In the Matter of D.K.D.

• Decision Date: 14 April 2011
• Docket Number: No. DA 10–0242.,DA 10–0242.
• Citation: 250 P.3d 856,360 Mont. 76,2011 MT 74
• Parties: In the Matter of D.K.D., Respondent and Appellant.
• Court: Montana Supreme Court

360 Mont. 76

250 P.3d 856

2011 MT 74

In the Matter of D.K.D., Respondent and Appellant.

No. DA 10–0242.

Supreme Court of Montana.

Submitted on Briefs Feb. 23, 2011.Decided April 14, 2011.

For Appellant: Joslyn Hunt, Chief Appellate Defender, Lisa S. Korchinski, Assistant Appellate Defender, Helena, Montana.For Appellee: Steve Bullock, Montana Attorney General, Matthew T. Cochenour, Assistant Attorney General, Helena, Montana, Thomas P. Meissner, Fergus County Attorney, Lewistown, Montana.Justice PATRICIA O. COTTER delivered the Opinion of the Court.

[360 Mont. 76] ¶ 1 D.K.D., a seriously developmentally disabled individual, was committed by the District Court to the Montana Development Center (MDC) for a period of one year. He does not appeal from the order of commitment, but does appeal from the portion of the commitment order that authorized MDC staff and treating professionals to administer medication to him on an involuntary basis, pursuant to MDC policy. For the reasons set forth below, we affirm.

ISSUES

¶ 2 A restatement of the dispositive issue on appeal is whether the District Court committed error, much less plain error, when in its order of commitment, it authorized MDC staff to administer medication to D.K.D. on an involuntary basis pursuant to MDC policy.

FACTUAL AND PROCEDURAL BACKGROUND

¶ 3 D.K.D., who is now twenty-three years old, began receiving mental health treatment when he was six years old after he displayed out-of-control behavior and started a fire in his home. He suffers from both a developmental disability and mental illness, and has been in and out of treatment centers in Montana and throughout the United States since he was seven years old. D.K.D. has a history of behaving in a manner that places himself and others in danger, and he has made multiple suicide attempts over the years. He has also received several diagnoses over the course of his life, including oppositional defiant disorder, borderline personality disorder, and mild mental retardation. At 6' 4? and 400 pounds, D.K.D. is morbidly obese and has a history of difficulty functioning in a community environment, poor psychosocial support and resources, and refusal to engage in personal care.

¶ 4 In the last three years, D.K.D. has received treatment in both community and institutional settings. He has been in and out of Montana State Hospital (MSH) and MDC since 2005. From January to August 2009, D.K.D. received community-based care through Creative Options, Inc. in Lewistown, Montana. During his tenure in Lewistown, D.K.D. lived in his own apartment and received 24–hour care and supervision from Creative Options staff. In August 2009, D.K.D.'s case manager requested the State file a petition for involuntary commitment after D.K.D. repeatedly engaged in behaviors that posed risk of harm to himself and the Creative Options staff.

¶ 5 Upon the filing of the State's petition for involuntary commitment, D.K.D. was appointed counsel and referred to the Residential Facility Screening Team (RFST) to determine the most appropriate placement for him. The RFST concluded D.K.D. was seriously developmentally disabled, posed an imminent risk of harm to himself and others, and could not be effectively or safely treated in a voluntary community setting. The RFST recommended a community treatment plan that required the participation of a medical doctor, a psychiatrist, and a mental health counselor.

¶ 6 In September 2009, before a hearing on the State's petition was held, D.K.D. was admitted to MSH on an emergency basis and eventually involuntarily committed, after he made numerous serious threats to harm himself and the Creative Options staff. D.K.D.'s case manager stated that the staff was fearful of D.K.D.'s physical size and violent, tempestuous outbursts, and felt they had neither the knowledge to assist D.K.D. nor the ability to control him. While at MSH, D.K.D. repeatedly attempted to harm himself and threatened other MSH patients and staff. D.K.D.'s response to medication while at MSH was unpredictable as well because, while he generally took his medication willingly, there were other times when he refused to do so.

¶ 7 After several months at MSH, D.K.D.'s treating physician, Dr. Carlson, requested that the State petition to have D.K.D. committed to MDC because Dr. Carlson believed MDC would be better equipped to meet D.K.D.'s specific mental health needs. In his January 21, 2010 Psychiatric Evaluation for Recommitment, Dr. Carlson and the MSH Ewing treatment team recommended D.K.D. receive long-term care at MDC with a strict behavior plan as the most appropriate treatment. Additionally, Dr. Carlson stated that due to D.K.D.'s extreme lability (defined as “characterized by rapidly shifting or changing emotions, as in bipolar disorder and certain types of schizophrenia; emotionally unstable” by Mosby's Medical, Nursing, & Allied Health Dictionary 879 (Kenneth N. Anderson et al., eds. 4th ed., Mosby 1994)), an existing order that authorized the administration of involuntary medication was an important tool and should be continued in the event D.K.D. “again reach[es] a prolonged period of oppositional, self-destructive, and/or other violent behavior.”

