COA affirms commitment for woman with suicidal ideations

An Indiana appellate panel affirmed the commitment and forced-medication order of a woman found to be a danger to herself, finding there was clear and convincing evidence to support both orders despite her contentions otherwise.

Indiana University Health’s Bloomington Hospital filed a petition seeking a temporary involuntary commitment and forced medication order for B.D.  in October 2018, alleging she was a danger to herself due to the “definite threat” that she would attempt to commit suicide after informing doctors she had a plan to harm herself with a “medication overdose.”

B.D. had previously attempted suicide through medication overdose and was treated for mania and substance abuse at another hospital just one month before her commitment. IU Health physician Dr. Gregory Sidell diagnosed B.D. with bipolar disorder with psychotic features after she exhibited suicidal ideations during two separate mental-health hotline phone calls she placed. Upon her arrival at IU Health, B.D. refused to be examined, however, banging her head against a gurney and kicking a hole in the wall of the crisis care unit.

Sidell testified that a temporary commitment and injections of Abilify were the best treatment options for B.D., and that the specific medication would be best fit to stabilize B.D.’s mood so that she would not experience extreme depression or manic episodes. B.D. objected to taking Abilify because it reportedly caused her to gain weight and experience muscle stiffness, but Sidell concluded the benefits outweighed the side effects and that it would treat B.D.’s bipolar disorder and not just control her symptoms.

Thus, the Monroe Circuit Court ordered the temporary commitment to not exceed 90 days. It later declined to hear B.D.’s motion to reconsider, and the Indiana Court of Appeals upheld the trial court’s decision in B.D. v. Indiana University Health Bloomington Hospital,18A-MH-2672.

On appeal, B.D. argued insufficient evidence existed to support the orders, that she was not a danger to herself, and that Sidell’s opinion she would attempt to commit suicide was mere speculation. She also claimed affirming the orders would have a chilling effect on reporting suicidal ideations.

“However, B.D. overlooks evidence in the record that she not only reported having suicidal ideation on multiple occasions spanning a number of days, but she also expressed a plan to harm herself by overdosing on medication, so our decision is not based merely on a single instance of suicidal ideation or anti-social behavior being reported to a hotline,” Judge Patricia Riley wrote for the panel.

The panel further denied B.D.’s assertions that the order lacked clear and convincing evidence, finding Sidell had considered two other forms of treatment apart from Abilify and concluded that the latter was in B.D.’s best interest based on her need for a mood stabilizer.

It also denied her assertion that IU Health did not make an adequate showing of other limiting guidelines set out in In re Mental Commitment of M.P., 510 N.E.2d 645 (Ind. 1987), thus resolving that the medication was directly related to her reasons for commitment and should remain undisturbed.

“(T)he trial court’s Order finding that B.D. was a danger to herself and authorizing IU Health to medicate B.D. was supported by clear and convincing evidence,” the panel concluded.