IN THE

TENTH COURT OF APPEALS

No. 10-11-00379-CV

EX PARTE R.W.M.

From the County Court at Law No. 2

Johnson County, Texas

Trial Court No. F201100018

MEMORANDUM OPINION

Appellant R.W.M. appeals from a judgment of involuntary commitment for inpatient mental-health services for a period not to exceed ninety days and an order to 

administer psychoactive medication. In two issues, Appellant argues that the evidence 

is legally and factually insufficient. We will affirm.

In his first issue, Appellant contends that the evidence supporting the trial 

court’s judgment of involuntary commitment is legally and factually insufficient. In 

particular, Appellant asserts that the State did not present evidence of a recent overt act 

or a continuing pattern of behavior confirming that he poses a likelihood of causing 

serious harm to himself or others. Appellant further asserts that the State did not 

present expert testimony demonstrating the need for further in-patient treatment.
Ex parte R.W.M. Page 2

The burden of proof for an involuntary commitment is clear and convincing 

evidence. TEX. HEALTH & SAFETY CODE ANN. § 574.034(a) (West 2010). The same burden 

applies to an order to administer psychoactive medication. See A.S. v. State, 286 S.W.3d 

69, 71 (Tex. App.—Dallas 2009, no pet.). Clear and convincing evidence is that “degree 

of proof which will produce in the mind of the trier of fact a firm belief or conviction as 

to the truth of the allegations sought to be established.” State v. Addington, 588 S.W.2d 

569, 570 (Tex. 1979); see A.S., 286 S.W.3d at 70. And, because the State’s burden of proof 

is clear and convincing evidence, we apply a heightened standard of review. In re C.H.,

89 S.W.3d 17, 25 (Tex. 2002).

In reviewing a legal-sufficiency claim, we look at all the evidence in the light 

most favorable to the finding to determine whether a reasonable trier of fact could have 

formed a firm belief or conviction that its finding was true. In re J.F.C., 96 S.W.3d 256, 

266 (Tex. 2002). On the other hand, when reviewing a factual-sufficiency claim, we 

must give due consideration to evidence that the factfinder could reasonably have 

found to be clear and convincing and then determine whether, based on the entire 

record, a factfinder could reasonably form a firm conviction or belief that the allegations 

in the petition were proven. Id.

Section 574.034(a) of the Health and Safety Code provides that a trial court may 

order temporary inpatient mental-health services if it finds by clear and convincing 

evidence that the patient is mentally ill and at least one of three criteria results from that 

mental illness. TEX. HEALTH & SAFETY CODE ANN. § 574.034(a). Two of the alternative 

criteria are that the patient is likely to cause serious harm to himself or others. Id. § 
Ex parte R.W.M. Page 3

574.034(a)(2)(A)-(B). The third alternative criterion requires clear and convincing 

evidence that: (1) Appellant is suffering severe and abnormal mental, emotional, or 

physical distress; (2) Appellant’s mental or physical deterioration impacts his ability to 

function independently, “which is exhibited by the proposed patient’s inability, except 

for reasons of indigence, to provide for [his] basic needs, including food, clothing, 

health, or safety”; and (3) Appellant is unable to make rational and informed decisions 

as to whether or not to submit to treatment. Id. § 574.034(a)(2)(C).

For the State to satisfy its burden of clear and convincing evidence, section 

574.034 states that the evidence must include expert testimony and, unless waived, 

evidence of a recent overt act or a continuing pattern of behavior that tends to confirm: 

(1) the likelihood of serious harm to the patient or others; or (2) the patient’s distress 

and the deterioration of the patient’s ability to function. Id. § 574.034(d). The recent 

overt act or continuing pattern of behavior must relate to the criteria on which the 

judgment is based. T.G. v. State, 7 S.W.3d 248, 252 (Tex. App.—Dallas 1999, no pet.). 

The expert’s opinions and recommendations must be supported by a showing of the 

factual bases on which they are grounded. Id.

It is undisputed that Appellant, a fifty-year-old male, suffers from severe mental 

illness and is being cared for by staff at Pecan Valley Centers for Behavioral Health and 

Intellectual Disability in Johnson County. Psychiatrists William Beatty, M.D. and 

Zahida Syed, M.D. both opined that Appellant suffers from paranoid schizophrenia and 

schizoaffective disorder. In her report, Dr. Syed indicated that Appellant:

is paranoid, delusional, and grandiose. He believes he is telepathic and 
Ex parte R.W.M. Page 4

his mind projecting thought broadcasting. He believes his wife “Nicole” 

was kidnapped by MHMR and they amputated her three fingers. 

