COA reverses regular commitment for lack of evidence

The Indiana Court of Appeals reversed and remanded a trial court’s decision to order a mentally ill woman to regular commitment at Indiana University Health Bloomington Hospital, finding there was not clear and convincing evidence to prove commitment was necessary.

In January 2018, Bloomington police responded to a 911 call regarding an incident in which D.S. was waving a sign out of a vehicle while screaming. Believing D.S. to be suffering from psychosis, police forcibly removed her from the vehicle and brought her to the hospital for an emergency detention.

D.S. was held in the hospital’s crisis care unit after Dr. Daniel J. Garrison filed an application for emergency detention on her behalf. Garrison determined D.S. appeared to have “acute or chronic psychosis” and was “manic.” Garrison further alleged D.S.’s decision making was impaired, thus placing her in a potentially harmful situation.

Hospital social worker James D. Baugh then filed a petition with the Monroe Circuit Court seeking regular commitment of D.S. at the hospital for a period of one year. Simultaneously, psychiatrist Carey Mayer filed a physician’s statement alleging D.S. was suffering from a psychiatric disorder and was “delusional.”

At trial, Mayer read into the record, over D.S.’s objection, an assessment done by one of the hospital’s therapists when D.S. was admitted. Mayer also testified he believed D.S. suffered from a “schizoaffective disorder, bipolar type” and that she refused to consider taking necessary medications.

Mayer concluded that in her week-long stay at the hospital, D.S. had remained “psychotic” and “preoccupied,” solidifying his belief that “she is gravely impaired and unable to provide for her own safety, shelter, food, clothing, [and] needs.” The trial court granted the hospital’s petition, finding that D.S. was gravely disabled and in need of commitment for a period expected to exceed ninety (90) days while also granting a forced medication order.

On appeal, D.S. argued the trial court erred in ordering her regular commitment because there was insufficient evidence to prove that she was “gravely disabled,” as required by statute. She claimed she is not unable to provide for her essential human needs and does not have a substantial impairment or obvious deterioration of judgment that results in her inability to function independently.

D.S. did not dispute the trial court’s finding that she is mentally ill in In Re: The Commitment of D.S.; D.S. v. Indiana University Health Bloomington Hospital, 18A-MH-590, but argued the only evidence bearing on the finding that she was “gravely disabled” was the incident involving police and her refusal to take medication.

For its part, the hospital contended D.S.’s apparent “inability to . . . abide by the normal rules of conduct[,]’” in the car incident was sufficient to prove that she was gravely disabled. But the appellate court found the hospital’s burden of proof required more than a showing that D.S. behaved abnormally or idiosyncratically, and that it failed to show by clear and convincing evidence that D.S. lacked the judgment and ability to function independently.

The appeals court pointed D.S.’s testimony about her life outside of the hospital, noting D.S. stated she had a place of residence, maintained relationships with family and friends, and had held a steady job until January 2018. It also noted D.S. indicated that she was unwilling to take medication because of negative side effects, but that she would be willing to try an alternative.

“Other than Dr. Mayer’s diagnosis of psychosis caused by schizoaffective disorder, the Hospital presented no evidence at all, much less clear and convincing evidence, that D.S. could not function independently,” Judge Rudolph Pyle wrote for the court. “The Incident was one isolated event, and while D.S.’s actions during the Incident were unusual, there was no evidence that her unusual conduct prevented her from functioning independently outside the Hospital.”

“…Accordingly, because the only evidence the Hospital presented at trial did not constitute clear and convincing evidence to support D.S.’s regular commitment, we reverse the trial court’s decision and remand for the trial court to vacate the regular commitment.”