FILED
FEBRUARY 2, 2017
In the Office of the Clerk of Court
WA State Court of Appeals, Division III
IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON
DIVISION THREE
In the Matter of the Detention of )
) No. 33763-4-111
C.A.E, )
)
)
Appellant ) UNPUBLISHED OPINION
KORSMO, J. -C.A.E. appeals from an order committing him to 180 days of
involuntary treatment at Eastern State Hospital (ESH). He contends that the State was
required to limit its proof efforts to only one prong of the commitment statute and that the
evidence did not support the commitment order. We affirm.
FACTS
Due to the nature of the evidentiary sufficiency challenge, we need to discuss the
facts of C.A.E.' s encounters with central Washington mental health treatment agencies in
some detail. This case has its original genesis in a complaint by a business that C.A.E.
was eating out of its dumpster. He was jailed, at the Okanogan County Jail, for trespass.
While in custody, C.A.E. refused to participate in the booking process, declined to attend
to his hygiene, made delusional and violent statements, and was generally
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uncommunicative. He was in custody at the jail for approximately two-and-a-half
months.
At an April 14, 2015 mental health evaluation, the treating physician noted that
C.A.E. was unwilling to participate in the examination and appeared to suffer from
schizophrenia and paranoia. A petition for initial detention was filed in Okanogan
County on April 17, 2015. The petition was granted. Okanogan County then dropped all
charges against C.A.E. when he was found incompetent to stand trial. He was moved to
Mid Valley Hospital, where he underwent mental and physical examinations.
When the lab results came back with multiple abnormalities, he was moved to
Bridges Evaluation and Treatment Center in Yakima. His blood pressure was so high the
medical doctors feared it would interfere with organ function.
On April 21, 2015, C.A.E.'s treating mental health practitioner petitioned Yakima
County for a 14-day detention because C.A.E. exhibited delusions, psychosis, and
paranoia, refused to take his medicine, and made verbal threats of violence to those !
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around him. On April 24, 2015, a Yakima County court commissioner found that C.A.E. I
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was gravely disabled and ordered the 14-day detention. On May 13, 2015, this detention I
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extended to 90 days of confinement. On June 2, 2015, C.A.E. transferred to ESH. Il
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On July 31, 2015, Dr. Laura Seymour, C.A.E.'s treating psychiatrist and
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professional designee of ESH, filed a petition in Spokane County Superior Court seeking
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to extend the detention to 180 days, stating that C.A.E. continued to be gravely disabled
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and that no less restrictive alternative treatment would suffice for his care. The petition
was supported by the affidavit of Patricia Gunderson, Ph.D., a licensed psychologist who
examined C.A.E. at ESH. She noted, for example, that C.A.E. denied any history of
mental illness and was surprised that his doctors were concerned about his high blood
pressure, as C.A.E. considered himself "young and healthy." C.A.E. received personal
service of notice of the hearing on August 3, 2015; the hearing was set for August 6,
2015.
At the hearing, the State called Dr. Seymour, who testified that C.A.E. remained
paranoid and was uninterested in attending to his hygiene or other activities of daily
living. She stated that his paranoia made him disinclined to apply for government
benefits, and he preferred to live as a transient. C.A.E. then testified on his own behalf,
stating he was completely sane, no longer suffered from mental illness, and that his
troubles arose from the police who harassed him.
At the conclusion of the hearing, the commissioner found C.A.E. continued to be
gravely disabled and ordered 180 days of confinement at ESH. C.A.E. timely filed his
appeal on September 3, 2015.
On October 7, 2015, Dr. Seymour filed a motion recommending a less restrictive
alternative because C.A.E. had demonstrated stability, treatment compliance, and was
ready to leave the hospital setting. On October 9, 2015, a different Spokane County
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commissioner released C.A.E. to the less restrictive alternative treatment of Carlyle Care
Center in Spokane.
ANALYSIS
This appeal presents issues concerning the notice of the pending commitment
hearing and the sufficiency of the evidence to support the commitment order. 1 We
address those two concerns in the order stated.
Notice
C.A.E. argues that because the petition form did not state why the mental health
professionals believed he was gravely disabled, he received insufficient notice of the case
against him. He did not seek clarification at the trial court and cites no relevant authority
limiting the State to one method of proving its case. Accordingly, we affirm on this
issue.
"Generally, under the statute, RCW 71.05, persons may be involuntarily
committed for treatment of mental disorders if, as a result of such disorders, they either
( 1) pose a substantial risk of harm to themselves, others, or the property of others, or (2)
are gravely disabled." In re LaBelle, 107 Wn.2d 196, 201-202, 728 P.2d 138 (1986). See
RCW 71.05.150(1). In this case, C.A.E. was involuntarily committed under the gravely
disabled standard. In tum, that standard can be established when, as a result of a mental
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C.A.E. also preemptively argues that the appeal is not moot. Since the State does
not contend otherwise, we will not address that contention.
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disorder, a person is either "in danger of serious physical harm resulting from a failure to
provide for his or her essential human needs of health or safety" or "manifests severe
deterioration in routine functioning evidenced by repeated and escalating loss of
cognitive or volitional control over his or her actions and is not receiving such care as is
essential for his or her health or safety." RCW 71.05 .020( 17).
Because involuntary commitment for mental disorders is a "massive curtailment of
liberty" requiring due process protections, the notice requirements are strictly construed.
