Title: In re N.H.

State: vermont

Issuer: Vermont Supreme Court

Document:

In re N.H.  (97-255); 168 Vt. 508; 724 A.2d 467

[Filed 18-Dec-1998]

  NOTICE:  This opinion is subject to motions for reargument under
  V.R.A.P. 40 as well as formal revision before publication in the Vermont
  Reports.  Readers are requested to notify the Reporter of Decisions,
  Vermont Supreme Court, 109 State Street, Montpelier, Vermont 05609-0801 of
  any errors in order that corrections may be made before this opinion goes
  to press.

                                 No. 97-255

  In re N.H.	                               Supreme Court

  					       On Appeal from
                                               District Court of Vermont,
                                               Unit No. 4, Waterbury Circuit

                                               June Term, 1998

       Marilyn S. Skoglund, J.

       William Sorrell, Attorney General, Montpelier, and Marybeth McCaffrey,
  Special Assistant

       Attorney General, and Sean Brown, Law Clerk, Waterbury, for
  Plaintiff-Appellee.

       Kristina I. Michelsen, Vermont Legal Aid, Inc., Waterbury, for
  Defendant-Appellant.

  PRESENT:  Amestoy, C.J., Dooley, Morse and Johnson, JJ.

       JOHNSON, J.   N.H. appeals from a family court order granting the
  Department of Developmental and Mental Health Services' application for
  continued treatment.  N.H. contends the Department failed to present clear
  and convincing evidence that she was a patient in need of further
  treatment, as required by 18 V.S.A. § 7616(b).  We affirm.(FN1)

       The material facts as found by the trial court are largely undisputed. 
  In December 1995, N.H. became incensed at her younger sister and repeatedly
  assaulted her, screaming profanely and accusing her of killing their
  father.  N.H.'s older sister testified that N.H.'s sanity had steadily
  eroded since their father's death in 1991, and that since that time she had
  threatened suicide, stated that taxis and buses were following her,
  complained that her landlord was routinely searching her apartment, and
  engaged in random and senseless acts of violence such as slapping her
  mother, smashing a fax machine, and breaking a remote control and
  videotape.  

  

       Following her arraignment on charges stemming from the 1995 assault,
  N.H. was evaluated at the Vermont State Hospital (VSH) and found to be
  competent to stand trial.  She subsequently pled nolo contendere to two
  counts of unlawful mischief and was given two four-year deferred sentences. 
  In August 1996, the court revoked both deferred sentences for violation of
  the counselling condition of her sentence and placed N.H. on probation with
  the same conditions.  Several months later, an arrest warrant was issued
  for new violations.  Thereafter, N.H. reportedly drove her car off the
  road.  When the police responded, she was arrested on the outstanding
  warrant and admitted to VSH for a psychiatric evaluation.  The evaluator
  concluded that N.H. was incompetent to stand trial and insane at the time
  of the violation.  By stipulation, the court entered a judgment of not
  guilty by reason of insanity, dismissed the violation of probation charge,
  and, following a hearing, committed N.H. to VSH for ninety days.  

       Shortly after her commitment, the director of VSH filed an application
  for involuntary medication.  Before that application went to hearing, N.H.
  filed an application for discharge, and the Department filed an application
  for continued treatment.  The parties agreed to go forward with the hearing
  on the application for continued treatment, and N.H. withdrew her
  application for discharge.  

       At the hearing, N.H.'s older sister recounted N.H.'s marked decline
  since the 1995 assault.  According to her sister, N.H. was increasingly
  unable to focus (requiring verbal prompting to turn while driving),
  displayed a flat affect, made no eye contact, wrote on the walls of her
  bedroom, and often spoke of suicide.  She would not leave the house during
  daytime, but only under cover of darkness.  N.H.'s younger sister also
  testified concerning N.H.'s steady decline, and expressed concerns for her
  own safety should N.H. be released without further treatment.

       N.H.'s psychiatrist at VSH, Dr. Malloy, also testified.  Based upon
  his observations and the reports of family members and hospital staff, Dr.
  Malloy diagnosed N.H. as suffering from

  

  a psychotic disorder which substantially affected her thought processes. 
  He opined that her underlying psychotic features were steadily eroding her
  mental health, and impairing her ability to function.  Dr. Linder, who
  performed an independent psychiatric evaluation, testified that unlike Dr.
  Malloy he had not observed symptoms from which he could diagnose a
  psychosis, but conceded that further evaluation might reveal some form of
  personality disorder.

       The court found that N.H. suffered from a mental illness that caused a
  substantial disorder of thought and impaired her judgment, and that as a
  result she posed a danger to herself or others.  The court concluded,
  accordingly, that the Department had shown by clear and convincing evidence
  that N.H. was a patient in need of further treatment, and committed her to
  the custody of the Commissioner of the Department to be hospitalized for an
  indeterminate period.  This appeal followed. 

                                     I.

       Before turning to N.H.'s arguments, we address the Department's claim
  that the appeal should be dismissed as moot.  During the pendency of her
  appeal, N.H. entered into a stipulation with the Department to modify the
  order of continued treatment from one of hospitalization to one of
  non-hospitalization.  See 18 V.S.A. § 7617(b).  The new order included
  conditions that N.H. take all prescribed medications, keep all medical
  appointments, comply with the treatment plan, and refrain from any threats,
  assaults or other behaviors that would pose a danger to herself or others. 

       The Department argues that by agreeing to an alternate program of
  non-hospitalization, N.H. implicitly conceded that she has a mental
  illness, and tacitly agreed to continue her involuntary commitment. 
  Accordingly, the Department contends that by entering into the stipulation
  N.H. has either waived or mooted her appeal.  We are not persuaded,
  however, that N.H. waived her right to appeal the original
  continued-treatment order merely by agreeing to a non-hospitalization
  placement.  No such intent is stated in the parties' stipulation, and we
  are unwilling to infer an intent to forfeit such a fundamental right. 
  Furthermore, it would not be 

  

  in the public interest to condition a patient's opportunity to participate
  in an alternative treatment plan upon the patient's willingness to forego
  an appeal from the original order of continued treatment.  

       Nor are we persuaded that the appeal is moot as a result of the
  stipulation.  A case becomes moot when the issues presented are no longer
  "live" or the parties lack a cognizable interest in the outcome.  See In re
  P.S., 167 Vt. 63, 67,