IN THE COURT OF APPEALS OF IOWA

No. 19-2044

Filed November 30, 2020

IN THE MATTER OF R.B.,

Alleged to Be Seriously Mentally Impaired,

R.B.,

Respondent-Appellant.

________________________________________________________________

Appeal from the Iowa District Court for Marshall County, James A. McGlynn, 

Judge.

R.B. appeals the district court’s refusal of R.B.’s petition for a writ of habeas 

corpus. AFFIRMED.

John L. Dirks of Dirks Law Firm, Ames, for appellant.

Thomas J. Miller, Attorney General, and Gretchen Kraemer, Special 

Assistant Attorney General, for appellee State.

Considered by Vaitheswaran, P.J., and Tabor and Schumacher, JJ.
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VAITHESWARAN, Presiding Judge.

R.B. was found to have a “serious mental impairment.” See Iowa Code 

§ 229.1(20) (2019). He was placed at the Iowa Veterans Home in Marshalltown, 

Iowa. The court of appeals affirmed the placement in In re R.B., No. 15-0823, 

2015 WL 6507836, at *1 (Iowa Ct. App. Oct. 28, 2015). 

Approximately four years after our opinion was filed, R.B. petitioned for a 

writ of habeas corpus. See Iowa Code § 229.37 (“All persons confined as seriously 

mentally impaired shall be entitled to the benefit of the writ of habeas corpus, and 

the question of serious mental impairment shall be decided at the hearing.”). 

Following an evidentiary hearing, the district court “refused” the writ. R.B. 

appealed.

“Serious mental impairment” describes “the condition of a person with 

mental illness” who, “because of that illness lacks sufficient judgment to make 

responsible decisions with respect to the person’s hospitalization or treatment, and 

who because of that illness meets any of the following criteria”:

a. Is likely to physically injure the person’s self or others if 

allowed to remain at liberty without treatment.

b. Is likely to inflict serious emotional injury on members of the 

person’s family or others who lack reasonable opportunity to avoid 

contact with the person with mental illness if the person with mental 

illness is allowed to remain at liberty without treatment.

c. Is unable to satisfy the person’s needs for nourishment, 

clothing, essential medical care, or shelter so that it is likely that the 

person will suffer physical injury, physical debilitation, or death.

d. Has a history of lack of compliance with treatment and any 

of the following apply:

(1) Lack of compliance has been a significant factor in 

the need for emergency hospitalization.

(2) Lack of compliance has resulted in one or more acts 

of serious physical injury to the person’s self or others or an attempt 

to physically injure the person’s self or others.
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Id. § 229.1(20). “The continuation of an involuntary commitment requires the same 

impairment as ascribed to it by section 229.1[(20)], although reviewed in habeas 

corpus proceedings pursuant to section 229.37.” In re B.T.G., 784 N.W.2d 792, 

796 (Iowa Ct. App. 2010) (citation omitted). 

R.B. focuses on subsection 229.1(20)(a). He argues the court improperly 

“concluded he is likely to injure himself or others if released from the civil 

commitment.” We review “the propriety of continued involuntary commitment” for 

errors of law. B.A.A. v. Univ. of Iowa Hosps., 421 N.W.2d 118, 120 (Iowa 1988). 

“The district court’s findings of fact are binding upon this court if supported by 

substantial evidence.” B.T.G., 784 N.W.2d at 796.

The district court made the following pertinent findings: “First, the 

respondent continues to have a multi-faceted mental health diagnosis which 

requires structure and medication to keep him safe. Second, the respondent’s 

traumatic brain injuries cannot be treated or reversed. Third, the respondent has 

recently demonstrated that he is unable to control his impulse to consume alcohol.” 

The court summarized the testimony of R.B.’s psychiatrist, citing R.B.’s mentalhealth diagnoses, “history of substance abuse and alcoholism,” history “of 

traumatic brain injuries,” and “a serious fall after drinking” that required a “lengthy 

hospitalization and treatment.” The court found the psychiatrist’s testimony 

“convincing.” The court next described an episode that occurred during a furlough 

with R.B.’s family, finding that, “[a]t some point during the furlough, [R.B.] was left 

alone . . . for a period of about one-half hour;” and, “[d]uring that period, [he]

consumed an estimated 11 beers.” The court determined:
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[R.B.’s] history of falling, the emergency treatment and lengthy

hospitalization resulting from his head injuries and the lack of impulse 

control shown by the failed visit with [his] family show that he is likely 

to physically injure himself if allowed to remain at liberty without 

treatment. His history of lack of compliance with treatment has 

resulted in the need for emergency hospitalization and resulted in 

one or more acts of serious physical injury to [himself].

