In the Matter of the Civil Commitment of M.S. v. Community Health Network, Inc. (mem. dec.) ( 2020 )

MEMORANDUM DECISION
Pursuant to Ind. Appellate Rule 65(D),
this Memorandum Decision shall not be FILED
regarded as precedent or cited before any Nov 20 2020, 9:14 am
court except for the purpose of establishing
CLERK
the defense of res judicata, collateral Indiana Supreme Court
Court of Appeals
estoppel, or the law of the case. and Tax Court
ATTORNEYS FOR APPELLANT ATTORNEYS FOR APPELLEE
Joel M. Schumm Jenny R. Buchheit
Indianapolis, Indiana Stephen E. Reynolds
Sean T. Dewey
Valerie K. Boots Ice Miller LLP
Marion County Public Defender Agency Indianapolis, Indiana
Indianapolis, Indiana
IN THE
COURT OF APPEALS OF INDIANA
In the Matter of the Civil November 20, 2020
Commitment of M.S., Court of Appeals Case No.
Appellant-Respondent, 20A-MH-508
Appeal from the Marion Superior
v. Court
The Honorable Steven R.
Community Health Network, Eichholtz, Judge
Inc., The Honorable Melanie Kendrick,
Magistrate
Appellee-Petitioner.
Trial Court Cause No.
49D08-2001-MH-4455
Baker, Senior Judge.
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Statement of the Case
[1] Appellant M.S. appeals the trial court’s order of temporary involuntary
commitment. We affirm.
Issue
[2] M.S. presents one issue for our review, which we restate as: whether the trial
court’s order of temporary involuntary commitment is supported by sufficient
evidence.
Facts and Procedural History
[3] On January 24, 2020, sixty-five-year-old M.S. was admitted into a hospital in
the Community Health Network (“Hospital”). The circumstances surrounding
M.S.’s admission are that she was living in her car, and, because the weather
was cold, she was running her car to stay warm. She eventually ran out of gas
and contacted one of her brothers for gas money. When her brother refused to
give her money, M.S. threatened to burn down his house. M.S.’s brother then
contacted the police, who found her living in her car in unsanitary conditions
and exhibiting delusional and psychotic behavior. M.S. was taken to the
hospital where she was evaluated and determined to be suffering from
schizophrenia.
[4] Based upon this evaluation, hospital staff filed an application for the emergency
detention of M.S. In the application it was alleged that M.S. was suffering from
a psychiatric disorder and was both gravely disabled and dangerous to others.
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The application specified that M.S. was “paranoid and delusional, threatening
to kill her brother and Evan Bayh with a gun or baseball bat” and believing that
everyone around her is “Satanists who are trying to steal [her] intellectual
property.” Appellant’s App. Vol. II, p. 13.
[5] A few days later, Dr. Jacob Mulinix, on behalf of the Hospital, filed a Report
Following Emergency Detention, requesting the trial court to order a temporary
involuntary commitment of M.S. Dr. Mulinix indicated that M.S. was
suffering from schizophrenia and was gravely disabled. More specifically, Dr.
Mulinix reported that M.S. was living in her car, which had feces throughout it,
that she had no insight into her illness, and that she had refused to begin
voluntary treatment.
[6] On February 3, the court held a commitment hearing. Dr. Gaimur Mian and
M.S.’s two older brothers, R.S. and W.S., testified in support of her temporary
commitment. Dr. Mian, a psychiatrist, testified that he had examined M.S. ten
times since she had been admitted to the hospital, including on the day of the
hearing, and he had diagnosed M.S. with schizophrenia. He testified that,
while in the hospital, M.S. was being given the oral form of Haldol to treat her
mental illness. However, M.S. was taking the medication “quite reluctantly”
and only to “appease” her medical providers during her commitment. Tr. Vol.
II, p. 9. Dr. Mian stated that M.S. does not believe she is ill, and therefore she
does not want to take any medication and had no intention of continuing any
medication once she was released.
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[7] Dr. Mian further testified that although the oral medication M.S. had been
taking during her hospital stay had helped her thought processes to become
more logical and coherent, it had not improved her delusions. Dr. Mian stated
that M.S. was “still very delusional” and “still ha[d] poor insight” into her
condition in that she did not believe she has schizophrenia. Id. at 7. He
explained that the two major fixed delusions held by M.S. involved her belief
that Evan Bayh was persecuting her and that she had invented things like a five
screen television and the microwave oven but that this intellectual property had
been stolen from her.
