In re MH 2009-001907

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NOTICE: THIS DECISION DOES NOT CREATE LEGAL PRECEDENT AND MAY NOT BE CITED EXCEPT AS AUTHORIZED BY APPLICABLE RULES. See Ariz. R. Supreme Court 111(c); ARCAP 28(c); Ariz. R. Crim. P. 31.24 IN THE COURT OF APPEALS STATE OF ARIZONA DIVISION ONE IN RE MH 2009-001907 ) ) ) ) ) ) ) ) ) ) DIVISION ONE FILED: 06-03-2010 PHILIP G. URRY,CLERK BY: GH 1 CA-MH 09-0068 DEPARTMENT E MEMORANDUM DECISION (Not for Publication Rule 28, Arizona Rules of Civil Appellate Procedure) Appeal from the Superior Court in Maricopa County Cause No. MH 2009-001907 The Honorable Patricia Arnold, Judge Pro Tempore AFFIRMED ___________________________________________________________________ Richard M. Romley, Maricopa County Attorney By Anne C. Longo, Deputy County Attorney Roberto Pulver, Deputy County Attorney Civil Division Attorneys for Appellee Phoenix James J. Haas, Maricopa County Public Defender Phoenix By Edith M. Lucero, Deputy Public Defender Attorneys for Appellant ___________________________________________________________________ H A L L, Judge ¶1 Appellant challenges his involuntary treatment order. For the reasons set forth below, we affirm. FACTS AND PROCEDURAL HISTORY ¶2 The facts relevant to the issue on appeal are as follows. On July 30, 2009, Diana Fletcher, M.D., petitioned the superior court seeking an involuntary inpatient mental health evaluation of Appellant. As set forth in the petition, Dr. Fletcher averred that there was reasonable cause to believe that Appellant has a mental disorder and is a danger to others. In addition, Dr. Fletcher noted that Appellant refuses medication and treatment and has a history of bipolar disorder and paranoid delusions. The next day, the superior court issued a detention order for Appellant s evaluation. ¶3 On August 4, 2009, Michael Hughes, M.D., petitioned the superior court seeking court-ordered treatment for Appellant. As set forth in the petition, Dr. Hughes averred that there was reasonable cause to believe that Appellant has a mental disorder, is persistently and acutely disabled, and is a danger to others. ¶4 On August 12, 2009, the superior court held a hearing on the petition for court-ordered treatment. After the petitioner s presentation of evidence and Appellant s testimony, the superior court found, by clear and convincing evidence, that Appellant is suffering from a mental disorder and, as a result, is persistently and/or acutely disabled, is in need of treatment and is either unwilling or unable to accept voluntary treatment. The superior court also found, however, insufficient evidence to support the 2 allegation that Appellant is a danger to others and dismissed that allegation. ¶5 Appellant timely appealed. We have jurisdiction pursuant to Arizona Revised Statutes (A.R.S.) sections 12-2101(B) (2003) and 36-546.01 (2009). DISCUSSION ¶6 As his sole issue on appeal, Appellant contends that the petitioner presented insufficient evidence to support the superior court s finding that he is persistently and/or acutely disabled. We disagree. ¶7 We uphold an order for treatment unless it is clearly erroneous or unsupported by any credible evidence. In re Mental Health Case No. MH 94-00592, 182 Ariz. 440, 443, 897 P.2d 742, 745 (App. 1995). We review the record to determine whether the order is supported by substantial evidence. ¶8 Id. at 446, 897 P.2d at 748. A civil commitment constitutes a significant deprivation of liberty, id. at 447, 897 P.2d at 749, and therefore involuntary treatment proceedings requirements. must strictly meet the statutory In re Maricopa County Superior Court No. MH 2001- 001139, 203 Ariz. 351, 353, ¶ 8, 54 P.3d 380, 382 (App. 2002). A patient is persistently or acutely disabled if the patient has a severe mental disorder that: (1) if left untreated, has a substantial probability of causing the patient to suffer severe and abnormal mental, emotional or physical harm that significantly 3 impairs judgment, reason, behavior or capacity to recognize reality; (2) substantially impairs the patient s ability to make decisions and understand the advantages and disadvantages of treatment; and (3) has a reasonable prospect of being treatable. A.R.S. § 36-501(33) (2009). The evidence to support a finding of persistent or acute disability must include the testimony of two or more witnesses acquainted with the patient at the time of the alleged mental disorder and testimony of the two physicians who performed examinations in the evaluation of the patient. A.R.S. § 36-539(B). ¶9 At the outset of the hearing, the petitioner called Dr. Hughes as a witness. Dr. Hughes testified that he conducted a psychiatric evaluation of Appellant on July 30, 2009, the day after Appellant was admitted to Desert Vista hospital. During the evaluation, Dr. Hughes observed that Appellant was slight[ly] irritabl[e] and resistant to any psychiatric treatment. Appellant nonetheless cooperated with the interview and disclosed that he had a history of mania and depression but denied experiencing any associated symptoms presently. Appellant also admitted that he had ongoing conflicts with his family, but he denied making any threats toward family members. After meeting with Appellant and reviewing his medical history, Dr. Hughes diagnosed Appellant as suffering from a mood disorder not otherwise specified. 