In re Commitment of E.F., 012221 INCA, 20A-MH-1103

Docket Nº:20A-MH-1103
Opinion Judge:MATHIAS, JUDGE.
Party Name:In the Matter of the Commitment of E.F., E.F. Appellant-Respondent, v. Health and Hospital Corporation d/b/a Sandra Eskenazi Mental Health Center, Appellee-Petitioner.
Attorney:ATTORNEYS FOR APPELLANT Valerie K. Boots Deborah Markisohn Marion County Public Defender Agency - Appellate Division Indianapolis, Indiana ATTORNEYS FOR APPELLEE Bryan H. Babb Sarah T. Parks Bose McKinney & Evans, LLP Indianapolis, Indiana
Judge Panel:Altice, J., and Weissmann, J., concur.
Case Date:January 22, 2021
Court:Court of Appeals of Indiana

In the Matter of the Commitment of E.F., E.F. Appellant-Respondent,


Health and Hospital Corporation d/b/a Sandra Eskenazi Mental Health Center, Appellee-Petitioner.

No. 20A-MH-1103

Court of Appeals of Indiana

January 22, 2021

Pursuant to Ind. Appellate Rule 65(D), this Memorandum Decision shall not be regarded as precedent or cited before any court except for the purpose of establishing the defense of res judicata, collateral estoppel, or the law of the case.

Appeal from the Marion Superior Court The Honorable Kelly M. Scanlan, Judge Pro Tempore Trial Court Cause No. 49D08-2005-MH-15959

ATTORNEYS FOR APPELLANT Valerie K. Boots Deborah Markisohn Marion County Public Defender Agency - Appellate Division Indianapolis, Indiana

ATTORNEYS FOR APPELLEE Bryan H. Babb Sarah T. Parks Bose McKinney & Evans, LLP Indianapolis, Indiana



[¶1] E.F. appeals the Marion Superior Court's order temporarily committing her to Eskenazi Mental Health Center ("Eskenazi"). E.F. argues that the trial court's finding that she is gravely disabled is not supported by clear and convincing evidence.

[¶2] Concluding that Eskenazi failed to prove that E.F. is gravely disabled, we reverse.

Facts and Procedural History

[¶3] E.F. is a thirty-three-year-old woman who has been diagnosed with schizophrenia and lives with her mother. E.F. has been hospitalized on several occasions over the past five years as a result of her mental illness. Most recently, she was hospitalized from February 26, 2020 to March 9, 2020, and from April 2, 2020 to April 4, 2020. When she was discharged from those hospitalizations, she was prescribed oral medications, which she did not maintain.

[¶4] On May 13, 2020, law enforcement officers transported E.F. to Eskenazi for an immediate detention following allegations that she was not taking her prescribed medication and had threatened to kill her mother. She also threatened to break the windows in her mother's house. When she was admitted, E.F. "described a delusion that her mother was in some kind of . . . gang bang with the place [she] used to work, and a guy named Bill for ninety billion dollars." Tr. p. 7.

[¶5] The next day, Eskenazi filed in Marion Superior Court a "Report Following Emergency Detention." Appellant's App. p. 19. Dr. Halimah Oral ("Dr. Oral"), the treating physician, opined that E.F. suffers from schizophrenia and is gravely disabled. Eskenazi recommended that E.F. be detained in its facility pending a hearing. Dr. Oral believed that E.F. needed custody, care, or treatment in an appropriate facility and stated that E.F. refused to begin voluntary treatment. Id. at 24-25. Dr. Oral recommended a temporary commitment not to exceed ninety days.

[¶6] The trial court held a commitment hearing on May 20, 2020. Eskenazi only presented evidence from Dr. Oral who testified that she had examined E.F. on numerous occasions during the emergency detention. Dr. Oral stated that E.F. suffers from schizophrenia, hallucinations, delusions, and impaired thinking and judgment. Dr. Oral expressed her opinion that E.F. would not take medication as prescribed if she were released from Eskenazi. Dr. Oral was concerned that if E.F. refused to take medications, her delusions would worsen and E.F. might become a danger to herself and/or others. Dr. Oral also testified that during the emergency detention, she has not observed that E.F. was a danger to herself or others, only that she possibly could be. Tr. pp. 9, 13.

[¶7] E.F. testified and, on multiple occasions, denied suffering from schizophrenia. Tr. pp. 15, 20. Yet, she stated she would take her prescribed medications. While she did not deny prior hospitalizations, she did not agree that she was hospitalized as a result of her mental illness. E.F. was able to care for her basic needs during the emergency detention. And, Eskenazi did not present any evidence that she acted dangerously or aggressively toward hospital staff.

