Court Opinion

ID: 9389538
Source: CourtListenerOpinion
Date Created: 2023-04-25 20:02:47.29011+00
Date Added: 2024-06-11T17:18:28.339262
License: Public Domain

Filed 4/25/23 P. v. Espinoza CA3
                                           NOT TO BE PUBLISHED
California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for
publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication
or ordered published for purposes of rule 8.1115.

              IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
                                      THIRD APPELLATE DISTRICT
                                                     (Sacramento)
                                                            ----

THE PEOPLE,                                                                                   C095758

                   Plaintiff and Respondent,                                     (Super. Ct. Nos. 14F01201,
                                                                                    14F01270, 15F02768,
         v.                                                                             16FE005418)

CHRISTINE ELIZABETH ESPINOZA,

                   Defendant and Appellant.

         Defendant Christine Elizabeth Espinoza appeals from the trial court’s order
extending her commitment to the Department of State Hospitals (Pen. Code, § 1026.5,
subd. (b))1 and denying her petition for outpatient release to the community under the
supervision of the conditional release program (CONREP) (§ 1026.2). She claims
insufficient evidence supports the court’s extension order, and the court prejudicially

1   Further undesignated statutory references are to the Penal Code.

                                                             1
erred by shifting her burden of proof regarding her petition for outpatient release to the
People.
       We first conclude substantial evidence supports the trial court’s extension order,
and therefore we will affirm that order. Next, while we agree with Espinoza that the
court erred by shifting Espinoza’s burden of proof to the People, we conclude the error
was harmless. Accordingly, we will also affirm the court’s order denying Espinoza’s
petition for release into the community under the supervision of CONREP.
                             FACTS AND PROCEEDINGS
       Factual Background
       Espinoza has been diagnosed with schizoaffective disorder (bipolar type), and
methamphetamine and opioid use disorders. Espinoza used various substances in her
teenage years and her twenties but had not experienced symptoms related to mental
illness. Around 2013, when she was about 30 years old, her methamphetamine use
increased, which coincided with a significant decompensation. She experienced mania,
hallucinations, and delusional beliefs, including that people were trying to “pop her soul,”
certain people were demons or Satan, and Satan was working for Jesus. She experienced
symptoms while under the influence of methamphetamine as well as while sober,
indicating that her psychosis was independent of her substance use, although substance
use could exacerbate the symptoms of her mental illness.
       Beginning in 2014, Espinoza repeatedly followed and harassed a sheriff’s deputy
(the deputy) while in custody, including writing the deputy’s name all over her jail cell
and tattooing the deputy’s name on herself.
       In 2014 and 2015, Espinoza was charged and convicted of felony grand theft
(§ 487, subd. (a)) related to shoplifting over $950 worth of wine and champagne bottles,
felony embezzlement (§ 508) from her place of employment, and a combined conviction
for felony assault with force likely to produce great bodily injury (§ 245, subd. (a))
related to ramming a shopping cart into an employee while shoplifting, and misdemeanor

                                              2
theft (§ 484, subd. (a)) related to entering a gas station convenience store while
pretending to have a gun, threatening to kill employees if they did not give her money,
and stealing $200.2 Espinoza acknowledged she committed crimes in order to go to jail
to see the deputy. In 2016, while on probation for the aforementioned convictions,
Espinoza sent the deputy 53 typed and handwritten pages in which she expressed various
delusional beliefs and sexual and threatening content, including that Jesus said she had to
kill the deputy, that she wanted to drink the deputy’s blood, and that Jesus promised her
that she could rape the deputy. Espinoza was arrested and charged with making criminal
threats (§ 422) and stalking (§ 646.9, subd. (a)) related to those letters. She pled no
contest to the stalking charge and agreed to be found not guilty by reason of insanity on
probation violation allegations. Pursuant to that agreement, Espinoza was committed to
the Department of State Hospitals for a maximum term of five years four months.
        In June 2019, Espinoza was discharged from Napa State Hospital (NSH) and
released to the community under the supervision of CONREP. In May 2020, Espinoza
decompensated. She did not report her decompensation, despite having a plan to do so,
because her symptoms and delusions felt so real she did not believe she was
decompensating. She experienced delusions and auditory hallucinations, including
believing that she was communicating telepathically with her therapist, whom she
believed had authorized her to purchase alcohol. She prepared a box for the deputy, into
which she placed a knife, writings expressing delusional beliefs regarding the deputy, and
other items, and she prepared writings for her therapist expressing delusional beliefs. She
also carried a knife on her person. She was arrested on May 2, 2020; she had consumed
alcohol and a Rockstar energy drink that day. She was readmitted to NSH in October
2020.

