Court Opinion

ID: 9900411
Source: CourtListenerOpinion
Date Created: 2023-11-18 22:12:32.190613+00
Date Added: 2024-06-11T09:21:05.252969
License: Public Domain

No. 345                July 6, 2023                      777

          IN THE COURT OF APPEALS OF THE
                  STATE OF OREGON

          NICHOLAS JUDSON RINNE,
                     Petitioner,
                          v.
     PSYCHIATRIC SECURITY REVIEW BOARD,
                    Respondent.
         Psychiatric Security Review Board
                 991597; A174602

  Submitted December 5, 2022.
  Harris S. Matarazzo filed the briefs for petitioner.
   Ellen F. Rosenblum, Attorney General, Benjamin Gutman,
Solicitor General, and Rolf C. Moan, Assistant Attorney
General, filed the brief for respondent.
  Before Tookey, Presiding Judge, and Egan, Judge, and
Kamins, Judge.
  KAMINS, J.
  Reversed and remanded.
778                                                       Rinne v. PSRB

           KAMINS, J.
         Petitioner seeks judicial review from three orders
of the Psychiatric Security Review Board (PSRB), each of
which denied his discharge from PSRB’s jurisdiction and
continued his commitment to the Oregon State Hospital.
Petitioner raises four assignments of error. Because the
issue is dispositive, we write to address the fourth assign-
ment, in which he argues that PSRB’s decisions were not
supported by substantial evidence and substantial reason.
We reverse and remand.
                          I. BACKGROUND
          Petitioner has been under PSRB’s jurisdiction since
1999, when he was found guilty except for insanity of sev-
eral crimes involving child sex abuse and committed to the
Oregon State Hospital for up to 60 years. See ORS 161.327(1)
(authorizing commitment to state hospital of a person found
guilty except for insanity of a felony, if the person “is affected
by a qualifying mental disorder and presents a substantial
danger to others”). He has been a patient at the hospital
ever since, except for five years between 2008, when he
was granted a conditional release, and 2013, when it was
revoked after he violated its terms by visiting a community
pool without permission. This is not the first time that his
commitment has been reviewed by this court; several years
ago, we reversed and remanded two PSRB orders continu-
ing its jurisdiction. Rinne v. PSRB, 297 Or App 549, 443 P3d
731 (2019) (Rinne II); Rinne v. PSRB, 299 Or App 275, 448
P3d 654 (2019) (Rinne I). On remand, after a consolidated
proceeding, PSRB again decided that jurisdiction was war-
ranted, and those are the orders now before us.
         Some context is necessary to understand the
unusual posture of this case. For a person to be subject
to PSRB’s jurisdiction, they must have a “qualifying men-
tal disorder”1 which causes them to present a “substantial

    1
      Until 2018, the statutes used the term “mental disease or defect.” In
updating the terminology, the legislature did not intend to change its meaning.
Or Laws 2017, ch 634 (“[T]he purpose of this 2017 Act is to replace the term
‘mental disease or defect’ with the term ‘qualifying mental disorder’ and to
retain the meaning of the replaced term, without making a substantive change
to Oregon law.”).
Cite as 326 Or App 777 (2023)                                              779

danger to others.” See ORS 161.351(1)2 (“Any person placed
under the jurisdiction of the Psychiatric Security Review
Board under ORS 161.315 to 161.351 shall be discharged at
such time as the board, upon a hearing, finds by a prepon-
derance of the evidence that the person is no longer affected
by a qualifying mental disorder or, if so affected, no longer
presents a substantial danger to others that requires reg-
ular medical care, medication, supervision or treatment.”);
OAR 859-010-0005(8) (“ ‘Substantial Danger’ * * * means
a demonstration or previous demonstration of intentional,
knowing, reckless or criminally negligent behavior which
places others at risk of physical injury because of the per-
son’s qualifying mental disorder.” (Emphasis added.)).
         Personality disorders, which include sexual conduct
disorders like pedophilia, are not “qualifying mental disor-
ders.” See ORS 161.295(2)3 (“[T]he term ‘qualifying mental
disorder’ does not include an abnormality manifested only
by repeated criminal or otherwise antisocial conduct, nor
does the term include any abnormality constituting solely
a personality disorder.”); Beiswenger v. PSRB, 192 Or App
38, 54, 84 P3d 180, rev dismissed as improvidently allowed,
337 Or 669 (2004) (concluding that the legislature intended
“personality disorder” to include sexual conduct disorders,
alcohol dependency, and drug dependency).
         As a result, for PSRB to retain jurisdiction, the
record must contain substantial evidence that petitioner
was affected by a mental health condition other than a
personality disorder (such as pedophilia) that caused him
to present a substantial danger to others. The issue in this
case is whether petitioner’s dangerousness was “because of”
a qualifying disorder.
        Petitioner’s diagnoses have varied considerably
over time. When he was first admitted to the hospital in
1999, he was diagnosed with autism spectrum disorder,

