Court Opinion

ID: 9730314
Source: CourtListenerOpinion
Date Created: 2023-08-26 15:08:18.490813+00
Date Added: 2024-06-11T18:26:05.746566
License: Public Domain

SHARPNACK, Judge,
dissenting.
I respectfully dissent for I believe the majority has reweighed the evidence and created an incorrect standard for review of trial court determinations that an individual is mentally ill and dangerous to self.
There is no question that the elements necessary to support a commitment must be proved by clear and convincing evidence.
*453There is no question that the person in question must be proved to be both:
1. mentally ill and
2. gravely disabled or dangerous.
1.0. § 16-14-9.1-8.
In order for a person to be found "mentally ill," it must be proved that the person has
a psychiatric disorder that substantially disturbs an individual's thinking, feeling, or behavior and impairs the individual's ability to function. The term includes any mental retardation, alcoholism, or addiction to narcotics or dangerous drugs.
I.C. 16-14-9.1-1(a).
In order for a person to be found "gravely disabled," it must be proved that the person has a condition
in which an individual, as a result of mental illness, is in danger of coming to harm because the individual:
(1) Is unable to provide for that individual's food, clothing, shelter, or other essential human needs; or
(2) Has a substantial impairment or an obvious deterioration of that individual's judgment, reasoning, or behavior that results in the individual's inability to function independently.
1.C. 16-14-9.1-1(b).
In order for a person to be found "dangerous," it must be proved that the person has a condition
in which an individual as a result of mental illness presents a substantial risk that the individual will harm the individual or others.
1.C. 16-14-9.1-1(0).
We deal with the review of a case decided on a "clear and convincing" standard as we do with a case decided on a "beyond a reasonable doubt" standard. When we review the evidence supporting such a judgment, we may neither reweigh the evidence nor judge the credibility of the witnesses. Washington v. State (1982), Ind., 441 N.E.2d 1355, 1358. Where the evidence is in conflict, we are bound to view only that evidence which is most favorable to the verdict and judgment of the trial court. Id. If there is any substantial evidence supporting the judgment, we must affirm. Hutchinson v. State (1985), Ind., 477 N.E.2d 850.
I agree that, in this case, it must have been shown by clear and convincing evidence that J.B. was dangerous to herself as a result of her particular mental illness-addiction to alcohol.4 I also agree that there must have been some factual basis beyond the mere opinion of a physician that such was the case. However, I do not agree that the factual basis must have been some activity that in and of itself would demonstrate to a judge the causal connection between J.B.'s illness and her activity. I read the majority opinion to require just that.
The majority asserts that "J.B. made a decision to put herself at risk by running away into traffic and hitchhiking in order to avoid her mother. There is no inherent showing in this conduct that it would not occur but for her mental illness."5 Further, while the action of J.B. is recognized by the majority to have put her "at risk", the majority does not find that, "[s|tanding alone ... [it] form[s] a sufficient basis for a determination that she is dangerous to herself." How is a court to make a judgment that conduct standing alone is demonstrative of a causal connection between *454mental illness and behavior that creates risk of personal injury?
Whether or not particular behavior is a "result of mental illness" is not a factual determination that lay persons, albeit judges, are capable of making without benefit of medical testimony. A person who might take such extreme action as suicide may do so either as a result of mental illness or from a desire to communicate a deep protest against government policy. As judges, we would need the studied opinion of a qualified physician to choose between such alternatives.
As the Supreme Court stated in Adding-ton v. Texas (1979), 441 U.S. 418, 99 S.Ct. 1804, 60 L.Ed.2d 323:
Whether the individual is mentally ill and dangerous to either himself or others and is in need of confined therapy turns on the meaning of the facts which must be interpreted by expert psychiatrists and psychologists. (original emphasis.)
441 U.S. 418 at 429, 99 S.Ct. 1804 at 1811.
The majority discounts the need for and value of the involvement of physicians in involuntary commitment proceedings. The majority indicates that, in a properly decided case, expert testimony about whether a person's dangerous conduct is causally related to the person's mental illness would not make that link any more clear to a court than would the factual cireumstances alone. I disagree. Had the legislature believed as the majority does, the legislature would not have made it necessary to include either a physician's testimony or a physician's report in virtually every step of our involuntary commitment process.
