In re Interest of K.C.

• Decision Date: 18 October 2018
• Docket Number: NO. 01-18-00010-CV,NO. 01-18-00009-CV,01-18-00009-CV
• Citation: 563 S.W.3d 391
• Parties: IN the INTEREST OF K.C., Appellant
• Court: Texas Court of Appeals

563 S.W.3d 391

IN the INTEREST OF K.C., Appellant

NO. 01-18-00009-CV

NO. 01-18-00010-CV

Court of Appeals of Texas, Houston (1st Dist.).

Opinion issued October 18, 2018

Tom Zakes, 1217 Prairie Suite 206, Houston, TX 77002, for Appellant.

Keith A. Toler, Assistant County Attorney, 1019 Congress, 15^th Floor, Houston, TX 77002, for Appellee.

Panel consists of Justices Keyes, Bland, and Lloyd.

Evelyn V. Keyes, Justice

In this case, the State of Texas, through the Harris County Attorney’s Office, applied for temporary mental health services for K.C. and also sought an order allowing the administration of psychoactive medication to K.C.¹ The trial court granted both orders, ordering that K.C. be admitted for inpatient treatment for forty-five days and that psychoactive medication be administered as part of K.C.’s treatment regimen. In one issue on appeal, K.C. contends that the trial court erred by waiving her appearance at the hearing on the State’s applications over her objection.

We affirm.

Background

On December 12, 2017, the State applied for temporary mental health services for K.C. The State alleged that K.C. was mentally ill and that, as a result of her mental illness, she was likely to cause harm to herself. The State also alleged that K.C. was "suffering severe and abnormal mental, emotional, or physical distress," she was "experiencing substantial mental or physical deterioration of [her] ability to function independently, except for reasons of indigence, to provide for [her] basic needs[,] including food, clothing, health, or safety," and she was "not able to make a rational and informed decision as to whether to submit to treatment." The State further alleged that K.C. required court-ordered temporary mental health services for her "own welfare and protection or for the protection of others" and that she "present[ed] a substantial risk of serious physical harm, if not immediately restrained."

The State attached to its application a "Certificate of Medical Examination" completed by Dr. Theresa Harring. Dr. Harring certified that she had examined K.C. on December 12 and that K.C. presented to the emergency room with an "altered mental status" and that K.C. had been diagnosed with "major depressive disorder

recurrent severe with psychotic features." Dr. Harring opined that K.C. was mentally ill and was likely to cause serious harm to herself, and she stated that K.C. "was found trying to poke [her] eye out with a fork" and that K.C. was "aggressive and assaultive towards nursing staff." Dr. Harring further stated: "[K.C.] presents as agitated, responding to internal stimuli and makes several attempts to gouge [her] eyes out with a stapler and pen found at nursing station. [K.C.] attempted to elope from ER, ran towards exit doors and bit a nurse on the chest." Dr. Harring further stated that emergency detention of K.C. was necessary because she was "incoherent and illogical in [her] thought process[.]"

Based on the State’s application, the trial court found that K.C. met the criteria for the issuance of an order of protective custody. The trial court ordered a constable to take K.C. into protective custody and transport her to Methodist West Houston Hospital where she would remain pending further orders from the court. The trial court ordered Dr. Harring to re-examine K.C. The trial court also set a hearing to determine whether probable cause existed for K.C.’s immediate restraint on December 15, 2017, and the court set a hearing on the State’s application for court-ordered mental health services for December 22, 2017. The trial court also appointed an attorney to represent K.C.

At a hearing on December 15, 2017, at which K.C.’s attorney waived her appearance, the hearing officer found that probable cause existed to believe that K.C. presented a substantial risk of serious harm to herself and that she should remain in the hospital pending the final hearing on the State’s application for mental-health services. The trial court also signed an order on this date transferring K.C. from Methodist West Houston to Harris County Psychiatric Center (HCPC).

On December 19, 2017, after K.C. had been transferred to HCPC, Dr. Jonathan Findley completed a second "Certificate of Medical Examination." Dr. Findley certified that K.C. had been diagnosed with schizoaffective disorder

, and he opined that she was likely to cause serious harm to herself and to others. Dr. Findley stated that K.C. was "experiencing depressive and psychotic episodes" and that she "[a]ttempted to pull out [her] eye due to delusions." He also opined that K.C. presented a substantial risk of serious harm to others because she bit a nurse in the transferring emergency department and she "attempted to elope" from the hospital. Dr. Findley stated that K.C. had "impaired judgment, insight, [and] impulse control" and that she required hospitalization to ensure her safety and the safety of others.