4 Dr. Hughes also concluded Appellant was a danger to others based on the allegations set forth in his father s sworn affidavit. ¶10 four On cross-examination, Dr. Hughes acknowledged that in the times he observed Appellant in the hospital he never demonstrated manic or depressive symptoms other than some slight irritability during the evaluation. Dr. Hughes also testified that Appellant was cooperative in taking his diabetes medication after the first day he was admitted and that Appellant also cooperated in taking the antibiotic he was prescribed to treat his recent bout of pneumonia. Although Appellant refused to take Depakote, a mood stabilizer, Dr. Hughes testified that Appellant had not demonstrated any of the behaviors or symptoms the medication is prescribed to treat. Finally, Dr. Hughes acknowledged that Appellant s behavior toward hospital staff and other patients had been appropriate. ¶11 After Dr. Hughes testimony, the petitioner called Sami Ahad, M.D., to testify. Dr. Ahad testified that he also conducted a psychiatric evaluation of Appellant. During the examination, Appellant admitted to having mood swings, . . . being irritable . . ., talkativeness, and . . . racing thoughts. Dr. Ahad also testified that, other than irritability, Appellant did not manifest those symptoms during the evaluation, but his concentration was poor and he appeared somewhat disheveled. Based on the evaluation and his review of Appellant s medical history, Dr. Ahad diagnosed 5 Appellant as specified. suffering from a mood disorder not otherwise Dr. Ahad also testified that he met with Appellant every day since his admission to the hospital and he had repeatedly observed Appellant s irritability, refusal to take medications, and failure to cooperate with medical treatment. ¶12 On cross-examination, Dr. Ahad acknowledged that Appellant has generally behaved appropriately at the hospital and never required physical or chemical restraint. Dr. Ahad also stated that his primary concern is that Appellant will exhibit symptoms when he experiences stress outside of the hospital setting. ¶13 The petitioner then called Appellant s father (Father) as a witness. He testified that he had not seen Appellant for approximately six months, but he became increasingly concerned about Appellant s welfare after he received a series of telephone calls in early July. During the first telephone call, Appellant was very agitated and referred to a dead faggot. to answer telephone calls from Appellant at Father refused that point and Appellant began leaving scary animalistic sounds on the answering machine. ¶14 The petitioner then called Appellant s mother (Mother) as a witness. She testified that she had not seen Appellant for approximately two years because he didn t want to have anything to do with [her]. She spoke with him on the phone in early May, 6 however, and Appellant repeatedly told her This harassment has to stop. On May 19th, Mother received numerous hang-up calls that she believed were placed by Appellant. At approximately 3:00 a.m. the morning of May 27th, Appellant called Mother and ranted and raved, and screamed at the top of his lungs. He told Mother that he was going to come up there and kill you. The next day, Mother petitioned for a restraining order against Appellant. Appellant did not contact Mother again. ¶15 The petitioner then rested and Appellant s attorney moved to have the petition dismissed, which the superior court denied. Appellant then testified on his own behalf. He denied making the threatening phone calls alleged by his parents. Appellant also testified that he deals with his agitation, anxiety, and other symptoms through push-ups, sit-ups, running in place, breathing exercises. When asked about his decision to not participate in mental health services, Appellant stated he did not want the stigma attached with mental health. ¶16 Upon review of the record, we conclude the superior court s commitment order is supported by substantial credible evidence. Both of Appellant s physicians independently diagnosed him as suffering from a mood disorder not otherwise specified. In addition, each physician testified that Appellant has at times refused medication and medical treatment. symptoms are presently limited 7 to Although his manifested irritability and poor concentration, Appellant disclosed during his evaluation with Dr. Ahad that he has been experiencing mood swings and racing thoughts. Appellant s parents also testified Appellant s mood swings and rage. that they have witnessed Therefore, we cannot say the superior court erred in finding Appellant has a mental disorder and is persistently and/or acutely disabled. CONCLUSION ¶17 For the foregoing reasons, we affirm the superior court s findings and order for treatment. /s/ PHILIP HALL, Judge CONCURRING: /s/ DIANE M. JOHNSEN, Presiding Judge /s/ PATRICK IRVINE, Judge 8

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