Humphrey v. Cady, 405 U.S. 504, 509, 92 S. Ct. 1048, 31 L. Ed. 2d 394 (1972); In re
Cross, 99 Wn.2d 373, 382, 662 P.2d 828 (1983). The commitment statute provides that
the detainee must be provided with a copy of the petition for detention. RCW 71.05.300;
In re Det. ofDydasco, 135 Wn.2d 943,952,959 P.2d 1111 (1998). The petition must
"summarize the facts which support the need for further confinement," "describe in detail
the behavior of the detained person which supports the petition," and require "a statement
of all alternative grounds" on which it is based. RCW 71.05.290(2); Cross, 99 Wn.2d at
382.
The purpose of providing notice is to "apprise the affected individual of, and
permit adequate preparation for, an impending hearing." Id. To accomplish this purpose,
the notice must indicate the issues the State will address at the hearing; if the notice meets
these standards, the affected person has received adequate notice and their due process
rights were not violated. Id.
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C.A.E. argues that the complaint is defective for failing to specify which definition
of "gravely disabled" the State intended to prove at trial. However, he cites no authority
limiting the State to one means of proving his disability. The statute permits proof of two
different means of establishing a grave disability. Nothing in the statute or in our case
law limits the State to attempting to prove the existence of a grave disability by only one
method. The petition form is not defective for failing to select a single alternative.
A petition can still be unconstitutionally vague. Because the standard form used
does not require the State to identify which prong ofRCW 71.05.020(17) it is alleging
when identifying a person as gravely disabled and does not contain specific details of the
case, the statutorily required details must be found in the affidavits of the mental health
providers.
That notice was provided here. In the affidavits attached to the petition, the State
summarized its version of events leading up to C.A.E.'s detention in Okanagan, Yakima,
and Spokane counties, and described his numerous paranoid, delusional outbursts, his
failure to attend to his hygiene and healthcare needs, and his lack of understanding
regarding trespassing on others' property and the law enforcement attention it draws; the
State psychologists discussed the likelihood that C.A.E. would fail to thrive in an
outpatient setting and concluded no less restrictive treatment than commitment at ESH
would suffice. See RCW 71.05.290(2); Cross, 99 Wn.2d at 382. The affidavits complied
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with the requirements ofRCW 71.05.290 in terms of factual specificity and discussion of
the grounds for support ofC.A.E.'s commitment.
Dr. Seymour's testimony at the hearing did not assert any new grounds for
commitment not raised in the petition and affidavit. Accordingly, the information
provided to C.A.E. in the petition was sufficient to inform him of the issues to be raised
in the hearing and provided him the time in which to prepare. Cross, 99 Wn.2d at 382.
Due process notice requirements were satisfied.
Sufficiency of the Evidence
C.A.E. also argues that the evidence did not support the commitment order. The
evidence supported both prongs of the gravely disabled standard.
The burden of proof to support a 180-day commitment is clear, cogent, and
convincing evidence. RCW 71.05.310. That standard "means the ultimate fact in issue
must be shown by evidence to be 'highly probable.'" LaBelle, 107 Wn.2d at 209. The
reviewing court will not disturb the trial court's findings of "gravely disabled" if they are
"supported by substantial evidence." Id. If the findings are supported by substantial
evidence, the court then determines if the findings support the trial court's conclusions of
law and judgment. Id. Commitment is justified if either prong of the "gravely disabled"
standard is met. Id. at 202.
To show that an individual is "in danger of serious physical harm resulting from a
failure to provide for his or her essential human needs of health or safety," RCW
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71.05 .020( 17)(a), "the State must present recent, tangible evidence of failure or inability
to provide for such essential human needs as food, clothing, shelter, and medical
treatment which presents a high probability of serious physical harm within the near
future unless adequate treatment is afforded." LaBelle, 107 Wn.2d at 204-205. The
"failure or inability to provide for these essential needs must be shown to arise as a result
of mental disorder and not because of other factors." Id. at 205.
In order to find someone gravely disabled under RCW 71.05 .020( l 7)(b ), the
evidence presented must include recent proof of significant loss of cognitive or volitional
control, and it "must reveal a factual basis for concluding that the individual is not
receiving or would not receive, if released, such care as is essential for his or her health
or safety." LaBelle, 107 Wn.2d at 208.
The trial court's findings of fact, conclusions oflaw, and order are contained in a
form document. Clerk's Papers (CP) at 38-43. Although the document lacks detailed
findings of fact, it incorporates the petition and the affidavits of the ESH medical
professionals as findings. CP at 39-40. C.A.E. assigns error to the allegations of the
petitions and attached affidavits as incorporated into the trial court's findings of fact.
The court did not err in finding C.A.E. gravely disabled. The affidavits, and the
testimony at the hearing, including testimony by C.A.E. himself, established that C.A.E.
suffered from unspecified paranoia and schizophrenia; had dangerously high blood
pressure; denied he had a mental disorder; intended to not take medications or to seek
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treatment if released; failed to complete his activities of daily living; declined to apply for
benefits necessary for his health and well-being; and, would continue to live a transient
lifestyle, increasing his chances of run-ins with small-town law enforcement. For
example, his lack of understanding regarding the damage high blood pressure had on his
kidneys and his need for medication, evidenced his failure to tend to his health care
needs, presented a high probability of organ damage. LaBelle, I 07 Wn.2d at 204-205.
Similarly, his ongoing paranoid schizophrenic episodes, coupled with his statements and
testimony that it is not necessary for him to take antipsychotic medications, led the court
to find that he would not receive essential care if released. Id. at 208.
The evidence supported the commitment order.
Affirmed
A majority of the panel has determined this opinion will not be printed in the
Washington Appellate Reports, but it will be filed for public record pursuant to RCW
2.06.040.
WE CONCUR:
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