2   The assault charge was originally charged as a robbery. (§ 211.)

                                              3
        Commitment Extension Proceedings
        On March 4, 2021, Espinoza filed a petition to transfer to outpatient treatment
under the supervision of CONREP. (§ 1026.2.) The court appointed Dr. Elizabeth
Stotler-Turner to evaluate Espinoza’s current mental condition to determine whether she
would be a danger to the health and safety of others if treated in the community.
        In April 2021, Espinoza had made sufficient progress that she was recommended
to be released to outpatient treatment. However, in August 2021, after receiving a “less-
than-favorable” report from CONREP, Espinoza experienced a “very rapid”
decompensation and was segregated from her roommates because she was experiencing
symptoms of her mental illness and presented a risk of violence. She expressed signs of
mania or hypomania in addition to psychosis, including delusional beliefs and violent
ideation, such as making “cold threats” to staff. 3 She believed she was God, members of
the treatment staff were Satan and were out to harm her, people were trying to “pop her
soul,” witchcraft had been performed on her and she did not have a mental illness, and
Jesus or God was providing her with commands or directives of behaviors to engage in.
She denied experiencing any depressive, anxiety-related, or manic symptoms and initially
refused a change in her medication during this time, but later agreed.
        NSH senior psychologist Dr. Rachel Powers interviewed Espinoza in August 2021
and subsequently recommended that she remain hospitalized due to the recency and
severity of her symptoms, which matched the symptoms she experienced at the time of
her committing offense. Espinoza asserted during the interview that she had recognized
the early signs of decompensation and sought out the support of staff, but Dr. Powers
noted the records demonstrated that she had failed to recognize her symptoms for several
days.

3 A “cold threat” alludes to violence; for example, “something bad might happen to
you,” or “I’m going to get you.”

                                             4
       On November 24, 2021, the People filed a petition to extend Espinoza’s
commitment to the State Department of Mental Health for an additional two years.
(§ 1026.5, subd. (b).)4 In support of their petition, the People attached a November 2021
report prepared by Dr. Powers, which recommended that Espinoza’s commitment be
extended because she posed a substantial risk of physical harm to others and continued to
have difficulty controlling her dangerous behavior.
       The parties conducted a five-day bench trial on Espinoza’s petition to transfer to
outpatient status and the People’s petition to extend her commitment. Among the
witnesses at trial were Dr. Stotler-Turner, Dr. Powers, and Rhonda Love, who was
familiar with Espinoza’s conduct while on CONREP from 2019 to 2020.
       Dr. Stotler-Turner was a clinical psychologist who worked for the Board of Parole
Hearings and had a private forensic practice. To prepare her evaluation of Espinoza, she
reviewed Espinoza’s records and interviewed her in May 2021. She evaluated
Espinoza’s risk for violence using a structured risk assessment tool used in the forensic
psychology field known as the Historical Clinical and Risk Management 20, Version 3
(HCR-20). The HCR-20 assists evaluators conceptualize risk factors from the
individual’s historic past, recent past (known as “clinical factors”), and future.
       Dr. Stotler-Turner identified the factors relevant to Espinoza’s risk of violence as
her major mental illness, violence and violent attitudes, substance use, problematic
relationships, and problems with treatment and supervision response. She opined that
Espinoza’s history of mental illness, which had contributed to her prior acts of aggression
and psychotically driven violence, was “extremely relevant” due to her recent rapid and
severe decompensation, which Espinoza failed to recognize or report. Additionally,
while Espinoza recognized she was delusional, she did not appear to understand the

4The State Department of Mental Health is now known as the State Department of State
Hospitals.

