Title: Mercer v. Commonwealth
Citation: N/A
Docket Number: 990821
State: Virginia
Issuer: Virginia Supreme Court
Date: January 14, 2000

Present:  All the Justices 
 
BRIGITTE MERCER 
 
v. Record No. 990821   OPINION BY JUSTICE CYNTHIA D. KINSER 
January 14, 2000 
COMMONWEALTH OF VIRGINIA 
 
FROM THE CIRCUIT COURT OF THE CITY OF NEWPORT NEWS 
Verbena M. Askew, Judge 
 
 
In this appeal, we consider the definition of the term 
“[m]entally ill” in Code § 37.1-1 in relation to the 
criteria set forth in Code §§ 19.2-182.3 and –182.5 for the 
continued commitment of an individual found not guilty of 
criminal charges by reason of insanity.  Because we 
conclude that there is sufficient evidence in the record to 
support the circuit court’s judgment that the acquittee 
does not satisfy the requirements for conditional release, 
we will affirm that judgment. 
FACTS 
Brigitte Daniele Mercer was found not guilty by reason 
of insanity (NGRI) on charges of carjacking, grand larceny, 
maiming, and robbery.  Pursuant to Code § 19.2-182.2,1 the 
circuit court remanded Mercer to the custody of the 
Commissioner of the Department of Mental Health, Mental 
                     
1 Code § 19.2-182.2 requires, in pertinent part, that a 
person acquitted by reason of insanity shall be placed in 
the temporary custody of the Commissioner of Mental Health, 
Mental Retardation and Substance Abuse Services “for 
Retardation and Substance Abuse Services (the 
Commissioner).  In January 1997, the court conditionally 
released her from custody pursuant to Code § 19.2-182.7.2  
However, the circuit court required Mercer to undergo a 30-
day inpatient evaluation in June 1997 after Mercer claimed 
that she had been raped and had sustained a stab wound to 
her thigh.  The court eventually recommitted Mercer to the 
custody of the Commissioner. 
 
Mercer next appeared before the circuit court on 
August 25, 1998, pursuant to Code § 19.2-182.5,3 for the 
purpose of determining whether she continued to need 
____________________ 
evaluation as to whether the acquittee may be released with 
or without conditions or requires commitment.” 
2 Code § 19.2-182.7 provides that upon consideration of 
an NGRI acquittee’s need for inpatient hospitalization, the 
acquittee must be conditionally released if the court finds 
that 
 
(i) based on consideration of the factors which the 
court must consider in its commitment decision, he 
does not need inpatient hospitalization but needs 
outpatient treatment or monitoring to prevent his 
condition from deteriorating to a degree that he would 
need inpatient hospitalization; (ii) appropriate 
outpatient supervision and treatment are reasonably 
available; (iii) there is significant reason to 
believe that the acquittee, if conditionally released, 
would comply with the conditions specified; and (iv) 
conditional release will not present an undue risk to 
public safety. 
 
3 Code § 19.2-182.5(A) requires that a “committing 
court shall conduct a hearing twelve months after the date 
of commitment to assess each confined acquittee’s need for 
inpatient hospitalization.” 
 
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inpatient hospitalization.  At that hearing, the court 
heard testimony from two expert witnesses, Evan S. Nelson, 
Ph.D., a licensed clinical psychologist, and Christine A. 
Bryant, Psy.D., also a licensed clinical psychologist.  
Both experts examined Mercer prior to the hearing and 
submitted written reports to the court pursuant to Code 
§ 19.2-182.5(B).  Based on their evaluations, Dr. Bryant 
and Dr. Nelson opined that Mercer suffers from antisocial 
personality disorder (APD) and polysubstance dependence 
(PSD).  However, they expressed differing opinions with 
regard to whether either APD or PSD falls within the 
definition of a mental illness in Code § 37.1-1. 
 
Relying primarily on the Diagnostic and Statistical 
Manual for Mental Disorders (4th ed. 1994) (DSM-IV), Dr. 
Bryant testified that both APD and PSD are mental 
illnesses.  She described APD as being “the disregard for 
authority or for social rules and mores,” and defined PSD 
as the addiction to multiple drugs.  According to Dr. 
Bryant, Mercer has been “drug free” only during her periods 
of hospitalization.  With regard to Mercer’s risk of harm 
to other persons, Dr. Bryant stated that Mercer’s history 
of aggressive behavior, demonstrated by her “extensive 
legal history,” was one of several risk factors requiring 
continued inpatient hospitalization.  Dr. Bryant believed 
 
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that Mercer “continues to be a risk for future aggressive 
behavior,” and that she cannot be adequately controlled as 
an outpatient. 
 
