Title: MATTER OF C M

State: montana

Issuer: Montana Supreme Court

Document:

b. No. 81-252 IN THE SUPREME COURT OF THE STATE OF MONTANA IN THE MATTER OF C.M. Appeal from: District Court of the Thirteenth Judicial District, In and for the County of Yellowstone. Honomble Robert Wilson, Judge presiding. Counsel of Record: For Appellant: Terry L. Seiffert, Billings, Montana For Respondent: Harold F. Hanser, County Attorney, Billings, Montana Submitted on briefs: August 11, 1981 Decided : Filed: DCT 2 9 M 3 ! 1 M r . J u s t i c e Fred J. Weber d e l i v e r e d t h e Opinion of t h e Court. C. M. was i n v o l u n t a r i l y committed to W a r m S p r i n g s S t a t e H o s p i t a l a f t e r p r o c e e d i n g s i n t h e District Court of t h e T h i r t e e n t h J u d i c i a l D i s t r i c t , Yellowstone County. She a p p e a l s from t h e o r d e r of commitment. W e a f f i r m . On March 21, 1981, C. M. was placed i n t h e p s y c h i a t r i c s e c t i o n of B i l l i n g s Deaconess H o s p i t a l i n B i l l i n g s , Montana. On March 23, C. M. I s mother asked t h e Yellowstone County A t t o r n e y to f i l e a p e t i t i o n a l l e g i n g C. M. to be s e r i o u s l y m e n t a l l y ill and r e q u e s t i n g t h a t C. M. b e committed f o r a p e r i o d of up to t h r e e months. The p e t i t i o n was f i l e d and a h e a r i n g was h e l d on March 30. On A p r i l 1, t h e d i s t r i c t judge i s s u e d h i s o r d e r committing C. M. to t h e S t a t e H o s p i t a l f o r t h e s t a t u t o r y 90-day p e r i o d . S e c t i o n 53-21-127 ( 2 ) ( a ) ( i) , MCA. She a p p e a l s from t h a t o r d e r and raises t h e f o l l o w i n g i s s u e s : (1) Was t h e r e s u f f i c i e n t e v i d e n c e to s u p p o r t t h e conclu- s i o n t h a t C. M. w a s " s e r i o u s l y m e n t a l l y ill," and ( 2 ) Was t h e r e s u f f i c i e n t e v i d e n c e to show t h a t W a r m S p r i n g s S t a t e H o s p i t a l was t h e least r e s t r i c t i v e form of commitment? Three p e r s o n s tes t i £ i e d a t t h e commitment hearing--C. M. s m o t h e r , D r . W i l l i a m Hague and C. M. The mother t e s t i f i e d t h a t C. M. had been l i v i n g w i t h h e r f o r a b o u t one month p r i o r to t h e h e a r i n g . She s t a t e d t h a t C. M. had been behaving i n a paranoid and confused manner. C. M. 's mother s a i d t h a t C. M. was obsessed w i t h c l e a n i n g , had shaved h e r head, changed c l o t h e s f i v e o r s i x times d a i l y , was o u t d o o r s i n March w i t h o u t s h o e s or a b l o u s e , and had broken down t h e door to t h e f a m i l y r e s i d e n c e . The mother also t e s t i f i e d t h a t C. M. had t h r e a t e n e d C. M . ' s 9-year o l d son and on one o c c a s i o n had l e f t a number of k i t c h e n k n i v e s l y i n g a b o u t t h e house. D r . Hague is a p s y c h i a t r i s t who had been i n v o l v e d i n t h e t r e a t m e n t of C. M. o v e r a p e r i o d of t w o y e a r s . H e had also examined C. M. d u r i n g h e r t h e n p r e s e n t s t a y i n B i l l i n g s Deaconess H o s p i t a l . D r . Hague diagnosed C. M. as s c h i z o p h r e n i c . H e t e s t i f i e d t h a t C. M. I s mother had t o l d him t h a t C. M. had t h r e a t e n e d h e r son with b o d i l y harm and had a h i s t o r y o f abusing t h e boy. D r . Hague also r e l a t e d t h a t t h e mother f e l t t h a t t h e i n c i d e n t w i t h t h e k n i v e s suggested t h a t C. M. m i g h t be t h i n k i n g of harming h e r s e l f or o t h e r s . D r . Hague t e s t i f i e d t h a t , based upon t h e m o t h e r ' s o b s e r v a t i o n s and h i s own e x a m i n a t i o n , it was h i s o p i n i o n t h a t C. M. w a s s e r i o u s l y m e n t a l l y ill. H e b e l i e v e d t h a t h e r i l l n e s s was i n t e r r u p t i n g h e r c o g n i t i v e p r o c e s s e s , was c a u s i n g d e l u s i o n a l t h i n k i n g , and was t h e r e b y i n t e r f e r i n g i n a s e v e r e way w i t h h e r f u n c t i o n i n g . D r . Hague f e l t t h a t it would be v e r y d i f f i c u l t f o r C. M. to c a r e f o r h e r s e l f . It had been h i s e x p e r i e n c e w i t h C. M. t h a t she d i d n o t f o l l o w through w i t h out- p a t i e n t programs. D r . Hague t e s t i f i e d t h a t C. M. needed a l e n g t h y p e r i o d of h o s p i t a l i z a t i o n which could n o t be accomplished i n B i l l i n g s . It was D r . Hague's recommendation t h a t C. M. be t r e a t e d a t W a r m S p r i n g s S t a t e H o s p i t a l . I n h e r t e s t i m o n y , C. M. e i t h e r g e n e r a l l y denied t h e a l l e g a t i o n s of h e r mother or e x p l a i n e d t h e conduct i n q u e s t i o n . B e f o r e a person may be committed t o t h e S t a t e H o s p i t a l under s e c t i o n 53-21-127, MCA, t h e person must be adjudged " s e r i o u s l y m e n t a l l y ill ." " ' S e r i o u s l y m e n t a l l y ill ' means suf- f e r i n g from a mental d i s o r d e r which h a s r e s u l t e d i n s e l f - i n f l i c t e d i n j u r y or i n j u r y to o t h e r s or t h e imminent t h r e a t t h e r e o f or which h a s d e p r i v e d t h e p e r s o n a f f l i c t e d of t h e a b i l i t y t o p r o t e c t h i s l i f e o r h e a l t h . " S e c t i o n 53-21-102(14), MCA. "Imminent t h r e a t of s e l f - i n f l i c t e d i n j u r y or i n j u r y to o t h e r s s h a l l be evidenced by o v e r t acts, s u f f i c i e n t l y r e c e n t i n t i m e as t o be material and r e l e v a n t as to t h e r e s p o n d e n t ' s p r e s e n t c o n d i t i o n . " S e c t i o n 53-21-126(2), MCA. C. M. a r g u e s t h a t D r . Hague had no p e r s o n a l knowledge of t h e i n c i d e n t s which a l l e g e d l y c o n s t i t u t e d e v i d e n c e of an imminent t h r e a t of sel £ - i n f l i c t e d i n j u r y or i n j u r y to o t h e r s , and t h e r e f o r e t h e c o u r t could n o t p r o p e r l y f i n d t h e e x i s t e n c e of such a t h r e a t . However, a p r o f e s s i o n a l person may o p i n e t h a t t h e respondent is s e r i o u s l y m e n t a l l y ill even though t h e evidence of an imminent t h r e a t of i n j u r y is o b t a i n e d from a s o u r c e o t h e r t h a n t h e p r o f e s s i o n a l p e r s o n . S e c t i o n 53-21-126 ( 4 ) , MCA. C. M. also c o n t e n d s t h a t t h e r e was a f a i l u r e to show any " o v e r t actsvv which evidenced an imminent t h r e a t of i n j u r y . W e d i s a g r e e . C. M. t h r e a t e n e d h e r son and a t h r e a t can be an o v e r t act which, i n i t s e l f , e v i d e n c e s an imminent t h r e a t of i n j u r y to a n o t h e r . Matter of Goedert ( 1 9 7 9 ) , 180 Mont. 484, 591 P.2d 222, 36 St.Rep. 393. An o v e r t act can also be evidenced by a p r e s e n t i n d i c a t i o n of probable p h y s i c a l i n j u r y which is l i k e l y t o o c c u r a t any moment o r i n t h e immediate f u t u r e . Matter o f F. B. ( 1 9 8 0 ) , Mont . , 615 P.2d 867, 37 St.Rep. 1442. Y The i n c i d d n t w i t h t h e k n i v e s , t h e o t h e r f a c t s p r e s e n t e d , and t h e