In the Matter of D.M., Alleged to Be Seriously Mentally Impaired ( 2019 )

IN THE COURT OF APPEALS OF IOWA
No. 18-1498
Filed May 15, 2019
IN THE MATTER OF D.M.
Alleged to Be Seriously Mentally Impaired,
D.M.,
Respondent-Appellant.
________________________________________________________________
Appeal from the Iowa District Court for Des Moines County, Mark E.
Kruse, Judge.
D.M. appeals the court’s ruling of serious mental impairment. AFFIRMED.
Curtis Dial of Law Office of Curtis Dial, Keokuk, for appellant.
Thomas J. Miller, Attorney General, and Gretchen Kraemer, Assistant
Attorney General, for appellee State.
Considered by Potterfield, P.J., and Doyle and Tabor, JJ.
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POTTERFIELD, Presiding Judge.
D.M. challenges the trial court’s finding of serious mental impairment,
claiming there is insufficient evidence that he poses a risk to his own or others’
safety. In light of D.M.’s recent suicidal ideations, refusal to follow-through with
mental-health treatment, a telephoned threat to a former employer, and the
recent purchase of AR15 rifle, we find clear and convincing evidence to support
the court’s finding that D.M. poses a risk to himself or others. We therefore
affirm.
On August 8, 2018, D.M.’s septuagenarian parents sought assistance
from law enforcement because D.M. was suicidal and had purchased a weapon.
D.M. was hospitalized and evaluated.
The evaluating psychiatrist, Dr. Amanda Winter, submitted an initial report
on August 13 in which she stated: (1) D.M. was experiencing a major depressive
disorder, alcohol abuse, and had antisocial and narcissistic personality traits that
contributed to the risk of impulsive acts of harm to himself or others; (2) D.M. was
not capable of making responsible decisions with respect to treatment; and
(3) based on D.M.’s self-reporting, he was not then likely to harm himself or
others. However, on April 14—the day of the involuntary commitment hearing—
Dr. Winter submitted an amended report. Dr. Winter reported the need for more
time to gather information and evaluate D.M.’s likelihood of harming himself or
others, stating, “[B]ased on new information that continues coming to light, it is
more and more likely that he is not being truthful about his intents and
motivations.”
3
At the hearing on the allegations of serious mental impairment, Dr. Winter
testified she spoke to several sources1 who indicated D.M. had “significant
suicidal ideation with a plan to use the gun to kill himself.” D.M. had been
engaged in psychiatric care with Dr. Sanchez and had agreed he would not
purchase firearms but had then purchased an AR15.2 Dr. Winter testified that
upon learning of the purchase, Dr. Sanchez did not feel comfortable having D.M.
as a patient. Dr. Winter further testified that “[d]ue to the severity of [D.M.’s]
depression, along with the alcohol abuse and the effects of his wife’s death,” she
believed that if left untreated, D.M. would be a danger to himself or others. She
stressed D.M’s “behavior is quite impulsive,” and those with “poor impulse control
are always left at increased risk for harming themselves or others due to
unforeseeable circumstances and unpredictable stressors that come up.”
Lieutenant Brett Grimshaw testified concerning a report received just
before D.M.’s hospitalization from D.M.’s former employer that D.M. had called
and made threats. D.M.’s telephone call prompted the employer to have an
armed deputy on the property and to request law enforcement provide security.
Lieutenant Grimshaw testified law enforcement provided the employer active-
shooter training that day as a result of D.M.’s call because “[t]hey demanded it”
because many employees “didn’t want to come to work.”
D.M.’s sister testified that though D.M. was “saddened” by his wife’s
recent death, he was not a danger to anyone. However, she testified she was
1
Dr. Winter had communicated with D.M.’s therapist, Dr. Sanchez; Dr. Labio, who had
evaluated D.M. at the time of admission; and with Officer Kevin Glendening about the
weapon D.M. had purchased.
2
D.M. told Dr. Winter the weapon was a target model. However, Glendening informed
Dr. Winter it was a “full-use AR15 tactical weapon.”
4
not aware D.M. had recently purchased a firearm, that their mother had reported
her concern for officers’ safety should they go to D.M.’s house, or that D.M. was
discharged from treatment with Dr. Sanchez.
The court found clear and convincing evidence supported a finding that
D.M. was seriously mentally impaired under Iowa Code chapter 229 (2018). The
court noted Dr. Winters testified she believed D.M. was a danger to himself or
others—though she “then indicate[d] she doesn’t have sufficient statements
before her or sufficient outside information” to determine whether D.M. was being
truthful when he told her “I’m not a danger to myself or I’m not going to do
anything.” Still, the court concluded:
In this particular case, that outside information tips the balance
because it’s very clear that that information, if true, and I think it is
true, that you made threats, put an entire business on alert of you
coming after them, possibly with a gunman, so for that reason I
believe that each of the elements was shown in this case by clear
and convincing evidence.
D.M. appeals, contending there is not clear and convincing evidence that
he poses a risk of danger to himself or others.
We review rulings of involuntary commitment for serious mental illness
under Iowa Code chapter 229 for corrections of errors at law. In re B.B., 826
N.W.2d 425, 428 (Iowa 2013). The district court’s findings of fact are binding if
they are supported by substantial evidence. In re J.P., 574 N.W.2d 340, 342
(Iowa 1998). “Evidence is substantial if a reasonable trier of fact could conclude
the findings were established by clear and convincing evidence.” In re B.T.G.,
784 N.W.2d 792, 796 (Iowa Ct. App. 2010).
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The statutory definition of serious mental impairment includes three
elements. The person must: (1) have a mental illness; (2) as a result of the
mental illness, lack “sufficient judgment to make responsible decisions with
respect to the person’s hospitalization or treatment”; and (3) be likely, if allowed
to remain at liberty, to either inflict physical or serious emotional injury to
themselves or another, or be unable to satisfy their own basic physical needs.
Iowa Code § 229.1(20); see also J.P., 574 N.W.2d at 343. Courts generally call
the last element “dangerousness,” as it requires a showing of danger posed to
the person or others. See, e.g., B.A.A. v. Chief Med. Officer, 421 N.W.2d 118,
123 (Iowa 1988) (examining dangerousness as prerequisite to involuntary
commitment). On appeal, D.M. does not dispute the court’s finding of mental
illness or lack of judgment. He challenges only the sufficiency of the State’s
proof of dangerousness.
Dangerousness can manifest in three ways: (1) a likelihood to physically
injury one’s self or others; (2) a likelihood of inflicting serious emotional injury on
others; or (3) an inability to satisfy one’s own needs for nourishment, clothing,
essential medical care, or shelter, making physical injury, debilitation, or death
likely. Iowa Code § 229.1(20)(a)–(c).
A finding of dangerousness under any of the alternatives requires proof of
a recent overt act, attempt, or threat. In re L.H., 890 N.W.2d 333, 341 (Iowa Ct.
App. 2016). “An ‘overt act’ is ‘past aggressive behavior or threats by the
respondent manifesting the probable commission of a dangerous act upon
himself or others that is likely to result in physical injury.’” Id. (quoting In re
Foster, 426 N.W.2d 374, 378 (Iowa 1988)).
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There is substantial evidence supporting the court’s finding of
dangerousness. D.M.’s family called law enforcement due to his acquisition of
an AR15 and suicidal threats. D.M.’s therapist terminated their therapeutic
relationship because she had asked him not to purchase a weapon and he
disregarded this request. D.M. threatened a former employer who took the
threats seriously and insisted on active-shooter-response training from law
enforcement and that security measures be taken. We therefore affirm.
AFFIRMED.