The State of Texas for the Best Interest and Protection of C.M.--Appeal from County Court at Law of Cherokee County

NO. 12-05-00140-CV

IN THE COURT OF APPEALS

TWELFTH COURT OF APPEALS DISTRICT

TYLER, TEXAS

 THE STATE OF TEXAS   ' APPEAL FROM THE

 FOR THE BEST INTEREST   ' COUNTY COURT AT LAW

 AND PROTECTION OF C.M.   ' CHEROKEE COUNTY, TEXAS

MEMORANDUM OPINION

Appellant C.M. appeals from an order of commitment for temporary inpatient mental health services. After a hearing without a jury, the trial court ordered C.M. committed to Rusk State Hospital for a period not to exceed ninety days. In one issue, C.M. asserts the evidence is legally and factually insufficient to support the trial court=s order. We affirm.

Background

On April 15, 2005, an application for court ordered temporary mental health services was filed requesting the court commit C.M. to Rusk State Hospital for a period not to exceed ninety days. The application was supported by a certificate of medical examination for mental illness prepared by a physician, Dr. S. Lahiri, who examined C.M. on April 6, 2005.

Dr. Lahiri diagnosed C.M. as suffering from paranoid schizophrenia. He found that C.M. is mentally ill; is likely to cause serious harm to himself; and is suffering severe and abnormal mental, emotional, or physical distress, is experiencing substantial mental or physical deterioration of his ability to function independently, which is exhibited by his inability, except for reasons of indigence, to provide for his basic needs, including food, clothing, health, or safety, and is unable to make a rational and informed decision as to whether or not to submit to treatment. Dr. Lahiri reached these conclusions because C.M. heard voices telling him to harm himself and responded by engaging in Aself injurious@ behavior. Dr. Lahiri noted that C.M. also suffered from persecutory delusions and believed there was a conspiracy against him.

On April 12, 2005, C.M. was examined by Dr. Vasantha Orocofsky who also prepared a certificate of medical examination for mental illness. Dr. Orocofsky concurred with Dr. Lahiri=s diagnosis and findings based upon C.M.=s auditory hallucinations, including Acommand hallucinations@ telling him to hurt himself, and his statements that he heard voices and then Ahits them out@ or Apains them out@ after Athey enter his body.@

Dr. Lahiri testified at the hearing, explaining that C.M. is suffering from paranoid schizophrenia and that he hears voices telling him to harm himself. In response to the voices, C.M. becomes agitated, bangs his head, and hits his face. Although C.M.=s condition improved after he was hospitalized, he continued to hear voices and to respond by engaging in self injurious behavior. According to Dr. Lahiri, these incidents constitute a continuing pattern of behavior for which C.M. requires close observation. Dr. Lahiri also stated that C.M. believes others were trying to harm him as part of a conspiracy against him. Based upon these facts, Dr. Lahiri further concluded that C.M. is suffering severe and abnormal mental, emotional, or physical distress; is experiencing substantial mental or physical deterioration of his ability to function independently, which is exhibited by his inability, except for reasons of indigence, to provide for his basic needs, including food, clothing, health, or safety; and is unable to make a rational and informed decision as to whether or not to submit to treatment. He stated that if C.M. were released, he could probably recognize the dangers of walking into traffic, but would not be able to make rational decisions such as to pay bills or get into an apartment. Dr. Lahiri also stated that Rusk State Hospital was the least restrictive alternative for C.M. at the time.

On cross examination, Dr. Lahiri stated that C.M. signed a written consent to medication. He agreed that this behavior indicated C.M. had the capacity to make a rational and informed decision as to whether or not to submit to medication treatment. He also stated that based on C.M.=s therapeutic response to his medication, he could be ready for a group home in Aa month or so.@

C.M. testified that in the free world, he does not hear voices telling him to hurt himself and that he wants to try something Aoutside@ that is different. Although he understands that Dr. Lahiri believes he needs at least another month in the hospital before going to a group home, C.M. asked to be released immediately and hospitalized again if he needed additional help.

The trial court entered an order for temporary inpatient mental health services after determining that the evidence supported the allegations in the application for temporary mental health services and making specific findings that C.M. is mentally ill; that he is likely to cause serious harm to himself; and that he is suffering severe and abnormal mental, emotional, or physical distress, is experiencing substantial mental or physical deterioration of his ability to function independently, which is exhibited by his inability, except for reasons of indigence, to provide for his basic needs, including food, clothing, health, or safety, and is unable to make a rational and informed decision as to whether or not to submit to treatment. This appeal followed.

Sufficiency of the Evidence

In his sole issue, C.M. asserts the evidence is neither legally nor factually sufficient to support the order of commitment. Instead, he argues, the State=s evidence, if anything, merely shows that he may be mentally ill and may be in need of hospitalization.

