In re Luciano G.

• Decision Date: 17 October 2019
• Docket Number: Supreme Court No. S-16654
• Citation: 450 P.3d 1258
• Parties: In the MATTER OF the Necessity for the Hospitalization of LUCIANO G.
• Court: Alaska Supreme Court

450 P.3d 1258

In the MATTER OF the Necessity for the Hospitalization of LUCIANO G.

Supreme Court No. S-16654

Supreme Court of Alaska.

October 17, 2019

OPINION

CARNEY, Justice.

I. INTRODUCTION

A man appeals the court order involuntarily committing him for mental health treatment. He argues that the court erred in making two findings: (1) that as a result of his mental illness he posed a risk of harm to others and (2) that there was no less restrictive alternative to committing him to the Alaska Psychiatric Institute (API). He contends that his conduct did not meet the statutory criteria of "likely to cause serious harm" and that there was insufficient evidence presented that there was no less restrictive alternative for his treatment. Because the superior court’s findings were supported by clear and convincing evidence and the superior court properly determined that the man’s conduct met the statutory criteria, we affirm the commitment order.

II. FACTS AND PROCEEDINGS

Anchorage airport police took Luciano G.¹ into emergency custody and transported him to the psychiatric emergency department at Providence Alaska Medical Center for emergency detention and evaluation.² Providence filed a petition for evaluation the same day; the petition was granted and Luciano was transported to API for evaluation. A few days later API staff filed a petition to commit him to API for up to 30 days for further treatment.³

At a hearing to address API’s petition, an airport police officer testified that Luciano had come to her attention after an airline employee had called to report a man was acting "irate" at the ticketing counter. She said Luciano had repeatedly refused to state his destination before eventually naming Arizona, had instantly squared up and balled his fists when she contacted him, and had continued to clench his fists and tighten his shoulders even after he had been handcuffed. The officer testified Luciano had both carry-on bags and luggage to be checked located about 500 feet away from where she first made contact with him. She noted that one piece of the luggage was a gun case with no visible lock, which concerned her because "to fly with an airlines [sic] you have to have a locked, secured case for weapons to go underneath the aircraft." Officers took Luciano to their office. They took his luggage, including the case, for safekeeping and performed an inventory search. Inside the case were a rifle, two revolvers, and another handgun. Three of the guns were loaded. The officer testified: "One revolver had six bullets inside and it was aligned with the chamber[,] [a]nother revolver had five bullets inside," and the third handgun had a fully loaded magazine with a bullet in the chamber. Luciano also had 120 rounds of ammunition and a "load bearing vest"⁴ in his other luggage.

Dr. Anthony Blanford, a psychiatrist at API, was called as an expert witness; he testified that he had spoken with Luciano four or five times since Luciano’s admission to API. He testified that Luciano appeared to suffer from an unspecified psychotic disorder. Dr. Blanford stated that people he had interviewed described Luciano’s recent behavior as very odd, especially in the last month, and that Luciano said that he had suffered a head injury as a result of a motor vehicle accident in the last month. Dr. Blanford noted Luciano had recently lost his job at the Veterans Administration (VA).

Dr. Blanford testified Luciano had been unwilling to talk to him about what happened at the airport other than to minimize the event and state it was just a misunderstanding. Dr. Blanford informed the court he had spoken to a person at the VA who described Luciano as engaging in an intense intimidating stare. Dr. Blanford testified Luciano had stared at him a couple of times and that the stare was "quite intimidating where [Luciano] would stop cooperating and then just engage in a stare, without blinking." He testified he interpreted Luciano’s stare as a threat. Dr. Blanford stated, "So when ... [Luciano] started doing that[,] I actually asked him ... what was he trying to do, intimidate[?] And he would say, well, why are you feeling scared, are you feeling frightened of me[?]" Dr. Blanford opined that Luciano’s behavior at the airport reflected confused thinking and paranoia and that he would expect someone with Luciano’s military background to know how to properly handle guns, including separating bullets from weapons. Dr. Blanford testified Luciano had told him that if he were released he wanted to go to Arizona to be near family, but that Luciano had refused to sign releases of information to enable API staff to confirm he could stay with family members.