    2
      ORS 161.351 was amended in 2017; however, because those amendments
were not substantive and do not affect our analysis, we refer to the current ver-
sion of the statute in this opinion.
    3
      ORS 161.295 was amended in 2017; however, because those amendments
were not substantive and do not affect our analysis, we refer to the current ver-
sion of the statute in this opinion.
780                                                           Rinne v. PSRB

schizophrenia, pedophilia, and another personality disorder.
A few years later, the schizophrenia diagnosis was ruled out
after petitioner admitted to having malingered symptoms
of psychosis in order to be hospitalized rather than incar-
cerated. Rinne II, 297 Or App at 554-55. He was later diag-
nosed with major depressive disorder, which has since been
in sustained remission. The autism spectrum diagnosis was
ruled out in 2014, after petitioner’s treatment team deter-
mined that it could not be supported. Different treatment
providers have at times also diagnosed petitioner with vari-
ous anxiety disorders.
         As of 2015, petitioner’s diagnoses were pedophilia,
obsessive-compulsive personality disorder, major depres-
sive disorder in sustained remission, and two anxiety dis-
orders—other specified anxiety disorder and illness anxiety
disorder.4 Petitioner’s treatment team concluded that those
anxiety disorders—the only remaining active qualifying
diagnoses5 —did not cause his potential dangerousness. The
team presented its reasoning to the hospital’s risk review
panel, which is comprised of mental health professionals
who are not members of the patient’s treatment team and
is tasked with determining the hospital’s official opinion
about jurisdictional issues. Rinne II, 297 Or App at 564. The
panel concurred with the treatment team, and accordingly
requested that PSRB discharge petitioner.
        After a hearing, PSRB denied the requested dis-
charge and continued petitioner’s commitment. Petitioner
appealed, and while the appeal was pending, petitioner
requested another hearing, at which the hospital again
supported discharge. That hearing took place in 2017 and
resulted in another denial, which petitioner again appealed.
As noted, we reversed and remanded both denials for lack
of substantial evidence and reason. Rinne II, 297 Or App
at 566 (reversing and remanding the 2017 order); Rinne I,

    4
      In 2016, PSRB switched from using the DSM-IV-TR to the updated DSM-5,
which renamed “hypochondriasis” to “illness anxiety disorder” and “anxiety dis-
order not otherwise specified” to “other specified anxiety disorder.” 55 Or Bull 191
(Jan 1, 2016). Because there was no significant change in petitioner’s symptom-
atology, we use the updated terms throughout this opinion.
    5
      PSRB does not make any arguments on appeal related to petitioner’s major
depressive disorder.
Cite as 326 Or App 777 (2023)                             781

299 Or App at 276 (per curiam opinion relying on the rea-
soning of Rinne II to reverse and remand the 2015 order).
On remand, PSRB consolidated the matters into a single
proceeding and again denied discharge. PSRB issued three
orders, one based on the record as of 2015, the second based
on the record as of 2017, and the third based on the record
as of 2020, when the hearing on remand took place. The
parties agree that all three orders must be valid for PSRB
to retain jurisdiction.
                     II. DISCUSSION
         We review agency orders for errors of law, sub-
stantial evidence, and substantial reason. Dorn v. Teacher
Standards and Practices Comm., 316 Or App 241, 243, 504
P3d 44 (2021). “Substantial evidence exists to support a
finding of fact when the record, viewed as a whole, would
permit a reasonable person to make that finding.” ORS
183.482(8)(c). Substantial reason exists where the agency
has articulated a rational connection between the facts and
the legal conclusion that the agency draws from them. Dorn,
316 Or App at 243.
         The statutes governing PSRB jurisdiction require
that PSRB discharge a person who “no longer presents a
substantial danger to others,” and, conversely, prohibit the
discharge of a person who “is a substantial danger to oth-
ers.” ORS 161.351(1); ORS 161.346(1). In implementing those
statutes, PSRB adopted rules defining “substantial danger”
as a demonstration of “behavior which places others at risk
of physical injury because of the person’s qualifying mental
disorder.” OAR 859-010-0005(8).
         The parties agree that petitioner meets both compo-
nents of that definition of “substantial danger.” First, they
agree that petitioner has the “qualifying mental disorders”
of other specified anxiety disorder and illness anxiety disor-
der. Second, the parties also agree that petitioner is likely
to engage in behavior which places children at risk of sexual
abuse. The parties disagree, however, as to the existence
of a causal nexus—whether that danger is “because of” a
qualifying mental disorder. Petitioner argues that his dan-
gerousness is “because of” his nonqualifying mental disor-
der of pedophilia. PSRB, on the other hand, contends that
782                                           Rinne v. PSRB

