THE STATE OF TEXAS FOR THE BEST INTEREST AND PROTECTION OF S.S.M

AFFIRMED; Opinion Filed May 28, 2008.
 
 
 
In The
Court of Appeals
Fifth District of Texas at Dallas
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No. 05-08-00264-CV
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THE STATE OF TEXAS FOR THE BEST INTEREST AND PROTECTION OF S.S.M.
 
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On Appeal from the Probate Court No. 3
Dallas County, Texas
Trial Court Cause No. MI-08-50292
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MEMORANDUM OPINION
Before Justices Moseley, Francis, and Lang
Opinion By Justice Francis
        S.S.M. appeals the trial court's judgment commiting him for temporary mental health services as an in-patient for no more than ninety days. In three issues, S.S.M. challenges the legal and factual sufficiency of the evidence to support the commitment. We affirm.
        On February 8, 2008, Dallas police officer Christopher McCormic applied for emergency detention of S.S.M. at Parkland Hospital. That same day, an application for temporary court-ordered mental health services was filed. Dr. Joy Kennedy examined S.S.M. and diagnosed him as “psychosis NOS.” In her Physician's Certificate of Medical Examination for Mental Illness, Dr. Kennedy opined that S.S.M. was mentally ill and, because of his illness, presented a substantial risk of harm to himself and others. In an addendum attached to the certificate, Dr. Kennedy set out the statements and conduct by appellant, as well as her observations as to his mental status, supporting her opinion.
        Dr. Kennedy noted that S.S.M. had made the following statements: “God sent me a special message through the drugs,” “I am supposed to find the lost and kill the devils,” and “Satan is going to get me.” As for conduct, Dr. Kennedy noted that S.S.M. “was hostile with ER staff and was put in seclusion” and tried to kick and punch staff members. Dr. Kennedy also noted police report statements that S.S.M. had said “[t]hat God told [S.S.M.] to kick in the door to somone's apartment” and that S.S.M. had “claimed to have died and been resurrected.” Finally, her mental status evaluation revealed that S.S.M. was alert, disheveled, had a flat affect, and a decreased psychomotor activity. He also had paranoid, disorganized, and homicidal thoughts and poor insight and judgment. In her comments, she noted that S.S.M. presented with “paranoid thoughts, very religious, homicidal toward others, including staff members” and had been “punching windows in dayroom.”
        Five days later, on February 13, S.S.M. was evaluated by Dr. James Shupe at Green Oaks Hospital, who also diagnosed S.S.M.'s condition as “Psychosis NOS.” Like Dr. Kennedy, Dr. Shupe opined that S.S.M. was mentally ill and, as a result of his mental illness, was likely to cause serious harm to himself and others. The basis for Dr. Shupe's opinion, however, was far briefer and more conclusory than that provided by Dr. Kennedy: “Remains very psychotic and easily becomes aggressive.”
        A hearing was scheduled for the following day. Before the hearing, S.S.M. signed a “No Contest Agreement” asserting his lawyer had explained the nature of the proceedings and his legal rights and choices of contesting or not contesting the doctors' recommendation for inpatient psychiatric services. S.S.M. asserted that he understood his rights and agreed to the proposed mental health treatment. Further, S.S.M. waived the calling of witnesses and the right to cross-examine the State's witnesses. At the hearing, the State submitted the two doctors' certificates and S.S.M.'s attorney informed the trial court of S.S.M.'s no contest agreement.
         The trial court ordered S.S.M. to in-patient treatment for a period not to exceed ninety days. In its judgment, the trial court found S.S.M. was mentally ill and, as a result of that mental illness, was likely to cause serious harm to himself or others. The court also found that S.S.M. was able to make a rational and informed decision as to whether or not to submit to treatment. S.S.M. appealed.
        Before a mentally ill patient can be ordered confined to a hospital on a temporary basis, the State must establish by clear and convincing evidence at least one of three criteria outlined in the mental health statute. See Tex. Health & Safety Code Ann. § 574.034(a)(2) (Vernon 2003). Here, the judge made findings on two statutory criteria: that S.S.M. was likely to cause serious harm to himself or to others. Id. § 574.034(a)(2)(A), (B). 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 (1) the likelihood of serious harm to the proposed patient or others or (2) the proposed patient's distress and the deterioration of his ability to function. Id. § 574.034(d) (Vernon 2003). Clear and convincing evidence is that “degree of proof which will produce in the mind of the trier of fact a firm belief or conviction as to the truth of the allegations sought to be established.” State v. Addington, 588 S.W.2d 569, 570 (Tex.1979) (per curiam).
        A hearing on an application for court-ordered mental health services may not be held unless there are on file with the court at least two certificates of medical examination for mental illness completed by different physicians. Tex. Health & Safety Code Ann. § 574.009(a) (Vernon 2003). The certificate must include, among other things, the detailed reason for each of the examining physician's opinions. Id. §574.011(e). When, as here, the proposed patient and his attorney waive the right to call witnesses and to cross-examine the State's witnesses, the court may admit as evidence the physicians' certificates. Id. § 574.034(f). Under such circumstances, the certificates constitute competent medical or psychiatric testimony, and the court may make its findings solely from the certificates. Id. An expert diagnosis, without more, is not sufficient to confine a patient for compulsory treatment. T.G. v. State, 7 S.W.3d 248, 252 (Tex. App.-Dallas 1999, no pet.).
