IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

In the Matter of the Detention of

M.Y. 

No. 85921-8-I

DIVISION ONE

UNPUBLISHED OPINION

SMITH, C.J. — M.Y. was admitted to Western State Hospital in August 

2022, following the dismissal of a non-violent criminal offense. Upon his 

admission, Dr. Vanessa Kieu and Dr. Carola Rong petitioned for further

involuntary treatment. As a basis for the petition, Dr. Kieu testified that she 

diagnosed M.Y. with unspecified schizophrenia spectrum and other psychotic 

disorders. Dr. Kieu also stated that M.Y. lacked insight and judgment, which put 

him at risk of serious physical harm. M.Y. testified that he had temporary 

housing accessible, would live with his parents if the shelter was unavailable and 

agreed to seek mental health treatment in the community. The court nonetheless 

found M.Y. was gravely disabled and ordered him detained for 90 days of less 

restrictive involuntary treatment. Because of delays in permanent housing 

options, M.Y. stayed at Western State Hospital. On appeal, M.Y. contends that 

the evidence was insufficient to find him gravely disabled. We agree and vacate 

the trial court’s 90-day involuntary commitment order. 
No. 85921-8-I/2

2

FACTS

In August 2022, M.Y. was admitted to Western State Hospital following the 

dismissal of a non-violent criminal charge. The underlying incident arose when a 

citizen called law enforcement after seeing a man leave the Bothell Home Depot

store, shouting and talking to himself about carrying a bomb. The citizen

provided a description of the man and law enforcement eventually arrested M.Y. 

Although it had been over an hour since the original 911 call and he was four 

miles away from the Home Depot, M.Y. roughly matched the citizen’s description 

and seemed disheveled and incoherent. The State charged M.Y. with the nonviolent felony of threat to bomb or injure property. 

The court found M.Y. incompetent to stand trial. The court later found

that, because of the delay in competency restoration, M.Y. was unlikely to regain 

competency in a reasonable period of time. The State conceded the delay, and 

several months after M.Y.’s arrest, the court dismissed the charge without 

prejudice. The court then referred M.Y. for a civil commitment evaluation. The 

court committed M.Y. to Western State for 120 hours to perform that evaluation. 

After the five day involuntary detention, Dr. Vanessa Kieu and Dr. Carola 

Rong petitioned to detain M.Y. for up to 180 days of further involuntary treatment 

under chapter 71.05 RCW. The doctors provided two separate grounds for the 

petition. First, they alleged that M.Y. had committed a felony and that he 

presented a substantial likelihood of repeating the act because of a behavioral 

health disorder. And second, the doctors alleged that M.Y. was gravely disabled 

because of a behavioral health disorder.
No. 85921-8-I/3

3

In September 2022, at a hearing before a court commissioner, M.Y. 

sought to represent himself pro se but was denied on the basis that his request 

was not voluntary, knowing, and intelligent. 

The commitment hearing centered on the doctors’ testimony. As to the 

first ground in the petition, the commissioner found that the facility failed to meet 

its burden of proof by clear, cogent, and convincing evidence that M.Y. had 

committed acts which amounted to a felony and presented a substantial 

likelihood of repeating the act. The citizen witness could not identify M.Y. as the 

man from the Home Depot and no other evidence supports the felony charge. 

Without a felony charge, no basis exists for commitment on that ground in the 

petition.

Concerning the second ground, whether M.Y. was gravely disabled, 

Dr. Kieu testified that she was familiar with M.Y. and had evaluated him for 

potential commitment. She had made multiple attempts to speak with M.Y., but 

as he was often agitated and guarded, he only spoke with her once. Dr. Kieu’s 

evaluation primarily involved reviewing records and consulting with M.Y.’s regular 

treatment team. That information allowed her to diagnose M.Y. with “unspecified 

schizophrenia spectrum and other psychotic disorder.” Dr. Kieu’s evaluation 

detailed that M.Y. was argumentative, confrontational, and paranoid. He often 

circled back to beliefs that he was being held illegally, was being persecuted by 

the hospital, and kept for monetary gain. He did not believe he had any mental 

illness and was consistently non-compliant with medication. While in the 

hospital, M.Y. informed his providers that, if discharged, he would not take any of 
No. 85921-8-I/4

4

the medication prescribed. Dr. Kieu indicated that taken together, this behavior 

showed that M.Y. did not have the tools to maintain himself safely in the 

community and should not be discharged. 

M.Y.’s mother testified that she and her husband would help M.Y. settle

once released. She also testified to M.Y.’s history of mental illness. Although 

she sought M.Y.’s discharge, M.Y.’s mother noted that he had a history of 

delusions and being verbally combative. She detailed his consistent refusal of 

any medication at all. 

M.Y. also testified on his own behalf. He pointed to a shelter in Bellevue 

he had used in the past as a temporary housing option. He stated that he would 

accept his parents’ help in getting treatment. And he identified mental health 

services that he trusted and was willing to attend. In contrast to his earlier 

statements, M.Y. asserted that he would continue treatment outside of the 

hospital, to “clear [his] name.” 

The commissioner found that M.Y. met the definition of gravely disabled 

by clear, cogent, and convincing evidence and granted the petition for involuntary 

treatment. M.Y. appeals.

ANALYSIS

M.Y. contends that substantial evidence does not support the trial court’s 

finding that he is gravely disabled. We agree.

