State v. C. V.-I. (In re C. V.-I.)
| Decision Date | 18 August 2021 |
| Docket Number | A168502 |
| Citation | 314 Or.App. 39,496 P.3d 5 |
| Parties | In the MATTER OF C. V.-I., a Person Alleged to have Mental Illness. State of Oregon, Respondent, v. C. V.-I., aka C. A. V.-I., Appellant. |
| Court | Oregon Court of Appeals |
Alexander C. Cambier and Multnomah Defenders, Inc., filed the brief for appellant.
Ellen F. Rosenblum, Attorney General, Benjamin Gutman, Solicitor General, and Jonathan N. Schildt, Assistant Attorney General, filed the brief for respondent.
Before DeHoog, Presiding Judge, and Mooney, Judge, and Kistler, Senior Judge.
Appellant appeals an order continuing her commitment to the custody of the Oregon Health Authority for a period not to exceed 180 days. Appellant contends that the trial court erred in ruling that she was a person with a mental illness. Specifically, appellant argues that the evidence was insufficient to support the court's finding that, due to a mental disorder, she was unable to provide for her basic personal needs. See ORS 426.130 ; ORS 426.005(1)(f)(B). For the reasons that follow, we affirm.
"When reviewing a civil commitment, we view the evidence, as supplemented and buttressed by permissible derivative inferences, in the light most favorable to the trial court's disposition and assess whether, when so viewed, the record was legally sufficient to permit that outcome." State v. E. J. J. , 308 Or. App. 603, 604, 479 P.3d 1073 (2021) () (internal quotation marks omitted); see also State v. M. C. D. , 304 Or. App. 775, 780-81, 467 P.3d 84 (2020) (). In this case, the record consists of testimony from Dr. Pointon, appellant's attending psychiatrist at the Oregon State Hospital (OSH), and appellant herself.
Appellant was the subject of a recommitment hearing on July 10, 2018. At the time of the hearing, appellant was 31 years old and had been originally committed to OSH on January 19, 2018, after she had exhibited assaultive behavior towards family members. Pointon became appellant's psychiatrist in March 2018, during appellant's initial commitment to OSH. In examining her medical history, Pointon noted that appellant had a history of psychiatric hospitalizations, methamphetamine use, marijuana use, and possible brain injury. Pointon's opinion was that appellant had a "more severe disorganized type" of schizophrenia. Pointon testified that appellant often exhibits disorganized speech or "word salad"; that is, "when [appellant] starts talking for more than just a few minutes, *** the words are so jumbled up, you're really not sure what she's talking about." Appellant's methamphetamine and marijuana use makes her more psychotic, and each time she has a psychotic event, she "loses some of her function."
According to Pointon, appellant had been difficult to treat while at OSH. Due to the severity of appellant's mental illness, she was prescribed clozapine, but her medications had to be changed after clozapine caused her severe side effects that ultimately placed her in the ICU. Thereafter, appellant's medication was switched to Prolixin, which appeared to "have a calming effect" on her and was less likely to have the medical side effects associated with clozapine. Pointon acknowledged that appellant's symptoms had improved somewhat in that she was no longer assaultive. However, appellant's psychotic symptoms persisted, and she continued to respond to internal stimuli by talking to people who were not present.
Pointon opined that if appellant were to be released from the hospital she would not be able to provide herself with food or seek appropriate medical care, and she "would be at tremendous risk out in the community for rape, assault, just every possible bad thing that you could think of." Based on the review of appellant's medical records, Pointon testified that appellant had previously been physically and sexually assaulted outside of the hospital as a result of her mental illness. Further, Pointon noted that appellant's thought and speech processes were still so disorganized at the time of the hearing that she did not know if appellant would be able to make her needs understood or otherwise provide for those needs once she was out in the community.
When she was asked whether appellant had any medical issues, Pointon replied:
Pointon agreed with appellant's trial counsel that appellant was "medically stable except for [her] teeth." However, even though Pointon acknowledged that "you can never predict" how long it would take for an abscess to develop, she emphasized that abscesses "can flare up so quickly" and the infected areas can drain into the brain.
Additionally, Pointon believed that appellant would not take her medications outside of a supervised setting, particularly in light of appellant's methamphetamine addiction and her history of noncompliance and resulting decompensation. Although Pointon recognized that, if appellant were to be released, it would take "probably a couple of months before she got into real trouble," that timeline would be shortened and the consequences of not taking her medication would be more severe if appellant resumed her methamphetamine use, which the doctor viewed as likely. Appellant had been using methamphetamine since she was a teenager, and she had acknowledged using drugs regularly prior to her admission to OSH. And if she were to reengage in methamphetamine use, Pointon opined, appellant's decompensation would accelerate because "her brain [was] already very delicate" and had already suffered considerable damage due to her methamphetamine use and failure to take her medications. As the doctor explained, "schizophrenia [is] a progressive disease." According to Pointon, "[t]he most [the] medicines can do is kind of halt it." That is, that medication would "maintain" appellant's current brain function, but additional brain damage could result if appellant discontinued her medication and began using methamphetamine again.
Pointon testified that appellant's mother would pick her up from the hospital, as she was very involved with appellant, but, for reasons the doctor was unable to disclose on the record, her mother's care was not a "good setting" for appellant to return to; in fact, it would not be possible. Appellant, on the other hand, testified that she wanted to stay with her parents for a few weeks upon her release from the hospital; she also said that she would continue taking her medications at a clinic in West Salem. Despite her admission to regular drug use prior to her hospitalization, appellant assured the court that she would not resume her use upon being released.
The trial court concluded that appellant has a mental disorder (schizophrenia ) and that she was unable to provide for her basic needs as a result of that disorder. The court therefore continued appellant's commitment. In articulating its basis for continuing appellant's commitment, the court referenced appellant's history of not taking her medications when left unsupervised, her history of substance abuse, and her inability to care for herself when using drugs. Additionally, the court noted Pointon's testimony that living with her mother was not an option for appellant. The court found that not only would appellant not have a place to live, but she also would not have meals or the ability to take care of her medical needs, referring specifically to her "dental issue."
On appeal, appellant does not dispute that she has a mental disorder; she only contends that the evidence did not support the trial court's finding that she was unable to provide for her basic personal needs as a result. In support of her argument, appellant observes that she was able to effectively communicate her plan to stay with her parents once she was released and explain her plan to continue taking her medications, even identifying the clinic where she would get them. Appellant emphasizes Pointon's acknowledgement that appellant was medically stable "except for [her] teeth." And as to her dental health, appellant argues that any risk from an abscess was speculative because there was no evidence that appellant currently had any abscessed teeth and that, even if she did, she already was on a waitlist to have her teeth examined. Finally, appellant argues that there was no indication that she was incapable of obtaining food and that any concern that she would suffer serious physical harm from an inability to obtain food or water was also speculative.
In response, the state contends that the following evidence demonstrates that, at the time of the hearing, appellant was unable to provide for her basic...
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