In re MH2009-003191
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THIS DECISION DOES NOT CREATE LEGAL PRECEDENT AND MAY NOT BE CITED
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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
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)
IN RE MH 2009-003191
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__________________________________)
No. 1 CA-MH 11-0023
DEPARTMENT B
DIVISION ONE
FILED: 09/29/2011
RUTH A. WILLINGHAM,
CLERK
BY: DLL
MEMORANDUM DECISION
(Not for Publication Rule 28, Arizona Rules
of Civil Appellate
Procedure)
Appeal from the Superior Court in Maricopa County
Cause No. MH 2009-003191
The Honorable Michael D. Hintze, Judge Pro Tem
AFFIRMED
People of Color Network, Inc.
By Steven Wiggs
Attorneys for Appellee
Gilbert
Marty Lieberman, Maricopa County Legal Defender,
By Colin F. Stearns, Deputy Legal Defender
Attorneys for Appellant
Phoenix
D O W N I E, Judge
¶1
Appellant seeks reversal of an order continuing his
involuntary
mental
health
treatment.
For
the
reasons
that
follow, we affirm.
FACTS AND PROCEDURAL HISTORY
¶2
In
December
2009,
Appellant
believed
slowly killed with exposure to radiation.”
he
was
“being
He reported loss of
vision and muscle tone, nerve damage, weight loss, and a general
decline in health because “people spray[ed] him and his food”
with
“nerve
pesticides.”
“radiation
agents,
He
and
claimed
the
cell
herbicides,
he
was
phones,
industrial
“extremely
radio,
and
cleaners,
sensitive”
remote
to
control”
because of the “particles . . . floating from these objects.”
Although medications had been prescribed to address his physical
and mental condition, Appellant believed they were not helping
and refused treatment.
¶3
Petitions for court-ordered evaluation and treatment
were
filed.
Two
evaluating
physicians
suggested
Appellant
suffered from paranoid schizophrenia and found him persistently
or
acutely
hearing
disabled
occurred
in
and
in
need
December
of
2009,
inpatient
treatment.
at
the
which
evaluating
physicians, a crisis therapist, and Appellant testified.
conclusion
of
the
hearing,
the
court
ordered
A
At the
Appellant
to
participate in combined inpatient/outpatient treatment for 365
days.
2
¶4
Appellant was initially compliant with treatment.
But
by October 2010, he was “substantially non-adherent,” and his
treatment
team
recommended
continued
court-ordered
treatment.
Appellant filed a Request for Judicial Review of Court Ordered
Treatment.
Appellant
He was examined by a psychiatrist, who reported that
continued
having
“poor
illness” and paranoid thoughts.
insight
into
his
mental
Appellant’s “history of being
agressive [sic] when he is off medication” was also noted.
The
report further explained that Appellant refused to take oral
antipsychotic medications, so he had been placed on injectable
drugs.
The
court-appointed
counsel,
who
consulted
with
Appellant and forwarded his request for release to the court,
did not request a hearing.
The court denied Appellant’s request
for release.
¶5
In
December
2010,
Appellant’s
outpatient
treatment
provider filed an application for continued treatment, alleging
Appellant remained persistently or acutely disabled and in need
of treatment, and recommending he not be released from courtordered treatment.
The Psychiatric Report for Annual Review
(“annual report”) stated that Appellant continued to believe a
“wave of radiation from computer Pesticide [sic] are affecting
his mind and his body” and refused to take medications because
of
“delusional”
thoughts.
The
reporting
psychiatrist
also
stated that Appellant’s mental disorder affected his compliance
3
with medications and treatment and opined that Appellant would
not
continue
medications
court order.
and
treatment
if
released
from
the
Appellant opposed the application, and a hearing
was held.
¶6
who
Appellant was represented by counsel at the hearing,
stipulated
to
admission
of
the
report “in lieu of testimony.”
evaluating
psychiatrist’s
The clinical coordinator who
worked directly with Appellant testified that Appellant refused
medications and was placed on injectable drugs.
The coordinator
and case manager testified Appellant would likely discontinue
medications
if
because
believed
he
court-ordered
that
treatment
the
were
medications
not
continued
caused
physical
symptoms, and that he did not need them.
¶7
made
Appellant testified that “exposure to the chemicals”
him
“produced
“vulnerable
by
to
man-made
low-level
radiation,”
electronics.”
such
Appellant
as
that
believed
the
anti-psychotic drugs were “toxic” to him and that the injections
“activate[d]”
his
symptoms
of
fibromyalgia
sensitization of the central nervous system.”
and
“over
Additionally, he
described “daily attacks” from police officers, who he believed
sprayed
“nerve
agents”
on
his
body
and
food.
Appellant
testified that, without a court order, he would take “any meds
that [would] benefit” him, but believed the side effects of the
anti-psychotic
drugs
“greatly
outweigh[ed]
4
any
benefit”
he
received.