                                              5
severity of her delusions or the severity of her behaviors. Instead, Espinoza had a pattern
of minimizing her prior violent or aggressive behaviors, including stating that she was not
really a violent person and describing her threats to the deputy as a joke or otherwise
minimizing those threats. In assessing Espinoza’s violence and violent attitudes, Dr.
Stotler-Turner noted that Espinoza had possessed weapons while on CONREP and had a
delusional understanding of her relationship with the deputy, which had caused her to
threaten the deputy and commit a robbery to get back to the deputy.
       Dr. Stotler-Turner also found Espinoza’s history of substance use relevant because
Espinoza had recently relapsed to alcohol while on CONREP, her plans for sobriety upon
release to the community were underdeveloped or insufficient, she continued to lack an
understanding of her internal triggers for substance use, and she had requested to be taken
off medication while on CONREP just before decompensating.
       Turning to Espinoza’s risk management factors, Dr. Stotler-Turner recognized
Espinoza had a support system, but she observed that Espinoza recently decompensated
while that support system was in place, and there was no indication that her support
system was better prepared to assist her should she be released. Nor had Espinoza
improved her ability to cope with or tolerate stress. Stotler-Turner was also concerned
that Espinoza would not fully engage in future substance use recovery programs based on
her previous experience with such programming.
       Dr. Stotler-Turner acknowledged Espinoza had not been physically violent since
she was initially committed. She also recognized that Espinoza was aware she had
schizoaffective disorder and was able to describe her various symptoms, was forthright
about her past substance abuse and involvement with the criminal justice system, and
admitted that the deputy was probably scared by her actions. Nevertheless, she opined
that Espinoza continued to represent a danger to others due to her illness because she was
not any better prepared for release than she was the last time she was on CONREP.

                                             6
       Dr. Powers also assessed Espinoza’s risk of violence in the community using the
HCR-20, and she opined that Espinoza represented a substantial danger of physical harm
to others due to her mental illness, and that she had serious difficulty controlling her
dangerous behavior. In assessing Espinoza’s risk of violence, Dr. Powers identified as
relevant factors her major mental disorder, her history of violence and substance use, her
recent and historical problems with treatment and supervision response, her recent
problems with instability, and her lack of insight.
       Dr. Powers noted the severity and speed with which Espinoza’s symptoms
appeared in the hospital setting during her August 2021 decompensation. While
Espinoza understood that she has been diagnosed with a mental illness and could identify
her symptoms, she had been unable to identify her symptoms or respond to the feedback
of her treatment team during her decompensation, and she had initially refused to make
recommended medication changes. Dr. Powers also noted that Espinoza continued to
blame others for the degree to which she declined, rather than taking responsibility, she
frequently presented as anxious and urgent and relied on staff to reduce her anxiety, and
she had acted in unusual or dangerous ways, including pacing, chanting, posting notes on
her wall that said, “Fuck you,” playing music at odd times, and reporting that God or
Jesus informed her what she needed to do. Powers also pointed to Espinoza’s ongoing
fixation on changing her medications, which she considered relevant because medication
changes had historically preceded her decompensations.
       According to Dr. Powers, Espinoza continued to have gaps in her appreciation for
the severity of her illness and her risk of violence, and she overestimated her ability to
prevent the symptoms of her illness. For example, Espinoza failed to appreciate the
imminent risk of violence she posed while on CONREP due to her alcohol and caffeine
use, her delusions, and her purchase and possession of knives. While Espinoza stated she
did not want to hurt anyone with knives, she continued to have gaps in her understanding