Standard of Review

In a legal sufficiency review where the burden of proof is clear and convincing evidence, the reviewing court must consider all of the evidence in the light most favorable to the finding to determine whether a reasonable trier of fact could have formed a firm belief or conviction that its finding was true. In re J.F.C., 96 S.W.3d 256, 266 (Tex. 2002). The reviewing court must assume that the factfinder resolved disputed facts in favor of its finding if a reasonable factfinder could do so. Id. A court should disregard all evidence that a reasonable factfinder could have disbelieved or found to have been incredible. Id.

In addressing a factual sufficiency of the evidence challenge, we must consider all the evidence in the record, both that in support of and contrary to the trial court=s findings. In re C.H., 89 S.W.3d 17, 27-29 (Tex. 2002). This court must give due consideration to evidence that the factfinder could reasonably have found to be clear and convincing. Id. at 25. We must determine whether the evidence is such that a factfinder could reasonably form a firm belief or conviction about the truth of the State=s allegations. Id. We must also consider whether the disputed evidence is such that a reasonable trier of fact could not have reconciled that disputed evidence in favor of its finding. In re J.F.C., 96 S.W.3d at 266. Appellate courts retain deference for the constitutional roles of the factfinder. In re C.H., 89 S.W.3d at 26. The trier of fact is the exclusive judge of the credibility of the witnesses and the weight to be given their testimony. See id. at 27; In re J.J.O., 131 S.W.3d 618, 632 (Tex. App.BFort Worth 2004, no pet.).

Applicable Law

The trial judge may order a proposed patient to receive court ordered temporary inpatient mental health services if the judge or jury finds, from clear and convincing evidence, that the proposed patient is mentally ill and, as a result of the mental illness he is likely to cause serious harm to himself, is likely to cause serious harm to others, or is (i) suffering severe and abnormal mental, emotional, or physical distress, (ii) experiencing substantial mental or physical deterioration of his ability to function independently, which is exhibited by his inability, except for reasons of indigence, to provide for his basic needs, including food, clothing, health, or safety, and (iii) unable to make a rational and informed decision as to whether or not to submit to treatment. Tex. Health & Safety Code Ann. ' 574.034(a) (Vernon 2003). To be clear and convincing under the statute, the evidence must include expert testimony and, unless waived, evidence of a recent overt act or a continuing pattern of behavior that tends to confirm either the likelihood of serious harm to the proposed patient or others or the proposed patient=s distress and the deterioration of his ability to function. Id. ' 574.034(d).

Analysis

In his certificate of medical examination, Dr. Lahiri explained that C.M. heard voices telling him to harm himself and responded by engaging in Aself injurious@ behavior. Dr. Orocofsky=s certificate included a note that in response to the voices, C.M. Ahits them out@ or Apains them out@ after they Aenter his body.@ Based upon C.M.=s self injurious behavior, both doctors concluded in their certificates that C.M. was likely to cause serious harm to himself.

At trial, Dr. Lahiri testified that in response to these voices, C.M. becomes agitated, bangs his head, and hits his face. He also stated that these acts constitute a continuing pattern of behavior and that C.M. requires close observation as a result of this conduct. This is expert testimony of a continuing pattern of behavior that tends to confirm the likelihood that C.M. would cause serious harm to himself.

Considering all the evidence in the light most favorable to the findings, we conclude a reasonable trier of fact could have formed a firm belief or conviction that C.M. is likely to cause serious harm to himself. See In re J.F.C., 96 S.W.3d at 266. Therefore, the evidence is legally sufficient to support the trial court=s order. See id.

In addressing C.M.=s factual sufficiency complaint, we consider the evidence, giving due consideration to evidence the factfinder could reasonably have found to be clear and convincing. In re C.H., 89 S.W.3d at 25. C.M. did not deny hearing voices nor did he deny the behavior Dr. Lahiri described. However, he testified that he does not hear the voices Aoutside,@ which, by implication, constitutes testimony that the self injurious behavior would not occur if he were released. The trial court was entitled to disbelieve C.M.=s testimony and disregard evidence contrary to the State=s position. See id. at 27. Accordingly, in light of the entire record, the evidence that the trial court could not have credited in favor of its findings is not so significant that it could not reasonably form a firm belief or conviction that C.M. is likely to cause serious harm to himself. See id. Thus, the evidence is factually sufficient to support the trial court=s order. Because we hold the evidence is both legally and factually sufficient to support the trial court=s order, we overrule C.M.=s sole issue.[1]

Disposition

We affirm the trial court=s order of commitment for temporary inpatient mental health services.

SAM GRIFFITH

Justice

Opinion delivered December 21, 2005.

Panel consisted of Worthen, C.J., Griffith, J., and DeVasto, J.

(PUBLISH)

[1] Because the trial court=s finding that C.M. is likely to cause serious harm to himself is one of the alternative findings required by section 574.034, see Tex. Health & Safety Code Ann. ' 574.034(a)(2)(A) (Vernon 2003), we need not address the sufficiency of the evidence to support the trial court=s finding relating to C.M.=s distress, deterioration, and inability to make a rational informed treatment decision. See id. ' 574.034(a)(2)(C).