IN THE MATTER OF THE CIVIL COMMITMENT OF T.C.

RECORD IMPOUNDED

NOT FOR PUBLICATION WITHOUT THE

APPROVAL OF THE APPELLATE DIVISION

SUPERIOR COURT OF NEW JERSEY

APPELLATE DIVISION

DOCKET NO. A-0

IN THE MATTER OF THE CIVIL

COMMITMENT OF T.C.

June 2, 2015

Argued October 16, 2014 Decided

Before Judges Maven and Carroll.

On appeal from the Superior Court of New Jersey, Law Division, Ocean County, Docket No. 00181513.

Stanley Shur, Assistant Deputy Public Defender, argued the cause for appellant T.C. (Joseph E. Krakora, Public Defender, attorney; Mr. Shur, on the briefs).

Elizabeth C. D'Ancona, Assistant County Counsel, argued the cause for respondent State of New Jersey (James F. Ferguson, Atlantic County Counsel, attorney; Ms. D'Ancona, on the brief).

PER CURIAM

T.C. appeals from an order dated November 27, 2013, that continued his civil commitment for psychiatric treatment at Ancora Psychiatric Hospital (Ancora) and scheduled a review hearing for the following month. We affirm.

T.C. was voluntarily committed to Ancora on September 12, 2013. Prior to his hospitalization T.C. had been living in a group home. According to the report of S. Bagchi, M.D., T.C.'s treating psychiatrist, T.C. had been non-compliant with treatment, and was hospitalized due to "psychotic decompensation" and "aggression towards peers at the group home."

Dr. Bagchi examined T.C. on November 22, 2013, five days prior to the review hearing at issue in this appeal. According to the psychiatrist's report

[T.C.] remains very psychotic with paranoid and grandiose delusions. He has unrealistic plans of living in his own mansion, which does not exist. In view of very poor vision he needs a lot of support and supervision for his daily living activities.

Dr. Bagchi opined that T.C. was unable to take care of himself, explaining

[T.C.] suffers from major mental illness and remains very psychotic. His insight into his own mental health problems is very limited and judgment is impaired. He needs continued hospitalization and care in a structured inpatient setting.

The review hearing was conducted on November 27, 2013. Dr. Bagchi was the only witness. Consistent with his report, he testified that T.C.'s current diagnosis was schizophrenia chronic paranoid type. The psychiatrist explained, as he had in his report, that T.C. remained delusional. T.C. had a "fixed belief" that he had a "big home in north Jersey" and that he only wanted to "[g]o and live there in a place that does not exist." According to Dr. Bagchi

As a result, there is no realistic housing option at this time that [T.C.] is willing to entertain, so that is why we are still trying to work with him with different therapeutic modalities, to see if he will engage in some kind of a realistic release [].

When asked whether T.C. had any insight into his mental illness, Dr. Bagchi replied

No. In fact, for example, he has very poor vision. He can barely see. He firmly believes that that can be cured by an antidote that is there in his car.

He doesn't know where the car is but if he can locate the car and he's able to get the antidote, he'll be able to restore his vision.

Based on T.C.'s delusional symptoms, Dr. Bagchi concluded that he was dangerous to himself, a condition warranting continuing involuntary commitment.

On cross-examination, Dr. Bagchi indicated that T.C.'s mental illness had not improved since his hospitalization and that "[h]e continues to have the strong, sustained delusions all the time." However, the psychiatrist conceded he was unaware whether T.C. had ever refused to accept the shelter that was provided to him. He also acknowledged there was no basis to believe that T.C. refuses necessary nourishment or medical care.

The court determined that T.C. had a current mental illness and that he was a danger to himself if released to a less restrictive facility. The court continued T.C.'s commitment pending another review in thirty days, and entered a confirming order that is the subject of this appeal.

The court held another review hearing on January 17, 2014. Dr. Bagchi's updated examination, conducted three days earlier, found that T.C. was then calm, cooperative, and compliant with treatment. Consequently, he recommended that T.C. be discharged to a less restrictive setting. Following that recommendation, the court's January 17 order changed T.C.'s status to conditional extension pending placement (CEPP) in a group home.

In this appeal from the November 27, 2013 order continuing his commitment, T.C. presents the following arguments

POINT I.

THE TRIAL COURT FAILED TO APPLY THE REQUIRED LEGAL STANDARD IN ORDERING T.C.'S CONTINUED COMMITMENT.

A. The Absence Of An Agreed Upon Residence Does Not Support Continued Commitment

B. The Court Erred In Finding That T.C.'s Poor Vision Was A Basis For Continued Commitment

POINT II.

T.C.'S APPEAL IS NOT MOOT

We are unpersuaded by T.C.'s arguments. The Legislature has declared "[t]he State is responsible for providing care, treatment and rehabilitation services to mentally ill persons who are disabled and cannot provide basic care for themselves or who are dangerous to themselves, others or property . . . ." N.J.S.A. 30:4-27.1(a). The procedure for committing such individuals who are unwilling or unable to seek appropriate treatment is set forth in N.J.S.A. 30:4-27.1 to -27.23, Rule 4:74-7, and, in the case of minors, Rule 4:74-7A.

