release of individuals involved in that system. See RSA 135–C:1, :6, : 27–:54. A PERSON MAY BE INVOLUNTARILY ADMITTED INTO AN APPROVED treatment facility by either involuntary emergency admission (IEA) or nonemergency involuntary admission, which is commonly referred to as an " involuntary admission." RSA 135–C:27, : 34; see also In re Perley, 137 N.H. 209, 211, 625 A.2d 452 (1993) (referring to an RSA 135–C:34 proceeding as an "involuntary admission"). An IEA may only last for a maximum of ten days unless extended. RSA 135–C:31, :32. The maximum duration of an involuntary admission is five years, unless renewed under RSA 135–C:45 or : 46. Along with determining the length of the involuntary admission, the probate court shall include an appropriate period of time, if any, to allow for conditional discharge. RSA 135–C:45, II.

Conditional discharge allows a person who has been involuntarily admitted to participate in treatment on an out-patient basis, provided that the patient agrees to abide by the rules of the conditional discharge. RSA 135–C:50. Failure to comply with such rules may result in a temporary or permanent revocation of the conditional discharge, which requires a return to a treatment facility. RSA 135–C:51. A conditional discharge may not exceed the period of time remaining on the involuntary admission ordered by the probate court. RSA 135–C:50, II.

I. Renewal of Conditional Discharge

We first address DeVoe's argument that she presented sufficient evidence to support an extension of B.T.'s involuntary admission pursuant to RSA 135–C:45, III.

The interpretation of a statute is a question of law, which we review de novo. We are the final arbiters of the legislature's intent as expressed in the words of the statute considered as a whole. We first examine the language of the statute, and, where possible, ascribe the plain and ordinary meanings to the words used. When a statute's language is plain and unambiguous, we need not look beyond it for further indication of legislative intent, and we will not consider what the legislature might have said or add language that the legislature did not see fit to include.

Woodview Dev. Corp. v. Town of Pelham, 152 N.H. 114, 116, 871 A.2d 58 (2005) (citations omitted).

RSA 135–C:45, III states:

If the respondent is on a conditional discharge at the time of the hearing, the court may order involuntary admission to a receiving facility, or renew such an order, for the purpose of permitting the respondent to remain on conditional discharge if such treatment is necessary to prevent the recurrence of the circumstances which led to the person's dangerous condition.

RSA 135–C:45, III (emphasis added). This provision expressly requires that the respondent be on a conditional discharge at the time of the hearing. According to the record, B.T.'s latest involuntary admission expired on June 4, 2004, prior to the filing of the instant petition. Cf. RSA 135–C:39 (2005). A conditional discharge cannot exceed the period of time remaining on an involuntary admission order. RSA 135–C:51, II. Accordingly, B.T.'s conditional discharge also expired on June 4, 2004. The hearing at issue occurred on July 22, 2004. Since B.T.'s conditional discharge had expired at the time of the hearing, the probate court could not have applied RSA 135–C:45, III to renew the prior order for involuntary admission and conditional discharge.

II. Admission for the Purposes of Conditional Discharge

We next address whether DeVoe presented sufficient evidence to support an involuntary commitment for the purposes of conditional discharge. "We review sufficiency of the evidence claims as a matter of law and uphold the findings and rulings of the trial court unless they are lacking in evidential support or tainted by error of law." In the Matter of Alexander and Evans, 147 N.H. 441, 442, 790 A.2d 142 (2002). "The findings of fact of the judge of probate are final unless they are so plainly erroneous that such findings could not be reasonably made." RSA 567–A:4 (1997). As our analysis also requires statutory interpretation, which is a question of law, we apply our de novo standard for statutory interpretation, as stated above.

RSA chapter 135–C permits a court to order admission for the purposes of conditional discharge:

In any order of admission to a receiving facility, the court

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