### COURT Cr APrFAK Hi'.' 

## 20fiiMAR 10 AHII: ||

IN THE COURT OFAPPEALS OF THE STATE OF WASHINGTON DIVISION ONE In the Matter ofthe Detention of M.T., Appellant,

STATE OF WASHINGTON, Respondent. No. 70238-6-1

UNPUBLISHED OPINION FILED: March 10, 2014 

### Per Curiam. M.T. appeals her involuntary civil commitment, arguing thatthe State presented insufficient evidence to supportthe court's finding that she suffered from a grave disability. We affirm. On March 17, 2013, M.T.'s son brought herto the emergency room at Harborview Medical Center, where she was admitted due to multiple recentfalls and failure to thrive. Hospital records noted her history ofmajor depressive disorder and obsessive-compulsive disorder (OCD). M.T. received treatmentfor chronic leg ulcers thatwere not healing due to malnutrition and poorwound care. On March 26, the State filed an involuntary commitment petition alleging that M.T. was gravely disabled and should be committed for 14 days. On March 27, the superior court held a hearing on the petition. The State presented testimonyfrom Dr. Allison Osborn, a licensed clinical psychologist and evaluatorfor Harborview; Dr. Elsa Haloman, a Harborview psychiatry resident; andNo. 70238-6-1/2 

### Cathy Erskine, a social worker forthe Departmentof Social and Health Services (DSHS). Dr. Osborn testified that M.T. suffers from OCD and majordepressive disorder, and thatthe disorders have a substantial adverse impact on her cognitive and volitional 

### functions. Regarding her OCD, Dr. Osborn testified that M.T. scored 37 on an OCDtest that has a maximum score of40. She testified that M.T. is extremely phobic and fearful 

### ofgerms. As a result, M.T. has extreme compulsions or rituals that interfere with her self-care. Dr. Osborn noted that prior to entering the hospital, M.T.'s rituals required so much time that she would only intake food, water, and medication once every three to 

### eight days. While in the hospital, M.T. reported fears ofcontamination, particularly of 

### dirt orgerms entering her mouth, and told staff that she would noteator drink and would continue to starve herself. Dr. Olson concluded that M.T. was gravely disabled 

### and at risk ofserious physical harm as a result ofher mental disorders. She recommended that M.T. be committed for up to 14 days, adding that a less restrictive alternative would not meet her needs. Dr. Haloman testified that M.T. suffers from chronic ulcers on her legs, which are 

### complicated by her malnourishment. M.T. has also fallen multiple times and because her bones have not healed correctly, she is unable to walk. She needs surgeryto 

### regain her abilityto walk but is too malnourished for surgery. M.T. has also tested 

### positive formethicillin-resistantstaphylococcus aureus (MRSA), an antibiotic-resistant bacterium that puts her at risk for superinfections, sepsis, amputation, and death. Dr.No. 70238-6-1/3
Haloman concluded that M.T. was gravely disabled and that itwas not safe for herto leave the hospital. 

### Cathy Erskine testified that DSHS attempted to place M.T. at every nursing facility inthe state ofWashington. The onlyfacility that accepted her in the pastwould
no longer accept her due to her noncompliance withcare. Ifdischarged from the hospital, M.T. would only have the assistance ofher son. 

### M.T. testified and agreed that she should stay inthe medical unit ofthe hospital but objected to psychiatric treatment. M.T. further testified that ifprovided with a care plan, she would follow it. The court granted the petition for M.T.'s involuntary commitment. M.T. appeals. DECISION The sole issue on appeal is whetherthe State presented sufficientevidence to 

### provethatM.T. wasgravelydisabled.1 Ourreview islimitedto"determiningwhether substantial evidence supports the findings and, ifso, whetherthe findings in turn supportthe trial court's conclusions of law andjudgment." In re Detention ofLaBelle. 107 Wn.2d 196, 209, 728 P.2d 138 (1986) (citing Ridqeview Props, v. Starbuck, 96 Wn.2d 716, 719, 638 P.2d 1231 (1982)).



### 1Although thechallenged commitmentterminated long ago, the State has not argued that the case is moot and expressly requests that this court resolve the appeal on the merits. M.T. argues in partthatthe case is not moot because a reversal would restore her right to possess a firearm. Underthe circumstances, we exercise our discretion to decide the appeal on the merits. 3No. 70238-6-1/4
To grantthe State's petition in this case, the superiorcourt had to find by a preponderance ofthe evidence that M.T. was gravely disabled as a result of a mental disorder. RCW 71.05.240(3). [Ujnderthe gravely disabled standard, the State must present recent, tangible evidence of failure or inability to provide for such essential human needs as food, clothing, shelter, and medical treatmentwhich presents a high probability ofserious physical harm within the nearfuture unless adequate treatment is afforded. LaBelle. 107 Wn.2d at 204-05. Here, it is undisputed that M.T. suffered from serious, long-standing mental disorders atthe time ofher commitment. The State provided substantial evidence that M.T. was gravely disabled by those disorders. The State's witnesses testified that her disorders significantly interfered with her self-care and care by others, resulting in malnourishment. In turn, her malnourishment contributed to her chronic ulcers, infection, recentfalls, broken bones, and immobility. These conditions put M.T. at serious risk ofamputation, injury, or death. There is thus substantial evidence that M.T. is indanger ofserious physical harm due to a failure or inability to provide for her essential human needs. M.T. contends the court overlooked her "commitmentto her own care" and her requested alternative ofremaining on the medical floor. But as noted above, there was evidence that M.T. had minimal insight into her condition, overwhelming evidence that her "commitment" did not translate into action, and evidence that involuntary commitmentwas the least restrictive alternative capable of remedying her situation.No. 70238-6-1/5 

### The credibility, weight, and persuasiveness ofthe evidence are matters forthe trier of fact. State v. Walton. 64 Wn. App. 410, 415-16, 824 P.2d 533 (1992). Affirmed.

FOR THE COURT: 

# V^ve'