Where the trial court has weighed evidence, our review is “limited to 

determining whether substantial evidence supports the findings and, if so, 

whether the findings in turn support the trial court’s conclusions of law and 
No. 85921-8-I/5

5

judgment.” In re Det. of LaBelle, 107 Wn.2d 196, 209, 728 P.2d 138 (1986). 

Substantial evidence is evidence sufficient to persuade a rational, fair-minded 

person of the asserted premise. State v. Homan, 181 Wn.2d 102, 106, 330 

P.3d 182 (2014). We will not disturb a trial court’s finding of grave disability if 

that finding is supported by substantial evidence the lower court could have 

reasonably found to be clear, cogent, and convincing. LaBelle, 107 Wn.2d

at 209.

“[I]nvoluntary commitment for mental disorders is a significant deprivation 

of liberty which the State cannot accomplish without due process of law.” 

LaBelle, 107 Wn.2d at 142. In general, an individual may only be involuntarily 

committed as the result of a mental disorder if the individual either (1) poses a 

substantial risk of harm to themselves, others, or the property of others, or is 

gravely disabled. LaBelle 107 Wn.2d at 202.

RCW 71.05.020(25) defines “gravely disabled” as

a condition in which a person, as the result of a behavioral health 

disorder: (a) [i]s in danger of serious physical harm resulting from a 

failure to provide for his or her essential human needs of health or 

safety; or (b) manifests severe deterioration in routine functioning 

evidenced by repeated and escalating loss of cognitive or volitional 

control over his or her actions and is not receiving such care as is 

essential for his or her health or safety.

Under the first definition, the petitioner must offer “recent, tangible 

evidence” that the individual’s failure or inability to provide for needs like food, 

clothing, shelter, or medical treatment presents a high likelihood of serious 

physical harm in the near future. LaBelle, 107 Wn.2d at 204-205. This failure or 
No. 85921-8-I/6

6

inability to provide must stem directly from the mental disorder. LaBelle, 107 

Wn.2d at 204-205. 

Under the second definition, the petitioner must provide a factual basis for 

the conclusions that the individual “ ‘manifests severe deterioration in routine 

functioning.’ ” LaBelle, 107 Wn.2d at 208 (quoting RCW 71.05.025(b)). This 

evidence must include recent proof of significant loss of cognitive or volitional 

control. RCW 71.05.020(25). “It is not enough to show that care and treatment 

of an individual’s mental illness would be preferred or beneficial or even in [their]

best interests. To justify commitment, such care must be shown to be essential

to an individual’s health or safety.” LaBelle, 107 Wn.2d at 208. The fact that an 

individual is mentally ill is not enough to demonstrate that the person is incapable 

of making a rational choice as to their treatment. LaBelle, 107 Wn. App. at 208.

Here, the court ordered M.Y.’s involuntary commitment based solely on 

M.Y.’s “grave disability,” as defined by RCW 71.05.020(25)(b). But the court’s 

findings are insufficient to establish that M.Y. is gravely disabled under either 

definition. 

The State offered no evidence that M.Y.’s mental or physical state while at 

Western State was a severe deterioration from a higher level of function. M.Y.’s 

mother testified to his long history of behavioral and mental health issues. She 

described instances of delusion and paranoia, a history of combative behavior 

and a consistent refusal of any medication. This indicates that M.Y.’s level of 

functioning while at Western State tracked closely with his level of function 
No. 85921-8-I/7

7

across the decades before his commitment. A history of similar issues does not 

establish a “severe deterioration.” 

The State also failed to present evidence that M.Y. had a repeated and 

escalating loss of cognitive or volitional control. This was M.Y.’s first admission 

to Western State, undermining the idea that this is part of a repeated pattern of 

loss of control. And the State provided no evidence of escalating behavior. 

Rather, M.Y.’s behavior on admission to the hospital was similar to that before 

his admission, and then began to improve.

Despite the improvement, the State did not offer evidence that the care 

M.Y. received at Western State was essential to his health or safety. Although 

M.Y. appeared disheveled at the time of his arrest and sometimes while in the 

hospital, Dr. Kieu testified that he was eating, showering, and maintaining basic 

hygiene. The State provided no evidence that M.Y. was malnourished, 

dehydrated, or otherwise injured while he was arrested or any time at Western

State. This indicates that M.Y. was capable of meeting his basic needs while in 

the community and that his time in the hospital was not essential to his ability to 

do so. 

Looking to the future, M.Y.’s mother indicated that she was willing to

clothe him, house him for a few days, and help him get treatment in the 

community. She had already located resources on bus lines so that M.Y. could 

easily reach them. In addition, M.Y. testified about a shelter he knew he could 

use, mental health services he trusts, and his willingness to follow any court
No. 85921-8-I/8

8

instructions. All of this suggests that M.Y. would continue to be capable of caring 

for his essential needs once released. 

Again, the fact that an individual has a mental illness is not enough to 

prove they are incapable of caring for themselves. LaBelle, 107 Wn. App. at 208. 

No evidence exists of any severe deterioration in M.Y.’s routine functioning or 

any inability to care for his essential needs. Accordingly, the evidence is 

insufficient to find that, as a result of a behavioral health disorder, M.Y. manifests 

severe deterioration in routine functioning evidenced by repeated and escalating 

loss of cognitive or volitional control over actions, and he is not receiving such 

care as is essential for health and safety.

We hold that the trial court’s findings do not support its conclusion that 

M.Y. is gravely disabled. We therefore vacate the court’s 90-day involuntary 

commitment order. 

WE CONCUR: