In re MH 2010-002646

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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 MH2010-002646 ) ) ) ) ) ) ) ) __________________________________) No. 1 CA-MH 11-0014 DIVISION ONE FILED: 08/11/2011 RUTH A. WILLINGHAM, CLERK BY: DLL DEPARTMENT A MEMORANDUM DECISION (Not for Publication Rule 28, Arizona Rules of Civil Appellate Procedures) Appeal from the Superior Court in Maricopa County Cause No. MH 2010-002646 The Honorable Veronica W. Brame, Judge Pro Tem AFFIRMED William G. Montgomery, Maricopa County Attorney By Anne C. Longo, Deputy County Attorney Bruce P. White, Deputy County Attorney Attorneys for Appellee Phoenix Brent Graham, Maricopa County Legal Defender, By Cynthia D. Beck, Deputy Legal Defender Attorneys for Appellant Phoenix D O W N I E, Judge ¶1 Appellant appeals from an order for involuntary mental health treatment. For the following reasons, we affirm. FACTS AND PROCEDURAL HISTORY ¶2 Appellant was transported to Aurora Behavioral Health Center ( Aurora ) admitted, she from was the Urgent experiencing Psychiatric auditory Center. When hallucinations. Appellant reported being terrorized 24/7 by [ ] satanic views and stated [t]hey are infringing upon my rights, getting into my anatomy and subliminal mind. After one day, Appellant requested a discharge form, which she signed against medical advice. However, Appellant later withdrew her request to leave and remained at Aurora. ¶3 A petition for court ordered evaluation was filed, stating that Appellant won t take meds, has poor insight and judgement [sic], is psychotic, and cannot care for herself. It further alleged Appellant was persistently or acutely disabled. Two physicians affidavits were attached. Dr. Leet reported that Appellant had a history of serious mental illness dating back to 2003. Appellant had reportedly engaged in extreme self-harming behavior, [such as] stabbing herself in the stomach when decompensated. 1 taking any Dr. Leet stated Appellant has not been medications, according to the records, for some period of time until she was admitted to Aurora Hospital, and 1 Dr. Leet could not complete his interview of Appellant, as she abruptly ended it after a few minutes. He thus relied on information from Appellant s medical records. 2 then signed out against medical advice, prompting the current petition for court ordered evaluation. ¶4 In his affidavit, Dr. Patel reported that Appellant was focused on concepts of paranormal activity [and] satanic abuse. During an limited insight, and interview, her Appellant judgment was appeared impaired. to have Dr. Patel noted Appellant s history of mental illness, offered a diagnosis of psychotic disorder, and stated Appellant had been both compliant and noncompliant with medications and treatment in the past. He opined that Appellant lacks insight into her mental illness, as well as the need and reason for treatment at an inpatient level of care, as evidenced by refusal of voluntary treatment and previous noncompliance with medication. ¶5 the At the hearing, the parties stipulated to admission of physicians testified, as affidavits. did Two Appellant. witnesses Appellant from testified Aurora that she sought treatment for a physical ailment, not psychiatric care. She wanted to be taken to St. Joseph s Hospital because she had trouble with [her] head. . . . Like it cracked. Appellant testified that court-ordered treatment was unnecessary because I knew I had a problem. I went to a medical facility. Something happened and I had a troublesome satanic abuse. . . . And the doctor understands satanic abuse. 3 That s a term he understood. She conceded she wasn t voluntary the whole time at Aurora. ¶6 The Aurora social worker testified about Appellant s symptoms and behaviors, including her statements that the hospital was unsafe because there were satanic views in the area, that she was being subjected to back-door infringement, and that different things [ ] were going on within her body having subliminal social worker splicing opined that or espousing Appellant of her lacked brain. the insight judgment to tend to her mental health needs if released. The and She also testified that Appellant s fears of non-existent physical ailments, such as ear infections and wet substances . . . [that were] attacking her body and her brain, fueled