HCPC filed a psychosocial assessment of K.C., completed by Jovelle Cutting on December 19, 2017, with the trial court. The assessment reflected that K.C. had been admitted to HCPC on four previous occasions, with her most recent admission from October 24 to November 3, 2017. The assessment stated:

[K.C.] has a psychiatric history of [s]chizoaffective disorder, bipolar type. Per transfer report, [K.C.] presented to the emergency room and was highly illogical, disorganized, and aggressive. She was reportedly running around, attempted to elope, and bit a nurse on the chest. She reported after her last discharge, she arrived home and was frequently visited by CPS, which caused family conflict. She stated that during this time, she felt depressed and had thoughts of pulling her eyeball out, because "an eye for an eye." She stated that her "eye is messing with her." She endorsed paranoia, stating "when I sleep I get paranoid that I am living in déjà vu." .... She endorsed some compliance with medication at discharge, but also stated "I don't believe in medication."

K.C. stated that attempting to remove her eye was a suicide attempt and that she had attempted suicide on previous occasions by slitting her wrists and jumping out of a car into traffic. K.C. also reported that she has a two-year-old daughter and that CPS was involved in her daughter’s life, which contributed to her depression.

On December 22, 2017, the State filed a petition seeking an order to administer psychoactive medication to K.C. Dr. Findley certified that antipsychotic medication would be an appropriate course of treatment for K.C. He opined that K.C. lacked the capacity to make a decision concerning the administration of medication because K.C. was experiencing psychotic episodes, she had attempted to remove her eye with a pen, a spoon, and a stapler, and she "does not believe that she has a psychiatric illness or requires treatment." Dr. Findley further opined that if she were treated with antipsychotic medication K.C.’s prognosis would be good because she "has responded well to medication in [the] recent past with stabilization of mood and resolution of psychosis

." He opined that if K.C. does not receive antipsychotic medication she "will remain psychotic, with unstable mood, [and] unable to maintain safety outside [of the] hospital." Dr. Findley further stated that he had considered alternative forms of treatment, but K.C. had "not responded to general ward milieu interventions," and her "symptoms are of sufficient severity that medications are necessary to ensure reasonable chance of efficacy."

The trial court held a hearing on both of the State’s applications on December 22, 2017. At the beginning of the hearing, K.C.’s court-appointed attorney requested that she be brought to the hearing, noting that Dr. Douglas Samuels, a psychiatrist who was to testify at the hearing on behalf of the State, and personnel from the constable’s office were unwilling to bring K.C. to the hearing room because they "fel[t] that she is a risk of elopement." Dr. Samuels elaborated, stating to the trial court:

She’s on suicide precaution. She’s on combative/destructive precaution because of harm inflicted to the staff, and she’s on elopement precaution. And she’s off her medicine and flagrantly psychotic and unable to respond to redirection.

She attacked a nurse and bit a nurse in the chest. She has taken objects and tried to stab her eye out in the hospital.

The trial court stated, "I don't think it being in the lady’s self interest to be here, so I'm going to waive her appearance."

K.C.’s counsel argued that he was basing the request on K.C.’s constitutional right to face her accusers. He stated, "She is dealing with being incarcerated against her will. So whether it’s classified as criminal or not, she still has those rights under the Texas Constitution." The trial court asked one of the constables to determine if it was possible to bring K.C. to the hearing room, and an off-the-record conversation ensued. After the off-the-record discussion, the trial court stated on the record: "From my understanding, [K.C.] is a serious threat to herself and others, and law enforcement does not think that she can be brought down without posing a risk to a number of people, so I'm going to waive her appearance." The hearing then proceeded in K.C.’s absence, although her attorney was present.

With respect to the State’s request that K.C. be admitted for temporary mental health services, the State asked that K.C.’s counsel review the State’s application as well as Dr. Harring’s and Dr. Findley’s certificates of medical examination and stipulate to those documents. K.C.’s counsel did so and stipulated to the contents of those documents. The trial court took judicial notice of those documents and ordered K.C. committed for temporary mental health services.

With respect to the State’s request that the trial court order the administration of psychoactive medication to K.C., the State called Dr. Samuels to testify. Dr. Samuels testified that he had read...