United States v. Thomas Conroy , 546 F. App'x 311 ( 2013 )

UNPUBLISHED
UNITED STATES COURT OF APPEALS
FOR THE FOURTH CIRCUIT
No. 13-6869
UNITED STATES OF AMERICA,
Petitioner – Appellee,
v.
THOMAS CONROY,
Respondent - Appellant.
Appeal from the United States District Court for the Eastern
District of North Carolina, at Raleigh. W. Earl Britt, Senior
District Judge. (5:06-hc-02050-BR)
Submitted: November 19, 2013 Decided: November 22, 2013
Before GREGORY, SHEDD, and WYNN, Circuit Judges.
Affirmed by unpublished per curiam opinion.
Thomas P. McNamara, Federal Public Defender, Joseph Bart
Gilbert, Assistant Federal Public Defender, Susan Umstead,
Research & Writing Attorney, Raleigh, North Carolina, for
Appellant. Thomas G. Walker, United States Attorney, Jennifer
P. May-Parker, Jennifer D. Dannels, Assistant United States
Attorneys, Raleigh, North Carolina, for Appellee.
Unpublished opinions are not binding precedent in this circuit.
PER CURIAM:
Thomas Conroy appeals the district court’s order
continuing his civil commitment pursuant to 18 U.S.C. § 4246
(2012). As set forth below, we affirm.
I.
In March 2005, the United States District Court for
the Central District of California found Conroy incompetent to
stand trial on a charge of mailing a threatening communication,
in violation of 18 U.S.C. § 876(c) (2012). Thereafter, the
California district court ordered that Conroy be transported to
the Bureau of Prisons’ facility at Butner, North Carolina, and
evaluated for civil commitment pursuant to 18 U.S.C. § 4246. 1
Later, the Government filed a certificate of mental disease or
defect and dangerousness in the United States District Court for
the Eastern District of North Carolina. 2 That court—the district
1
“Section 4246 applies to individuals who are due for
release from federal custody either because they have been found
not competent to stand trial, because the charges against them
have been dropped solely because of mental illness, or because
they have completely served their sentences of imprisonment.”
United States v. Baker, 45 F.3d 837, 840 n.1 (4th Cir. 1995).
2
Under § 4246(a), the director of the facility in which a
person found incompetent to stand trial is hospitalized may
certify that the person is “presently suffering from a mental
disease or defect as a result of which his release would create
a substantial risk of bodily injury to another person or serious
damage to property of another, and that suitable arrangements
for State custody and care of the person are not available,” and
the director “shall transmit the certificate to the clerk of the
(Continued)
2
court below—later held a § 4246 hearing to determine Conroy’s
mental condition. After finding by clear and convincing
evidence that Conroy was then suffering from a mental disease or
defect as a result of which his release would create a
substantial risk of bodily injury to another person or serious
damage to the property of another, the district court committed
him to the care and custody of the Attorney General under
18 U.S.C. § 4246(d) by order dated July 11, 2006.
On June 20, 2007, the district court ordered Conroy’s
conditional release to a group housing facility in Durham, North
Carolina. In July 2010, the district court revoked Conroy’s
release, and Conroy was returned to FMC Butner.
In August 2012, the Warden of FMC Butner filed an
annual forensic report with the district court in accordance
with 18 U.S.C. § 4247(e)(1)(B) (2012) concerning Conroy’s mental
condition and the need for his continued commitment. The report
was signed by FMC Butner staff psychiatrist Dr. Ralph Newman and
staff psychologist Dr. Adeirdre Riley (“the FMC staffers”) and
contained references to Conroy’s relevant background history, a
court for the district in which the person is confined.”
18 U.S.C. § 4246(a). Because Conroy was then hospitalized at
the Federal Medical Center in Butner, North Carolina
(“FMC Butner”), the certificate was filed in the Eastern
District of North Carolina.
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mental health diagnosis, and a risk assessment pursuant to
§ 4246. The annual report reflects that Conroy was diagnosed as
suffering from Schizophrenia, Undifferentiated Type, and that,
in the year since FMC Butner’s last update to the district
court, his mental status had deteriorated. In this regard, the
report reflects that Conroy demonstrated a “prominent thought
disorder” and voiced the “primary delusion” that a device able
to control his behavior had been inserted into his neck when he
was a child. The FMC staffers opined that Conroy’s judgment and
insight into his condition were impaired and noted that he
viewed medication as having no effect on himself.