her concerns about whether outside. Appellant The could social take worker, care though, of herself on acknowledged the that Appellant had very good insight into understanding that . . . a lot of people wouldn t agree with what she thought and that she wanted a psychiatrist . . . that specialized in her views. ¶7 The superior court found, by clear and convincing evidence, that Appellant suffered from a mental disorder and, as a result, was persistently or acutely disabled. It concluded Appellant was in need of treatment and was either unwilling or unable to accept treatment. The court thus ordered Appellant to undergo combined inpatient and outpatient treatment. 4 ¶8 While Appellant was receiving outpatient treatment, the treatment provider sought a court order to return her to inpatient status. The motion alleged Appellant had been non- compliant by refusing to attend out-patient appointments. The court ordered Appellant into an inpatient treatment program. ¶9 Appellant pursuant to timely Arizona appealed. Revised Statutes We have ( A.R.S. ) jurisdiction sections 36- 546.01 and 12-2101(B). DISCUSSION ¶10 We will uphold an order for mental health treatment unless it is clearly erroneous or unsupported by any credible evidence. In re Mental Health Case No. MH 94-00592, 182 Ariz. 440, 897 443, P.2d 742, 745 (App. 1995). We interpretation and application of statutes de novo. ¶11 review the Id. Involuntary treatment proceedings must strictly comply with statutory requirements. Maricopa Cnty. Super. Ct. No. MH 2001-001139, 203 Ariz. 351, 353, ¶ 8, 54 P.3d 380, 382 (App. 2002). Once statutory requirements are satisfied, it is the superior court s conflicts. role to weigh the evidence and resolve any See In re MH 2007-001236, 220 Ariz. 160, 171 n.17, ¶ 33, 204 P.3d 418, 429 n.17 (App. 2008). The superior court, as the trier of fact, is in the best position to weigh the evidence, observe the parties, judge witnesses, and make appropriate findings. 5 the credibility of Jesus M. v. Ariz. Dep t of Econ. Sec., 203 Ariz. 278, 280, ¶ 4, 53 P.3d 203, 205 (App. 2002). ¶12 A finding that a person is persistently or acutely disabled must be based on clear and convincing evidence. A.R.S. § 36-540(A); In re Mental Health Case No. MH 94-00592, 182 Ariz. 440, 444, 897 persistently mental or disorder individual to significantly ability P.2d to 742, acutely that: 746 disabled (1) if if or he A she person has will and impairs untreated, abnormally in severely judgment; decisions 1995). left suffer make (App. (2) and substantially understand the a a is severe cause the way that impairs the advantages and disadvantages of treatment; and (3) has a reasonable prospect of being treatable. ¶13 ability A.R.S. § 36-501(33). Appellant focuses on the second criterion, arguing her to make treatment decisions was not impaired. She contends the doctors relied on the social worker s erroneous statement that Appellant evaluation and treatment. was unwilling to undergo voluntary She asserts that she demonstrated an understanding of the need for treatment by willingly remaining at Aurora after withdrawing her request to leave against medical advice. ¶14 Even assuming that the physicians relied on incorrect factual statements by the social worker, the record nonetheless supports the treatment order. Appellant s ultimate willingness 6 to remain at Aurora is a relevant factor. But by her admission, her stay at Aurora was not entirely voluntary. though Appellant wouldn t agree at with times what recognized she that thought, a she lot also of own And people experienced significant periods where she was incapable of recognizing her mental health needs--focusing on non-existent physical causes instead. ¶15 court Even where there is contradictory evidence, a trial may still find clear and ordered treatment is necessary. convincing proof that court See MH 2007-001236, 220 Ariz. at 171 n.17, ¶ 33, 204 P.3d at 429 n.17. Because the record includes evidence sufficient to uphold the determination that Appellant was unable or unwilling to make appropriate treatment decisions, we discern no error. CONCLUSION ¶16 For the reasons stated, we affirm the involuntary treatment. /s/ MARGARET H. DOWNIE, Presiding Judge CONCURRING: /s/ PATRICK IRVINE, Judge /s/ LAWRENCE F. WINTHROP, Judge 7 order for

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