### RECORD IMPOUNDED

SUPERIOR COURT OF NEW JERSEY APPELLATE DIVISION DOCKET NO. A-1667- 22
IN THE MATTER OF THE CIVIL COMMITMENT OF A.E.

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Argued February 12, 2024

– Decided February 21, 2024 Before Judges Mawla and Vinci. On appeal from the Superior Court of New Jersey, Law Division, Camden County, Docket No. MNCC- 00 0 047

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. Brian P. Hughes, Assistant Deputy Public Defender , argued the cause for appellant A.E. (Jennifer Nicol e Se llitti, Public Defender, attorney; Brian P. Hughes, on the briefs). Matthew White, Assistant County Counsel, argued the cause for respondent State of New Jersey (Emeshe Arz ó n, Camden County Counsel, attorney; Krista Ayn Schmid, Assistant County Counsel, on the brief).
PER CURIAM NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION This opinion shall not "constitute precedent or be binding upon any court. " Although it is posted on the internet, this opinion is binding only on the parti es in the case and its use in other cases is limite d. R. 1:36- 3.2 A- 1667

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A.E. appeals from the January 26, 2023 order that continued his involuntary commitment. Based on our review of the record and applicable principles of law, we affirm. On January 9, 2023, A.E., who was sixty years old at the time, was admitted to Northbrook Behavioral Health Hospital ( "Northbrook") in Camden suffering from acute unspecified psychotic disorder . A.E. was experiencing delusions that he was paralyzed. His delusions beg an after he saw a player sustain an injury while watching a professional foo tball game. On January 10, 2023, a judge entered a temporary order for involun tary commitment. On January 26, 2023, the court conducted a commitment hearing. A.E. applied for immediate discharge. He did not seek Conditional E xtension Pending Placement ("CEPP"). Dr. Thomas Campo, A. E.'s treating psychiatrist at Northbrook, testified for the State, and recommended continuing involunta ry commitment. Dr. Campo testified A.E. was suffering from a mental illn ess, unspecified psychotic disorder. At the time of the hearing, A.E. was sti ll experiencing delusions that he had previously been paralyzed but was "somewhat recovered" and suffering "vestigial weakness es ." According to Dr. Campo, A.E. believed "if he [was] on the floor, his limitations [ would not] allow him to get up by himself, [and] he3 A- 1667

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[would have] to remain on the floor." During his s tay at Northbrook, hospital staff did, in fact, need to help him up from the fl oor. A.E. was not suffering from any medical or neuroco gnitive issues that would cause paralysis or weakness. Dr. Campo was t reating A.E. with Risperdal and Gabapentin. Dr. Campo testified A.E. was medic ation compliant, but A.E. believed he did not need medication. A.E. also believed he needed a defibrillator implanted to help with his medical issues. Dr. Campo testified A.E. could not attend to his n ecessary activities of daily li ving , including general hygiene, without assistance in t he hospital due, in part, to his delusions. Dr. Campo testified A.E . had poor insight into his mental illness and believed he was being treated fo r a medical condition causing his paralysis and weakness. Although A.E. desired to return to his elderly parents' home where he lived since 1973, his parents advised Northbrook they wou ld not allow him to return until he was stable. Dr. Campo testified that return ing A.E. to his parents' home when he was ready was a better option than alternat ive housing. He explained no less restrictive environment was appropriate at the time, and A.E. was an imminent danger to himself due to his inability to care for himself because of his mental illness. Specifically, Dr. Campo opined that if A.E. was released4 A- 1667

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immediately, he would need to go to an emergency sh elter and would end up in the emergency room by the end of the day because of his delus ions. Dr. Campo believed A.E. was "getting better" and expected A.E . would be released in "another week or so." A.E. testified he had "a condition in [his] spine. It hits [his] peroneal nerve, so [he] can't get down on the floor and get back up . [He has] to be by a chair. [He] didn 't fall down getting up. Nobody helps [him], in [N orthbrook], [ to ] get back up." A.E. also testified, contrary to D r. Campo's testimony, he showered regularly and cared for himself at Northbr ook and never needed assistance to get up from the floor. Based on Dr. Campo's testimony and written report, the court found the State proved by clear and convincing evidence A.E. suffered from a mental illness, unspecified psychotic disorder. The court also found A.E. suffered " a delusional incident where he believed himself to be come paralyzed. He ha[d] since regained some mobility, but he still believe[ ed] that if he [was] on the ground, he [could] not stand up." The court noted there was no evidence A.E. had a source of income and found A.E. had no place to live other than his parents' home, which was not available to him until his cond ition improved. It found A.E. would not be able to survive outside the hospi tal because he would not have5 A- 1667