[8] Dr. Mian also testified that due to her mental illness, M.S. is unable to function
and meet her own needs. He agreed that M.S. suffers from a substantial
impairment of her judgment, reasoning, and behavior such that she is unable to
function independently and that she needs medication to treat her mental
illness. Dr. Mian concluded that M.S. was gravely disabled due to her chronic
mental illness.
[9] Dr. Mian further testified that a temporary commitment of M.S. was necessary
in order to convince her to take her antipsychotic medications and make her
accountable for doing so. In addition, the medical staff would be able to assist
her with social services in order to find housing and manage her money. Dr.
Mian testified that his treatment plan for M.S. included the injectable form of
Haldol because it remained in a patient’s system for a month and alleviated the
necessity of the patient remembering to take their medication as well as
avoiding the issue of patients refusing to take the medication. Dr. Mian
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anticipated a one-week in-patient stay to administer the injection, monitor any
effects, and allow social services to arrange for housing and other needs. He
also stated that notes from a prior commitment of M.S. indicated she was given
the injection of Haldol, and her mental status improved such that she could
continue merely with out-patient care. Dr. Mian testified that with the
temporary commitment and medication, M.S.’s prognosis would be “fair to
good,” but without treatment, her prognosis would be “poor.” Id. at 13.
[10] Next, R.S., one of M.S.’s brothers, testified. R.S. stated that M.S. calls him and
their other brother, W.S., asking for money. Previously, they had given her
money and paid for her car to be repaired, but recently the brothers had told
M.S. that they would not give her any more money until she went back to the
doctor and got back on her medication. However, when they told her that, she
threatened them, stating she was going to kill them, shoot them, burn down
W.S.’s house, and beat W.S. with a baseball bat.
[11] R.S. also testified that M.S. had been living in her car for approximately two
years after she was evicted from her apartment because she would not allow her
apartment to be treated for bedbugs. M.S. thought they were going to try to kill
her and she referred to the situation as “the Holocaust.” Id. at 17. R.S.
described the condition of M.S.’s car as “completely full . . . of all of her
belongings, food, garbage” with the bumper dragging on the ground. Id. at 18.
He testified that there were “bags of poop” in the trunk and that the car repair
shop believed the car to be beyond repair and refused to take it inside their
building to verify this because of the smell. Id.
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[12] Additionally, R.S. testified that M.S. had told him that she carried Evan Bayh’s
children for the first six months before they were extracted from her body and
placed into the body of Susan Bayh for delivery. Yet, R.S. testified that when
M.S. is on her medication, she “has almost a normal life.” Id. In the past,
social services assisted her in securing an apartment, R.S. and W.S. helped with
furnishings, and M.S. was able to afford the rent and utilities. In addition, R.S.
testified that he bought the car for M.S. and that she was previously able to
maintain it. However, R.S. stated that M.S. has a history of noncompliance
with her medication and that he believed she would not take her medication
without a court order.
[13] W.S., M.S.’s other brother, also testified. He described M.S. as “a completely
different person,” “a real sweet person, lovable person” that everyone loves
being around when she is on her medication. Id. at 21. He also testified about
another eviction in which M.S. “was screaming and hollering at the other
tenants.” Id. W.S. agreed with his brother’s assessment that M.S. would not
take her medication without a court order.
[14] Finally, M.S. testified on her own behalf at the commitment hearing. She
began by describing her plan to get on the waiting list for an apartment where
the rent is based on a sliding scale. In the meantime, she stated she was hoping
to be allowed to stay at a shelter where she had previously stayed after she was
evicted. Counsel then asked M.S. if she is able to take care of herself. M.S.
responded:
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Most definitely I am. I have so many things to address. These
are the clothes that have not been washed. And I have a red
sweater, it is too hot to put on. But I had it on that day. And
there is no feces in my car. And if there is a smell it is
manufactured by Evan Bayh’s Satanism. I have known him
since I was thirteen years old. I met him through my classmate
at Chartrand High School, which turned into Roncalli just that
following year. Danny Dryer, a mutual friend, is how I met
Evan Bayh. And I have known Shelly Season – Shelly Jackson
through Susan Bayh since she was in college at Ball State.
Friends with her parents, Frank and Sharon Jackson, who lived
on East Southport Road. She was not from California as that big
spread said when he was governor. And we [rode] to some
church functions together and she showed me her first apartment.
