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A hospital psychiatry resident had enough training, experience and interactions with a mentally ill woman to be considered an expert when she testified at the woman’s commitment hearing, the Court of Appeals of Indiana affirmed Tuesday.
According to court records, in the early morning hours of Dec. 13, 2022, residents of a home in Marion County called police and reported that K.K., whom they did not know, had been standing on their front porch for hours, clothed only in pajamas.
Police believed K.K. was displaying “erratic behavior” and took her to a Community Health Network hospital, where she was admitted.
Over the next few days, Dr. Beatrice Thunga, a psychiatry resident at the hospital, examined K.K. and found her to have a “disorganized thought process” and “disorganized behavior.” K.K. was “barely talking” and, when she did talk, she was “incoherent.”
When asked questions, K.K. would not reply and instead produced items, such as a crayon or a piece of paper, but could not explain their significance. She was also “unable to express emotions” and did not understand that she had a mental illness or needed to take medication.
Based on her behavior and prior medical history, including an involuntary commitment earlier that year, doctors at the hospital diagnosed K.K. with schizoaffective disorder, bipolar type.
On Dec. 15, a report was filed with the Marion Superior Court requesting temporary involuntary commitment for up to 90 days.
At an ensuing evidentiary hearing, Thunga testified that she had recently graduated from medical school, held a temporary medical license and was six months into her residency at the hospital.
For four of those months, she had been working in psychiatry, which she identified as the “particular focus of [her] training.” She said she primarily worked with adult patients “with various mental disorders of mood, substance use and psychosis.”
Over K.K.’s objection, the trial court found Thunga met the qualifications as an expert in psychiatry.
Thunga then testified that she had examined K.K. nine times since her admission and confirmed K.K.’s diagnosis.
A friend of K.K.’s also testified at the hearing that he could give her a temporary place to stay should she be released, but could not offer any permanent housing and was unwilling to be responsible for her taking prescribed medication or attending medical appointments.
After the hearing, the trial court entered an order of temporary commitment not to exceed 90 days.
K.K. appealed, arguing that the trial court erred in allowing Thunga to testify as an expert witness under Indiana Evidence Rule 702. She also argued that even with Thunga’s testimony, there was insufficient evidence to support her involuntary commitment.
The Court of Appeals disagreed, finding that Thunga had sufficient knowledge and experience to qualify as an expert and that there was sufficient evidence to support the involuntary commitment
Judge Nancy Vaidik wrote the opinion for the appellate court.
Vaidik pointed to Thunga’s resume, which includes four years of medical school; a temporary medical license; six months of residency, four of which focused on psychiatry; experience treating adults with various mental disorders of mood, substance use and psychosis; and her work as K.K.’s treating physician, including examining her nine times.
“Given this evidence, and the deference given to trial courts in these circumstances, we cannot say the court erred in determining Dr. Thunga met the qualifications for an expert witness,” Vaidik wrote.
As for K.K.’s sufficiency challenge, the COA held that Thunga’s testimony established that K.K. was unable to meet her needs.
Vaidik pointed to Thunga’s testimony that, in the five days K.K. was hospitalized, she did not appear to be eating, never changed clothes or showered, and would not take prescribed medication.
K.K. was also experiencing poverty of speech and cognitive decline and was never able to coherently communicate with Thunga about her medical needs or housing situation.
“Ultimately, K.K.’s inability to communicate, combined with her hygiene, food, and housing issues, supports the trial court’s determination that she was gravely disabled,” Vaidik concluded.
Judges Paul Mathias and Rudolph Pyle concurred.
The case is In the matter of the Civil Commitment of: K.K. v. Community Health Network, Inc., 23A-MH-114.
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