Dr. Blanford stated that Luciano did not believe he had a mental health problem. Dr. Blanford did not believe Luciano would participate in outpatient treatment because Luciano "believes he didn’t really do anything wrong when he arrived at the airport, and he didn’t threaten anybody." Dr. Blanford testified he expected Luciano’s symptoms would continue if not treated and that his head injury might have made things worse. On cross-examination Dr. Blanford conceded that Luciano had not made any verbal threats and that Luciano’s behavior "at the worst, [had been] described as menacing, and intense ... and not able to engage."

Dr. Blanford also expressed concern that Luciano planned to escape from API because he demonstrated "elopement behavior," including asking to go outside frequently and carrying all of his belongings around API in a bag. Dr. Blanford described two incidents: Luciano attempted to "pull the fire alarm" so that he might escape, and he was observed in the gym attempting to "leap right up on a wall about six to eight feet high." Dr. Blanford believed that "[Luciano was capable] of trying to leap the wall in the yard."

Luciano testified that after his discharge from the U.S. Army in 2015 he primarily worked as a security guard before obtaining a position at the VA as a medical support assistant. He testified that he left his job at the VA because he wanted to take a vacation. Luciano described the situation at the airport as "just a misunderstanding between [himself] and the airport clerk and the police." He conceded that his interaction with the police was "not good" and that he was frustrated by the police putting their hands on him.

Luciano testified that he was not aware of having any mental health diagnoses, but that he did have an adjustment disorder he "personally ... classif[ied] ... as a [traumatic brain injury ]." He said he had suffered from too many head injuries to count and that he had not had treatment for many of those injuries. He described experiencing "[a] huge flash of light" countless times as a result of his head injuries and confirmed he had recently been in a motor vehicle accident.

Luciano stated he could see a doctor through the VA if he "wanted" to and agreed he was willing to be "evaluated" by the VA. But when asked whether he would be willing to take medication if recommended "for adjustment disorder, insomnia, some of the things [he was] struggling with[,]" he responded, "[P]ersonally ... I believe ... I don’t need it." When questioned further by his lawyer, Luciano agreed that he was willing to see a doctor. But he testified he did not want to be at API and would prefer to see an outpatient provider.

Luciano stated that he never intended to harm anyone with the guns he had at the airport and that he did not at any point intend to harm himself. He also stated that he had not had any desire to harm anyone since he had been at API. He said if he were released he would go to a doctor’s appointment scheduled for the next day and then he would want to get on a plane to go home. Luciano stated that if he were able to travel to Arizona, he would probably crash on his brother’s couch, but acknowledged that his brother was not expecting him.

On cross-examination Luciano admitted that he had received training about how to handle weapons while he was in the Army, but he stated that this had been his first time traveling at the airport as a civilian. He denied that his guns were loaded at the airport. Luciano agreed he had tried to stare down Dr. Blanford, but he could not remember asking if the doctor felt scared and denied that he had tried to stare down anyone else at API. He conceded that he had been balling his fists and squaring off to the officers at the airport, but said that he was not trying to send a message to the officers.

The magistrate found by clear and convincing evidence that Luciano was suffering from a mental illness based upon Dr. Blanford’s testimony and the adjustment disorder diagnosis from the VA, and that the mental illness finding was corroborated by Luciano’s current behavior and some of his own testimony. The magistrate stated that it appeared Luciano had suffered a "psychotic break."

The magistrate then considered "how much of an inference can be drawn from [Luciano’s] showing up at the airport with loaded, unlocked guns and behaving in the manner that he did." She noted that she was particularly concerned by Luciano’s denial that the weapons were loaded and believed that, given his military training and background, he would know not to come to the airport with loaded weapons. The magistrate stated that although she had not heard testimony of verbal threats, both the police officer and Dr. Blanford — professionals trained to assess these situations — testified they found Luciano’s nonverbal behavior threatening. The magistrate found by clear and convincing evidence that Luciano was likely to cause harm to others as defined by the statute. This finding was, in part, based upon Luciano’s apparent inability to assess and remember what was going on. The magistrate determined that there was no less restrictive alternative to confinement because there did not appear to be any place for Luciano to go and because she did not believe that he would follow up on...