Court Opinion

ID: 9680875
Source: CourtListenerOpinion
Date Created: 2023-08-24 07:40:27.137978+00
Date Added: 2024-06-11T18:17:31.085547
License: Public Domain

MAJORITY OPINION
SCOTT BRISTER, Chief Justice.
Appellant G.H. was involuntarily committed for temporary inpatient mental health services and administration of psychoactive medication for a period not to exceed ninety days. Through her attorney ad litem, she challenges the legal and factual sufficiency to support this order. We affirm.
The medical records indicate G.H. has a history of bipolar disorder “with psychotic features.” She was brought to the emergency room of the University of Texas Medical Branch by a mental health deputy due to disruptive and disorganized behavior at home. When she arrived, she was unclean, yelling, and “washing her hair in cold water.” She also was delusional, complaining that her 13-year-old grandchildren were stored in test tubes at the hospital.
At the commitment hearing, G.H.’s testimony showed not only that she was suffering from delusions, but that she refused any medication to treat her condition. Although G.H.’s attorney characterizes her behavior as merely “disorganized” and “irritable,” the evidence clearly shows she suffers from severe mental distress. The specialists who examined her so testified, and gave concrete examples of her behavior to confirm their conclusions.
*116The trial court ordered temporary commitment, finding there was clear and convincing evidence that G.H. was (1) likely to seriously harm herself, and (2) experiencing a substantial deterioration of her ability to function independently and was unable to make a rational and informed decision whether to submit to treatment. Tex. Health & Safety Code 574.034(a)(2). To be clear and convincing, the evidence supporting these findings must include “a recent overt act or a continuing pattern of behavior that tends to confirm ... the proposed patient’s distress and the deterioration of the proposed patient’s ability to function.” Tex. Health & Safety Code 574.034(d)(2).
We believe there is factually and legally sufficient evidence to support the trial court’s second ground. The medical records and testimony established delusional and disruptive overt acts, both at home and at the emergency room, that showed a substantial deterioration of G.H.’s ability to function independently. It is hard to imagine how she could function in supermarkets, retail stores, welfare or other government offices, or public transportation with these disabilities.
Nor was there evidence that any friend or family member was available to help her cope with these necessaries of daily life. There was no one at G.H.’s home who could care for her; to the contrary, her elderly father had been relying upon her to take care of him.
Additionally, there was evidence that G.H. was unable to make a rational and informed decision whether to submit to treatment, and that outpatient treatment without commitment was unlikely to be successful. The medical records indicate G.H. had been “hospitalized several times in the past” and “has been noncompliant with med[ication]s on an outpatient basis.” The testimony at the commitment hearing indicated she refused medications that would help her because she claimed she was allergic to them. While her treating doctor admitted he had not thoroughly investigated her alleged allergies, he testified that the type and dosage of these medications could be adjusted to make allergies a non-issue. The trial court was in the best position to judge who was testifying accurately about why G.H. was refusing the medications she needed.
Several courts have held a patient’s refusal to take medication is insufficient to support temporary commitment.1 But others appear to recognize this refusal may affect a proposed patient’s ability to function and make rational decisions about treatment.2 We believe (1) G.H.’s refusal to take prescribed medication, (2) her actions at home that caused her family to *117contact a mental health deputy, and (3) her bizarre behavior at the emergency room are recent overt acts that tend to confirm her distress and deteriorating ability to function.
Texas law does not require relatives or physicians of the mentally ill (or the courts) to stand idly by until serious harm occurs. Indeed, the purpose of temporary commitment is to avoid just such harm. In this case the evidence concerning G.H.’s acts and behavior tends to confirm the trial judge’s conclusion that she was likely to suffer substantially deteriorated ability to function independently due to her severe mental distress, and to be unable to take the steps needed to remedy it. Thus, we overrule appellant’s points of error, and affirm the trial court’s judgment.
SEYMORE, J. dissents.

. See Johnstone v. State, 961 S.W.2d 385, 389 (Tex.App.-Houston [1st Dist.] 1997, no writ) (holding patient's refusal to take medication was legally insufficient as overt act or pattern of behavior to support commitment); Broussard v. State, 827 S.W.2d 619, 621 (Tex.App.Corpus Christi 1992, no writ) (same); In re J.S.C., 812 S.W.2d 92, 95-96 (Tex.App.-San Antonio 1991, no writ) (holding patient’s refusal to take medication was factually insufficient to support commitment).

. See In re State for Best Interest and Protection of K.D.C., 78 S.W.3d 543, 550 (Tex.App.Amarillo 2002, no pet.) (finding no evidence of overt act or pattern of behavior, but suggesting such evidence might include discontinuance of prescribed medications); D.J. v. State, 59 S.W.3d 352, 356-57 (Tex.App.-Dallas 2001, no pet,) (holding testimony that patient was not taking medication insufficient without proof of what those medications were or that failure to take them would lead to deterioration); Mezick v. State, 920 S.W.2d 427, 430 (Tex.App.-Houston [1st Dist.] 1996, no pet.) (holding evidence that patient refused all medication, did not believe he was ill, and lost thirty pounds in three months sufficient to establish likelihood of serious harm to himself).