A "court may enter an order of temporary commitment to treatment authorizing the assignment of a person to . . . admission to or retention of custody by a facility pending final hearing if it finds probable cause . . . to believe that the person is in need of involuntary commitment to treatment." R. 4:74-7(c). A court may enter a final order involuntarily committing a person if the court finds "by clear and convincing evidence presented at the hearing that the patient is in need of continued involuntary commitment to treatment . . . ." R. 4:74-7(f)(1).

The phrase "in need of involuntary commitment to treatment" means

that an adult with mental illness, whose mental illness causes the person to be dangerous to self or dangerous to others or property and who is unwilling to accept appropriate treatment voluntarily after it has been offered, needs outpatient treatment or inpatient care at a short-term care, or psychiatric facility or special psychiatric hospital because other services are not appropriate or available to meet the person's mental health care needs.

[N.J.S.A. 30:4-27.2(m).]

A person is "dangerous to self" if

by reason of mental illness the person has threatened or attempted suicide or serious bodily harm, or has behaved in such a manner as to indicate that the person is unable to satisfy his need for nourishment, essential medical care or shelter, so that it is probable that substantial bodily injury, serious physical harm or death will result within the reasonably foreseeable future; however, no person shall be deemed to be unable to satisfy his need for nourishment, essential medical care or shelter if he is able to satisfy such needs with the supervision and assistance of others who are willing and available. This determination shall take into account a person's history, recent behavior and any recent act, threat or serious psychiatric deterioration.

[N.J.S.A. 30:4-27.2(h).]

The term "'[r]easonably foreseeable future' means a time frame that may be beyond the immediate or imminent, but not longer than a time frame as to which reasonably certain judgments about a person's likely behavior can be reached." N.J.S.A. 30:4-27.2(kk).

A person who has been involuntarily committed is entitled to periodic reviews of the commitment. R. 4:74-7(f)(2). If a patient is entitled to discharge from an inpatient facility but has no appropriate place to go, "the court shall enter an order conditionally extending the patient's hospitalization and scheduling a placement review hearing within [sixty] days thereafter." R. 4:74-7(h)(2).

In order to continue a civil commitment, a court must find by clear and convincing evidence that the danger a committed person poses constitutes "a substantial risk of dangerous conduct within the reasonably foreseeable future." In re Commitment of T.J., 401 N.J. Super. 111, 119 (App. Div. 2008) (citation and internal quotation marks omitted). The mere potential for dangerous conduct, without more, is insufficient. In re Commitment of J.R., 390 N.J. Super. 523, 530 (App. Div. 2007).

Preliminarily, we note that the State does not contest T.C.'s contention that his appeal is not moot even though he was released and placed on CEPP status at the next review hearing. Generally, our courts consider appeals challenging civil commitment because of the importance of the committee's liberty interest and the likelihood of repetition of error that will escape review. See In re Commitment of N.N., 146 N.J. 112, 124 (1996); see also In re Commitment of P.D., 381 N.J. Super. 389 (App. Div. 2005), certif. granted and remanded, 186 N.J. 251 (2006).

We turn to T.C.'s argument that his commitment should not have been continued following the November 27, 2013 hearing. When reviewing civil commitment decisions, "we afford deference to the trial court's supportable findings," T.J., supra, 401 N.J. Super. at 119, and "reverse[] only when there is clear error or mistake." In re Commitment of M.M., 384 N.J. Super. 313, 334 (App. Div. 2006). Nevertheless, we "must consider the adequacy of the evidence." Ibid. "[W]e have not hesitated to reverse involuntary commitments when the record failed to contain clear and convincing evidence of 'a substantial risk of dangerous conduct within the reasonably foreseeable future.'" T.J., supra, 401 N.J. Super. at 119 (quoting In re S.L., 94 N.J. 128, 138 (1983)).

Contrary to T.C.'s arguments, the State produced clear and convincing evidence that he posed a danger to himself. T.C. does not dispute Dr. Bagchi's opinion that he was mentally ill and severely delusional. After all, he believed that he could live in a non-existent mansion in northern New Jersey, and that his vision could be restored via an antidote that was in his car. And though T.C. was capable of eating and caring for himself in a supervised institutional setting, he was incapable of caring for his psychiatric and medical needs. When the court continued T.C.'s commitment on November 27, 2013, there was no evidence that anyone outside of the hospital was willing and available to supervise and assist him. Moreover, he had not yet shown any sign of improvement.

In short, we find no clear error or mistake in the court's decision warranting reversal. T.C. challenged neither the psychiatric diagnosis nor the causal link between that condition and his severely delusional state. Considering the undisputed diagnosis and the undisputable degree of T.C.'s delusions, the trial court did not err in concluding that T.C. represented a danger to himself if released to a less restrictive facility; and, that left to his own devices, he would suffer serious harm within "a time frame as to which reasonably certain judgments about a person's likely behavior can be reached." N.J.S.A. 30:4-27.2(kk).

Affirmed.