b.
No. 81-252
IN THE SUPREME COURT OF THE STATE OF MONTANA
IN THE MATTER OF C.M.
Appeal from: District Court of the Thirteenth Judicial District,
In and for the County of Yellowstone.
Honomble Robert Wilson, Judge presiding.
Counsel of Record:
For Appellant:
Terry L. Seiffert, Billings, Montana
For Respondent:
Harold F. Hanser, County Attorney, Billings, Montana
Submitted on briefs: August 11, 1981
Decided :
Filed: DCT 2 9 M!
31
Mr. J u s t i c e F r e d J. Weber d e l i v e r e d t h e O p i n i o n of t h e C o u r t .
C. M. was i n v o l u n t a r i l y c o m m i t t e d to W a r m S p r i n g s S t a t e
H o s p i t a l a f t e r p r o c e e d i n g s i n t h e D i s t r i c t Court of t h e
T h i r t e e n t h J u d i c i a l D i s t r i c t , Y e l l o w s t o n e County. She a p p e a l s
f r o m t h e o r d e r o f commitment. W affirm.
e
On March 2 1 , 1 9 8 1 , C. M. was p l a c e d i n t h e p s y c h i a t r i c
s e c t i o n of B i l l i n g s D e a c o n e s s H o s p i t a l i n B i l l i n g s , Montana. On
March 2 3 , C. M. I s m o t h e r a s k e d t h e Y e l l o w s t o n e County A t t o r n e y to
f i l e a p e t i t i o n a l l e g i n g C . M. to be s e r i o u s l y m e n t a l l y ill and
r e q u e s t i n g t h a t C. M. b e c o m m i t t e d f o r a p e r i o d of up to t h r e e
months. The p e t i t i o n was f i l e d and a h e a r i n g was h e l d o n March
30. On A p r i l 1, t h e d i s t r i c t j u d g e i s s u e d h i s o r d e r c o m m i t t i n g
C. M. t o t h e S t a t e H o s p i t a l f o r t h e s t a t u t o r y 90-day p e r i o d .
S e c t i o n 53-21-127 ( 2 ) ( a ) ( i ), MCA. She a p p e a l s from t h a t o r d e r and
raises t h e following i s s u e s :
(1) Was t h e r e s u f f i c i e n t e v i d e n c e to s u p p o r t t h e c o n c l u -
s i o n t h a t C. M. w a s " s e r i o u s l y m e n t a l l y ill," and
(2) Was t h e r e s u f f i c i e n t e v i d e n c e t o show t h a t W a r m
S p r i n g s S t a t e H o s p i t a l was t h e l e a s t r e s t r i c t i v e form o f
commitment?
T h r e e p e r s o n s tes t i £ i e d a t t h e commitment hearing--C. M. s
m o t h e r , D r . W i l l i a m Hague and C. M. The m o t h e r t e s t i f i e d t h a t C.
M. had b e e n l i v i n g w i t h h e r f o r a b o u t o n e month p r i o r to t h e
hearing. She s t a t e d t h a t C. M. had b e e n b e h a v i n g i n a p a r a n o i d
and confused manner. C. M. ' s m o t h e r s a i d t h a t C. M. was o b s e s s e d
w i t h c l e a n i n g , had s h a v e d h e r h e a d , c h a n g e d c l o t h e s f i v e o r s i x
times d a i l y , was o u t d o o r s i n March w i t h o u t s h o e s or a b l o u s e , and
h a d b r o k e n down t h e d o o r t o t h e f a m i l y r e s i d e n c e . The m o t h e r
a l s o t e s t i f i e d t h a t C. M. had t h r e a t e n e d C. M.'s 9-year o l d son
a n d o n o n e o c c a s i o n had l e f t a number of k i t c h e n k n i v e s l y i n g
a b o u t t h e house. Dr. Hague is a p s y c h i a t r i s t who had b e e n
i n v o l v e d i n t h e t r e a t m e n t o f C. M. o v e r a p e r i o d o f t w o y e a r s .