¶ 8 On January 26, 2010, the State filed a petition for the involuntary commitment of D.K.D. to MDC. The District Court again appointed counsel to represent D.K.D. and referred him to the RFST for a recommendation of appropriate treatment. The RFST concluded D.K.D. was seriously developmentally disabled, and posed an imminent risk of harm to himself and others “due to his self-injurious behavior, suicide threats, physical aggression towards others, verbal threats to harm or kill others, and his physical size.” The RFST recommended D.K.D. be committed to MDC for up to one year and that MDC follow a multidisciplinary team approach to D.K.D.'s treatment.

¶ 9 On March 16, 2010, the District Court held a hearing on the petition for involuntary commitment. Present at the hearing were D.K.D., D.K.D.'s attorney, and the prosecutor. Dr. Carlson and the chairperson of the RFST, Leslie Howe, appeared via videoconference. During the proceeding, Howe explained the rationale behind the RFST's recommendation. Near the end of the hearing and consistent with his prior written report, Dr. Carlson informed the District Court that the order authorizing MSH staff to administer medication to D.K.D. involuntarily had been “one of the most important tools” in D.K.D.'s recent treatment at MSH.

¶ 10 Ultimately, the District Court found that D.K.D. posed an imminent threat to himself and others and committed him to MDC for up to one year. Near the end of its order, the court inserted the following language: “D.K.D. shall be committed to treatment at Montana Development Center for a period of no more than one year from March 16, 2010. The staff and treating professionals at Montana Development Center shall have the authority to administer medication to D.K.D. on an involuntary basis, pursuant to their policy.” D.K.D.'s counsel did not object to the commitment order or to the inclusion of the language quoted above. On appeal, D.K.D. does not challenge the order of commitment as a whole; rather, he appeals only the portion of the District Court's order authorizing administration of involuntary medication. D.K.D. requests that we exercise plain error review and strike that language from the court's order.

STANDARD OF REVIEW

¶ 11 At the outset, we resolve the conflicting standards of review presented by the parties in their opening briefs. Relying on In re L.S., 2009 MT 83, ¶ 18, 349 Mont. 518, 204 P.3d 707, D.K.D. urges us to apply a de novo standard to the District Court's legal conclusions and statutory interpretations, and an abuse of discretion standard to the court's discretionary rulings, which include administration and evidentiary issues. Citing In re S.C., 2000 MT 370, ¶ 8, 303 Mont. 444, 15 P.3d 861, the State urges us to apply the clearly erroneous standard to the court's findings of fact and the correctness standard to its conclusions of law.

¶ 12 We conclude that D.K.D.'s reliance on the standard of review as set forth in ¶ 18 of In re L.S. is inappropriate. While the In re L.S. Court did recite the standard of review endorsed by D.K.D., that Court actually applied the conventional clearly erroneous and correctness standards of review in its analysis at ¶ 24. Moreover, the case the In re L.S. Court relies on, In re Mental Health of E.P.B., 2007 MT 224, ¶ 5, 339 Mont. 107, 168 P.3d 662, also correctly applies the clearly erroneous and correctness standards. Further, we have consistently applied the clearly erroneous and correctness standards in civil commitment cases. See e.g. In re Mental Health of L.K.-S., 2011 MT 21, ¶ 14, 359 Mont. 191, 247 P.3d 1100; In re T.P., 2008 MT 266, ¶ 10, 345 Mont. 152, 190 P.3d 313; In re Mental Health of E.P.B., ¶ 5; In re G.M., 2007 MT 100, ¶ 12, 337 Mont. 116, 157 P.3d 687; In re A.K., 2006 MT 166, ¶ 9, 332 Mont. 511, 139 P.3d 849; In the Matter of T.S.D., 2005 MT 35, ¶ 13, 326 Mont. 82, 107 P.3d 481; In re Mental Health of C.R.C., 2004 MT 389, ¶ 11, 325 Mont. 133, 104 P.3d 1065; In re Mental Health of S.C., ¶ 8; In re Mental Health of L.C.B., 253 Mont. 1, 5, 830 P.2d 1299, 1302 (1992); In re G.S., 215 Mont. 384, 390, 698 P.2d 406, 410 (1985). Therefore, we reaffirm that in a civil commitment case we determine whether a district court's findings were clearly erroneous and whether its conclusions of law were correct.

DISCUSSION

¶ 13 Issue: Whether the District Court committed error, much less plain error, when in its order of commitment, it authorized MDC staff to administer medication to D.K.D. on an involuntary basis pursuant to MDC policy.

¶ 14 As a preliminary matter, we briefly address whether this case is moot in light of the fact that the court's commitment order, by its terms, expired on March 16, 2011. While not an issue raised by...