The majority states that some dangerous conduct is so apparently linked to a person's mental illness that the causal relationship between the person's illness and the conduct is apparent on its face. For examples of such conduct, the majority points to an individual who compulsively ran into traffic for no apparent reason and an individual who wandered about aimlessly through traffic on a freeway ramp. The conduct called into question in J.B.'s case is not so different from the conduct cited by the majority. J.B.'s mother testified that J.B. was an individual who walked out in front of cars, and who jumped out of the mother's car at busy intersections and ran through traffic. In addition, the record shows that J.B. had during the same time frame driven an automobile while intoxicated. The evidence was clear that J.B. had severe problems due to alcoholism and that her consumption and problems were increasing.
The majority discounts and holds of no probative value the following testimony of Dr. Detrana, the resident physician, who had treated and examined J.B.:
Q. You have heard her mother testify as to what she has done while she has been drinking. Do you feel that that is a manifestation of her illness?
A. Yes, I do.
Q. Do you feel that those manifestations can make her dangerous to herself?
A. Yes, they can.
Q. Do you feel that they may potentially make her dangerous to others?
A. Yes, I do.
* * * a * a
Q. Dr. Detrana, you began to explain why you felt, on the 26th, that she was commitable [sic]. Why was ... what changed your mind?
A. I felt that she was gravely disabled and a danger to herself by reading the trouble that she had gotten into in the past month due to her alcoholism. She had previously not admitted to me.
(Record, pp. 77, 82)
I believe that the majority has concluded that the basis for Dr. Detrana's opinion is inadequate and, in an effort to avoid an apparent reweighing of the evidence, has generated a sort of per se test which allows the appellate court to substitute its judgment for that of the trial court. Although I might have come to a conclusion contrary to that of the trial court, I cannot say that the trial court erred in agreeing with the opinion of Dr. Detrana. Dr. De-trana's opinion was based on her examination of the patient and her history, and her opinion was that J.B.'s conduct of exposing herself to the dangers of traffic and of *455going off with strangers was a manifestation of her mental illness which was alcoholism. This, together with the mother's description of J.B.'s actions, the driving while intoxicated, and the court's opportunity to observe J.B. and listen to her testimony, provides an adequate basis for the trial court's decision.
I believe the majority, in the understandable desire to protect the mentally ill who are not dangerous or gravely disabled from unwarranted commitment, has developed a standard for review of the factual basis for commitment that calls for judges to make a threshold determination that conduct is a result of mental illness without benefit of medical testimony as to causation. The standard suggested by the majority, as I understand it, is that the conduct must be such that a lay person (judge) would recognize that it could only result from mental iliness. Only if that is the case could the court accept a medical opinion that the conduct was a result of the mental illness. I have overstated the matter to illustrate the problem I have with the majority.
Here, the trial court had before it the testimony of J.B., her mother, and Dr. De-trana, from which the court could infer that J.B. had engaged in conduct which created a risk of physical harm to her and that that conduct was a result of her addiction to alcohol. The trial court could have concluded that it would not accept Dr. De-trana's opinion and that would have been that. It did accept the opinion and there was a factual basis for the opinion. That the majority is not prepared to accept the opinion or to find the facts favorable to the trial court judgment of sufficient weight is not a basis for reversal.
I respectfully dissent and would affirm the trial court order of commitment.

. It is clear that this case would have been much easier to resolve if it had turned on a determination as to whether J.B. was gravely disabled. The record provides ample evidence that would support the conclusion that she was gravely disabled. Proceeding on a theory of dangerousness to self seems to have resulted from advice to the mother that nothing could be done about J.B. on an involuntary basis unless she was dangerous to herself or others. That is true for an emergency detention under IC. § 16-14-9.1-7(a), but not for a temporary or regular commitment under LC. § 16-14-9.1-8 or § 16-14-9.1-10.

. Even if you accept, as did the majority, that J.B. jumped from her mother's car while stopped in traffic "to avoid her mother," there remains the permissible inference that the reason that she wanted to avoid her mother was to prevent her mother from interfering with her addiction to alcohol-that is, that her leaping from the car was a result of her addiction.