In the Interest of: W.A. ( 2015 )

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NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37
IN THE INTEREST OF: W.A. IN THE SUPERIOR COURT OF
PENNSYLVANIA
APPEAL OF: W.A.
No. 56 MDA 2015
Appeal from the Order entered December 24, 2014,
in the Court of Common Pleas of Centre County,
Civil Division, at No(s): 2006-660
BEFORE: BENDER, P.J.E., ALLEN, and WECHT, JJ.
MEMORANDUM BY ALLEN, J.: FILED JUNE 01, 2015
W.A. (“Appellant”) appeals from the trial court’s order denying his
petition for review of certification for involuntary inpatient mental health
treatment. We affirm.
Relative to this appeal, the trial court set forth the following
background:
Appellant is currently serving a sentence of five to twenty-
three years’ imprisonment at SCI Rockview in connection with a
guilty plea to arson, simple assault and terroristic threats. On
November 13, 2014, Appellant was committed for a psychiatric
evaluation under Section 302 of the Mental Health Procedures
Act, [(“MHPA”),] and was examined on the same date by Carol
Eidsvoog, M.D. It was noted that he was very dehydrated
requiring medical intervention and had only slept about four
hours in the previous six days. He was shouting and was
focused on various delusions. His hygiene was poor and he was
urinating throughout his living quarters.
On November 14, 2014, an Application for Extended
Involuntary Treatment under Section 303 of the MHPA was filed.
Dr. Eidsvoog noted her findings that Appellant had a history of
Bipolar Disorder with Mania and was non-compliant with
medications. He was manic at the time of her examination and
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exhibited pressured, nonsensical speech, and made incoherent
statements. He was throwing feces and urine and had visibly
lost weight.
On December 4, 2014, SCI Rockview filed a petition
pursuant to Section 304 of the MHPA seeking to extend
Appellant’s period of involuntary treatment for an additional
ninety days. At the time the petition was filed, Appellant was
still receiving treatment pursuant to the Section 303
commitment ordered on November 20, 2014. On December 5,
2014, a hearing was held on the Section 304 extension before
Sonja F. Napier, Mental Health Review Officer. Following the
hearing, on December 5, 2014, Hearing Officer Napier filed a
report recommending that the involuntary commitment of
Appellant continue. [On December 11, 2014, Appellant filed a
writ of habeas corpus seeking release from involuntary
psychiatric treatment, and arguing that his Section 303
commitment had expired and that the trial court had not abided
by the Section 304’s requirement to issue a commitment
decision by December 7, 2014.] On December 11, 201[4], this
Court entered an Order directing that Appellant be involuntarily
committed at SCI Rockview for up to ninety days. [On
December 16, 2014, the trial court issued an order denying
Appellant’s writ of habeas corpus.] Appellant filed a Petition for
Review of Certification on December 22, 201[4], which this Court
denied on December 24, 2014. On January 2, 2015, Appellant
filed this appeal.
Trial Court Opinion, 2/12/15, at 1-2. Appellant and the trial court have
complied with Pa.R.A.P. 1925.
Appellant seeks our review of the following issue:
I. Whether the lower court was required to discharge
petitioner following its failure to abide by its statutory
requirement to render a decision within 48 hours of the
close of the evidence?
Appellant’s Brief at 5.
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We recognize that Appellant’s issue is a question of law regarding
which our standard of review is de novo and our scope of review is plenary.
See In re Interest of W.A., 91 A.3d 702, 704 (Pa. Super. 2014).
In rebutting Appellant’s claim of error, the trial court explained:
In this case, the commitment extension hearing concluded
on Friday, December 5, 2014. The decision was due on
Sunday[, December 7, 2014,] but was not filed until the
following Thursday, December 11, 2014. Thus, more than forty-
eight hours elapsed between the close of evidence and entry of
the decision. However, the Court believes this error was the
kind of minor breach that the Superior Court has held does not
invalidate an involuntary commitment order.
The Superior Court has distinguished between provisions
of the Act that directly affect due process and those that do not,
recognizing that the Act “attempts to strike a balance between
the state’s valid interest in imposing and providing mental health
treatment and the individual patient’s rights.” [Commonwealth
v.] Helms, [506 A.2d 1384,] 1389 [(Pa. Super. 1986)]; In re
S.L.W., 698 A.2d 90 (Pa. Super. 1997). []
***
In this case, the [four] day delay in filing the decision did
not deprive Appellant of the protection of the Act’s due process
rights or liberty interests. Furthermore, to find otherwise would
have deprived him of necessary mental health treatment. He
was afforded notice and a meaningful opportunity to be heard as
well as appointed counsel who was present at the hearing and
cross-examined Dr. Eidsvoog. The late filing of the decision did
not prejudice his rights, and to invalidate the order on that basis
would contravene the Act’s purpose of securing help for those
who need mental health treatment.
Trial Court Opinion, 2/12/15, at 5-7. Based on our review of the record and
applicable jurisprudence, we agree with the trial court.
