Source: http://mn.gov/law-library-stat/archive/ctapun/9712/1549.htm
Timestamp: 2018-06-23 23:48:29
Document Index: 785484183

Matched Legal Cases: ['§ 253', '§ 253', '§ 253', '§ 253', '§ 10', '§ 253']

In the Matter of: Lynda Rae Vega. C8-97-1549, Court of Appeals Unpublished, December 30, 1997.
C8-97-1549
Lynda Rae Vega.
File No. P89760317Q
Douglas F. McGuire, Smith.Fisher, MSB Center, Suite 400, 1401 West 76th Street, Richfield, MN 55423 (for appellant)
Hubert H. Humphrey III, Attorney General, Steven J. Lokensgard, Assistant Attorney General, 1400 NCL Tower, 445 Minnesota Street, St. Paul, MN 55101 (for respondent); and
Michael O. Freeman, Hennepin County Attorney, Peter Fransway, Assistant County Attorney, A-2000 Government Center, Minneapolis, MN 55487
Appellant Lynda Vega appeals from trial court orders for commitment and authorization to administer neuroleptic medication, contending that the state failed to produce clear and convincing evidence that (1) she is mentally ill; (2) she poses a substantial likelihood of harm to herself or others; (3) commitment is the least restrictive alternative; (4) administration of neuroleptic medication is reasonable and necessary; and (5) the benefits of the use of neuroleptic medication outweigh the risks. We affirm.
This court reviews commitment orders by examining whether the trial court complied with the statute, "which requires specific findings of fact, separate conclusions of law, and a listing of less restrictive alternatives considered and rejected." In re Fusa, 355 N.W.2d 456, 457 (Minn. App. 1984); Minn. Stat. § 253B.09, subd. 2 (1996). The commitment must be "justified by findings based upon evidence at the hearing." Minn. R. Civ. Commitment 11.01. These findings of fact "shall not be set aside unless clearly erroneous, and due regard shall be given to the opportunity of the trial court to judge the credibility of the witnesses." Minn. R. Civ. P. 52.01; see Fusa, 355 N.W.2d at 457.
Appellant contends that the trial court erred in finding that she is mentally ill. The state produced ample evidence to prove that appellant is mentally ill as defined by the Civil Commitment Act, Minn. Stat. § 253B.02, subd. 13 (1996).[3]
Appellant contends that the trial court erred in finding that she is mentally ill. The state produced ample evidence to prove that appellant is mentally ill as defined by the Civil Commitment Act, Minn. Stat. § 253B.02, subd. 13 (1996).[1] A psychiatrist, a psychologist, and a psychiatric social worker all testified at the hearing that appellant is mentally ill with bipolar affective disorder with psychotic features. Appellant's argument that she is not mentally ill is based on her own self-serving testimony, which the trial court could have properly disregarded as not credible. Thus, the trial court did not clearly err in finding that appellant is mentally ill.
Appellant also contends that the court erred in finding that she poses a substantial likelihood of harm to herself or others. The trial court based its findings partly on her assault of her daughter, but also on evidence that appellant has refused to take her medication or seek treatment for her illness, exhibits "irritability, paranoia, delusional thinking, tangential thinking, agitation, and hostility" and believes her husband and daughter want to murder her. Based on this evidence, the trial court did not clearly err in finding appellant poses a substantial likelihood of harm to herself or others.
2.	Least Restrictive Alternative
Appellant contends that commitment is not the least restrictive alternative available to treat her. She argues that she is willing to voluntarily undergo treatment by working with a doctor on a one-to-one basis and that the trial court erred in not considering her preferences in making its determinations. Minn. Stat. § 253B.09, subd. 1, provides that the preferences of the patient shall be considered, but they are not a controlling factor in the least restrictive alternatives determination.
In finding that commitment was the least restrictive alternative for treating appellant, the trial court considered all other options and rejected them. There is no reason to believe the court did not consider appellant's preferences, but properly rejected them. A psychiatric social worker and a licensed psychologist testified that commitment was the least restrictive alternative for treating appellant because of her inability to care for herself and need for neuroleptic medication. See In re Melcher, 404 N.W.2d 309, 312 (Minn. App. 1987) (finding that commitment as mentally ill is the least restrictive alternative where patient required stabilization on medication and no expert recommended release). Thus, the trial court did not clearly err in ordering appellant's commitment.
3.	Neuroleptic Medication
Appellant contends the she is competent to make decisions about her medical treatment. The trial court must make a legal determination of incompetency before it can order involuntary medication with neuroleptics. Jarvis v. Levine, 418 N.W.2d 139, 148 n.7 (Minn. 1988). A patient is competent to refuse treatment only if the patient has an awareness of having a mental illness, possesses sufficient knowledge about medication and mental illness, and the refusal is not based on delusional beliefs. In re Peterson, 446 N.W.2d 669, 673 (Minn. App. 1989) review denied (Minn. Dec. 1, 1989).
Appellant cannot meet any of the criteria for establishing competency. A psychiatrist testified that appellant had no insight into her illness and cannot recognize the potential benefits of medication. Thus, the trial court properly found that appellant is unable to "understand and use information about her mental illness, its symptoms, and treatment."
B.	Reasonable and Necessary Treatment
Appellant contends that treatment with neuroleptic medication is not reasonable and necessary. In determining whether treatment is reasonable and necessary, the court considers (1) the extent and duration of changes effected by use of the medication, (2) the risk of adverse side effects, (3) the experimental nature of the treatment, (4) the treatment's acceptance by the medical community, and (5) the extent of instrusion and pain caused by treatment. Jarvis, 418 N.W.2d at 144.
Appellant claims that the trial court erred in finding that she had experienced no known significant side effects from the use of neuroleptic medications in the past. A psychiatrist testified that when he discussed side effects with appellant, she stated that she had experienced some of them, but could not connect these conditions to any particular medication. Based on this information, the trial court did not clearly err in finding that she had not experienced significant side effects from the use of medication.
Appellant also argues that because the court failed to consider her past side effects, it did not do a proper risk/benefit analysis. There is no evidence to indicate the court did not follow the Jarvis risk/benefit analysis. The court analyzed both the benefits and risks of the medication and concluded that the benefits outweighed the risks. Accordingly, the court did not err in authorizing the use of neuroleptic medication to treat appellant.
[ Retired judge of the Minnesota Court of Appeals, serving by appointment pursuant to Minn. Const. Art. VI, § 10.]
[1] The Civil Commitment Act, Minn. Stat. § 253B.02, subd. 13, defines a "mentally ill person" as:
any person who has an organic disorder of the brain or a substantial psychiatric disorder of thought, mood, perception, orientation, or memory which grossly impairs judgment, behavior, capacity to recognize reality, or to reason or understand, which (a) is manifested by instances of grossly disturbed behavior or faulty perceptions; and (b) poses a substantial likelihood of physical harm to self or others as demonstrated by: (i) a failure to obtain necessary food, clothing, shelter, or medical care as a result of the impairment, or (ii) a recent attempt or threat to physically harm self or others.