petitioner’s dangerousness is “because of” his qualifying
anxiety disorders in that, “when combined with” pedophilia,
they reduce the likelihood that petitioner will take mea-
sures to mitigate his pedophilia such as alert his doctor or
seek treatment. Put another way, PSRB contends that peti-
tioner’s qualifying mental disorders exacerbate the danger-
ousness caused by his pedophilia, and thus the dangerous-
ness is “because of” those qualifying mental disorders. The
parties’ arguments require us to determine the meaning of
“because of” in OAR 859-010-0005(8).
A. Rule Construction
         When we construe an administrative rule, “we
begin with the text and context, just as we would for inter-
preting a statute.” OR-OSHA v. Loy Clark Pipeline, Co., 320
Or App 205, 211, 514 P3d 544, rev den, 370 Or 471 (2022).
Just as when interpreting a statute, we may also look to
the rule’s adoption history. Id. Additionally, when an agency
interpretation of a rule “is plausible, given the rule’s text
and context and any other applicable sources of law, then
we defer to that interpretation.” Nacey v. Board of Massage
Therapists, 287 Or App 228, 233, 401 P3d 275 (2017).
         As noted, the text of the rule defines “substantial
danger” as a demonstration of “behavior which places others
at risk of physical injury because of the person’s qualifying
mental disorder.” OAR 859-010-0005(8) (emphasis added).
The word “because” is not defined, meaning that we look to
its “plain, natural, and ordinary meaning.” PGE v. Bureau
of Labor Industries, 317 Or 606, 611, 859 P2d 1143 (1993).
The most relevant dictionary definition of “because” is “for
the reason that” and “on account of the cause that.” Webster’s
Third New Int’l Dictionary 194 (unabridged ed 2002).
“Reason” is further defined as “a consideration * * * leading
to an action or course of action.” Id. at 1891. Under the plain
text of the rule then, the “qualifying mental disorder” must
be what leads to or causes the “behavior which places others
at risk of physical injury.” OAR 859-010-0005(8).
        The statutory context of the rule’s definition of dan-
gerousness further supports the conclusion that the quali-
fying mental disorder must be the thing that causes a per-
son’s dangerousness. See Growing Green Panda v. Dept. of
Cite as 326 Or App 777 (2023)                                                 783

Human Services, 302 Or App 325, 332, 461 P3d 1026 (2020)
(When construing an administrative rule, “we consider the
text of the rule in its regulatory and statutory context.”).
Specifically, the statute governing discharge from PSRB
jurisdiction prevents discharge of any person “whose quali-
fying mental disorder may, with reasonable medical proba-
bility, occasionally become active and when it becomes active
will render the person a danger to others.” ORS 161.351(2)
(emphasis added). Under that framework, the qualifying
mental disorder must be what “renders” the person danger-
ous to support continued PSRB jurisdiction.6
          Another related statute provides additional help-
ful context. ORS 161.295(1) delineates the circumstances
required for a criminal defendant to be found “guilty except
for insanity,” a precursor to placement within the jurisdic-
tion of PSRB. ORS 161.327(1) (providing for the determina-
tion of placement within the jurisdiction of PSRB “[a]fter the
defendant is found guilty except for insanity”). Under that
statute, a defendant may be found guilty except for insan-
ity if they are unable to appreciate the criminality of their
conduct or conform to the law “as a result of a qualifying
mental disorder.” ORS 161.295(1). We have interpreted that
language to mean that the qualifying mental disorder must
“be sufficient—on its own—to bring about the requisite inca-
pacity.” State v. Meiser, 323 Or App 674, 685, 524 P3d 130,
rev allowed, 371 Or 60 (2023). That interpretation is con-
sistent with a conclusion that the qualifying disorder must
itself be the source of a person’s dangerousness in order to
justify continued PSRB jurisdiction.
        The rule’s adoption history also provides clues elu-
cidating whether dangerousness must be directly caused
by the qualifying diagnosis. The previous version of OAR
859-010-0005 tracked the statutory language more pre-
cisely and, in the definition of “mental disease or defect,”