 

The court’s findings are supported by substantial evidence. Specifically, the 

psychiatrist described R.B.’s bouts of drinking during two furloughs, then opined,

“He does show a definite loss of impulse control when it comes to his drinking.” 

He spoke to the dangers of R.B.’s alcohol use as follows:

I think it’s dangerous on many levels. It may exacerbate his tendency 

to be aggressive or violent, which I think stems mainly from his 

antisocial personality disorder, as well as his brain injury which 

reduces his ability to control impulses. I think alcohol would make 

those behaviors even worse. Also I think it could cause further 

cognitive impairment or cognitive or brain damage for him if he 

continued to drink, and I think that alcohol would put him at risk for 

falls which could result in additional brain damage if he struck his 

head.

The psychiatrist was unpersuaded that R.B.’s willingness to take Antabuse would 

control his drinking. He testified, “There are many people who have this lack of 

impulse control who will just simply drink and experience the consequences of 

Antabuse, but still just push through that and continue to drink.” See In re B.B.,

No. 04-1886, 2005 WL 1225959, at *3 (Iowa Ct. App. May 25, 2005) (finding B.B. 

was a danger to himself based on a recent fall due to alcohol dependency and his 

continued neglect of self-care). As for R.B.’s compliance with his existing 

medication regimen, the psychiatrist testified:

[R.B] has been compliant with his medication in this setting. My 

concern is that particularly if he started drinking, that he would very 

quickly stop the medication. I don’t think he’s opposed to taking it, 

but I think he would not have that structure of someone giving him 
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the medication and monitoring it. And without that, I think it would 

become unimportant to him and he would very quickly stop doing it.

He opined that, without one of the medications, R.B.’s “psychotic symptoms, 

his delusions and hallucinations would be worse” and, without two others, “his 

aggression could become worse.” The delusions, the psychiatrist stated, might 

cause R.B. to “journey out to California,” a prediction grounded in R.B.’s testimony 

that he wished to do just that, notwithstanding his lack of a valid driver’s license. 

Notably, R.B. did not attend follow-up visits with the psychiatrist even in the 

supervised VA setting, lending credence to the psychiatrist’s concern about his 

ability to independently manage his medication regimen. Because the district 

court’s findings are supported by substantial evidence, we conclude the court did 

not err in ordering R.B.’s continued placement.

In reaching this conclusion, we recognize that other record evidence 

supports R.B.’s assertion that he did not pose a danger to himself. For example, 

the psychiatrist conceded R.B. had freedom to come and go into town and he 

remained sober during those outings. 

We also recognize the State was obligated to prove R.B. committed a recent 

overt act establishing dangerousness and the family furlough during which R.B. 

consumed eleven beers in thirty minutes occurred close to a year before the 

habeas corpus hearing. See In re L.H., 890 N.W.2d 333, 341 (Iowa Ct. App. 2016)

(finding the “recent overt act” requirement was not satisfied where “the last overt 

act occurred . . . nearly one year before [the] placement review”). But the record 

of dangerousness in L.H. was thin. The “State offered no testimony or other 

evidence at the perfunctory [initial] hearing” and, on appeal to the district court, 
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which held a “de novo trial,” the State apparently declined to call the treating 

psychiatrist as a witness. See id. at 336–37, 340. Here, in contrast, the treating 

psychiatrist thoroughly explained his reasons for believing R.B. posed a danger to 

himself. See In re J.R., No. 17-0449, 2018 WL 2084819, at *2 (Iowa Ct. App. May 

2, 2018) (citing testimony of same psychiatrist and stating “[a]lthough [certain] 

behaviors are not currently occurring and have not occurred in some time, the 

evidence shows they are likely to occur again if [the] commitment was not 

continued”). 

We affirm the district court’s denial of R.B.’s petition for writ of habeas 

corpus.

AFFIRMED.