Court Opinion

ID: 9898561
Source: CourtListenerOpinion
Date Created: 2023-11-14 19:31:31.292291+00
Date Added: 2024-06-11T09:16:49.070467
License: Public Domain

Filed
                                                                                       Washington State
                                                                                       Court of Appeals
                                                                                        Division Two

                                                                                        May 16, 2023

    IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

                                         DIVISION II
 In the Matter of the Detention of:                                No. 56896-9-II

 B.L.R.,
                                                             UNPUBLISHED OPINION
                                Appellant.

         GLASGOW, C.J.—BLR was arrested in late 2017 after he assaulted his father and threatened

to kill him. BLR was found incompetent to stand trial and civilly committed for involuntary

treatment. The superior court repeatedly entered new 180-day commitment orders for the next four

years.

         In early 2022, doctors petitioned for another 180-day commitment for BLR. A

commissioner found that as a result of his mental illness, BLR continued to present a substantial

likelihood of repeating acts similar to his charged criminal behavior and that BLR was gravely

disabled. The commissioner ordered him committed for another 180 days. A judge declined to

revise the commissioner’s ruling.

         BLR appeals, arguing only that substantial evidence does not support the finding that he

was gravely disabled. We affirm.

                                             FACTS

         BLR has been involuntarily committed intermittently since 2013. In December 2017, BLR

was living in the community when he was arrested on charges of second degree assault and felony

harassment for trying to strangle his father and threatening to kill him. A trial court found that
No. 56896-9-II

BLR was not competent to stand trial and the charges were dismissed. BLR was then civilly

committed at Western State Hospital in early 2018. He has since been recommitted every 180 days

for multiple years.

                      I. CURRENT PETITION FOR INVOLUNTARY TREATMENT

       In February 2022, a physician and a psychologist petitioned to commit BLR for an

additional 180 days. The petition asserted that BLR was gravely disabled as a result of a behavioral

health disorder and that he presented a substantial likelihood of repeating acts similar to the

behavior that led to his arrest for a violent felony offense. The petition stated that BLR was not

ready for a less restrictive placement in the community.

A.     Evidence of BLR’s Mental Health Condition

       The doctors filed a declaration discussing BLR’s mental health history. They diagnosed

BLR with schizoaffective disorder, antisocial personality disorder, and several substance abuse

disorders. The doctors stated that when BLR lived in the community, “he did not regularly engage

in treatment for his symptoms, but rather neglected his care and accessed services only when in

crisis.” Clerk’s Papers (CP) at 73.

       The doctors explained that BLR’s substance abuse disorders were “in remission in a

controlled environment,” and his mental health symptoms improved during a period in late 2019

and early 2020 when he consistently took his medication and was involved in treatment. CP at 86.

He showed improvement to the point of being placed on the discharge list. However, he was

removed from the list after he began refusing medication and his symptoms reappeared. Overall,

BLR was “generally uncooperative with treatment” over the course of his commitment. CP at 74.

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       The doctors addressed BLR’s behavior during the most recent commitment period. In

general, BLR resisted treatment during that period. His symptoms during that time included

“vacillations in emotional stability, impaired judgment and insight, [and] disorganized thinking”

as well as delusions about owning multiple houses and vehicles. CP at 75-76. BLR was both

verbally and physically aggressive towards hospital staff between October 2021 and January 2022.

Staff reported that BLR asked to be deported, believed that it was 2023 when it was 2021, and he

accused staff of “‘racketeering’ to say it was 2021.” CP at 77. He also requested the removal of a

healthy tooth because he believed that it had decayed.

       At a hearing, the psychologist, who saw BLR roughly three times a week, testified that she

reviewed BLR’s records and met with both BLR and his treatment team. She stated that at the time

of the hearing, BLR’s “judgment and insight” were “severely impacted” by his mental illness,

affecting his decisions to seek treatment and care for his health. Verbatim Rep. of Proc. (VRP)

(Mar. 1, 2022) at 16.

       1.      Likelihood to repeat behavior similar to charged conduct

       The doctors assessed BLR’s historical, clinical, and risk management factors to determine

the likelihood he would repeat acts that were similar to his charged criminal conduct, assault and

harassment, due to his mental illness. Historical factors assess past behavior, clinical factors

consider the potential for change, and risk management factors “examine those elements of a

person’s future care that will mitigate or exacerbate their risk in the community.” CP at 84.

       The declaration the doctors submitted with the petition asserted that BLR “required high

levels of staff support and intervention when demonstrating poor volitional control” during the

most recent commitment period. CP at 81. At times, he “required physical restraint and seclusion.”

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Id. The psychologist believed that BLR’s volitional control was “likely to de-stabilize very

quickly” if he were released, due to his refusal to take medication without a court order. VRP (Mar.

1, 2022) at 17. During the most recent commitment period, BLR was reported to have physically

grabbed staff or tried to bite them in at least two incidents, broke a payphone in another, and spat

on staff at least twice.

        Overall, the doctors concluded that BLR was “likely at an overall moderate to high risk

level of violent recidivism at this time.” CP at 84. Because of BLR’s difficulties with volitional

control when he did not take his medication and his refusal to take medication without a court

order, the psychologist testified that BLR’s risk of repeating acts similar to his charged offense

would increase if he were released.

        2.      Grave disability

        In addition, the psychologist did not believe that BLR could take care of his own “basic

needs of health and safety” or support himself financially if released. VRP (Mar. 1, 2022) at 16.