d o c t o r ' s d i a g n o s i s of C. M. I s c o n d i t i o n were, when t a k e n t o g e t h e r , s u f f i c i e n t to show a p r o b a b i l i t y of p h y s i c a l i n j u r y i n t h e immediate f u t u r e . W e a l s o n o t e t h a t a d e t e r m i n a t i o n of s e r i o u s mental i l l n e s s can be made i f t h e p e r s o n ' s mental d i s o r d e r h a s d e p r i v e d t h e person of t h e a b i l i t y to p r o t e c t h e r or h i s h e a l t h . D r . Hague t e s t i f i e d t h a t C. M . ' s i l l n e s s was i n t e r r u p t i n g h e r c o g n i t i v e p r o c e s s e s , was causing d e l u s i o n a l t h i n k i n g , and was t h e r e b y i n t e r f e r i n g i n a s e v e r e way w i t h h e r f u n c t i o n i n g . The d o c t o r b e l i e v e d t h a t it would be v e r y d i f f i c u l t f o r C. M. to c a r e f o r h e r s e l f . Even a b s e n t a f i n d i n g of an i m m i - n e n t t h r e a t of i n j u r y , a f i n d i n g of s e r i o u s mental i l l n e s s could have p r o p e r l y been made because C. M. had been deprived of t h e a b i l i t y to protect h e r h e a l t h . S e c t i o n 53-21-102(14). The D i s t r i c t Court committed no error by r e a c h i n g t h e c o n c l u s i o n t h a t C. M. w a s s e r i o u s l y m e n t a l l y ill. F i n a l l y , C. M. a s k s u s to d e c i d e whether t h e r e w a s suf- f i c i e n t e v i d e n c e t o s u p p o r t t h e f i n d i n g t h a t Warm S p r i n g s S t a t e H o s p i t a l was t h e least r e s t r i c t i v e form of commitment. The pur- poses of Montana's laws f o r t r e a t m e n t of t h e s e r i o u s l y m e n t a l l y ill are to be accomplished " i n an i n s t i t u t i o n a l i z e d s e t t i n g o n l y when less r e s t r i c t i v e a l t e r n a t i v e s are u n a v a i l a b l e or i n a d e q u a t e and o n l y when a person is so m e n t a l l y ill as to r e q u i r e i n s t i t u - t i o n a l i z e d c a r e ." S e c t i o n 53-21-101( 3 ) , MCA. See a l s o s e c t i o n 53-21-120 , MCA. The District Court is g i v e n f o u r d i s p o s i t i o n a l o p t i o n s a f t e r a d e t e r m i n a t i o n of s e r i o u s mental i l l n e s s is made : " ( i ) c o m m i t t h e respondent to a f a c i l i t y f o r a p e r i o d of n o t more t h a n 3 months; " ( i i ) o r d e r t h e r e s p o n d e n t to be placed i n t h e care and c u s t o d y of h i s r e l a t i v e or g u a r d i a n or some o t h e r a p p r o p r i a t e p l a c e o t h e r t h a n an i n s t i t u t i o n ; " ( iii) o r d e r o u t p a t i e n t t h e r a p y ; or " ( i v ) make some o t h e r a p p r o p r i a t e o r d e r f o r t r e a t m e n t . " S e c t i o n 53-21-127 ( 2 ) ( a ) , MCA. D r . Hague had been involved i n t h e t r e a t m e n t of C. M. f o r two y e a r s . H e had found t h a t s h e d i d n o t f o l l o w through w i t h out- p a t i e n t programs. It was h i s o p i n i o n t h a t t h e h o s p i t a l i n B i l l i n g s would n o t be a b l e to provide t h e t r e a t m e n t t h a t C. M. needed. D r . Hague t e s t i f i e d t h a t because of t h e n a t u r e of h e r i l l n e s s , C. M. should be t r e a t e d a t Warm S p r i n g s S t a t e H o s p i t a l . C. M. d i d n o t p r e s e n t an e x p e r t i n b e h a l f of h e r p o s i t i o n t h a t s h e be t r e a t e d on an o u t p a t i e n t b a s i s . The e v i d e n c e supported t h e District C o u r t ' s d e c i s i o n t o c o m m i t C. M. t o Warm S p r i n g s S t a t e H o s p i t a l . The o r d e r of t h e District Court is a f firmed.