There – regarding that bag, in August, there was an only [sic]
feces in a bag in my trunk. I had been at Eagle Creek Park and I
had to go to the bathroom and I – it was near – it was nearing
closing time and I had to get out. And I did not have time to
drive to the – the park restroom, get out and go in, come back
and drive out. So I did go in a bag, put it in my trunk and forgot
to dispose. That is the only reason why that was still in there and
I did get out on time from the park. And I frequent Eagle Creek
Park. I usually buy a yearly pass. And I eat healthy and I try to
exercise. And my car is cluttered. Of course, I have food in my
car. Now it would be garbage because I have not for over a week
been in my car to discard. There was no – I keep extra cups
because I go to the Valero station and wash daily. And I have
this scrub, but it is gone so I do not – I cannot think – scrubber in
my car and soap. And I would fix morning coffee. They have a
microwave. I would microwave water and I buy my own coffee
and then would make it – my own coffee.
Id. at 24-25.
[15] M.S. denied needing a court order to take her medication, and, when asked if
there was anything else she wanted the court to know, she stated:
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Yes. Evan Bayh steals money from me and steals gas from me.
At the end of the month, frequently I do have to ask for money.
You will have to ask him why. I think it is just because he is
suffering because Evan and [ ] Susan both have stolen my
intellectual property and for decades and gotten wealthy. I
believe it used to be on file at my grade school, St. Mark’s
Catholic elementary school, all that I did, writing, movies, plays,
musicals, music. And I continued it in high school at Roncalli
and in college at IU and then at IUPUI, when I went back to
IUPUI in the 80’s until mid-90’s. And I was registered – I was
registered in January, begin January 13 and three courses that
IUPUI could complete my degree in sociology. Having me
detained has caused me that I have to drop out yet pay over
$3000 for these courses. And of course, being on Social Security,
that causes a problem for me. Plus, court fees that I still owe
from the apartment issue. I had excellent relationships with
people in that apartment. I was not yelling at them at all. I
yelled at no one in that apartment.
Id. at 25.
[16] On cross examination, M.S. acknowledged that she does not believe she has a
mental illness. When asked about her testimony that Evan Bayh had created
the odor in her car, she stated that she had “witnessed his Satanism,” that he
“can manufacture smells,” and that he “manufactures bugs – cockroaches and
bedbugs.” Id. at 26-27. In addition, she testified that five years ago Evan Bayh
told her he was a Satanist.
[17] At the conclusion of the hearing, the trial court granted the Hospital’s request
for a temporary involuntary commitment of M.S., finding that she suffers from
schizophrenia and is gravely disabled. The trial court ordered that M.S. should
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be temporarily committed for a period not to exceed ninety days. M.S. now
1
appeals.
Discussion and Decision
[18] M.S. contends the evidence was not sufficient to support the trial court’s order
of temporary involuntary commitment. Civil commitment proceedings have a
dual purpose: to protect the public and to ensure the rights of the person whose
liberty is at stake. Civil Commitment of T.K. v. Dep’t of Veterans Affairs, 27 N.E.3d
271, 273 (Ind. 2015). When reviewing a challenge to the sufficiency of the
evidence to support a civil commitment, we will affirm if, considering only the
probative evidence and the reasonable inferences supporting it, a reasonable
trier of fact could find that the necessary elements were proven by clear and
convincing evidence. Id. We will not weigh the evidence or assess witness
credibility. Id.
[19] The Hospital was required to prove by clear and convincing evidence that (1)
M.S. is mentally ill and either dangerous or gravely disabled and (2) that
commitment of M.S. is appropriate. See Ind. Code § 12-26-2-5(e) (2007). Clear
and convincing evidence requires proof that the existence of a fact is highly
1
M.S.’s ninety-day temporary commitment has expired, and therefore, the issue is moot. However, the issue
is one of great public importance that is likely to recur. Accordingly, we will address the issue on its merits.
See M.Z. v. Clarian Health Partners, 829 N.E.2d 634, 637 (Ind. Ct. App. 2005), trans. denied.
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probable. Matter of Commitment of C.N., 116 N.E.3d 544, 547 (Ind. Ct. App.
2019).
[20] M.S. does not challenge the trial court’s finding that she is mentally ill but
argues that the Hospital failed to prove by clear and convincing evidence that
she is gravely disabled. “Gravely disabled” means a condition in which an
individual, as a result of mental illness, is in danger of coming to harm because
the individual:
(1) is unable to provide for that individual’s food, clothing,
shelter, or other essential human needs; or
(2) has a substantial impairment or an obvious deterioration of
that individual’s judgment, reasoning, or behavior that results in
the individual’s inability to function independently.
Ind. Code § 12-7-2-96 (1992). The trial court found that M.S. is gravely
disabled, but it did not specify whether that finding was based on her inability
to provide for her basic needs or her inability to function independently. As this
Court has noted, because this statute is written in the disjunctive, a trial court’s
finding of grave disability survives if we find that there was sufficient evidence
to prove either that the individual is unable to provide for her basic needs or
that her judgment, reasoning, or behavior is so impaired or deteriorated that it
results in her inability to function independently. See Civ. Commitment of W.S. v.