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a place to live , be able to obtain food, or care for himself. The c ourt concluded A.E. "in his present situation" was not "able to ne gotiate the basic requirements of life and be able to care for himself." It ordered continued involuntary commitment and scheduled a review hearing for Febru ary 16, 2023. On February 7, 2023 , A.E. was released. On appeal, A.E. argues the court erred in not ordering CE PP. In his reply brief, A.E. also argues the State failed to meet it s burden to establish involuntary commitment was appropriate. More particularly, A.E. argues the State failed to establish by clear and convincing evidence it was p robable he would suffer substantial bodily injury within the foreseeable fu ture. We review the decision to continue an individual's civil commitment utilizing an abuse of discretion standard. See In re D.C., 146 N.J. 31, 58- 59 (1996). When reviewing civil commitment decisions, "we afford deference to the trial court's supportable findings." In re Com mitment of T.J., 401 N.J. Super. 111, 119 (App. Div. 2008) . We "reverse[] only when there is clear error or mistake." In re Commitment of M.M., 384 N.J. Super . 313, 334 (App. Div. 2006). However, we "must consider the adequacy of the evidence." Ibid. To continue an individual's involuntary commitment after a temporary commitment order, a court must find "by clear and c onvincing evidence6 A- 1667

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presented at [a] hearing that the patient is in nee d of continued involuntary commitment . . . . " R. 4:74 -7(f)(1). The Legislature has defined this to mean :

that an adult with mental illness, whose mental ill ness causes the person to be dangerous to self or danger ous to others or property and who is unwilling to accep t appropriate treatment voluntarily after it has been offered, needs outpatient treatment or inpatient ca re at a short-term care or psychiatric facility or specia l psychiatric hospital because other services are not appropriate or available to meet the person's menta l health care needs. [N.J.S.A. 30:4-27.2(m).] A person is "dangerous to self" if: by reason of mental illness the person has threatene d or attempted suicide or serious bodily harm, or has behaved in such a manner as to indicate that the pe rson is unable to satisfy [their] need for nourishment, essential medical care or shelter, so that it is pr obable that substantial bodily injury, serious physical harm, or death will result within the reasonably foreseeable future; however, no person shall be deemed to be unable to satisfy [their] need for nourishment, essent ial medical care, or shelter if [they are] able to sati sfy such needs with the supervision and assistance of others who are willing and available. This determination shal l take into account a person's history, recent behavior, a nd any recent act, threat, or serious psychiatric deterior ation. [N.J.S.A. 30:4-27.2(h).]
A patient who no longer needs involuntary commitment generally must be released within forty-eight hours in accordance wit h a plan developed by the7 A- 1667

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patient's treatment team. N.J.S.A. 30:4-27.15(b); see also N.J.S.A. 30:4-27.18 (stating the treatment team's obligation with respe ct to preparation of the plan). CEPP is a n exception to the general rule requiring release wit hin forty-eight hours. A CEPP order is proper only when the patien t no longer requires involuntary commitment but "is not able to survive in the community independently or with the help of family or friends ." In re S.L., 94 N.J. 128, 140 (1983)

. A judge must make the finding, and the evidence must be a dequate to satisfy the judge that CEPP is appropriate. Id. at 140- 41. We are not persuaded by A.E.'s argument that the co urt erred by continuing his involuntary commitment. A.E. does n ot dispute his diagnosis of unspecified psychotic disorder, or that his diagnos is qualifies as a mental illness under the statutory scheme. Based on Dr. Campo's t estimony, the court found , at the time of the hearing, A.E. would not have be en able to survive outside of the hospital because he did not have a place to liv e and, because of his mental illness, he would not have been able to obtain food or care for himself. The court also found A.E.'s parents were unwilling t o allow him back into their home until he stabilized and there were no ot her individuals to whom he could turn for assistance. It found A.E. "in his present situation" was not "abl e to negotiate the basic requirements of life and be able to care for himself." These8 A- 1667

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findings readily establish ed that A.E. was "unable to satisfy his need for nourishment, essential medical care or shelter, so that it [was] probable that substantial bodily injury, serious physical harm, o r death [would] result within the reasonably foreseeable future . . . " as required by N.J.S.A. 30:4 -27.2(h). We are satisfied the court's findings were supported b y sub stantial, credible evidence in the record and it did not abuse its discretion by continuing the involuntary commitment. A.E.'s argument, which was not raised below, that t he court was required to order CEPP is misplaced. CEPP is appropriate on ly if the pa tient no longer requi res involuntary commitment . Because we have determined the court correctly continued the involuntary commitment, the cou rt did not err by failing to consider CEPP. Affirmed.