Appellant urged the court to deny the application for
continued treatment, explaining he was not refusing treatment
but
wanted
“appropriate”
treatment.
The
court
ordered
that
treatment continue for 365 days.
¶8
Appellant
pursuant
to
timely
Arizona
appealed.
Revised
We
Statutes
have
jurisdiction
(“A.R.S.”)
section
36-546.01.
DISCUSSION
¶9
Appellant contends the order for continued treatment
must be vacated because insufficient evidence was presented to
prove
affirm
he
remains
a
court’s
persistently
order
for
or
acutely
involuntary
supported by substantial evidence.
disabled.
treatment
We
if
will
it
is
In re MH 2008-001188, 221
Ariz. 177, 179, ¶ 14, 211 P.3d 1161, 1163 (App. 2009).
We view
the facts in the light most favorable to sustaining the trial
court’s judgment.
Id.
¶10
As a threshold matter, Appellant’s reliance on A.R.S.
§
and
36-539
cases
arising
thereunder
§ 36-543 is the applicable statute.
is
misplaced.
A.R.S.
It dictates the procedures
and elements of proof applicable to individuals who are already
receiving court-ordered treatment.
A party seeking renewal of a
treatment order must prove all of the following by clear and
convincing evidence:
1. The patient is one of the following:
5
(a)
(b)
(c)
(d)
A danger to self.
A danger to others.
Persistently or acutely disabled.
Gravely disabled.
2. The patient is in need of treatment.
3. The patient is either unwilling or unable
to accept treatment voluntarily.
A.R.S. § 36-543(H).
¶11
The application for continued treatment alleged that
Appellant “continues to be persistently or acutely disabled.”
A
person is “persistently or acutely disabled” if he has a “severe
mental disorder” that:
(a) If not treated has a substantial probability of
causing the person to . . . suffer severe and abnormal
mental, emotional or physical harm that significantly
impairs judgment, reason, behavior or capacity to
recognize reality.
(b) Substantially impairs the person’s capacity to
make an informed decision regarding treatment . . . .
(c) Has a reasonable prospect of being treatable by
outpatient,
inpatient
or
combined
inpatient
and
outpatient treatment.
A.R.S. § 36-501(33).
¶12
The
report,
which
requirements. 1
parties
at
stipulated
least
The
to
minimally
report
was
1
admission
of
complies
with
completed
by
the
a
annual
statutory
licensed
The annual report is a standardized form that includes
statements corresponding to the statutory elements, with “yes”
and “no” check boxes and space to add “facts that support this
conclusion.”
In several instances, no supporting information
6
psychiatrist,
continues
to
Schizophrenia”
disabled.
A.R.S.
§
36-543(E),
suffer
and,
as
from
a
who
opined
“Delusional
result,
is
that
Appellant
disorder/Paranoid
persistently
or
acutely
The report also stated that voluntary treatment was
not appropriate because Appellant has “poor insight about his
mental illness,” refused oral medications, and would likely not
take prescribed medications or comply with other treatment for
his mental disability if released from the court order.
¶13
At the conclusion of the hearing, the superior court
ruled that Appellant remains persistently or acutely disabled as
a result of a mental disorder, that he is in need of continued
treatment, and that he is either unwilling or unable to accept
voluntary treatment.
¶14
The record supports these determinations.
It was proven that Appellant suffers from a severe
mental disorder that, if not treated, would cause him to “suffer
severe and abnormal mental . . . harm that significantly impairs
judgment, reason, behavior or capacity to recognize reality.”
A.R.S.
§
paranoid
36-501(33)(a).
schizophrenia,
Appellant
which
causes
has
him
been
to
diagnosed
believe
with
police
officers are spraying him and his food with “nerve agents” and
that anti-psychotic medications are toxic.
was provided. Where supporting information was provided, it was
relatively brief.
Nevertheless, the information required by
A.R.S. § 36-543(F) was present.
7
¶15
The
“capacity
to
record
make
also
an
demonstrates
informed
decision
that
regarding
Appellant’s
treatment,”
A.R.S. § 36-501(33)(b), is substantially impaired by his mental
illness.
Appellant believes his anti-psychotic medications are
toxic and increase his susceptibility to radiation and nerve
agents.
and,
Appellant testified the medications are not helpful
if
released
discontinue
Appellant
any
from
court-ordered
medications
improved
when
that
did
taking
treatment,
not
benefit
prescribed
he
would
him.
Yet
medication
in
injectable form.
¶16
Finally,
“reasonable
care.
the
prospect
of
record
demonstrates
being
treatable”
Appellant
through
has
a
outpatient
He was receiving outpatient treatment before the hearing
and, while on injectable medications, his symptoms improved.
CONCLUSION
¶17
For
the
reasons
stated,
we
affirm
treatment order.
/s/
MARGARET H. DOWNIE,
Presiding Judge
CONCURRING:
/s/
PETER B. SWANN, Judge
/s/
DONN KESSLER, Judge
8
the
continued
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