H e had a l s o examined C. M. d u r i n g h e r t h e n p r e s e n t s t a y i n
B i l l i n g s Deaconess H o s p i t a l . Dr. Hague d i a g n o s e d C. M. as
schizophrenic. H e t e s t i f i e d t h a t C. M. I s m o t h e r had t o l d him t h a t
C. M. had t h r e a t e n e d h e r s o n w i t h b o d i l y harm and had a h i s t o r y
o f a b u s i n g t h e boy. Dr. Hague a l s o r e l a t e d t h a t t h e m o t h e r f e l t
t h a t t h e i n c i d e n t w i t h t h e k n i v e s s u g g e s t e d t h a t C. M. m i g h t be
t h i n k i n g o f h a r m i n g h e r s e l f or o t h e r s . Dr. Hague t e s t i f i e d t h a t ,
b a s e d upon t h e m o t h e r ' s o b s e r v a t i o n s and h i s own e x a m i n a t i o n , i t
was h i s o p i n i o n t h a t C. M. w a s s e r i o u s l y m e n t a l l y ill. He
b e l i e v e d t h a t h e r i l l n e s s was i n t e r r u p t i n g h e r c o g n i t i v e p r o c e s s e s ,
was c a u s i n g d e l u s i o n a l t h i n k i n g , and was t h e r e b y i n t e r f e r i n g i n a
s e v e r e way w i t h h e r f u n c t i o n i n g . Dr. Hague f e l t t h a t it would be
v e r y d i f f i c u l t f o r C. M. to c a r e f o r h e r s e l f . I t had b e e n h i s
e x p e r i e n c e w i t h C. M. t h a t she did n o t f o l l o w through with out-
p a t i e n t programs. Dr. Hague t e s t i f i e d t h a t C. M. needed a
l e n g t h y p e r i o d o f h o s p i t a l i z a t i o n which c o u l d n o t be a c c o m p l i s h e d
i n Billings. I t was D r . H a g u e ' s r e c o m m e n d a t i o n t h a t C. M. be
t r e a t e d a t Warm Springs S t a t e Hospital. I n h e r t e s t i m o n y , C. M.
e i t h e r g e n e r a l l y d e n i e d t h e a l l e g a t i o n s o f h e r m o t h e r or
explained the conduct i n question.
B e f o r e a p e r s o n may be c o m m i t t e d t o t h e S t a t e H o s p i t a l
u n d e r s e c t i o n 53-21-127, MCA, t h e p e r s o n m u s t be a d j u d g e d
" s e r i o u s l y m e n t a l l y ill ." " ' S e r i o u s l y m e n t a l l y ill ' means s u f -
f e r i n g from a m e n t a l d i s o r d e r which h a s r e s u l t e d i n s e l f -
i n f l i c t e d i n j u r y or i n j u r y to o t h e r s or t h e i m m i n e n t t h r e a t
t h e r e o f or which h a s d e p r i v e d t h e p e r s o n a f f l i c t e d o f t h e a b i l i t y
to protect h i s l i f e o r health." S e c t i o n 53-21-102(14), MCA.
"Imminent t h r e a t of s e l f - i n f l i c t e d i n j u r y or i n j u r y to o t h e r s
s h a l l be e v i d e n c e d b y o v e r t a c t s , s u f f i c i e n t l y r e c e n t i n t i m e as
t o be m a t e r i a l and r e l e v a n t as to t h e r e s p o n d e n t ' s p r e s e n t
condition." S e c t i o n 53-21-126(2), MCA. C. M. argues t h a t D r .
Hague had no p e r s o n a l k n o w l e d g e of t h e i n c i d e n t s which a l l e g e d l y
c o n s t i t u t e d e v i d e n c e of an imminent t h r e a t of sel £ - i n f l i c t e d
i n j u r y or i n j u r y t o o t h e r s , and t h e r e f o r e t h e c o u r t c o u l d n o t
p r o p e r l y f i n d t h e e x i s t e n c e of such a t h r e a t . However, a
p r o f e s s i o n a l p e r s o n may o p i n e t h a t t h e r e s p o n d e n t is s e r i o u s l y
m e n t a l l y ill e v e n t h o u g h t h e e v i d e n c e of a n i m m i n e n t t h r e a t o f
i n j u r y is o b t a i n e d f r o m a s o u r c e o t h e r t h a n t h e p r o f e s s i o n a l
person. S e c t i o n 53-21-126 ( 4 ) , MCA.
C. M. a l s o c o n t e n d s t h a t t h e r e was a f a i l u r e to show a n y
" o v e r t a c t s v vw h i c h e v i d e n c e d a n i m m i n e n t t h r e a t o f i n j u r y . We
disagree. C. M. t h r e a t e n e d h e r s o n and a t h r e a t c a n be a n o v e r t
a c t w h i c h , i n i t s e l f , e v i d e n c e s a n i m m i n e n t t h r e a t o f i n j u r y to
another. Matter o f G o e d e r t ( 1 9 7 9 ) , 1 8 0 Mont. 4 8 4 , 5 9 1 P.2d
2 2 2 , 36 S t . R e p . 393. An o v e r t act c a n a l s o be e v i d e n c e d b y
a p r e s e n t i n d i c a t i o n o f p r o b a b l e p h y s i c a l i n j u r y which is l i k e l y
t o o c c u r a t a n y moment o r i n t h e i m m e d i a t e f u t u r e . Matter
o f F. B. (1980), Mont . , 615 P.2d 8 6 7 , 37 S t . R e p . 1442.