[Appellant] stopped taking his medications and has poor insight and 

judgment. He has been calling APS and the Chief of the Fire Department 

and leaving messages that are delusional in nature.

Based on her evaluation of Appellant, Dr. Syed determined that he is suffering from 

severe and abnormal emotional or physical distress and substantial mental or physical 

deterioration of his ability to function independently. She also noted that Appellant 

presents a substantial risk of serious harm to himself or others if not immediately 

restrained.

Dr. Beatty testified at trial that Appellant’s illness has gotten worse in the last 

year or so. Dr. Beatty stated:

[Appellant] is likely to get himself hurt in the sense of being arrested. He 

is a danger to others, in that he is very disruptive to his caregivers, very 

discourteous. He curses them. He has said that his roommate is trying to 

poison him, and that could conceivably lead to a violent confrontation. 

He has pestered one particular individual, woman, to the degree that her 

husband has said that he has a gun and he will shoot him if he continues.

Dr. Beatty also testified that he does not believe that Appellant can provide for his basic 

needs without supervision or assistance. According to Dr. Beatty, Appellant does not 

believe that he is ill and, as such, refuses to control himself or take any medication. In 

his report dated August 31, 2011, Dr. Beatty noted the following: “Patient [Appellant] 

has the psychotic delusion that he has a wife and daughter who are repeatedly 

kidnapped, requiring him to make frantic phone calls to the FBI, Fire Chief, Police, 

MHMR, DHS Austin, ect. [sic]. He cannot or will not stop this and does not agree to 

take recommended medications.”
Ex parte R.W.M. Page 5

On cross-examination, Dr. Beatty admitted that Appellant has not taken any 

direct action to harm others or himself. Dr. Beatty also acknowledged that he is not 

aware of Appellant engaging in violent confrontations. On re-direct, Dr. Beatty recalled 

an incident where Appellant harassed a television-news reporter in Dallas, which 

resulted in Appellant’s arrest and incarceration for forty-five days. Dr. Beatty believed 

this to be an overt act demonstrating Appellant’s mental illness.

The State also presented testimony from caseworkers at Pecan Valley. Becky 

Phillips, a care coordinator at Pecan Valley, recalled an incident where Appellant 

stalked a nurse in Weatherford. And based on her interactions with Appellant, Phillips 

believes that Appellant will be harmed or will harm others if he is not moved from his 

current placement. Phillips also testified that she does not know if Appellant has any 

family members, and she recounted that Appellant has been hospitalized twenty-eight 

times in the last thirty-three years. Finally, she thought that Appellant’s mental or 

physical condition had deteriorated to the point that he cannot function independently.

David Collier, a case manager at Pecan Valley, testified that he has closely 

monitored Appellant’s progress. According to Collier, Appellant’s condition has 

deteriorated to include the following:

Belligerence, agitation, insulting to just about everyone including myself 

[Collier] and other staff, neighbors. I will say he’s never been physically 

aggressive toward anyone although he will rare up as if he were wanting 

to attack someone, but I’ve never known him to actually strike or hit 

anyone. But he is verbally aggressive on frequent occasions.

Collier also described that Appellant has unusual preoccupations with sex and torture. 

Appellant has acknowledged that he has engaged in bestiality in the past and has 
Ex parte R.W.M. Page 6

alleged that he is frequently anally raped in his sleep, though medical evaluations do 

not support Appellant’s rape allegations. Moreover, Collier has heard Appellant talk 

about “hurting someone, stabbing, killing, all these kinds of things, but I don’t know 

whether or not he would ever actually act on them.” Further, Collier has observed 

Appellant be “very aggressive and threatening toward” a previous roommate. Collier 

also stated that “Nicole” does not exist and speculated that Appellant’s delusions about 

“Nicole” may pertain to a previous caseworker that he was fond of. In addition, Collier 

recalled that Appellant has been arrested for making a terroristic threat against a church 

in North Carolina that he believed to be sheltering “Nicole.” Appellant has also spent 

time in jail in Johnson and Collin Counties. Furthermore, Appellant repeatedly calls 

911 and various governmental agencies to report the alleged abduction of “Nicole.”

On cross-examination, Collier admitted that Appellant can shop for food at WalMart and use public transportation by himself. Collier also admitted that he has never 

seen Appellant hit anyone despite the above-mentioned verbal aggression and that 

Appellant has never harmed himself or attempted suicide.

