Court Opinion

ID: 9516993
Source: CourtListenerOpinion
Date Created: 2023-08-06 23:59:14.5686+00
Date Added: 2024-06-11T09:42:51.398461
License: Public Domain

LESLIE BROCK YATES, Justice,
dissenting.
Because I believe the evidence is legally sufficient to show recent overt acts or a continuing pattern of behavior that tend to confirm the likelihood that appellant will be a danger to himself or others, I respectfully dissent.
In 1996, appellant murdered his mother by stabbing her more than ninety-three times. He was found not guilty by reason of insanity and committed to Vernon State Hospital. He was subsequently transferred to Rusk State Hospital, where he has remained since 1999. Within two weeks of his arrival at Rusk, the staff physicians recommended that appellant be placed in an outpatient treatment facility. The trial court, however, issued an order re-committing appellant to Rusk for the statutorily mandated period of one year. Since that time, Rusk physicians have annually maintained that appellant should be released, but the court has consistently found appellant continues to meet the criteria for inpatient commitment.
In reviewing the legal sufficiency of the evidence to support a mental health re-commitment, we must review the evidence favorable to the court’s judgment to see if there is more than a scintilla to support the judgment. See K.T. v. State, 68 S.W.3d 887, 889-90 (Tex.App.-Houston [1st Dist.] 2002, no pet.). We consider only the evidence and inferences tending to support the fact finding, and disregard all contrary evidence and inferences. Id. If there is more than a scintilla of evidence to support the finding, then the legal sufficiency challenge fails. In re K.C.M., 4 S.W.3d 392, 395 (Tex.App.-Houston [1st Dist.] 1999, pet. denied).
Dr. Milton Altschuler examined appellant and filed a report in which he concluded appellant continued to be a danger to himself or others if released into a less restrictive environment. Dr. Altschuler noted that the stress and disappointment of returning to Rusk on October 7, 2004 caused appellant to decompensate.1 Dr. Altschuler reviewed appellant’s medical records and noted that there were indications that appellant’s paranoid ideation continued throughout the year. The nursing assessment dated October 7, 2004 noted that appellant had suffered deterioration in self-care, homicidal threats, aggression, and decompensation. Appellant contends the nurse’s notes from October 7, 2004 appear to be a “history entry,” which appellant defines as an entry that “can be referring to something that happened at or even before his hospitalization.” At trial, Dr. Altschuler agreed that the notes “lookfed] like a history entry.” However, the record is unclear whether the nurse was recording past behavior or current symptoms. The notation in the nurse’s assessment is titled: “Presenting Problems/Behavior.” The court could have inferred from the notes and Dr. Alt-schuler’s testimony that appellant exhibited those symptoms on the day he was readmitted to the hospital.
Even if the court determined the nurse’s assessment reflected past behavior, appellant’s lack of insight into his illness and the continued state of denial that his illness *509caused him to commit a crime shows a continuing pattern of behavior, which tends to confirm the trial court’s finding. Most concerning to Dr. Altschuler was appellant’s lack of insight into his illness and the fact that appellant has not been able to appreciate the consequences of his acute psychotic episode in 1996 that resulted in the murder of his mother. At the hearing before the trial court, Dr. Altschuler testified that appellant’s lack of insight could lead to the likelihood of serious harm to himself or others if appellant was placed in an outpatient setting. Because appellant has not taken responsibility for the murder of his mother and does not fully understand his illness, there is a substantial likelihood that appellant would leave an outpatient facility and stop his medication. Both Dr. Altschuler, and Dr. Abdulla, the Harris County physician, testified that appellant could only function as an outpatient if he continued to take his medication.
In Campbell v. State, No. 14-99-00620-CV, 2000 WL 675142 (Tex.App.-Houston [14th Dist.] May 25, 2000, pet. denied) (not designated for publication), this court determined that evidence of Campbell’s vicious crime, his continued state of denial, and the complete lack of treatment were factors sufficient to demonstrate a continued pattern of behavior under section 574.035(e) of the Texas Health and Safety Code. Similarly, in this case, appellant committed a vicious crime and demonstrated a continued pattern of denial that his illness caused him to commit that crime. The majority opinion attempts to distinguish Campbell on the grounds that Campbell did not receive treatment for his illness and the physicians at Rusk agreed that Campbell was in a state of denial. I disagree. The record reflects in this case that appellant received treatment for his illness in the form of medication. The treatment factor, however, does not bear directly on appellant’s continued pattern of behavior. With regard to appellant’s lack of insight into his illness, although the Rusk physicians recommended release, Dr. Srinivasan noted in appellant’s October 7, 2004 medical records that, “Patient readily admits guilt but denies responsibility.” Further, in a psychiatric evaluation on the same date, Dr. Srinivasan noted that one of appellant’s weaknesses was that he lacked insight.
Although appellant can articulate that he has paranoid schizophrenia and needs to take medicine, he does not take responsibility for his mother’s death. A notation in appellant’s medical records on January 29, 2005 reflected that he continued to have delusional and paranoid thoughts. Dr. Altschuler testified that appellant “also had suicidal ideation, that he had been making plans, but did not want to talk about medications. He also denied to the individual who had written the progress note that he was not paranoid, did not recognize that he was delusional.” I find this evidence legally sufficient to support the trial court’s finding of a continued pattern of behavior or an overt act.
In holding the evidence legally insufficient, the majority relies on Whitaker v. State, No. 01-03-00576-CV, 2003 WL 22413511 (Tex.App.-Houston [1st Dist.] Oct. 23, 2003, no pet.) (mem.op.). In Whitaker, the appellant was found incompetent to stand trial for the alleged offenses of assault and criminal mischief. Id. at ⅜1. The psychiatrist in that case testified that he was concerned because Whitaker did not recognize he had a mental illness and that he would stop taking his medicine, causing him to deteriorate. Id. at *3. He also opined that Whitaker was a danger to himself and others because due to his delusions, he could easily go on someone’s property, say he owns it, and become involved in an argument. Id. The court of appeals found that the evidence only sup*510ported the conclusion that Whitaker was mentally ill but was legally insufficient to show a recent overt act or continuing pattern of behavior tending to confirm the likelihood of serious harm to Whitaker or others. Id.
This case is distinguishable from Whitaker. In this case, appellant murdered his mother by stabbing her more than ninety-three times, but he refuses to take responsibility for her murder. In the year preceding the re-commitment hearing, appellant suffered decompensation and suicidal ideation. Evidence at the hearing reflected that because appellant was in a continued state of denial that his illness caused him to murder his mother, he would be unlikely to take medication in an outpatient facility.
The evidence presented at the hearing goes beyond mere evidence of appellant’s denial of his mental illness. Appellant exhibited a continuing pattern of denial that his illness caused him to commit a brutal crime in addition to exhibiting decompen-sation and suicidal ideation. “Texas law does not require relatives or physicians of the mentally ill (or the courts) to stand idly by until serious harm occurs.” G.H. v. State, 94 S.W.3d 115, 117 (Tex.App.-Houston [14th Dist.] 2002, no pet.). Because I believe this evidence is legally sufficient to show recent overt acts and/or a continuing pattern of behavior that tended to confirm the trial court’s finding that appellant was a danger to himself or others, I respectfully dissent.

. Dr. Altschuler defined "decompensation” as a regression into severe symptomology.