Y The i n c i d d n t w i t h t h e k n i v e s , t h e o t h e r f a c t s p r e s e n t e d , and t h e
d o c t o r ' s d i a g n o s i s o f C. M. I s c o n d i t i o n were, when t a k e n
t o g e t h e r , s u f f i c i e n t t o show a p r o b a b i l i t y o f p h y s i c a l i n j u r y i n
t h e immediate f u t u r e . W e a l s o n o t e t h a t a d e t e r m i n a t i o n of
s e r i o u s m e n t a l i l l n e s s c a n be made i f t h e p e r s o n ' s m e n t a l
d i s o r d e r h a s d e p r i v e d t h e p e r s o n o f t h e a b i l i t y to p r o t e c t h e r or
h i s health. Dr. Hague t e s t i f i e d t h a t C. M . ' s i l l n e s s was
i n t e r r u p t i n g h e r c o g n i t i v e p r o c e s s e s , was c a u s i n g d e l u s i o n a l
t h i n k i n g , and was t h e r e b y i n t e r f e r i n g i n a s e v e r e way w i t h h e r
functioning. The d o c t o r b e l i e v e d t h a t it would be v e r y d i f f i c u l t
f o r C. M. to c a r e f o r h e r s e l f . Even a b s e n t a f i n d i n g o f a n i m m i -
n e n t t h r e a t of i n j u r y , a f i n d i n g of s e r i o u s mental i l l n e s s c o u l d
h a v e p r o p e r l y b e e n made b e c a u s e C. M. had b e e n d e p r i v e d o f t h e
a b i l i t y to protect h e r h e a l t h . S e c t i o n 53-21-102(14).
The D i s t r i c t C o u r t c o m m i t t e d no e r r o r by r e a c h i n g t h e
c o n c l u s i o n t h a t C. M. w a s s e r i o u s l y m e n t a l l y ill.
F i n a l l y , C. M. a s k s u s to d e c i d e w h e t h e r t h e r e w a s s u f -
f i c i e n t evidence t o s u p p o r t t h e f i n d i n g t h a t Warm S p r i n g s S t a t e
H o s p i t a l was t h e l e a s t r e s t r i c t i v e form o f commitment. The p u r -
p o s e s o f M o n t a n a ' s laws f o r t r e a t m e n t o f t h e s e r i o u s l y m e n t a l l y
ill are to be a c c o m p l i s h e d " i n a n i n s t i t u t i o n a l i z e d s e t t i n g o n l y
when less r e s t r i c t i v e a l t e r n a t i v e s are u n a v a i l a b l e or i n a d e q u a t e
a n d o n l y when a p e r s o n is so m e n t a l l y ill as t o r e q u i r e i n s t i t u -
tionalized care ." S e c t i o n 53-21-101( 3 ) , MCA. See a l s o s e c t i o n
53-21-120 , MCA. The D i s t r i c t C o u r t is g i v e n f o u r d i s p o s i t i o n a l
o p t i o n s a f t e r a d e t e r m i n a t i o n o f s e r i o u s m e n t a l i l l n e s s is made :
" ( i )c o m m i t t h e r e s p o n d e n t to a f a c i l i t y f o r a
p e r i o d o f n o t more t h a n 3 m o n t h s ;
" ( i i ) o r d e r t h e r e s p o n d e n t to be p l a c e d i n t h e
care and c u s t o d y o f h i s r e l a t i v e or g u a r d i a n or
some o t h e r a p p r o p r i a t e p l a c e o t h e r t h a n a n
institution;
" ( i i i ) o r d e r o u t p a t i e n t t h e r a p y ; or
" ( i v ) make some o t h e r a p p r o p r i a t e o r d e r f o r
treatment."
S e c t i o n 53-21-127 ( 2 ) ( a ) , MCA.
Dr. Hague had b e e n i n v o l v e d i n t h e t r e a t m e n t o f C. M. f o r two
years. H e had found t h a t s h e d i d n o t f o l l o w t h r o u g h w i t h o u t -
p a t i e n t programs. I t was h i s o p i n i o n t h a t t h e h o s p i t a l i n
B i l l i n g s would n o t be a b l e t o p r o v i d e t h e t r e a t m e n t t h a t C. M.
needed. Dr. Hague t e s t i f i e d t h a t b e c a u s e o f t h e n a t u r e o f h e r
i l l n e s s , C. M. s h o u l d be t r e a t e d a t W a r m S p r i n g s S t a t e H o s p i t a l .
C. M. d i d n o t p r e s e n t a n e x p e r t i n b e h a l f o f her position t h a t
s h e be t r e a t e d o n a n o u t p a t i e n t b a s i s . The e v i d e n c e s u p p o r t e d
t h e D i s t r i c t C o u r t ' s d e c i s i o n t o c o m m i t C. M. t o Warm S p r i n g s
State Hospital.
The o r d e r o f t h e D i s t r i c t C o u r t i s a f f i r m e d .