                                              7
as to why she purchased and carried knives, and her behavior suggested someone was
going to get hurt.
       Dr. Powers acknowledged that Espinoza had not physically assaulted anyone from
the time she was hospitalized in 2016 through the time of trial. 5 But the absence of
recent physically violent conduct by Espinoza did not affect her opinion that Espinoza
represented a danger of physical harm to others; she observed that NSH had structures in
place to mitigate patients’ risk of violence and to relieve the stress of everyday life. She
noted that Espinoza would be at greater risk of violence in an outpatient program because
those programs typically have less monitoring and staff than a hospital, making it more
difficult to perform rapid interventions, and often require patients to administer their own
medications. In Dr. Powers’s opinion, the recency of Espinoza’s symptoms and her
current level of insight outweighed her lack of violent conduct in the hospital.
       Turning to Espinoza’s plans for release, Dr. Powers testified that Espinoza’s
support group had not been sufficient to prevent her decompensation while she was on
CONREP. Because Espinoza lacked an appreciation for the severity and competency of
her mental illness, she was unlikely to understand the ongoing self-reflection required to
understand her illness.
       Dr. Powers also recognized that Espinoza had not completed a substance use
treatment program, and her relapse prevention plan did not have a section specifically
outlining her plan for maintaining her sobriety if released. She noted that Espinoza
consumed alcohol on the day she was arrested while on CONREP, and she has never
exhibited sobriety outside of a supervised setting.

5 Dr. Powers testified that the letters Espinoza sent to the deputy were a violent act as
defined by the HCR-20, which defines violence to include psychological harm, but she
acknowledged those letters were sent before 2016.

                                              8
       Dr. Powers opined that Espinoza represented a high risk of violence if released
from the hospital due to the number of clinical factors present within the six months prior
to her testimony, and her insufficient plans for release. She concluded Espinoza needed
to be free of symptoms for a longer period before she could be deemed to be in remission,
during which time she needed to gain additional insight into her illness and develop a
plan to prevent violence when released to the community. She disagreed with the
assertion that Espinoza’s compliance with medication meant she was able to control her
substantial danger of physical harm to others; she observed that Espinoza experienced
breakthrough symptoms even when medication-compliant in the hospital.
       Love was the senior clinical director for CONREP. She opined that Espinoza was
not ready for release into the community due to her August 2021 decompensation, which
mirrored her May 2020 decompensation while on CONREP. In both instances, she failed
to appreciate the warning signs of her decompensations, was in denial that she was
decompensating, and had appeared well before experiencing delusions, after which she
became fixated on others and became aggressive. Love explained that it is crucial for
those in an outpatient program to be able to identify warning signs and early symptoms of
their mental illness because CONREP staff are not constantly with the individuals, and an
inability to follow a release plan indicates that the individual is not ready to be released
into CONREP. Love also expressed the concerns that Espinoza’s wellness and recovery
plan had not been changed to help her identify the warning signs of her illness, and that
she would have access to drugs and alcohol if released. On cross-examination, Love
acknowledged that Espinoza had not engaged in physical violence during her time on
CONREP.
       Trial Court Ruling
       The trial court granted the People’s petition to extend Espinoza’s commitment and
denied Espinoza’s petition for outpatient treatment.