She testified that she observed BLR being disruptive in the hospital and physically aggressive

towards others. Similarly, the doctors’ declaration asserted that BLR’s mental illness affected his

judgment, pointing to his recent requests for deportation and to remove the healthy tooth. His

delusions included believing that he was wealthy and telling “staff on multiple occasions that he

‘won a [least restrictive alternative confinement order] in court already.’” CP at 80. And BLR

repeatedly stated that he would take medication only when under court order to do so. Further,

BLR reported that he did not believe that he would require supportive services if released.

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       BLR also testified at the hearing. He stated that he would not take medication because of

the hand tremors his medication caused, and he told the commissioner, “I don’t believe I need

medication” and “I don’t need mental health treatment.” VRP (Mar. 1, 2022) at 25.

B.     Court Ruling and Later Proceedings

       In March 2022, the commissioner granted the petition to commit BLR for an additional

180 days. The commissioner found that as a result of his mental illness, BLR continued to “present

a substantial likelihood of repeating acts similar to [his] charged criminal behavior.” CP at 4.

       The commissioner also found that the State presented clear, cogent, and convincing

evidence that BLR was gravely disabled based on the testimony that he was “not capable of

meeting his own health and safety needs independently,” testimony that BLR was “impaired

volitionally,” and because he “continue[d] to exhibit that he [was] impaired cognitively.” VRP

(Mar. 1, 2022) at 29. Based on BLR’s presentation in court and his statements that he would not

take medication or seek treatment if released, the commissioner found that a less restrictive

alternative was not in BLR’s best interests.

       BLR moved to revise the commitment order. He contended that the State failed to establish

a prima facie case that he was likely to commit acts similar to those that led to his arrest. He also

argued that the State failed to show “any evidence that [BLR was] in danger of serious physical

harm as a result of his failure to provide for his essential human needs of health and safety, nor did

the court make such a finding.” CP at 24. And he reasoned that the State had not met its burden of

demonstrating BLR’s loss of volitional control. The State responded that BLR’s consistent refusal

to take medication or cooperate with treatment demonstrated a lack of insight and, because of his

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ongoing delusions, he could not care for his basic needs if released from the hospital without

support.

       The judge denied the motion to revise the commitment order. The trial court found that

BLR presented a substantial likelihood of committing similar acts to his charged conduct and met

both definitions of grave disability. The trial court noted that people can disagree with their doctors

without being found gravely disabled. However, BLR’s historical and ongoing symptoms of

delusions and aggression in response to internal stimuli, which were ongoing, coupled with his

lack of insight into his mental health problems, “indicated a significant deterioration in his routine

functioning because of his loss of cognitive and volitional control.” VRP (Apr. 1, 2022) at 17.

BLR appeals.

                                            ANALYSIS

       BLR argues that the superior court erred by declining to revise the commitment order

because substantial evidence did not support the finding that he was gravely disabled. He contends

that the State did not offer any evidence that he had recently failed to accommodate his essential

needs. He also insists that the State failed to establish that he had recently deteriorated in his

cognitive and volitional control. BLR does not assign error to or argue about the trial court’s

conclusion that he presented a substantial likelihood of committing similar acts to his charged

crimes, which was an independent basis for the commitment order.

                                      I. STANDARD OF REVIEW

       After a motion to revise a commissioner’s order, we “review the superior court’s ruling,

not the commissioner’s decision.” In re Det. of L.K., 14 Wn. App. 2d 542, 550, 471 P.3d 975

(2020). When a superior court judge denies a motion to revise; however, the commissioner’s order

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and findings “‘become the orders and findings of the superior court.’” Id. (quoting Maldonado v.

Maldonado, 197 Wn. App. 779, 789, 391 P.3d 546 (2017)). “Unchallenged findings of fact become

verities on appeal.” In re Det. of W.C.C., 193 Wn. App. 783, 793 n.5, 372 P.3d 179 (2016).

                     II. INDEPENDENT BASIS FOR THE 180-DAY COMMITMENT

       A court may involuntarily commit a person for 180 days of involuntary treatment on

several grounds, such as if the person has had criminal charges dismissed because they were

incompetent to stand trial, they have committed acts constituting a felony, and as a result of a

behavioral health disorder, they are substantially likely to repeat similar acts. RCW 71.05.280(3).1

A person can also be involuntarily committed for 180 days if they are gravely disabled. RCW

71.05.280(4). These are independent bases for involuntary commitment.

       The State emphasizes that BLR has not challenged the finding that he presented a

substantial likelihood of repeating acts similar to the behavior that led to his criminal charges,

which was an independent basis for civil commitment. The State is correct that this is an

independent ground to civilly commit a person for 180 days. RCW 71.05.280(3). The trial court

in this case found that BLR had performed acts constituting a violent offense and that he presented

a substantial likelihood of repeating similar acts if released. BLR does not challenge this finding

on appeal, instead arguing only that the trial court erred in finding BLR was gravely disabled.

       The doctors concluded that BLR had a moderate to high risk of violent recidivism because

of his struggles with volitional control when not medicated and his refusal to take medication

without a court order. The commissioner and the judge on revision both agreed, and BLR does not

1
 The relevant language has not changed since the commitment hearing, so we cite to the current
version of the statute.

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assign error to this finding or otherwise argue it was incorrect. See W.C.C., 193 Wn. App. at 793

n.5. The finding that BLR had a substantial likelihood of again committing a violent felony if

released is unchallenged on appeal. Thus, even if the trial court’s finding of grave disability were

in error, an issue we do not reach, we must affirm.

        A majority of the panel having determined that this opinion will not be printed in the

Washington Appellate Reports, but will be filed for public record in accordance with RCW 2.06.040,

it is so ordered.

                                                      Glasgow, C.J.
 We concur:

 Veljacic, J.

 Che, J.

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