Initially, we note that the MHPA, 50 P.S. § 7101 et seq, provides:
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§ 7304. Court-ordered involuntary treatment not to
exceed ninety days
(a) Persons for Whom Application May be Made.--(1) A
person who is severely mentally disabled and in need of
treatment, … may be made subject to court-ordered involuntary
treatment upon a determination of clear and present danger
under section 301(b)(1) (serious bodily harm to others), or
section 301(b)(2)(i) (inability to care for himself, creating a
danger of death or serious harm to himself), or 301(b)(2)(ii)
(attempted suicide), or 301(b)(2)(iii) (self-mutilation).
(2) Where a petition is filed for a person already subject to
involuntary treatment, it shall be sufficient to represent, and
upon hearing to reestablish, that the conduct originally required
by section 301 in fact occurred, and that his condition continues
to evidence a clear and present danger to himself or others. In
such event, it shall not be necessary to show the reoccurrence of
dangerous conduct, either harmful or debilitating, within the past
30 days.
(b) Procedures for Initiating Court-ordered Involuntary
Treatment for Persons Already Subject to Involuntary
Treatment.--(1) Petition for court-ordered involuntary
treatment for persons already subject to treatment under
sections 303, 304 and 305 may be made by the county
administrator or the director of the facility to the court of
common pleas.
***
(5) Treatment shall be permitted to be maintained pending the
determination of the petition.
(e) Hearings of Petition for Court-order Involuntary
Treatment.—A hearing on a petition for court-ordered
involuntary treatment shall be conducted according to the
following:
***
(7) A decision shall be rendered within 48 hours after the close
of evidence.
50 P.S. § 7304 (a)(2), (b)(5), and (e)(7) (internal footnotes omitted).
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In affirming a prior untimely Section 304 commitment order
concerning Appellant, we reasoned:
Because the hearing before Mental Health Review Officer
Napier concluded on September 25, 2013, which was a
Wednesday, a strict interpretation of subsection (e) required the
decision by the trial court to be filed by September 27, a Friday.
Although the order was not filed timely, because of the
intervening weekend, it was filed on Monday, September 30, the
next business day.
[Appellant] contends that this technical violation requires
that the commitment order be reversed and that he be
discharged. This Court has categorically rejected a mechanical
interpretation of the MHPA. See In re S.L.W., 698 A.2d 90 (Pa.
Super. 1997).
In In re S.L.W., a consolidated appeal, the panel
considered a pair of challenges arguing that technical violations
involving, among other things, delays in adhering to the
timeframe of the MHPA, required vacating of the commitment
orders. The panel rejected the arguments that advocated a
mechanical application of the MHPA's statutory provisions. The
panel explained that
[o]ne of the goals of the Mental Health Procedures Act is to
protect the due process interests of the patient who loses
his or her liberty by being committed to an institution.
Protection of those interests requires fundamental fairness
to the patient and respect for the patient's dignity and
individuality. Achieving this standard requires common
sense application of statutory provisions, not mechanical
application. A distinction must be made between those
standards that directly affect the due process and liberty
interests of the patient and those that do not.
Id., at 94. Moreover, the panel further instructed that “[i]n
applying the [MHPA] we must take a balanced approach and
remain mindful of the patient’s due process and liberty interests,
while at the same time permitting the mental health system to
provide proper treatment to those involuntarily committed to its
care.” Id. (footnote omitted).
***
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Here, [Appellant] has not identified how his due process
rights or liberty interests were violated other than the late filing
of the order by the trial court. Furthermore, we note that, at the
time the Section 304 commitment order was entered, albeit after
a one-weekend delay, [Appellant] was still receiving treatment
pursuant to the Section 303, 20–day commitment order entered
on September 12, 2013. [Appellant] suffers from bipolar
disorder and mania and, as a result, poses a clear and present
danger to himself and others. Thus, [Appellant] remains a
severely mentally disabled individual in need of continued
involuntary inpatient treatment. The lack of treatment could
lead to serious physical debilitation or death.
The involuntary civil commitment of mentally ill persons
constitutes a deprivation of liberty interests, and to justify this
deprivation the procedures must satisfy due process protections.
See 50 P.S. § 7102 (“The provisions of this act shall be
interpreted in conformity with the principles of due process to
make voluntary and involuntary treatment available where the
need is great and its absence could result in serious harm to the
mentally ill person or to others.”). See also In re R.D., 739 A.2d
548, 554 (Pa. Super. 1999). However,
[d]ue process, unlike some legal rules, is not a technical
conception with a fixed content unrelated to time, place
and circumstances. [D]ue process is flexible and calls for
such procedural protections as the particular situation
demands.
Id. (quoting Mathews v. Eldridge, 424 U.S. 319, 334, 96 S. Ct.
893, 47 L. Ed. 2d 18 (1976)). []
[W]e refuse to vacate [Appellant’s] Section 304
commitment on the technical grounds he asserts as it is evident
that [Appellant’s] due process and liberty interests were not
affected by the short delay and his continued needed
commitment.
In re Interest of W.A., 91 A.3d at 704-705 (internal footnote omitted).