Dr. Nelson did not categorize Mercer’s APD as a mental 
disease or illness.  Instead, he drew a distinction between 
the multiaxial diagnostic system in the DSM-IV, upon which 
Dr. Bryant relied, and the conditions that courts may 
consider to be mental illnesses under the Code.  However, 
Dr. Nelson seemingly contradicted himself because he also 
testified that, under the Code, both APD and PSD are 
considered mental diseases.  He admitted that if the court 
believed Mercer is mentally ill, continued commitment is 
warranted.  Like Dr. Bryant, Dr. Nelson also believed that 
Mercer poses a “very, very high risk” for future 
dangerousness. 
Based on this evidence, the circuit court found that 
Mercer suffers from a mental illness because of her history 
of drug abuse and addiction.4  The court concluded “that 
Mercer does not meet the conditions for conditional release 
. . . because: 1) Mercer is mentally ill and in need of 
                     
4 The circuit court did not rest its decision on 
Mercer’s APD.  The court stated that “the case does not 
rise and fall on whether the Court finds that Mercer’s 
[APD] is a mental illness.”  Instead, the court focused on 
“the last portion of [Code] § 37.1-1 which indicates that 
 
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inpatient hospitalization; 2) it is highly probable that 
Mercer will violate the terms of the conditional release; 
3) her conditional release will present an undue risk to 
public safety.”  We awarded Mercer this appeal. 
ANALYSIS 
Mercer acknowledges on brief that the sole issue 
before the Court is whether APD and PSD are mental 
illnesses.  She relies on Foucha v. Louisiana, 504 U.S. 71 
(1992), in arguing that APD can never be classified as a 
mental illness.  Mercer further contends that PSD is not a 
mental illness because, according to her, the definition of 
the term “[m]entally ill” in Code § 37.1-1 expressly 
excludes drug addiction and alcoholism from its purview for 
the purpose of determining if an NGRI acquittee should 
remain in the custody of the Commissioner.  Therefore, she 
asserts that Dr. Bryant’s testimony that PSD is a mental 
illness was insufficient, as a matter of law, to support 
the circuit court’s finding that Mercer suffers from a 
mental illness. 
 
The Commonwealth argues that Mercer misconstrues the 
decision in Foucha as well as Code § 37.1-1, and that, at 
any rate, this Court’s focus should be on PSD, not APD, 
____________________ 
the term ‘mentally ill’ shall be deemed to include any 
person who is a drug addict or alcoholic.” 
 
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since the circuit court did not base its decision on 
Mercer’s APD.  The Commonwealth finally asserts that the 
question whether an individual suffers from a mental 
illness is a factual determination to be made by the court 
after hearing the testimony of mental health experts.  We 
agree with the Commonwealth. 
As a preliminary matter, we note that the Supreme 
Court of the United States in Foucha did not, as Mercer 
argues, state that APD can never, as a matter of law, be 
classified as a mental illness.  Rather, the Court held 
that a finding of both mental illness and future 
dangerousness must be present in order to continue the 
confinement of an NGRI acquittee.  Foucha, 504 U.S. at 80.  
In that case, there was no medical evidence that Foucha was 
mentally ill at the time of his hearing, although the 
testimony regarding his future dangerousness was 
uncontested.  Id. at 74-75.  The government in Foucha did 
not argue that Foucha’s APD was a mental illness; rather, 
it relied on the trial court’s finding that the APD made 
Foucha a danger “to himself or others.”  Id. at 78.  Thus, 
the Supreme Court did not decide in Foucha whether APD is a 
mental illness, but simply affirmed the principle that a 
state cannot confine an individual with a mental illness 
absent a showing by clear and convincing evidence “that the 
 
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individual is mentally ill and dangerous.”  Id. at 80 
(quoting Jones v. United States, 463 U.S. 354, 362 (1983)). 
 
However, as the Commonwealth points out, the circuit 
court in the present case did not rest its decision on 
Mercer’s APD, but instead focused on her PSD.  Accordingly, 
we will now address that diagnosis and the circuit court’s 
analysis of it. 
 
As already noted, Mercer argues that Code § 37.1-1 
expressly excludes drug addicts,5 and thus individuals with 
PSD, from the definition of “[m]entally ill” when deciding 
whether to continue the confinement of an NGRI acquittee.  
That Code section provides, in pertinent part, “that for 
the purposes of Chapter 2 (§ 37.1-63 et seq.) of this 
title, the term ‘mentally ill’ shall be deemed to include 
any person who is a drug addict or alcoholic.”  According 
to Mercer, this language means that neither drug addiction 
nor alcoholism can serve as the basis for a finding of 
                     
5 The term “[d]rug addict” is defined in Code § 37.1-1 
as “a person who: (i) through use of habit-forming drugs or 
other drugs enumerated in the Virginia Drug Control Act 
(§ 54.1-3400 et seq.) as controlled drugs, has become 
dangerous to the public or himself; or (ii) because of such 
drug use, is medically determined to be in need of medical 
or psychiatric care, treatment, rehabilitation or 
counseling.” 
 
