In the Matter of G.G., Alleged to Be Seriously Mentally Impaired, G.G. ( 2017 )

IN THE COURT OF APPEALS OF IOWA
No. 16-0932
Filed January 11, 2017
IN THE MATTER OF G.G.,
Alleged to Be Seriously Mentally Impaired,
G.G.,
Respondent-Appellant.
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Appeal from the Iowa District Court for Johnson County, Magistrate
Edward J. Leff.
G.G. appeals the magistrate’s determination that he was seriously
mentally impaired. AFFIRMED.
Willie E. Townsend, Coralville, for appellant.
Thomas J. Miller, Attorney General, and Gretchen W. Kraemer, Assistant
Attorney General, for appellee State.
Considered by Vogel, P.J., and Vaitheswaran and McDonald, JJ.
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VOGEL, Presiding Judge.
G.G. is a sixty-six-year-old veteran who was diagnosed with bipolar
disorder and was treated with medication, which stabilized his manic episodes for
approximately twenty years. In 2016, G.G.’s physician told him to “taper off” the
medication. G.G. followed this instruction, but the result was a manic episode.
G.G.’s wife took him to a Veterans Administration hospital. On the way, G.G. got
out of the vehicle when the car stopped. His wife was able to get him back in the
vehicle and to the emergency room, where he was admitted.
A magistrate entered an emergency hospitalization order after finding
probable cause to believe G.G. was seriously mentally impaired and was likely to
injure himself or others if not immediately detained. Following a hearing, the
magistrate determined G.G. was seriously mentally impaired and civilly
committed him to the hospital on an inpatient basis. Four days later, the
magistrate terminated the commitment. G.G. filed an appeal with the district
court. After the matter was set for hearing, the State filed a motion to dismiss.
G.G. resisted, but the court dismissed the appeal on the ground that it was moot.
This appeal followed.
We first address G.G.’s assertion the district court was wrong in
dismissing his appeal as moot. Because the commitment order was terminated,
his appeal to the district court and now his appeal to this court are both, in
essence, moot, but the collateral-consequences exception to the mootness
doctrine permits review of the merits. See In re B.B., 826 N.W.2d 425, 429 (Iowa
2013) (noting the “stigma of mental illness” and concluding “a party who has
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been adjudicated seriously mentally impaired and involuntarily committed is
presumed to suffer collateral consequences justifying appellate review”).
We turn to the merits of the magistrate’s commitment order. The
magistrate’s findings “are binding on us if supported by substantial evidence.” In
re J.P., 574 N.W.2d 340, 342 (Iowa 1998).
A person is “seriously mentally impaired” if the person has:
mental illness and because of that illness lacks sufficient judgment
to make responsible decisions with respect to the person’s
hospitalization or treatment, and who because of that illness meets
any of the following criteria:
(a) Is likely to physically injure the person’s self or others if
allowed to remain at liberty without treatment;
(b) Is likely to inflict serious emotional injury on members of
the person’s family or others who lack reasonable opportunity to
avoid contact with the person with mental illness if the person with
mental illness is allowed to remain at liberty without treatment;
(c) Is unable to satisfy the person’s needs for nourishment,
clothing, essential medical care, or shelter so that it is likely that the
person will suffer physical injury, physical debilitation, or death.
Iowa Code § 229.1(20) (2016). The definition contains three elements: (1)
mental illness, (2) lack of sufficient judgment, and (3) the criteria labeled (a), (b),
and (c), which encompass the threshold requirement of dangerousness. In re
Oseing, 296 N.W.2d 797, 800-01 (Iowa 1980) (analyzing predecessor statute).
G.G. challenges the sufficiency of the evidence on the second and third
elements. The magistrate found G.G. lacked judgmental capacity in that he was,
“Impaired; currently in manic state and unable to make sound treatment
decisions.” The record supports this finding as G.G. was not medically compliant
until after arriving at the V.A. hospital and refused medication until he was
confronted by security officers. He then accepted his needed medication.
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The third element, or the “dangerous” prong requires evidence of a “recent
overt act, attempt or threat.” In re Mohr, 383 N.W.2d 539, 542 (Iowa 1986). An
overt act “connotes 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.” In re Foster, 426 N.W.2d 374, 378 (Iowa
1988). The magistrate found this element satisfied based on G.G.’s “current[]
manic state.” The magistrate also cited G.G.’s “[a]ttempt[] to run away while in
[a] vehicle on [the] way to [the] hospital” and the “[p]olice presence necessary to
get him to take medications upon admission.” Substantial evidence supports this
finding and satisfies the requirement of a recent overt act.
We affirm the civil commitment order.
AFFIRMED.
McDonald, J., concurs; Vaitheswaran, J., dissents.
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VAITHESWARAN, Judge. (dissenting)
I respectfully dissent.
Mental illness alone does not establish grounds for commitment. In re
J.P., 574 N.W.2d at 343. It follows that mental illness alone cannot serve as the
predicate to a finding of lack of judgment or dangerousness. The “manic
episode” cited in the commitment order was simply a symptom of G.G.’s mental
illness. As for G.G.’s compliance with his medication regimen, he testified he
was “[a]bsolutely” taking his medications and his psychiatrist confirmed he had
been taking his medications as prescribed. As the majority notes, G.G. only
“tapered off” his medication pursuant to his doctor’s orders.
Nor, in my view, does G.G.’s decision to exit the vehicle on his way to the
hospital show dangerousness. As noted, the vehicle was stopped and G.G.’s
wife was able to get him to the emergency room despite this momentary
disruption. Although a psychiatrist testified G.G. was agitated on his arrival, the
only “aggressive” acts she could point to were his failure to follow directions
when he first came in and a police presence to “contain him in his room” because
he was “pacing around the unit.” The psychiatrist acknowledged the officers “did
not physically restrain him.” She also acknowledged she “ha[d not] seen
anything . . . that would make [her] think he’d be a risk to others.” In my view,
this evidence does not constitute substantial evidence to support a finding of
dangerousness.
I would reverse the civil commitment order. This disposition would
essentially resolve G.G.’s additional contention that the magistrate should have
released him to the custody of his wife.