        In reviewing the legal sufficiency of the evidence where the burden of proof is clear and convincing evidence, we 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 findings were true. In re J.F.C., 96 S.W.3d 256, 266 (Tex. 2002). We must assume that the trier of fact resolved disputed facts in favor of its finding if a reasonable trier of fact could do so, and we must disregard all contrary evidence that a reasonable trier of fact could have disbelieved or found to be incredible. Id.
        In reviewing factual sufficiency challenges, we review all the evidence in the record, both supporting and opposing the trial court's findings. In re C.H., 89 S.W.3d 17, 27-29 (Tex. 2002). We must give due consideration to evidence the trier of fact could reasonably have found to be clear and convincing. Id. at 25. Under the clear and convincing standard, we determine whether the evidence is such that the trier of fact could reasonably form "a firm belief or conviction" as to the truth of the allegations sought to be established by the State. Id. We must consider whether disputed evidence is such that a reasonable trier of fact could not have reconciled that disputed evidence in favor of its finding. J.F.C., 96 S.W.3d at 266. The trial court as the trier of fact is the exclusive judge of the credibility of the witnesses and the weight to be given their testimony. In re Estate of Canales, 837 S.W.2d 662, 669 (Tex. App.-San Antonio 1992, no writ).         In three issues, argued together, S.S.M. contends the evidence is legally and factually insufficient to support the judgment confining him. Before addressing these complaints, we first consider the impact of the no contest agreement.
        Mental health commitment proceedings are considered to be civil proceedings, as opposed to criminal proceedings. Taylor v. State, 671 S.W.2d 535, 539 (Tex. App.-Houston [1st Dist.]1983, no writ ). In a civil proceeding, a party's consent to the trial court's entry of judgment waives any error, except for jurisdictional error, contained in the judgment, and that party has nothing to properly present for appellate review. Baw v. Baw, 949 S.W.2d 764, 766 (Tex. App.-Dallas 1997, no pet. ).
        While S.S.M.'s waiving of his right to call witnesses or cross-examine the State's witnesses does not in and of itself waive any claims regarding sufficiency of the evidence, S.S.M. did more than relinquish his right to call witnesses or question the State's witnesses. After expressly acknowledging that he understood his legal rights, S.S.M. affirmatively agreed to the proposed court-ordered mental health treatment at Terrell State Hospital and signed a document to that effect. Moreover, the trial court specifically found S.S.M. was able to make a rational informed decision as to whether or not to submit to treatment, and S.S.M. does not challenge this finding. Given these circumstances, we conclude S.S.M. has waived his complaints. See Baw, 949 S.W.2d at 766.
        But even if we assumed S.S.M. had not waived his complaints by agreeing, in writing, to treatment, reversal would not be required. The crux of S.S.M.'s complaint is that the certificate filed by Dr. Shupe failed to provide an adequate factual basis for his opinions that S.S.M. was mentally ill and, as a result, was a danger to himself and others. He argues that Dr. Shupe's certificate is insufficient to meet the statutory requirements, and since the statute required two certificates, the evidence is therefore insufficient to sustain the court's judgment. For support of his argument, he relies solely on In re Mayberry, 685 S.W.2d 121 (Tex. App.-Amarillo 1985, no writ).
        The appellant in Mayberry was involuntarily hospitalized on the basis of the certificates of the two doctors. However, both of the certificates contained only bare conclusions that the appellant suffered from a “schizo affective disorder” and the derivative opinions that, unless treated, she was likely to cause serious harm to herself or others. Mayberry, 685 S.W.2d at 123. The court held that certificates which fail to include a reasonably detailed factual basis for the conclusions and opinions are not sufficient to sustain a court's order. Id. Consequently, the evidence in Mayberry was insufficient.
        Unlike Mayberry, this record contains evidence other than bare conclusions and unsupported opinions. In fact, S.S.M. concedes that Dr. Kennedy's certificate contains “descriptive factual observations that would form a detailed basis” for her conclusions and opinions. We reject any notion that the failure of one certificate to meet the statutory requirements automatically renders the evidence legally or factually insufficient, irrespective of the quality and quantum of evidence provided by the second certificate. See In the Matter of D.T.M., 932 S.W.2d 647, 652 (Tex. App.-Fort Worth 1996, no pet.) (concluding that defects in certificate do not implicate jurisdiction, and objections to certificate made for first time on appeal are waived).
        Here, Dr. Kennedy's certificate provided clear and convincing evidence to support the trial court's findings. In particular, the evidence showed that on February 8, less than one week before the trial court's commitment judgment, S.S.M. believed God sent him a special message through drugs, believed he was supposed to find “the lost” and to “kill the devils,” and believed Satan was going to “get” him. S.S.M. believed that God had told him to kick in the door of someone's apartment and claimed to have died and been resurrected. While he was confined, he had been hostile with ER staff and tried to kick and punch staff members. Moreover, he was observed “punching windows” in the dayroom. S.S.M.'s statements reflect his paranoid and homicidal thoughts while his conduct shows his aggressive and violent behavior. Having reviewed the evidence under the appropriate standards, we conclude it is legally and factually sufficient to support the trial court's judgment. Accordingly, we overrule all of S.S.M.'s points of error.
        We affirm the trial court's judgment.
 
 
                                                          
                                                          MOLLY FRANCIS
                                                          JUSTICE
 
        
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