The report further reflects, however, that, in the
five months preceding its filing, Conroy’s “mental status” had
“slowly improved,” as evidenced by a decrease in his
preoccupation with auditory hallucinations and a decrease in
references to the device that he believed had been inserted into
his neck. Although the report reflects that Conroy had complied
with FMC Butner’s regulations and had received no incident
reports or disciplinary actions in the three months preceding
the filing of the report, he also chose not to participate in
therapeutic groups or an institutional job assignment, and he
continued to struggle with anxiety and restlessness. The FMC
staffers opined that Conroy’s prognosis for additional
improvement was “guarded.”
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The report further relates that Conroy exhibited
several factors associated with a risk of future violent
behavior, including: his past history of violence; his
schizophrenia diagnosis and history of acting in response to his
persecutory delusions of being followed or surveilled; his
history of gun possession; his lack of a social support system;
and the deterioration in his mental health status. In light of
these factors, Conroy’s “poor” insight into his condition, and
the fact that delusions, hallucinations, and a thought disorder
remained, the FMC staffers opined that Conroy was not an
“appropriate” candidate for conditional release into the
community.
The district court later granted Conroy’s motions for
a hearing to determine whether he should be discharged from
commitment under § 4246 and for the appointment of an
independent mental health examiner. The independent examiner,
psychiatrist Dr. Holly Rogers, completed a written report after
evaluating Conroy and considering his medical chart, prison
file, the annual report, Rogers’s prior evaluation of Conroy,
and a conditional release violation report. Rogers opined that,
although the most accurate diagnosis for Conroy was
Schizoaffective Disorder, Bipolar Type, the difference between
this diagnosis and a diagnosis of Schizophrenia was “somewhat
academic,” as the treatment for both conditions would be the
5
same. In Dr. Rogers’s view, there was evidence in Conroy’s case
both for and against his posing a risk of future dangerousness.
Factors that increased his risk of future dangerousness
included: the nature of his illness, which Rogers characterized
as a “difficult to treat, chronic psychotic illness”; Conroy’s
level of insight into his illness, which Rogers opined was
associated with an unlikelihood that he would continue treatment
of his own accord; Conroy’s history of acquiring weapons and
acting on his paranoid beliefs; and his lack of a relationship
with family members willing to care and take responsibility for
him. Factors that mitigated against his risk of future
dangerousness included: his intelligence and capability for
self-sufficiency when his psychotic symptoms were under control;
and his lack of a substance abuse history. Dr. Rogers opined,
however, that these mitigating factors did not outweigh the risk
factors and that Conroy thus still was suffering from a mental
disease and, as a result of the disease, presented a substantial
risk of future dangerousness to others or their property such
that he continued to meet the criteria for continued commitment
under § 4246.
After a hearing at which Conroy testified, Dr. Newman
testified as an expert in the field of forensic psychiatry, and
the annual report and Dr. Rogers’s report were admitted into
evidence, the district court determined that Conroy continued to
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meet the criteria for care and treatment under § 4246 and
ordered Conroy’s continued commitment. Conroy now appeals,
arguing that the district court erred in ordering his continued
commitment.
II.
A.
A person committed under 18 U.S.C. § 4246 may, through
his counsel or legal guardian, file a motion for a hearing to
determine whether he should be released. 18 U.S.C. § 4247(h).
The district court that ordered the commitment may discharge the
person committed if it finds, by a preponderance of the
evidence, that the person has recovered from his mental disease
or defect to such an extent that his release would no longer
create “a substantial risk of bodily injury to another person or
serious damage to property of another.” Id. § 4246(e)(1)-(2).
The committed person seeking discharge bears the burden of
proving he has so recovered. Sealed Appellee v. Sealed
Appellant, 665 F.3d 620, 623 & n.4 (5th Cir. 2011);
United States v. Evanoff, 10 F.3d 559, 563 (8th Cir. 1993).
The district court’s finding that continued commitment
is warranted is a factual determination this court will not
overturn unless clearly erroneous. United States v. Cox,
964 F.2d 1431, 1433 (4th Cir. 1992). A finding is clearly
erroneous “when, although there is evidence to support it, the
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reviewing court on the entire evidence is left with the definite
and firm conviction that a mistake has been committed.”