[¶8] The trial court found that E.F. suffers from schizophrenia. The court also found that E.F. is currently gravely disabled in that she is demonstrating a substantial impairment and obvious deterioration in her judgment and reasoning and behavior that has resulted in her inability to function independently at this point in time. The court basis [sic] that on all of the testimony including Dr. Oral's testimony - that of the delusions that [E.F.] reported and as well as her significant disorganized thought processes. . . . [H]er thoughts are not logical and goal directed, per Dr. Oral and her reasoning is significantly impaired which prevents her from reaching logical conclusions about what is going on around or what she should do which would certainly put her at risk for harm in the community. Furthermore, [E.F.] has . . . demonstrated no insight into her mental illness. She denies . . . having schizophrenia and it sounds as though . . . that she is not in agreement with taking medications once she is released from the hospital. . . . I will point out that the court is as well concerned with the multiple admissions since the end of February so [E.F.] has established a pattern of not following through with what has been prescribed and return to the hospital and she is a high risk of returning again if not on commitment.

Tr. pp. 21-22. For these reasons, the trial court granted Eskenazi's request to temporarily commit E.F. until August 18, 2020, unless discharged prior to that date.

[¶9] E.F. now appeals. Additional facts are provided below.

Discussion and Decision

[¶10] E.F. contends that there was insufficient evidence to support her involuntary regular commitment because Eskenazi did not prove by clear and convincing evidence that she is gravely disabled. First, we observe that E.F.'s appeal is arguably moot because ninety days have elapsed since the trial court issued its order and she has likely been released from her involuntary commitment. "When a court is unable to render effective relief to a party, the case is deemed moot and usually dismissed." In re Commitment of J.M., 62 N.E.3d 1208, 1210 (Ind.Ct.App. 2016) (quoting In re J.B., 766 N.E.2d 795, 798 (Ind.Ct.App. 2002)). However, "Indiana recognizes a public interest exception to the mootness doctrine, which may be invoked when the issue involves a question of great public importance which is likely to recur." T.W. v. St. Vincent Hosp. & Health Care Ctr., Inc., 121 N.E.3d 1039, 1042 (Ind. 2019) (quoting Matter of Tina T., 579 N.E.2d 48, 54 (Ind. 1991)). "[A]n involuntary commitment is of great public interest and involves issues which are likely to recur, so we generally choose to address the merits of such appeals, despite the mootness of the case." B.D. v. Ind. Univ. Health Bloomington Hosp., 121 N.E.3d 1044, 1048 (Ind.Ct.App. 2019).

[¶11] "'[T]he purpose of civil commitment proceedings is dual: to protect the public and to ensure the rights of the person whose liberty is at stake.'" T.K. v. Dep't of Veterans Affs., 27 N.E.3d 271, 273 (Ind. 2015) (quoting In re Commitment of Roberts, 723 N.E.2d 474, 476 (Ind.Ct.App. 2000)). "The liberty interest at stake in a civil commitment proceeding goes beyond a loss of one's physical freedom, and given the serious stigma and adverse social consequences that accompany such physical confinement, a proceeding for an involuntary civil commitment is subject to due process requirements." Id.

[¶12] To satisfy due process, the facts justifying an involuntary commitment must be proved by clear and convincing evidence. In re Commitment of G.M., 743 N.E.2d 1148, 1151 (Ind.Ct.App. 2001). Clear and convincing evidence is defined as an intermediate standard of proof greater than a preponderance of the evidence and less than proof beyond a reasonable doubt. T.D. v. Eskenazi Midtown Cmty. Mental Health Ctr., 40 N.E.3d 507, 510 (Ind.Ct.App. 2015). In order to be clear and convincing, the existence of a fact must be highly probable. Id. When we review the sufficiency of the evidence supporting an involuntary commitment, we will affirm if, "considering only the probative evidence and the reasonable inferences supporting it, without weighing evidence or assessing witness credibility, a reasonable trier of fact could find [the necessary elements] proven by clear and convincing evidence." T.K., 27 N.E.3d at 273 (citation omitted).

[¶13] To obtain an involuntary commitment, the petitioner is "required to prove by clear and convincing evidence that: (1) the individual is mentally ill and either dangerous or gravely disabled; and (2) detention or commitment of that individual is appropriate." Ind. Code § 12-26-2-5(e). Here, the trial court found that E.F. is mentally ill and gravely disabled. E.F. does not...

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