                                              9
       With respect to the People’s petition to extend Espinoza’s commitment, the trial
court first found beyond a reasonable doubt that Espinoza represented a substantial
danger of physical harm to others as a result of her mental disease. The court noted
Espinoza’s August 2021 decompensation “went on for a while” before she told hospital
staff she was having trouble sleeping, and in May 2020 she experienced delusions for
long enough to prepare the box for the deputy. Once decompensated, Espinoza quickly
developed violent ideation, exhibited by her possession of knives and her belief that Jesus
told her to kill the deputy. While Espinoza had not engaged in actual violence as a direct
result of her delusions, she had a history of committing violent acts while delusional,
including committing a robbery, ramming into a store employee with a shopping cart
while shoplifting, threatening a store clerk, and hitting a car with a hammer. The court
found that Espinoza’s mental illness lessened her inhibitions, creating a substantial
danger of physical harm to others.
       The trial court then found beyond a reasonable doubt that Espinoza had serious
difficulty controlling her dangerous behavior. It recognized that Espinoza “appreciates
what is happening to her,” but her May 2020 and August 2021 decompensations
demonstrated that she had not yet learned to control the “underlying mythology or
spirituality” that caused her, when decompensated, to believe she was being directed or
controlled by Jesus and by demons, and that they were attempting to capture her soul.
The court ordered her commitment extended for two years.
       Next, the trial court found by a preponderance of the evidence that, due to a
mental disease, Espinoza would be a danger to others if treated in the community under
supervision.6 It noted Espinoza’s long history of drug use and pointed out that, even
when abstaining from drug and alcohol use, she used a “supercaffeinated” energy drink

6 Espinoza claims the court prejudicially erred in its formulation of the applicable burden
of proof. We address that claim in the Discussion, post.

                                            10
that had some of the effects of an intoxicant. Appearing to refer to its ruling on the
People’s petition to extend Espinoza’s commitment, the court found that, even if under
CONREP’s supervision, there remained “underlying and I believe as of yet not fully
explored triggers that made Ms. Espinoza a danger to the health and safety of others.”
       Espinoza timely appealed the trial court’s order. (See § 1237, subd. (a) [an appeal
may be taken from “the commitment of a defendant for insanity”].) The case was fully
briefed in January 2023 and was assigned to this panel on January 31, 2023.
                                      DISCUSSION
                                              I
                            Extending Espinoza’s Commitment
       Under section 1026.5, subdivision (a)(1), a person found not guilty of a felony by
reason of insanity may be committed to a state hospital for a period no longer than the
maximum prison sentence for his or her offenses. This commitment may be extended in
up to two-year increments if, because of a mental disorder, the person both “represents a
substantial danger of physical harm to others” (id., subd. (b)(1), (8)) and has “serious
difficulty controlling his [or her] potentially dangerous behavior” (People v. Zapisek
(2007) 147 Cal.App.4th 1151, 1165 (Zapisek) [explaining due process requires this
“serious difficulty” requirement]; see also In re Lemanuel C. (2007) 41 Cal.4th 33, 40-41
[before extending a civil commitment for a dangerous youth, due process requires a
finding “that a mental deficiency, disorder, or abnormality causes serious difficulty in
controlling the person’s dangerous behavior”; “the constitutional principles set forth in
those cases [developing this requirement] apply to all civil commitment schemes”]). A
showing of historical dangerousness is insufficient; to satisfy the statute, the People must
show a connection between the committee’s ongoing mental illness and any current
threat the individual might pose if not committed for an additional term. (See People v.
Redus (2020) 54 Cal.App.5th 998, 1013 (Redus).)

