Opinion ID: 1115476
Heading Depth: 1
Heading Rank: 3

Heading: criteria for involuntary commitment

Text: Bradshaw asserts there was insufficient evidence introduced at the hearing for the magistrate to find and conclude that he lacked the capacity to make an informed decision about treatment. Idaho Code § 66-329(k) sets forth the criteria for an involuntary commitment and provides in pertinent part: If, upon completion of the hearing and consideration of the record, the court finds by clear and convincing evidence that the proposed patient: (1) is mentally ill; and (2) is, because of such condition, likely to injure himself or others, or is gravely disabled due to mental illness; the court shall order the proposed patient committed to the custody of the department director for an indeterminate period of time not to exceed three (3) years... . (Emphasis added.) In addition, I.C. § 66-329(m) requires that an order of commitment shall state whether the proposed patient lacks capacity to make informed decisions about treatment, ... (Emphasis added.) After determining that Bradshaw was mentally ill and likely to harm himself or others, the magistrate made a further finding regarding Bradshaw's incapacity to make informed treatment decisions. The application of I.C. § 66-329 in the instant appeal raises three evidentiary questions: 1) whether the court's finding regarding capacity to make informed decisions about treatment is subject to a clear and convincing evidentiary standard; 2) whether the designated examiners' certificates filed with the court are part of the record in the absence of their admission into evidence, and 3) whether, as contemplated by the Act, the certificates were properly relied upon by the magistrate in making its decision.
We first consider whether I.C. § 66-329 requires that a finding that the patient's capacity to make informed decisions about treatment be supported by clear and convincing evidence. As a preliminary observation, I.C. § 66-329(k) requires a finding by clear and convincing evidence that the patient is mentally ill and because of the condition is likely to injure himself or others. Although I.C. § 66-329(m) does not expressly require a clear and convincing evidentiary standard for involuntary medication and treatment, we feel compelled to adopt this level of proof given the significance of the intrusion upon the committed person's liberty interests. Cf. Washington v. Harper, 494 U.S. 210, 110 S.Ct. 1028, 108 L.Ed.2d 178 (1990). Additionally, we note an analogous situation exists under I.C. § 66-322(i), also a part of the Hospitalization of Mentally Ill Act. This part of the Act requires clear and convincing evidence in determining whether a guardian needs to be appointed to make treatment decisions for a patient who lacks the capacity to make informed decisions about treatment. Considering the general intent of the legislature in adopting the Act, there is no valid reason to require clear and convincing evidence to commit a patient, and then impose a different standard for a determination of capacity to make decisions regarding treatment. Given the significant interests involved, and to ensure uniform evidentiary standards are applied in commitment cases, we hold that a finding of lack of capacity to make an informed decision about treatment must also be supported by clear and convincing evidence.
The second evidentiary question before us relates to whether the designated examiner's certificate that is statutorily required to be filed with the court may be relied upon by the magistrate in making a determination regarding an involuntarily committed patient's capacity to make decisions about treatment. [5] I.C. § 66-329(k) requires the magistrate to make its determination upon completion of the hearing and consideration of the record, ... (Emphasis added.) I.C. § 66-329(j) states ... [a] record of the proceedings shall be made as for other civil hearings. The hearing shall be conducted in as informal a manner as may be consistent with orderly procedure. The court shall receive all relevant and material evidence consistent with the rules of evidence. (Emphasis added.) [6] We deem it significant that the legislature has required that commitment decisions be made upon consideration of the record, and that the proceeding be conducted consistent with the rules of evidence. While the designated examiners' certificates filed with the clerk of the court and contained in the file physically before the presiding magistrate are part of the record, we hold that they may not be relied upon by the magistrate in making its evidentiary decision to commit or involuntarily medicate a patient unless the certificates are actually admitted into evidence. This requires that any evidence upon which the magistrate relies, including the examiners' certificates already on file, must be properly admitted into evidence. In the instant case the examiners' certificates, although physically filed and contained in the clerk's file, were not offered or admitted into evidence. Accordingly, the magistrate court could not have considered or relied upon the certificates without further evidence and the order concerning treatment would not have been supported by the evidence. In addition, we note significant procedural protections exist that ensure the proposed patient is given the opportunity to challenge the conclusions of the designated examiners and other witnesses. I.C. § 66-329(f) and (g) entitle the proposed patient to court appointed counsel if he or she does not, or is unable to provide their own, and I.C. § 66-329(j) requires the proposed patient ... be afforded an opportunity to appear at the hearing, to testify, and to present and cross-examine witnesses... . In the instant case the designated examiners either testified or were present at the hearing and were available for cross-examination. The protections afforded under the Act were available, and Bradshaw's rights were not denied even though the certificates were not admitted into evidence. At the hearing, in addition to testimony from both Steckbauer and Groberg that Bradshaw was mentally ill and likely to injure himself or others, Steckbaurer testified that Bradshaw did not believe he was mentally ill or that others wanted to help him. Steckbauer also testified that without treatment, Bradshaw's condition would worsen and that it was more likely to improve rapidly if Bradshaw would take medication and cooperate with the staff. Dr. Groberg testified that because of Bradshaw's inability to follow treatment and medical advice, he believed Bradshaw would not care for himself and that his treatment needed to be ordered. It is well established that a trial court's findings of fact will not be disturbed on appeal where the court's findings are supported by competent and substantial evidence. Barber v. Honorof, 116 Idaho 767, 780 P.2d 89 (1989); State v. Tierney, 109 Idaho 474, 708 P.2d 879 (1985); MacNeil v. Minidoka Memorial Hosp., 108 Idaho 588, 701 P.2d 208 (1985). Having reviewed the record, the finding of the magistrate that Bradshaw lacked the capacity to make informed decisions about treatment is supported by substantial and competent evidence in the record. Therefore, the magistrate's findings regarding Bradshaw's lack of capacity to make informed decisions regarding his treatment will not be disturbed on appeal.