Instantly, as in his prior appeal, the record indicates that Appellant
“remains a severely mentally disabled individual in need of continued
involuntary inpatient treatment [and] [t]he lack of treatment could lead to
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serious physical debilitation or death.” Id. at 705. Indeed, during
Appellant’s Section 304 hearing on December 5, 2014, Dr. Eidsvoog testified
that Appellant is “impulsive, intrusive, [and] noncompliant … [and] tends to
be loud, argumentative and could easily get into fights and be assaulted or
assault others.” N.T., 12/5/14, at 7-8. Dr. Eidsvoog opined that Appellant
could not “provide for his own basic needs, including health, safety, welfare
and nutrition, without the care and assistance of others[.]” Id. at 7. Dr.
Eidsvoog testified that since Appellant “came in he’s rarely showered … his
cell is filthy with spit, garbage, [and] body secretions all over the cell.” Id.
Dr. Eidsvoog stated that “without the [involuntary mental health] treatment
[she was] seeking [for Appellant,] there would be a reasonable probability of
death, disability or serious physical debilitation within 30 days[.]” Id. The
record reflects that Appellant was unable to “control himself” and to remain
quiet during the testimony “even though he’d been instructed previously by
[Dr. Eidsvoog] … to be quiet until he had his turn to talk[.]” Id. at 8.
Dr. Eidsvoog confirmed that Appellant had “previously been subject to
a [Section] 303 proceeding[.]” Id. at 9. Dr. Eidsvoog denied that Appellant
had “been compliant with treatment and/or medication” since his Section
303 commitment. Id. Dr. Eidsvoog testified that Appellant was
noncompliant with his mood stabilizing medications and that she had not
“been able to get labs drawn consistently because of his refusal.” Id. at 10.
Dr. Eidsvoog opined that Appellant was “not where his baseline is, because I
know him fairly well from previous admissions.” Id. at 11. She stated that
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Appellant could “definitely” … “recapture more function … with … additional
treatment” under a Section 304 commitment. Id.
Further, Dr. Eidsvoog testified that she was “seeking a [Section] 304
commitment to be able to keep [Appellant] here and make further
medication adjustments” that would help Appellant “recapture more
function.” Id. Dr. Eidsvoog explained “we just recently started [Appellant]
on Risperdal Consta, because he had adverse reactions to the Abilify. And …
I need to let the Abilify get out of his system and the Risperdal to start
working” in the “inpatient environment[.]” Id. Dr. Eidsvoog testified that
the inpatient environment is the “least restrictive environment for
[Appellant] to receive the necessary and appropriate treatment[.]” Id. Dr.
Eidsvoog additionally confirmed that Appellant would receive a “therapy
component to his treatment” during the requested Section 304 commitment.
Id. Dr. Eidsvoog explained “once [Appellant] clears enough so he can have
a give-and-take conversation [Appellant will] be offered psychoeducation,
social skills training, working on … communication skills, listening skills. []
But right now he is incoherent and rambling and … I doubt he hears
anything.” Id.
As noted above, in Appellant’s prior appeal, we affirmed the trial
court’s order regarding Appellant’s Section 304 commitment, which was filed
3 days after the 48 hour deadline. In doing so, we recognized that “due
process, unlike some legal rules, is not a technical conception with a fixed
content unrelated to time, place and circumstances.” In re Interest of
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W.A., supra, at 705 (internal citation omitted). Here, we consider that the
filing delay was similarly short, and the MHPA provides that “[t]reatment
shall be permitted to be maintained pending the determination of the
petition.” 50 P.S. § 7304 (b)(5). Moreover, we are mindful that Appellant
has a great need, as reflected by the record, for continued involuntary
psychiatric treatment, without which Appellant poses a risk of harm to
himself or others. See In re R.D., 739 A.2d 548, 555 (Pa. Super. 1999)
citing Mental Health Procedures Act, § 102 (“The legislature's purpose in
enacting the Mental Health Procedures Act was ‘to assure the availability of
adequate treatment to persons who are mentally ill’ and ‘to make voluntary
and involuntary treatment available where the need is great and its absence
could result in serious harm to the mentally ill person or to others.’”). This
Court explained:
We must be mindful that the fundamental purpose of any [due
process procedural] protections we apply is to minimize the risk
of erroneous decisions [and that] [t]o discern the demands of
due process, we must adjudge the necessity of the protection
sought in view of the nature and purpose of the underlying
deprivation and the potential consequences in the absence of
that protection.
R.D., supra, at 554, citing Addington v. Texas, 441 U.S. 418, 425-427
(1979). Accordingly, applying the rationale espoused in the foregoing
authorities, we affirm the trial court’s Section 304 commitment order. See
In re Interest of W.A., supra, at 705 (“We refuse to vacate [Appellant’s]
Section 304 commitment on the technical grounds he asserts as it is evident
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that [Appellant’s] due process and liberty interests were not affected by the
short delay and his continued needed commitment.”).
Order affirmed. Jurisdiction relinquished.
PJE Bender joins the Memorandum.
Judge Wecht files a Concurring Statement.
Judgment Entered.
Joseph D. Seletyn, Esq.
Prothonotary
Date: 6/1/2015
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