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mental illness except for the purposes of Chapter 2.6  We 
disagree. 
The language of Code § 37.1-1 does not squarely 
address the question whether PSD qualifies as a mental 
illness for purposes other than Chapter 2, such as 
satisfying the standard for Mercer’s continued commitment 
as an NGRI acquittee.  In other words, it neither compels 
nor forbids a finding of mental illness based on PSD in 
situations that are not covered by Chapter 2.  However, we 
believe that it would strain credulity to say, as Mercer 
suggests, that PSD qualifies as a mental illness when 
deciding whether to voluntarily or involuntarily admit an 
individual who has not committed an unlawful act to a 
hospital for treatment, but is never a mental illness when 
determining whether to continue the inpatient 
hospitalization of an NGRI acquittee. 
Instead of focusing solely on the definition of 
“[m]entally ill” in Code § 37.1-1, we believe that the 
analysis should include the provisions of Code §§ 19.2-
182.3 and -182.5, which set forth the criteria that must be 
satisfied in order to continue Mercer’s commitment to the 
                     
6 Chapter 2 of Title 37.1 deals primarily with the 
voluntary and involuntary admission of a person with a 
mental illness to a hospital for treatment of such illness. 
 
 
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custody of the Commissioner.  Specifically, Code § 19.2-
182.5 provides that the court can retain an NGRI acquittee 
in the custody of the Commissioner if the acquittee 
“continues to require inpatient hospitalization based on 
consideration of the factors set forth in § 19.2-182.3.”  
Under Code § 19.2-182.3, “mental illness includes any 
mental illness, as this term is defined in § 37.1-1, in a 
state of remission when the illness may, with reasonable 
probability, become active.”  (Emphasis added.)  In 
contrast, the definition of “[m]entally ill” in Code 
§ 37.1-1 does not include the phrase “in a state of 
remission.”  Thus the term “mental illness” in Code § 19.2-
182.3 is not limited solely to the definition of 
“[m]entally ill” in  Code § 37.1-1. 
Code § 19.2-182.3 also establishes four factors that 
the circuit court had to consider in determining whether to 
continue Mercer’s commitment: 
1.  To what extent the acquittee is mentally ill or 
mentally retarded, as those terms are defined in 
§ 37.1-1; 
2.  The likelihood that the acquittee will engage in 
conduct presenting a substantial risk of bodily harm 
to other persons or to himself in the foreseeable 
future; 
3.  The likelihood that the acquittee can be 
adequately controlled with supervision and treatment 
on an outpatient basis; and 
4.  Such other factors as the court deems relevant. 
 
 
9
In Kansas v. Hendricks, 521 U.S. 346 (1997), the 
Supreme Court of the United States acknowledged that it had 
never “required State legislatures to adopt any particular 
nomenclature in drafting civil commitment statutes.”  Id. 
at 359.  Instead, the Court “left to legislators the task 
of defining terms of a medical nature that have legal 
significance.”  Id.  Consequently, the Court recognized 
that states have “developed numerous specialized terms to 
define mental health concepts” and that those “definitions 
do not fit precisely with the definitions employed by the 
medical community.”  Id.
Accordingly, we conclude that the determination with 
regard to whether Mercer suffers from a mental illness, and 
therefore should continue to be committed to the custody of 
the Commissioner, is a question of fact to be resolved by 
the trial court based upon consideration of the relevant 
Code provisions, and the report and testimony of mental 
health experts.  The circuit court in this case heard 
testimony from Dr. Bryant and Dr. Nelson, and also had the 
benefit of their written reports.  While the experts agreed 
that Mercer still presents a high risk of engaging in 
aggressive behavior and harming others, they disagreed 
about whether Mercer is mentally ill.  Thus, the circuit 
court had to resolve that conflict in the testimony. 
 
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There are several established principles that guide 
our review of the circuit court’s resolution of the 
conflict in the testimony of the two witnesses.  
“Conflicting expert opinions constitute a question of fact 
. . . .”  McCaskey v. Patrick Henry Hospital, 225 Va. 413, 
415, 304 S.E.2d 1, 2 (1983).  It is within the province of 
the finder of fact “to assess the credibility of the 
witnesses and the probative value to be given their 
testimony.”  Richardson v. Richardson, 242 Va. 242, 246, 
409 S.E.2d 148, 151 (1991).  The factual determinations of 
the trial court, like those of a jury, are binding on this 
Court, and we will reverse such findings “only if they are 
plainly wrong or without evidence to support them.”  Id.
Considering the evidence in this case in light of 
these established principles, we conclude that the circuit 
court correctly determined that Mercer continues to need 
inpatient hospitalization in accordance with the terms of 
Code §§ 19.2-182.3 and –182.5.  There is evidence in the 
record to support the court’s conclusion that Mercer 
suffers from a mental illness and presents a substantial 
risk of bodily harm to other persons because of her long 
history of drug abuse, drug addiction, and violence.  
Although not dispositive of the issue before us, it is 
significant that the circuit court also found that Mercer 
 
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meets the definition of the term “[d]rug addict” in Code 
§ 37.1-1.  Finally, Dr. Bryant and Dr. Nelson disagreed 
only with regard to whether PSD is a mental illness.  In 
resolving that conflict, the circuit court is not 
necessarily bound by the definitions employed by the 
medical profession.  See Hendricks, 521 U.S. at 359. 
For these reasons, we will affirm the judgment of the 
circuit court. 
Affirmed. 
 
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