 Sharon Scott, a community-support specialist at Pecan Valley who has worked 

with Appellant, stated that Appellant threatened to kill his previous roommate and that 

Appellant regularly refuses to take his medications because they interfere with his 

ability to transmit his thoughts.

Appellant testified on his own behalf and indicated that he believes that the staff 

at Pecan Valley has abducted “Nicole” and his daughter Josephine and that the staff 

amputated “Nicole’s” fingers and Josephine’s arms and left leg. Appellant 
Ex parte R.W.M. Page 7

acknowledged that he has been arrested in the past for stalking a store clerk with whom 

he attempted to be romantically involved. Appellant also acknowledged that his 

current roommate has tried to harm him. And finally, Appellant admitted to writing 

numerous letters to a “beautiful” female district attorney in Johnson County, though he 

explained that he thought the district attorney could help him with his case.

The jury concluded that there is clear and convincing evidence that Appellant: 

(1) has a “mental illness”; (2) is likely to cause serious harm to himself and others; and 

(3) is suffering severe and abnormal mental, emotional, or physical distress and is 

experiencing substantial mental or physical deterioration of his ability to function 

independently and is unable to make a rational and informed decision as to whether or 

not to submit to treatment. The trial court adopted the jury’s findings and signed the 

judgment for temporary in-patient mental-health services. The trial court also signed 

the order for customary administration of psychoactive medication.

Based on our review of the evidence, we conclude that the State presented clear 

and convincing evidence such that a reasonable factfinder could form a firm belief or 

conviction that Appellant has engaged in a continuing pattern of behavior that tends to 

confirm the likelihood of serious harm to Appellant or others. Although the record 

does not reflect that Appellant has attempted to harm himself, the State presented 

evidence of Appellant’s threatening nature, Appellant’s delusions and preoccupation 

with sex and torture, and Appellant’s tendency to stalk and harass females—all of 

which constitute a continuing pattern of behavior that tends to confirm the likelihood of 

serious harm to Appellant and others. See G.H. v. State, 94 S.W.3d 115, 117 (Tex. App.—
Ex parte R.W.M. Page 8

Houston [14th Dist.] 2002, no pet.) (“Texas law does not require relatives or physicians 

of the mentally ill (or the courts) to stand idly by until serious harm occurs. Indeed, the 

purpose of temporary commitment is to avoid just such harm.”). And in further 

support of our conclusion, the State presented evidence that at least one person—the 

husband of a Pecan Valley nurse—has stated that he will shoot Appellant if Appellant 

continues to stalk his wife.

Furthermore, Dr. Beatty identified at least one recent overt act—Appellant’s 

harassment of a Dallas television reporter—that resulted in Appellant’s incarceration 

and supports temporary, involuntary commitment. See State v. K.E.W., 315 S.W.3d 16, 

24 (Tex. 2010) (“In sum, the statute requires evidence of a recent act by the proposed 

patient, either physical or verbal, that can be objectively perceived and that is to some 

degree probative of a finding that serious harm to others is probable if the person is not 

treated. The overt act itself need not be of such character that it alone would support a 

finding of probable serious harm to others.”). Accordingly, we hold that the evidence 

supporting the trial court judgment for temporary in-patient mental-health services is 

legally and factually sufficient. Appellant’s first issue is overruled.

Appellant’s second issue pertaining to the trial court’s order to administer 

psychoactive medication is premised on the resolution of his first issue. Appellant 

argues that the trial court’s order to administer psychoactive medication is not 

supported by legally and factually sufficient evidence because the judgment of 

involuntary commitment is not supported by legally and factually sufficient evidence. 

See J.M. v. State, 178 S.W.3d 185, 197 (Tex. App.—Houston [1st Dist.] 2005, no pet.) (“In 
Ex parte R.W.M. Page 9

the absence of a valid order for temporary or extended mental[-]health services, the 

order authorizing the administration of psychoactive medication is not authorized by 

statute.”) (citing TEX. HEALTH & SAFETY CODE ANN. § 574.106(a)(1) (West 2010)). 

Because we have concluded that the trial court’s judgment of involuntary commitment 

is supported by legally and factually sufficient evidence, we overrule Appellant’s 

second issue.

Having overruled both of Appellant’s issues, we affirm the trial court’s judgment 

of commitment and order to administer psychoactive mediation.

REX D. DAVIS

Justice

Before Chief Justice Gray,

Justice Davis, and

Justice Scoggins

Affirmed

Opinion delivered and filed September 13, 2012

[CV06]