J-A34045-15

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37

IN THE INTEREST OF: D.C.W. IN THE SUPERIOR COURT OF

PENNSYLVANIA

APPEAL OF: D.C.W.

No. 1218 MDA 2015

Appeal from the Order Entered June 12, 2015

In the Court of Common Pleas of Centre County

Civil Division at No(s): 2015-1994

BEFORE: PANELLA, J., OTT, J., and JENKINS, J.

MEMORANDUM BY JENKINS, J.: FILED JANUARY 06, 2016

Appellant D.C.W. appeals from the order entered in the Centre County 

Court of Common Pleas, which denied his petition for review of certification 

to involuntary inpatient mental health treatment. We affirm.

The relevant facts and procedural history of this appeal are as follows. 

On June 2, 2015, the Office of Mental Health and Intellectual Disabilities of 

Centre County filed a petition seeking extended involuntary treatment of 

Appellant pursuant to Section 7304 of the Mental Health Procedures Act 

(“MHPA”).1 The next day, a mental health review officer conducted a 

hearing in which Dr. Carol Eidsvoog, staff psychiatrist at Rockview Mental 

Health Unit, testified that Appellant suffers from anorexia nervosa, the 

____________________________________________

1 50 P.S. § 7304.
J-A34045-15

- 2 -

binging and purging type.2 N.T., 6/3/15, at 7. Dr. Eidsvoog testified that 

Appellant had purged to the point of severe electrolyte abnormalities and 

dehydration and contraction alkalosis, and that without care and assistance, 

Appellant’s behavior could lead to death, disability or serious physical 

debilitation within thirty (30) days. Id. at 7-8.

Appellant testified that he had been doing very well eating and keeping 

his food down, and that he felt healthy. Id. at 14. He further testified that 

he still had certain struggles at certain times of the day, but that he wanted 

to go home as soon as possible. Id. at 14-15.

After the hearing, the mental health review officer granted the petition 

to extend Appellant’s involuntary treatment for ninety (90) days. On June 

10, 2015, Appellant filed a petition for review of certification to involuntary 

inpatient mental health treatment in the Centre County Court of Common 

Pleas. On June 12, 2015, the court denied Appellant’s petition. On July 7, 

2015, Appellant timely filed a notice of appeal. On July 13, 2015, the trial 

court ordered Appellant to file a concise statement of errors complained of 

____________________________________________

2 Anorexia nervosa is defined as “an eating disorder usually occurring in 

adolescent females, characterized by refusal to maintain a normal minimal 

body weight, fear of gaining weight or becoming obese, disturbance of body 

image, undue reliance on body weight or shape for self-evaluation, and 

amenorrhea. The two subtypes include one characterized by dieting and 

exercise alone and one also characterized by binge eating and purging.” 

DORLAND’S MEDICAL DICTIONARY FOR HEALTH CONSUMERS (2007), available at, 

http://medical-dictionary.thefreedictionary.com/anorexia.
J-A34045-15

- 3 -

on appeal pursuant to Pa.R.A.P. 1925(b), and he timely complied on July 17, 

2015.

Appellant raises the following issue for our review:

WHETHER THE TRIAL COURT LACKED CLEAR AND 

CONVINCING EVIDENCE FROM WHICH IT COULD 

CONCLUDE FORCED PSYCHIATRIC TREATMENT UNDER 

THE MENTAL HEALTH PROCEDURES ACT WAS NECESSARY 

WHERE IT WAS UNDISPUTED THAT UNFORCED MEDICAL 

ATTENTION WAS READILY AVAILABLE AT THE PRISON TO 

ACHIEVE THE TREATMENT OBJECTIVES SOUGHT BY THE 

PRISON?

Appellant’s Brief at 4.3

Appellant argues that the state failed to establish, by clear and 

convincing evidence, that Appellant was in need of involuntary treatment 

when he was voluntarily working on techniques designed to abate his selfinjurious behaviors. We disagree.

“In reviewing a trial court order for involuntary commitment, we must 

determine whether there is evidence in the record to justify the court’s 

findings.” In re T.T., 875 A.2d 1123, 1126 (Pa.Super.2005) (quoting 

Commonwealth ex rel. Gibson v. DiGiacinto, 439 A.2d 105, 107 

(Pa.1981)). “Although we must accept the trial court’s findings of fact that 

____________________________________________

3 Although Appellant’s 90 day period of involuntary commitment has ended, 

Appellant’s issue is not moot because it is capable of repetition and may 

evade review. See In re Woodside, 699 A.2d 1293, 1296 

(Pa.Super.1997).
J-A34045-15

- 4 -

have support in the record, we are not bound by its legal conclusions from 

those facts.” Id.

The MHPA provides:

§ 7304. Court-ordered involuntary treatment not to 

exceed ninety days

(a) Persons for Whom Application May be Made.--(1) 

A person who is severely mentally disabled and in need of 

treatment, as defined in section 301(a), may be made 

subject to court-ordered involuntary treatment upon a 

determination of clear and present danger under section 

301(b)(1) (serious bodily harm to others), or section 

301(b)(2)(i) (inability to care for himself, creating a 

danger of death or serious harm to himself), or 

301(b)(2)(ii) (attempted suicide), or 301(b)(2)(iii) (selfmutilation).