                                             11
         “ ‘ “ ‘Whether a defendant “by reason of a mental disease, defect, or disorder
represents a substantial danger of physical harm to others” under section 1026.5 is a
question of fact to be resolved with the assistance of expert testimony.’ [Citation.] ‘In
reviewing the sufficiency of evidence to support a section 1026.5 extension, we apply the
test used to review a judgment of conviction; therefore, we review the entire record in the
light most favorable to the extension order to determine whether any rational trier of fact
could have found the requirements of section 1026.5(b)(1) beyond a reasonable doubt.
[Citations.]’ [Citation.]” [Citation.] A single psychiatric opinion that an individual is
dangerous because of a mental disorder constitutes substantial evidence to support an
extension of the defendant’s commitment under section 1026.5.’ ” (Zapisek, supra, 147
Cal.App.4th at p. 1165.) “However, ‘expert medical opinion evidence that is based upon
a “ ‘guess, surmise or conjecture, rather than relevant, probative facts, cannot constitute
substantial evidence.’ ” ’ ” (Redus, supra, 54 Cal.App.5th at p. 1011.)
         Espinoza does not dispute that she has been diagnosed with schizoaffective
disorder (bipolar type), a mental disorder. But she contends there is no substantial
evidence that she posed a substantial danger of physical harm to others or that she had
serious difficulty controlling her dangerous behavior. She argues the state’s expert
witnesses based their opinions of her dangerousness on a definition of “physical harm”
that included psychological harm, the trial court improperly relied on her historical--
rather than current--dangerousness to determine that she represented a substantial danger
of physical harm to others, and the undisputed evidence shows she has not committed a
physically aggressive act since she was committed in 2016. As we next explain, our
review of the record demonstrates substantial evidence supports the court’s extension
order.
         A. Substantial Danger of Physical Violence to Others
         There is substantial evidence that Espinoza currently represents a substantial
danger of physical violence to others. During both of Espinoza’s recent

                                              12
decompensations, she failed to recognize the warning signs of decompensation or report
her symptoms, and she continued to lack understanding of the severity of her delusions
and behaviors and instead minimized her risk of violence. During her May 2020
decompensation, Espinoza consumed alcohol, became delusional, and purchased two
knives, one of which she carried on her person, and the other she prepared to send to the
victim of her stalking offense. Dr. Powers noted that Espinoza continued to have gaps in
her understanding as to why she purchased the knives and what she planned to do with
them. In August 2021, she made “cold threats” to staff and had to be segregated from her
roommates due to her risk of violence. Dr. Powers and Love testified that her behavior
during her decompensations mirrored her behavior in her committing offenses, indicating
that Espinoza was recently in a mindset similar to that displayed when she last acted in a
physically violent manner while delusional.
       Espinoza argues that the trial court impermissibly focused on her history of
violence rather than her current dangerousness. We disagree. Espinoza’s past acts are
generally relevant to determining whether her condition, at the time of a recommitment
hearing, rendered her dangerous to others. (See People v. Pace (1994) 27 Cal.App.4th
795, 799 [a mental health professional, when assessing a defendant’s risk of physical
harm to others, “should take into account the prisoner’s entire history . . . . This includes
prior violent offenses as well as the prisoner’s mental health history”].) Additionally, as
we have discussed, Espinoza’s behavior while decompensated in May 2020 and August
2021 mirrored the behavior she exhibited when she was stalking the deputy and
committing the offenses--some violent--that led to her commitment. Given that Espinoza
was recently in that same mindset, the nature of those prior offenses was relevant to the
court’s determination of her current dangerousness. Further, as we will discuss in greater
detail post, evidence of Espinoza’s history of violence when behaving similarly to her
behavior while decompensated in May 2020 and August 2021 was relevant to refute the

                                              13
argument that she did not represent a risk of physical violence based on the fact that she
had not been physically violent since being committed in 2016.
         This court’s recent opinion in People v. Cheatham (2022) 82 Cal.App.5th 782
provides a useful comparison to the facts here. In Cheatham, the evidence was
insufficient to support an extension of the defendant’s involuntary commitment because
the link between the mental disorder and the threat of harm to others was not shown.
Cheatham had been diagnosed with schizoaffective disorder and a separate substance use
disorder. Expert witnesses testified to Cheatham’s bizarre behavior, various rule
violations, and addictive behavior, and expressed the concern that he might discontinue
using his medications upon being released, leading to his mental decline. But no
evidence was offered to show Cheatham had engaged in any dangerous behavior, and on
appeal we concluded there was no evidence he would have serious difficulty controlling
his dangerous behavior should he discontinue his medication and experience
hallucinations. (Id. at p. 790.) Because Cheatham had never posed a danger of physical
harm to anyone in the past, any speculation he might pose such a threat in the future was
not enough to satisfy the substantial evidence test. (Id. at pp. 793-794.)
         In contrast to the facts in Cheatham, Espinoza has a history of violent conduct
when decompensated and acting pursuant to her delusional beliefs, and the similarity of
her recent conduct to that of her committing offense establishes a link between her prior
violent acts and her current dangerousness. (See Redus, supra, 54 Cal.App.5th at p.
1013.)
         Espinoza also argues the state’s expert witnesses failed to provide substantial
evidence that she was currently dangerous because their opinions regarding her
dangerousness were based on the risk of psychological, rather than physical, harm. She
points to Dr. Powers’s testimony that threats to the deputy constituted violence under the
HCR-20, and Love’s testimony that Espinoza’s conduct induced fear in the therapist. But
the trial court did not suggest that it based its conclusion regarding Espinoza’s

                                              14
dangerousness on her risk of inflicting psychological harm, and there is substantial
evidence in the record to support the finding that Espinoza represented a substantial risk
of physical harm, as we have described. Indeed, the court recognized that Espinoza had
not engaged in “actual violence as a direct result of these delusions” since she had been
committed, but it observed that Espinoza had previously committed physically violent
acts as a collateral function of her delusions. There is substantial evidence to support the
trial court’s order, and nothing suggests the court misapplied the law.
       B. Serious Difficulty Controlling Dangerous Behavior
       There is also substantial evidence in the record to support the trial court’s finding
that Espinoza had serious difficulty controlling her dangerous behavior. Dr. Powers, Dr.
Stotler-Turner, and Love testified that Espinoza failed to recognize the early signs her
May 2020 and August 2021 decompensations and continued to lack sufficient insight into
her mental illness. Lack of control over a behavior is often a factor considered when
courts are contemplating whether to extend a commitment related to mental health. (See
In re Howard N. (2005) 35 Cal.4th 117, 129.) While decompensated on CONREP,
Espinoza prepared a box for the victim of her stalking offense that contained a knife, and
she had to be taken into custody and readmitted to the hospital. A year later, while
hospitalized, she again experienced a “very rapid” decompensation and had to be
segregated from her roommates due to her risk of violence. That her behavior while
decompensated in May 2020 and August 2021 mirrored her behavior during her
committing offenses further demonstrated that she continued to have difficulty
controlling the behavior that led to her being committed.
       We disagree with Espinoza’s argument that because she had not committed a
physically aggressive act since being committed in 2016, she does not have difficulty
controlling dangerous behavior. She points to People v. Bowers (2006) 145 Cal.App.4th
870, and Zapisek, supra, 147 Cal.App.4th 1151, but those cases do not assist her. In
Bowers, the committee had a history of assaultive behavior toward others and had

                                             15
attempted suicide two months before her interview with one of the state’s experts.
(Bowers, at p. 879.) In Zapisek, the committee continued to experience delusions similar
to those he experienced when he committed his original offense of stabbing a stranger
because he believed the stranger was the devil incarnate. (Zapisek, at pp. 1154, 1155,
1166.) But while the committees in those cases committed overt violent acts, such overt
acts are not required. (People v. Overly (1985) 171 Cal.App.3d 203, 208 [“proof of a
recent overt act is not constitutionally required to extend the commitment of a person
found to be criminally insane”].)
       As the Attorney General points out, “[t]he fact that [the] defendant has not
misbehaved in a strictly controlled hospital environment does not prove [s]he no longer
suffers from a mental disorder that poses a danger to others.” (People v. Sumahit (2005)
128 Cal.App.4th 347, 353.) Here, Dr. Powers testified that Espinoza’s lack of violence in
the hospital is not dispositive because the hospital has structures in place specifically
designed to mitigate patients’ risk of violence. Rather, her failure to recognize and report
her decompensations, and the speed with which she began to develop violent ideations, is
substantial evidence that she continued to have serious difficulty controlling her
dangerous behavior. Finally, although Espinoza did not commit a physically violent act
while on CONREP, she became delusional, purchased two knives, carried one and
prepared to send the other to the victim of her stalking offense, and consumed alcohol.
While she did not become physically violent before being arrested, she posed a
significant risk of becoming violent at that time.
       Substantial evidence supports the trial court’s order extending Espinoza’s
commitment.7

7  Because we conclude substantial evidence supports the trial court’s findings, we do not
address Espinoza’s claim that the People are barred from refiling the petition upon a
finding of insufficient evidence.