    6
      The statute also requires discharge for a person who “is no longer affected
by a qualifying mental disorder or, if so affected, no longer presents a substantial
danger to others that requires regular medical care, medication, supervision or
treatment.” ORS 161.351(1). That formulation further suggests that the quali-
fying mental disorder is what requires care, treatment, and supervision, not a
nonqualifying diagnosis. In petitioner’s case, it is his nonqualifying diagnosis of
pedophilia that requires treatment to prevent dangerousness, not his anxiety.
784                                                        Rinne v. PSRB

prohibited the discharge of a person “whose mental disease
or defect may, with reasonable medical probability, occasion-
ally become active, and when active, render the person a
danger to others.” OAR 859-010-0005(6) (December 8, 1994).
The rule was revised to move discussion of causation to the
definition of “substantial danger,” but nothing indicates an
intent to change the substance of the requirement. 54 Or
Bull 464 (February 1, 2015).
        In sum, the text, context, and adoption history of
OAR 859-010-0005(8) indicate that “because of” means that
the person’s dangerousness must stem from their qualifying
disorder. PSRB’s contrary interpretation, that jurisdiction
is warranted when a qualifying disorder exacerbates the
danger posed by a nonqualifying disorder, is not plausible.
See Gafur v. Legacy Good Samaritan Hospital, 344 Or 525,
537, 185 P3d 446 (2008) (concluding that an agency’s inter-
pretation of its own rule is implausible where it “is inconsis-
tent with the wording of the rule and its context” (emphasis
omitted)).
B.    Application
         Having concluded that the qualifying mental dis-
order must be what renders the person dangerous, we must
determine whether that standard is met for each of peti-
tioner’s hearings, that is, whether substantial evidence
exists that petitioner’s dangerousness was caused—not
just exacerbated—by his qualifying anxiety disorders. This
record does not contain such evidence for the 2015 and 2017
hearings.
         We focus on the record as of 2017, which includes
the record as of 2015; PSRB’s reasoning is substantially the
same in both orders. At the hearings, the board heard from
petitioner’s treating psychiatrist, Dr. Roff, as well as from a
member of the hospital’s risk review committee, Dr. Sethi,
and from an expert retained by petitioner, Dr. Johnson.7
PSRB also considered the entirety of petitioner’s patient file.
         Dr. Roff opined that petitioner’s “risk of sexual
recidivism if released to the community stems from his
    7
      Dr. Roff testified at both hearings, Dr. Sethi testified only in 2015, and
Dr. Johnson testified only in 2017.
Cite as 326 Or App 777 (2023)                               785

diagnosis of pedophilia and borderline traits.” She explained
that petitioner’s personality was marked by rigid thinking,
oppositional traits, and difficulty forming trusting relation-
ships with adults. At the time of the underlying offenses, it
manifested in an identity disturbance whereby he identified
with his victims, seeing himself as childlike and adopting
a Russian name and accent. More recently, it made him
unable to understand why his unauthorized trips to a com-
munity pool caused his conditional release to be revoked,
which enraged him, and as a result, he became uncoopera-
tive with hospital staff. Dr. Roff also testified that it put him
at risk of “kidding himself” about his choices; for instance,
he saw those trips merely as exercise, and failed to recog-
nize the concomitant risk of recidivism that they posed.
         As to petitioner’s anxiety disorders, Dr. Roff’s view
was that they largely stemmed from his personality disor-
ders. She explained that illness anxiety disorder is “a per-
sistent concern regarding the possibility of having illnesses
for which there is no medical basis and a lack of reassurance
when told by medical professionals that there isn’t cause for
concern.” In petitioner’s case, it was most pronounced in his
struggles with hypersexuality, in that he believed that it
was caused by a physical issue such as a testicular tumor
or high testosterone levels, despite numerous tests ruling
out any such conditions. She connected that persistent belief
with his rigid thinking and difficulty trusting his medical
providers.
         Regarding petitioner’s other specified anxiety disor-
der, Dr. Roff explained that it is largely “organized around
being labeled or designated as a person with a sex offense
history,” in that he believed that he would face severe retal-
iation if people knew about that history. She testified that
some of that anxiety was situational and realistic under the
circumstances, but that his symptoms were also greater
than what one would expect from a typical person, which
is why she chose that diagnosis. In her view, petitioner’s
symptoms were a byproduct of his personality disorders
and his attempts to control his antisocial traits. She further
testified that petitioner’s anxiety is primarily protective,
because he is terrified of being caught reoffending. She also
cited a scientific meta-study which found no statistically
786                                                           Rinne v. PSRB