Eskenazi Health, Midtown Cmty. Mental Health, 23 N.E.3d 29, 34 (Ind. Ct. App.
2014), trans. denied (2015). Nevertheless, we discuss both factors here in order
to address all of M.S.’s concerns.
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[21] First, M.S. asserts that the Hospital has not shown by clear and convincing
evidence that she was in danger of coming to harm from living in her vehicle.
Additionally, she points to her monthly disability benefits and her stated plans
to rent an apartment and/or stay in a shelter and claims there is no evidence to
suggest she would not be able to live in an apartment.
[22] At the commitment hearing, the evidence showed that M.S. had been living in
her car for two years and that it was full of her belongings, food, and garbage.
At the time M.S. was taken to the hospital in January, she had been running the
car for heat, had run out of gas, and had asked her brothers for gas money.
M.S.’s brother, R.S., testified that the car’s bumper was dragging on the ground
and the car was believed to be beyond repair but the car repair shop was unable
to verify this due to the odor.
[23] Dr. Mian testified that, due to her mental illness, M.S. is unable to meet her
own needs and that she had been “[l]iving in her car in the cold with no
resources and really poor hygiene.” Tr. Vol. II, p. 7. He diagnosed M.S. with
schizophrenia and stated that M.S. does not believe she is ill. Dr. Mian testified
that, due to this belief, M.S. was taking medication in the hospital merely to
appease the hospital staff but had no intention of continuing any medication
once she was released.
[24] Although M.S. received approximately $1200 of Social Security benefits each
month, she routinely ran out of money and asked for money from her brothers.
In addition, although M.S. testified that she planned to get an apartment
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and/or stay in a shelter, she apparently had not done so in the past two years.
Moreover, the evidence revealed that M.S. had previously had difficulty
maintaining housing when she obtained it. As a result of her refusal to treat her
mental illness with the proper medication, M.S. had been evicted from two
different apartments. In one case she refused to let her apartment be treated for
bedbugs because she thought someone was trying to kill her and in another case
she was screaming at the other tenants. As a result, she was living in a parking
lot in an inoperative car, which at times did not have heat. In contrast to M.S.’s
current living arrangement, her brothers testified that when M.S. was on
medication, she was able to live in an apartment, pay her living expenses, and
maintain her car.
[25] M.S. next claims that the Hospital has not shown she is in danger of coming to
harm due to her inability to function independently, even given a substantial
impairment of judgment or reasoning.
[26] The evidence most favorable to the trial court’s determination indicates that she
suffers from “schizophrenia continuous,” a chronic mental illness and has been
the subject of at least two prior commitments. Tr. Vol. II, p. 8. Dr. Mian
testified that the oral medication M.S. was reluctantly taking while hospitalized
improved her thought processes in that she was more logical and coherent.
Although the oral medication provided little improvement with M.S.’s
“grandiose delusions,” the records from her most recent commitment showed
that the injectable form of the medication improved her mental status such that
she was appropriate for out-patient follow up. Id. Dr. Mian further testified
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that M.S.’s “judgment is completely misguided or impaired primarily by her
delusions” because she “believes these delusions so much that they actually
influence her life” and have caused her to be evicted from an apartment. Id. at
15. Dr. Mian also stated that M.S. continues to lack insight into her mental
illness. Indeed, M.S. testified that she does not believe she suffers from a
mental illness, denied refusing medication, and blamed the smell in her car and
her lack of funds on Evan Bayh.
[27] In summary, M.S. is not able to manage her money, does not have and has not
been able to maintain stable shelter, has not been able to maintain suitable
hygiene, and is guided by her severe delusions which substantially impair her
judgment and reasoning. Under these circumstances, we conclude the Hospital
presented clear and convincing evidence that, as a result of her mental illness,
M.S. is gravely disabled because she is in danger of coming to harm due to her
inability to provide for her shelter and other basic needs and/or due to her
inability to function independently as a result of the substantial impairment of
her judgment, reasoning, and behavior. M.S.’s assertion to the contrary is
merely an invitation for us to reweigh the evidence, which we cannot do. See
Civil Commitment of T.K., 27 N.E.3d at 273. The evidence was sufficient to
support the trial court’s order of temporary involuntary commitment.
Conclusion
[28] Based on the foregoing, we conclude the Hospital presented sufficient evidence
to support the trial court’s order of temporary involuntary commitment.
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[29] Affirmed.
Pyle, J., and Weissmann, J., concur.
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