Opinion ID: 165223
Heading Depth: 1
Heading Rank: 3

Heading: The Merits of Weed's Appeal

Text: 52 Finally, Weed contends that the district court's finding that he is dangerous due to a mental disease or defect is clearly erroneous. He argues that although he had a brief psychotic episode in December 2001, evidence presented at the commitment hearing establishes that he was not currently suffering from a mental disease or defect. According to Weed, the district court's ruling was improperly based on the possibility of future mental illness, not a finding of present mental disease or defect as required by § 4243. We disagree with Weed's assertion. 53 The district court's commitment determination under § 4243 is a question of fact we review for clear error. United States v. Gilgert, 314 F.3d 506, 512-13 (10th Cir.2002). A finding is clearly erroneous when, although there is evidence to support it, the reviewing court on the entire evidence is left with the definite and firm conviction that a mistake has been committed. United States v. De la Cruz-Tapia, 162 F.3d 1275, 1277 (10th Cir.1998) (quoting United States v. United States Gypsum Co., 333 U.S. 364, 395, 68 S.Ct. 525, 92 L.Ed. 746 (1948)). Our role on clear error review is not to re-weigh the evidence; rather, our review of the district court's finding is `significantly deferential.' Gilgert, 314 F.3d at 515-16 (quoting Concrete Pipe & Prods. v. Constr. Laborers Pension Trust, 508 U.S. 602, 623, 113 S.Ct. 2264, 124 L.Ed.2d 539 (1993)). 54 Section 4243(d) provides that an insanity acquittee has the burden of proving by clear and convincing evidence that his release would not create a substantial risk of bodily injury to another person ... due to a present mental disease or defect.  18 U.S.C. § 4243(d) (emphasis added). The Supreme Court observed that a verdict of not guilty by reason of insanity establishes two facts: (i) the defendant committed an act that constitutes a criminal offense, and (ii) he committed the act because of mental illness. Jones v. United States, 463 U.S. 354, 363, 103 S.Ct. 3043, 77 L.Ed.2d 694 (1983). From these two facts, Congress reasonably could make an inference of continuing mental illness and dangerousness of insanity acquittees, justifying their commitment for treatment. See id. at 366, 103 S.Ct. 3043. However, such an inference does not last indefinitely. As the Supreme Court stated in Foucha v. Louisiana, an insanity acquittee may be held as long as he is both mentally ill and dangerous, but no longer. 504 U.S. 71, 77, 112 S.Ct. 1780, 118 L.Ed.2d 437 (1992). 55 As the parties here recognize, courts have provided little guidance as to when a psychiatric condition constitutes a present mental disease or defect under § 4243(d). See United States v. Murdoch, 98 F.3d 472, 478 (9th Cir.1996) (Wilson, J., concurring) (There is little guidance as to when a psychiatric condition falls within the scope of § 4243's mental disease or defect.). Rather, courts have generally expressed reluctance in applying medical criteria to legal concepts. Id. For example, in Parrish v. Colorado, we observed that illnesses recognized by physicians to have a psychiatric basis sometimes do not equate with legal concepts defining mental states. 78 F.3d 1473, 1477 (10th Cir.1996). Because the Colorado commitment statute challenged in that case define[d], as a legal concept, the mental state an acquittee must have before he may be released from confinement, we concluded that the test is not whether the medical state is medically definable, but whether the acquittee has a mental condition that fits the legal definition. Id. 56 Similarly, other circuits have cautioned against conflating medical or diagnostic criteria with legal concepts when making determinations about an insanity acquittee's mental condition or a defendant's sanity. See Murdoch, 98 F.3d at 478 (Wilson, J., concurring) (observing that courts have expressed reluctance in relying on medical categories in determining limits of legal insanity, and finding one witness's testimony that personality disorders are not considered a mental disease or defect insignificant in making § 4243(d) determination); United States v. Lyons, 731 F.2d 243, 246 (5th Cir.1984) ([W]hat definition of `mental disease or defect' is to be employed by courts enforcing the criminal law is, in the final analysis, a question of legal, moral and policy — not of medical — judgment.). 57 We agree that the proper approach in insanity cases is to focus on the legislative pronouncement embodied in § 4243. We conclude that on the basis of the record below, the district court did not err in applying the statutory criteria. First, at the commitment hearing, Dr. Grundy testified that although Weed did not currently meet any DSM-IV criteria for mental disease, Weed had suffered a mental defect which caused his psychotic disorder. None of the tests Dr. Grundy administered explained the cause of Weed's psychosis, nor could the tests predict whether Weed will have another onset of symptoms. Dr. Grundy testified that the recurrence of a brief psychotic disorder is rare; however, he conceded that the public is at greater risk from someone with a history of such episodes. Additionally, Dr. Grundy stated that Weed may still have the mental defect, but that it has not been triggered since the time of the offense. 58 Second, Dr. Harrison Pope also testified that Weed is not currently psychotic. In his opinion, Weed's psychotic episode may have developed from a rare brain seizure, but he could not say with reasonable medical certainty that a seizure was the cause. Assuming a seizure caused the episode, Dr. Pope said that Weed is more vulnerable than the average person to having another recurrence of the seizure, but stated that the longer a person goes without having another seizure, the more the odds of recurrence are reduced. Dr. Pope agreed with the other consultants that Weed was dangerous when the psychotic condition was triggered. 59 Finally, the Bureau of Prisons (BOP) forensic evaluation offered a similar conclusion about Weed's current mental state. However, psychologists monitoring Weed's daily behavior viewed him as presenting a high risk of dangerousness if he relapsed into another psychotic episode, and stressed the risk of future recurrence is unknown. Thus, BOP recommended Weed be confined for a further period of observation, specifically concluding that Mr. Weed is currently suffering from a mental disease or defect as a result of which his release would create a substantial risk of bodily injury to another person or serious damages to the property of another. (Appellant's Addendum of Exhibits, Exh. F). 60 Based on this evidence, we conclude that the district court did not err in finding that Weed's mental state fits the legal definition in § 4243(d). Although Weed no longer shows symptoms of psychosis and meets no DSM-IV criteria for mental illness, the testifying doctors agree that Weed may still suffer from a condition not triggered since the time of the crime. The experts also agree that, if triggered, the condition may cause Weed to present a substantial danger to others. On this record, the district court did not err in concluding that such a condition constitutes a present mental defect within the meaning of the statute. 7 61 We recognize the difficulty that continuing confinement presents for a person that no longer exhibits overt symptoms of mental illness. However, we may not re-weigh evidence presented at the commitment hearing and we must give significant deference to the district court's findings. See United States v. Gilgert, 314 F.3d 506, 515-16 (10th Cir.2002). Given that two of the experts agreed that Weed would benefit from further observation and treatment, and considering the relatively short time period since the crime and his initial commitment, we are not left with the definite and firm conviction that the district court has committed a mistake. Thus, the record compels us to hold that the district court did not clearly err in finding that Weed failed to demonstrate by clear and convincing evidence that his release would not create a substantial risk of danger to others due to a present mental disease or defect.