Opinion ID: 2550767
Heading Depth: 2
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Heading: Definition of Mental Disease or Defect

Text: ¶ 23 Klein challenges the trial court's finding that she continues to suffer from a mental disease or defect. Under our current statutory scheme, the presence of a mental disease or defect is a requirement for asserting the insanity defense. RCW 9A.12.010. Conversely, the absence of such a condition is the threshold inquiry when an insanity acquittee petitions for full release from state commitment. RCW 10.77.200(2). Neither the legislature nor this court has defined the term in either context. ¶ 24 Washington follows the M'Naghten ( M'Naghten's Case, 10 Clark & Fin. 200, 210, 8 Eng. Rep. 718, 722 (H.L.1843)) rule for determining insanity, which has been codified at RCW 9A.12.010. See, e.g., State v. Wheaton, 121 Wash.2d 347, 352 n. 2, 850 P.2d 507 (1993) and Allstate Ins. Co. v. Raynor, 143 Wash.2d 469, 475 n.3, 21 P.3d 707 (2001) (citing M'Naghten's ). ¶ 25 To establish the defense of insanity, it must be shown that: (1) At the time of the commission of the offense, as a result of mental disease or defect, the mind of the actor was affected to such an extent that: (a) He was unable to perceive the nature and quality of the act with which he is charged; or (b) He was unable to tell right from wrong with reference to the particular act charged. (2) The defense of insanity must be established by a preponderance of the evidence. RCW 9A.12.010 (emphasis added). Although the presence of a mental disease or defect is necessary to establish the defense, it has only been on rare occasion that we have ascribed the term any significant independent meaning. See State v. Crenshaw, 98 Wash.2d 789, 800, 659 P.2d 488 (1983). ¶ 26 An individual who is acquitted under our insanity defense statute will rarely be unconditionally released immediately, however, because Washington law since 1905 has presumed the mental condition of a person acquitted by reason of insanity continues and the burden rests with that individual to prove otherwise. State v. Platt, 143 Wash.2d 242, 251 n. 4, 19 P.3d 412 (2001) (citing In re Brown, 39 Wash. 160, 166, 81 P. 552 (1905); State v. Blubaugh, 80 Wash.2d 28, 36, 491 P.2d 646 (1971); Soderquist v. Keller, 21 Wash.2d 1, 10-11, 149 P.2d 528 (1944)). Accordingly, the typical insanity acquittee is subjected to state custody in the form of commitment or conditional release. See RCW 10.77.150(1), .200. ¶ 27 While subject to state custody, an insanity acquittee may petition the courts at any time for full release. See Reid, 144 Wash.2d at 629, 30 P.3d 465. The legal standards governing the disposition of such petitions are set forth in RCW 10.77.200(2) and (3): The burden of proof shall be upon the petitioner to show by a preponderance of the evidence that the petitioner no longer presents, as a result of a mental disease or defect, a substantial danger to other persons, or a substantial likelihood of committing criminal acts jeopardizing public safety or security, unless kept under further control by the court or other persons or institutions. RCW 10.77.200(2) (emphasis omitted). We have construed this statute to mean that a petitioner must be discharged if it is demonstrated that he or she no longer suffers from a mental disease or defect, notwithstanding any potential danger to the community. See Reid, 144 Wash.2d at 630, 30 P.3d 465. ¶ 28 Here, as previously stated, the parties' respective psychologist experts agreed as to Klein's current diagnosis, including the presence of various recognized mental disorders. However, counsel disagreed as to whether such disorders legally constituted a mental disease or defect under RCW 10.77.200. [7] See, e.g., Br. of Appellant at 4-5; Br. of Resp't at 2. ¶ 29 Klein argues that her release is mandated under Reid. In Reid, an insanity acquittee petitioned for release from custody after approximately four years of commitment at Western State. 144 Wash.2d at 624, 30 P.3d 465. The original acquittal stemmed from an episode in which Reid ingested hallucinogenic drugs and shot and killed his roommate. Id. at 623, 30 P.3d 465. In support of Reid's petition for release, two experts, including the State's, testified that Reid no longer suffered from any mental disease or defect. Id. at 625, 30 P.3d 465. In fact, one even testified that there had been a 100 percent reversal since Reid's initial commitment. Id. Because it was unanimously agreed that Reid did not suffer from a mental disease or defect, this court never defined the term. In the present case, however, there is a dispute over whether Klein has a mental disease or defect, and the trial court held that she did. Thus, Reid is not controlling here. ¶ 30 The determination of whether Klein continues to suffer from a mental disease or defect is a question of fact. See id. at 631, 30 P.3d 465. Cf. State v. Sommerville, 111 Wash.2d 524, 533, 760 P.2d 932 (1988) (holding that motion for acquittal by reason of insanity should be decided by trial court as a question of fact). We review disputed findings of fact under a substantial evidence standard. State v. Mendez, 137 Wash.2d 208, 214, 970 P.2d 722 (1999). Evidence is substantial if it is sufficient to convince a reasonable person of the truth of the finding. Id. Where substantial evidence supports challenged facts, those facts as found by the trial court are binding on appeal. State v. Hill, 123 Wash.2d 641, 647, 870 P.2d 313 (1994). ¶ 31 Although the ultimate determination of the existence of a mental disease of defect is a question of fact, the absence of a statutory definition has invited confusion. When a statute fails to define a term, a court may rely on the ordinary meaning of the word as stated in a dictionary. See Budget Rent A Car Corp. v. Dep't of Licensing, 144 Wash.2d 889, 899, 31 P.3d 1174 (2001). Additionally, the plain meaning of a statute may be determined from related statutes that disclose legislative intent about the provision at issue. See State v. C.G., 150 Wash.2d 604, 609, 80 P.3d 594 (2003). ¶ 32 The dictionary indicates that the term mental disease or defect has the common meaning of mental disorder. See WEBSTER'S THIRD NEW INTERNATIONAL DICTIONARY 1411 (2002) (defining mental disease as a disease characterized esp. by mental symptoms: mental disorder.). Similarly, we have previously recognized that the terms mentally ill and mentally disordered are interchangeable. See In re Pers. Restraint of Young, 122 Wash.2d 1, 27 n. 3, 857 P.2d 989 (1993). Cf. BLACK'S LAW DICTIONARY 1007 (8th ed.2004) (defining mental illness as a mental disorder in thought or mood so substantial that it impairs judgment, behavior, perceptions of reality, or the ability to cope with the ordinary demands of life.). ¶ 33 Although our legislature has not further defined the term mental disease or defect, other state legislatures have. In doing so, these legislatures have exercised a legislative prerogative to depart from a dictionary definition and have instead made policy choices to exclude specific types of mental conditions from the term. [8] Were we to do so here by court decision, we would unduly encroach upon the legislative function, especially since our legislature has not seen fit to further define the term. ¶ 34 The American Psychiatric Association publishes the Diagnostic and Statistical Manual of Mental Disorders, which is a compilation of mental disorders that `reflect[s] a consensus of current formulations of evolving knowledge' in the mental health field. State v. Greene, 139 Wash.2d 64, 71, 984 P.2d 1024 (1999) (quoting AM. PSYCHIATRIC ASS'N, DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS: DSM-IV-TR at xxvii (4th rev. ed.2000)). We have relied on the DSM in a variety of contexts. See, e.g., In re Disability Proceeding Against Diamondstone, 153 Wash.2d 430, 105 P.3d 1 (2005); Braam v. State, 150 Wash.2d 689, 694 n. 1, 81 P.3d 851 (2003); In re Petition of Campbell, 143 Wash.2d 504, 506, 21 P.3d 1147 (2001). ¶ 35 However, in recognizing the term mental disease or defect often is synonymous with the term disorder, we reiterate our prior caveat that `[t]he DSM is, after all, an evolving and imperfect document ... [and it is not] ... sacrosanct.' In re Pers. Restraint of Young, 122 Wash.2d at 28, 857 P.2d 989 (quoting Alexander D. Brooks, The Constitutionality and Morality of Civilly Committing Violent Sexual Predators, 15 U. PUGET SOUND L. REV. 709, 733 (1991-1992)). Not all disorders defined therein will rise to the status of disease or defect under our statutes. ¶ 36 Our state's practice of conducting Frye hearings ( Frye v. United States, 293 F. 1013 (D.C.Cir.1923)) if individuals assert insanity defenses based on disorders of dubious repute in the legal or scientific communities assures that the DSM does not become the de facto definition of mental disease or defect. See generally Greene, 139 Wash.2d 64, 984 P.2d 1024; State v. Wheaton, 121 Wash.2d 347, 850 P.2d 507 (1993). The DSM is updated periodically and recognizes that [n]ew knowledge generated by research or clinical experience will undoubtedly lead to an increased understanding of the disorders included in DSM-IV, to the identification of new disorders, and to the removal of some disorders in future classifications. DSM-IV-TR at xxxiii. ¶ 37 In addition to Frye, ER 702 continues to control trial court analysis for both the insanity defense and application of the release statute. RCW 10.77.200. Expert evidence relating to a mental disease or defect (or disorder) that does not help the trier of fact is inadmissible. ¶ 38 While the definition of mental disease or defect is admittedly broad, we do not expect that it will demonstrably alter the historic application of our statutory scheme. Under our insanity defense statute, for example, the inquiries into the individual's capacity to perceive the nature and quality of the act and tell right from wrong have always been, and will continue to be, the primary factors that limit the availability of the insanity defense to those who should not be culpable in the eyes of the law. Indeed, the DSM undoubtedly contains mental disorders that do not prevent individuals from perceiving the nature and quality of their acts or telling right from wrong. ¶ 39 Because of the statutory presumption that an insanity acquittee continues to be insane, the primary inquiry for the release statute remains the dangerousness of the individual. The DSM undoubtedly contains many mental disorders that do not manifest themselves by dangerous behavior and therefore cannot support continued custody. Similarly, there are conditions which impair the ability to cope with the ordinary demands of life which do not manifest themselves by dangerous behavior. ¶ 40 Finally, Klein argues that a mental condition that is in remission is not a disease or defect. We disagree, as did the trial court and the Court of Appeals. A finding that a mental disease or defect is in remission does not preclude a finding that the person continues to suffer from the condition and requires further detention. Under the DSM, a diagnosis in full remission is appropriate for those individuals who no longer demonstrate any symptoms or signs of a disorder, but for which there is still clinical relevance in noting the disorder. DSM-IV-TR at 2. For example, Dr. Couturier testified that Klein's disorder is in remission only because she is being maintained in a wholly artificial setting with controls. The DSM has criteria for full recovery. See generally Reid, 144 Wash.2d 621, 30 P.3d 465. Klein did not meet those criteria. Accordingly, substantial evidence on the record indicates that Klein continues to suffer from a mental disease or defect.