significant correlation between anxiety and risk of sexually
reoffending.
         Dr. Sethi testified that the risk review committee
concurred with Dr. Roff’s opinion that petitioner’s danger-
ousness stemmed from his pedophilia and personality disor-
der, and that his anxiety was more likely to inhibit reoffend-
ing than promote it. He explained that in some cases, severe
anxiety can cause people to act out impulsively, but that in
petitioner’s case, his offenses were more planful, in that he
built up relationships with his victims for months before sex-
ually abusing them. He additionally testified that there was
no indication that petitioner engaged in pedophilic behavior
in order to relieve his anxiety; rather, his anxiety was about
the consequences of such behavior. Dr. Johnson agreed that
petitioner’s pedophilia was the driver of his dangerousness,
and that his anxiety disorders had no causal connection to
his likelihood of reoffending.
          Despite those experts’ opinions, PSRB found that
petitioner’s anxiety disorders, in combination with his pedo-
philia, rendered him more dangerous than he would other-
wise have been without them. In reviewing PSRB’s order,
“[o]ur duty is to evaluate the board’s logic, not to supply it.”
Knotts v. PSRB, 250 Or App 448, 455, 280 P3d 1030 (2012)
(citation omitted). Here, PSRB reasoned that petitioner’s
anxiety prevented him from engaging in sex offender treat-
ment because he was afraid that his peers would find out
about his history as a result. PSRB further reasoned that
if petitioner were to be discharged, his anxiety about retal-
iation would likely lead him to leave Oregon or even the
United States, in order to live somewhere that he perceives
to be less threatening to sex offenders, which would make it
more difficult to monitor his activities. As to petitioner’s ill-
ness anxiety disorder, PSRB reasoned that it also decreased
the likelihood of him engaging in treatment because it
caused him to attribute his hypersexuality to a physical
condition, despite his providers’ belief that its source was
psychological.8 Those reasons, however, are mechanisms for
    8
      To the extent that PSRB suggests that petitioner’s anxiety disorders
caused his hypersexuality, we are unable to find evidence in the record support-
ing that conclusion. On the contrary, Dr. Roff opined that its source was likely his
pedophilia.
Cite as 326 Or App 777 (2023)                             787

petitioner’s anxiety disorders to exacerbate—not cause—
the danger posed by his pedophilia. Accordingly, PSRB’s
analysis is not consistent with the meaning of “because of”
in OAR 859-010-0005(8).
         PSRB further argues that petitioner’s dangerous-
ness cannot be solely attributed to his pedophilia because
he has also engaged in dangerous behaviors towards adults.
In particular, he has engaged in some grooming behavior
toward younger, lower-functioning peers in the hospital,
and, while on conditional release, engaged in stalking and
harassing behavior toward gymnastics and boxing coaches.
We are not persuaded, however, that substantial evidence
supports the conclusion that petitioner’s anxiety caused
those behaviors. Even if PSRB is correct that those exam-
ples of dangerousness were not directly caused by pedo-
philia, that alone does not mean that they were caused by
anxiety. Indeed, none of petitioner’s providers, as reflected
in his hospital file, connected those behaviors to petitioner’s
anxiety.
         In sum, PSRB’s conclusion that petitioner’s dan-
gerousness was “because of” his anxiety disorders is not
supported by substantial evidence and reason. Regarding
substantial reason, in light of our conclusion that the per-
son’s qualifying mental disorder must be what causes their
dangerous behaviors, PSRB’s reasoning that petitioner can-
not be discharged because his anxiety exacerbated his dan-
gerousness cannot stand. Further, regarding substantial
evidence, there is no evidence in the record that petition-
er’s behavior, which places others at risk of physical injury,
was “because of” petitioner’s qualifying mental disorder as
required under OAR 859-010-0005(8).
        Reversed and remanded.