(2) Where a petition is filed for a person already subject to 

involuntary treatment, it shall be sufficient to represent, 

and upon hearing to reestablish, that the conduct originally 

required by section 301 in fact occurred, and that his 

condition continues to evidence a clear and present danger 

to himself or others. In such event, it shall not be 

necessary to show the reoccurrence of dangerous conduct, 

either harmful or debilitating, within the past 30 days.

50 P.S. § 7304.

§ 7305. Additional periods of court-ordered 

involuntary treatment

(a) At the expiration of a period of court-ordered 

involuntary treatment under section 304(g) or this section, 

the court may order treatment for an additional period 

upon the application of the county administrator or the 

director of the facility in which the person is receiving 

treatment. Such order shall be entered upon hearing on 

findings as required by sections 304(a) and (b), and the 

further finding of a need for continuing involuntary 

treatment as shown by conduct during the person’s most 

recent period of court-ordered treatment. The additional 
J-A34045-15

- 5 -

period of involuntary treatment shall not exceed 180 days; 

provided that persons meeting the criteria of section 

304(g)(2) may be subject to an additional period of up to 

one year of involuntary treatment. A person found 

dangerous to himself under section 301(b)(2)(i), (ii) or (iii) 

shall be subject to an additional period of involuntary fulltime inpatient treatment only if he has first been released 

to a less restrictive alternative. This limitation shall not 

apply where, upon application made by the county 

administrator or facility director, it is determined by a 

judge or mental health review officer that such release 

would not be in the person's best interest.

50 P.S. § 7305 (internal footnote omitted).

In order for a person to be committed to an extended period of 

treatment:

it is not necessary to show that the patient committed an 

overt act within 30 days of the hearing. It is necessary 

however for the court to find that within the patient’s most 

recent period of institutionalization, the patient’s conduct 

demonstrated the need for continuing involuntary 

treatment, Section 7305(a); i.e. his condition continues to 

evidence a clear and present danger to himself or others, 

Section 7304(a).

Commonwealth v. Romett, 538 A.2d 1339, 1341 42 (Pa.Super.1988).

“It is well-settled that involuntary civil commitment of mentally ill 

persons constitutes deprivation of liberty and may be accomplished only in 

accordance with due process protections.” In re R.D., 739 A.2d 548, 554 

(Pa.Super.1999) (quoting In re Hutchinson, 454 A.2d 1008, 1010 

(Pa.1982)). “The appropriate standard of proof for certification of extended 

involuntary treatment is clear and convincing evidence”. In re Hancock, 

719 A.2d 1053, 1056-57 (Pa.Super.1998). “Requiring clear and convincing 
J-A34045-15

- 6 -

evidence that an individual represents a clear and present danger to himself 

or others places the burden squarely on the facility or individual attempting 

to commit the individual involuntarily.” Id.

The trial court considered the clear and convincing evidence standard 

and reasoned:

In this case, these standards were satisfied by testimony 

of Dr. Carol Eidsvoog, M.D. a staff psychiatrist at Rockview 

Mental Health Unit who was [Appellant’s] treating 

physician. She testified that [Appellant] suffers from 

anorexia nervosa, binging and purging type. He posed a 

danger to himself by binging and purging because he had 

binged and purged to the point of suffering severe 

electrolyte abnormalities, dehydration, contraction 

alkalosis, and medical problems. The contraction alkalosis 

improved but was still abnormal. He had not reached the 

target weight the medical doctors sought. He was unable 

to provide for his own basic needs. [Appellant] was doing 

better and was developing self-distraction techniques after 

eating to avoid purging but could not do so by himself and 

needed help by staff to avoid purging. Without care and 

assistance there was a reasonable probability of death, 

disability or serious physical debilitation within 30 days 

especially with his physical exam abnormalities and lab 

abnormalities at admission. He has suffered some 

permanent physical deficits from his history of anorexia 

nervosa. He was prescribed Remeron for sleep difficulties, 

vitamin D, and iron supplements. Dr. Eidsvoog sought a 

Section 304 commitment to keep working therapeutically 

to help him to avoid purging after meals and to be less 

restrictive in his food intake. She also planned that he 

would receive cognitive therapy to deal with stress and 

control issues. She stated inpatient treatment was the less 

restrictive environment for him to receive the necessary 

treatment.

When [Appellant] was ordered to undergo mental health 

treatment under Section 303, he weighed 97 pounds at 

5’11”. It was clear to this [c]ourt that [Appellant] was still 

in need of involuntary mental health treatment for his 
J-A34045-15

- 7 -

anorexia nervosa and without the treatment he had a 

reasonable probability of death, disability or serious 

physical debilitation within 30 days. He was unable to 

provide for his basic need of food/nutrition which was 

demonstrated by the fact that his labs remained abnormal, 

he still had contraction alkalosis, he still needed the 

assistance from staff to avoid purging, and he had not 

reached his target weight. This [c]ourt does not agree with 

[Appellant] that the evidence established that unforced 

medical attention was readily available to achieve the 

treatment objectives as the therapies recommended were 

not available outside of the mental health unit.

Trial Court Pa.R.A.P. 1925(a) Opinion, filed August 17, 2015, at 2-3.

Based on our review of the record, we conclude the trial court properly 

certified Appellant’s continued involuntary treatment under Section 7304 

based on sufficient evidence of a clear and present danger he presented to 

himself. See 50 P.S.§ 7304(a)(2). Accordingly, we affirm.

Order affirmed.

Judgment Entered.

Joseph D. Seletyn, Esq.

Prothonotary

Date: 1/6/2016