                                              16
                                              II
                           Shifting Burden of Proof to the People
       To succeed on her petition for release to the community under the supervision of
CONREP, Espinoza was required to prove by a preponderance of the evidence that she
will not “be a danger to the health and safety of others, due to mental defect, disease, or
disorder, while under supervision and treatment in the community.” (§ 1026.2, subds.
(e), (k).) Although Espinoza indisputably bore the burden of proof, the trial court shifted
the burden of proof to the People when rendering its verdict: “[T]he Court must find by a
preponderance of the evidence that Ms. Espinoza would be a danger to health and safety
of others due to the mental disease even if under supervision and treatment in the
community, and [it] will find that that preponderance has been met and she still would be
a danger even if she’s under supervision treatment by the community.” (Italics added.) 8
       “Misallocation of the burden of proof in a bench trial is not reversible error per se
but must be prejudicial to warrant reversal. [Citation.] Prejudice means ‘ “a reasonable
probability that in the absence of the error, a result more favorable to [the appellant]
would have been reached.” ’ [Citation.] A probability does not mean ‘more likely than
not’ but ‘a reasonable chance, more than an abstract possibility.’ ” (Navigators
Specialty Ins. Co. v. Moorefield Construction, Inc. (2016) 6 Cal.App.5th 1258, 1287.)
       Espinoza claims that the trial court’s error prejudiced her in two ways. First, she
contends the error eliminated her statutory right to produce evidence to support her
petition. But Espinoza presented evidence, and she does not explain how she was
prevented from doing so. Further, her petition asserted that she bore the burden of

8 The Attorney General contends that Espinoza forfeited this argument by failing to
object at trial, while Espinoza responds the issue is strictly legal and should be reviewed
for the first time on appeal. Because we conclude the trial court’s error was clearly
harmless, we need not and do not address forfeiture.

                                             17
proving by a preponderance of the evidence that she no longer posed a danger to the
health and safety of others, and the trial court did not erroneously shift the burden to the
People until all the evidence had been presented. Accordingly, Espinoza understood
throughout trial that she bore the burden of proof, and there is nothing to suggest that she
was prevented from presenting evidence to support her petition.
       Second, Espinoza contends the trial court’s error lowered the burden for the
People to extend her commitment. To the contrary, the court expressly applied the
beyond-a-reasonable-doubt standard to the People’s petition to extend Espinoza’s
commitment. The court stated: “[O]n the petition for extension, the Court will be
applying the burden required by the statute and is finding beyond a reasonable doubt that,
due to suffering from a mental disorder, as a result of that mental disorder, Ms. Espinoza
poses substantial danger of physical harm to others and has serious difficulty controlling
her dangerous behavior.” The court then reiterated: “Now, despite that being a very high
burden, beyond a reasonable doubt, I think there is a clear basis for the Court’s finding in
this regard.” Thus, there is nothing to suggest that the court lowered the People’s burden
regarding its petition to extend Espinoza’s commitment.
       Because the effect of the trial court’s error was to raise the People’s burden and
lower Espinoza’s, there is no reasonable likelihood that a result more favorable to her
would have been reached absent the error.

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                                     DISPOSITION
      The trial court’s orders extending Espinoza’s commitment and denying her
petition for outpatient treatment in the community are affirmed.

                                                      /s/
                                                Duarte, J.

We concur:

     /s/
Mauro, Acting P. J.

     /s/
Boulware Eurie, J.

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