United States v. Harvey, 532 F.3d 326, 336-37 (4th Cir. 2008)
(internal quotation marks omitted). However, “if the district
court’s account of the evidence is plausible in light of the
record viewed in its entirety,” this court will not reverse the
district court’s finding even if it would have “decided the fact
differently.” United States v. Stevenson, 396 F.3d 538, 542
(4th Cir. 2005) (internal quotation marks and alteration
omitted).
B.
We conclude that the district court’s findings
justifying Conroy’s continued commitment were not clearly
erroneous. First, the FMC staffers and Dr. Rogers—through their
testimony and reports—agreed that Conroy suffers from a mental
illness, disagreeing only on the exact classification of the
disease. Although the FMC staffers’ diagnosis differed from
that given by Dr. Rogers, she herself characterized the
difference as “somewhat academic,” and Dr. Newman stated during
his hearing testimony that both schizophrenia and
schizoaffective disorder would be treated in “virtually the
same” manner and had similar prognoses. While Conroy argues on
appeal that the preponderance of the evidence produced at the
hearing showed that he had recovered from his schizophrenia to
8
the extent that his release would not create a substantial
danger to the community, he makes this argument in a wholly
conclusory fashion. Moreover, after review, we conclude that
nothing in the record contradicts the opinions that Conroy
continues to suffer from a mental disease or defect. In the
hearing below, Conroy offered no testimony or other evidence
suggesting that he had recovered from his illness, and nothing
else in the record on appeal suggests that Conroy has recovered
from his illness. Accordingly, the district court did not
clearly err when it found that Conroy continued to suffer from a
mental disease or defect.
Second, the totality of the evidence before the
district court established that, in light of Conroy’s mental
illness, his release would create a substantial risk of bodily
injury to another person or serious damage to property of
another. In support of their opinion, the FMC staffers reported
that Conroy exhibited several factors associated with a risk of
future violence, and, during his hearing testimony, Dr. Newman
reiterated his conclusion in that report that Conroy still met
the criteria under § 4246 for continued commitment. Dr. Rogers
also opined that Conroy exhibited factors associated with a risk
of future violence, that the mitigating factors present in his
case did not outweigh the risk factors, and that Conroy thus met
the criteria under § 4246 for continued commitment.
9
The factors relied upon by these professionals are
among those typically considered by mental health professionals
in conducting risk assessments under § 4246. E.g., United
States v. Ecker, 30 F.3d 966, 970 (8th Cir. 1994); Cox, 964 F.2d
at 1433. Thus, the evidence before the district court
established that Conroy’s release would create a substantial
risk of bodily injury to another person or serious damage to the
property of another.
Conroy responds by arguing that the finding in the
annual report of “possible dangerousness” is based on
“conjecture and speculation” and thus is not sufficient to
support a conclusion of substantial risk under § 4246. Conroy
emphasizes that Drs. Newman and Rogers—through their testimony
and reports—made note of his intelligence and capability for
self-sufficiency, his lack of a recent, significant history of
substance abuse, his improvements in insight into his illness,
institutional adjustment, and compliance with his medication
regimen, and his demonstrated ability to live a period of time
free from violence against others at FMC Butner. Conroy,
however, misstates the record. The annual report does not make
a finding of “possible dangerousness” as Conroy claims. Rather,
the report reflects the opinion that Conroy’s continued
commitment under § 4246 was appropriate in light of several risk
factors. Moreover, § 4246’s dangerousness evaluation and
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determination require evaluators and the district court to
consider the committed person’s “entire behavioral and
psychological profile.” United States v. Williams, 299 F.3d
673, 677 (8th Cir. 2002); see Cox, 964 F.2d at 1433. Conroy’s
intelligence, capabilities, and improvements were but pieces of
the data among the broad spectrum of information properly
considered.
Because the evaluators in this case considered a host
of relevant factors convincing them that Conroy still was
suffering from a mental disease or defect to the extent that his
release would create a substantial risk of bodily injury to
another person or serious damage to the property of another, the
evidence cleared the hurdle that Conroy’s release presented a
“substantial risk.” 18 U.S.C. § 4246(d). Accordingly, Conroy
did not meet his burden to show that he had recovered, and the
district court did not clearly err in relying on the
uncontroverted opinion evidence to find that Conroy continued to
satisfy the criteria for civil commitment under § 4246.
III.
We therefore affirm the district court’s order
continuing Conroy’s civil commitment. We dispense with oral
argument because the facts and legal contentions are adequately
11
presented in the materials before this court and argument would
not aid the decisional process.
AFFIRMED
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