In Re The Detention Of S.n.

• Court: Court of Appeals of Washington
• Decided: November 19, 2024
• Docket: 86230-8
• Status: Unpublished

Opinion

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

In the Matter of the Detention of: No. 86230-8-I S.N. DIVISION ONE

UNPUBLISHED OPINION

COBURN, J. — S.N. appeals a superior court’s civil commitment order for 14 days

of involuntary treatment, arguing that the superior court’s findings of fact are not

supported by sufficient evidence and do not support the conclusion that S.N. is gravely

disabled. We remand for the trial court to vacate the 14-day commitment order.

FACTS

In January 2024, S.N.’s sister called 911 with concerns about S.N.’s mental

health. John Folkestad, a Snohomish County designated crisis responder coordinated

with Mukilteo Police to conduct an Involuntary Treatment Act (ITA) investigation at

S.N.’s condo. They knocked on the door to S.N.’s apartment and he was agreeable to

allow them in. S.N. was immediately irritable, upset at his sister and repeatedly said he

was not crazy. He said his sister was behind trying to get him harmed or killed, and had

hired several people to try to mess with him, including a boy or child on the floor above

him. He showed Folkestad a picture of a hand that was sliced up with several stitches 86230-8-I/2

that he claimed was from his ex-wife, which was not relevant to the investigation or

Folkestad’s line of questioning. S.N.’s story was disorganized and spoke on unrelated

tangents at times, randomly saying “little puppet” without context. He said he had been

sleeping with a hammer because he believed he was in harm’s way and that he wanted

to obtain a firearm. He said he was blocked from obtaining a firearm because of an

emergency protection order but that he intended to go to court to get his firearms back

because he feared for his safety because of his sister. Police did see a hammer next to

his bed and moved it away upon entering the apartment.

That same day, Folkestad filed a petition for detention because of S.N.’s

paranoia and delusions. S.N. was admitted to the Telecare North Sound Evaluation

and Treatment Facility that same day. While in the facility, S.N. tested positive for

cocaine. S.N. has no prior history of being involved in the mental health system.

Detention Hearing

S.N. was represented by counsel in a contested involuntary commitment hearing

held six days later. At the hearing, Folkestad was qualified as an expert witness over

the objection of defense counsel, who noted that Folkestad was not offering a diagnosis

and had not been prior identified as an expert. Folkestad testified to his interactions

with S.N. at the condo and that S.N. was exhibiting “all new behaviors” that, according

to his sister, was a substantial departure from his baseline functioning three months ago

when he previously worked at Boeing as an engineer or mechanic, was independent

and had never previously been paranoid or delusional. Folkestad testified that it was

unclear to him whether S.N. left his job or was fired. The sister did not testify at the

hearing.

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Katie Monday, a social worker at Telecare North Sound Evaluation and

Treatment Facility, also testified. Monday was qualified as an expert by stipulation.

Monday testified that based on the prescriber and rehabilitation group notes, the

emergency room paperwork that came with S.N., and having “learned from family and

from the client,” that prior to October, S.N. did not have any mental health problems.

Monday also testified that S.N. reported that his sister and a man named Dan were

working together to set him up and that S.N. left numerous notes or messages in

various places indicating that if he were to die, they would be responsible. Monday said

S.N. reported to Monday that he went to his employer’s workplace and shouted out the

names of people involved so that they would be exposed.

Monday testified that S.N. has now been diagnosed with brief psychotic disorder,

which is a provisional diagnosis for someone who is experiencing psychotic symptoms

but has not been observed for a long enough period of time to make a fully formed

diagnosis. Monday explained that S.N. exhibited hyperverbal speech, tangential

pressured speech, persecutory delusional thoughts, paranoia, disorganization, impaired

insight, and irritability.

While in the facility, S.N. was currently taking Zyprexa twice a day, but had

refused a dose on two different days. When asked how S.N. was doing in the facility,

Monday said S.N. “has been eating well . . . he is getting enough sleep . . . and he is

caring for his hygiene just fine. He is able to make his needs known.” Monday testified

that S.N.’s delusions and paranoia were still present but appeared to have lessened and

were not as elaborate as they were previously. When asked about evidence of a

baseline to compare S.N.’s symptoms to, Monday responded: “Just what his sister told

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me that previous to November, she did not know of any mental health problems. That

they lived together, and he would go to work and come home and often be in his room,

and she wasn’t aware of any problems.” Monday testified that she did not believe that

S.N. could provide for his health and safety needs because he has had a loss of

cognitive and volitional control over time. She believed that if S.N. were to stay and get

treatment, the medications would continue to help him and reduce the paranoia and the

delusions. When pressed on cross examination to explain specifically how his

symptoms caused him to not be able to provide for his health and safety, Monday

answered that S.N. reported that he had done quite well working 12 years as an

electrician, and while S.N. is not terminated from his job, she understood there is an

investigation into his job and “so I’m concerned, how is he going to provide for his

essential health and safety needs if he doesn’t have a job for finances?” Monday

added, while S.N. does have a condo, “he’s awfully paranoid about what goes on

around the condo.”

S.N. moved to exclude as hearsay his sister’s statements as relayed by

Folkestad, arguing that while Folkestad had been qualified as an expert, “he didn’t offer

an expert opinion, and he didn’t offer a diagnosis. He just relayed hearsay back to

what’s in his report.” The court ruled that it would permit Folkestad’s testimony “about

his observation” despite the fact that “he wasn’t asked if he had a diagnosis or anything

like that.” S.N. did not testify.

The court ordered that S.N. be detained for up to 14 days after finding him

gravely disabled. The court orally held that S.N. has “an inability to provide for his own

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health and safety in the community” because of his paranoid delusions and need for a

hammer for protection. In support, the court found that S.N.’s sister

indicated to both Ms. Monday and to Mr. Folkestad that he had been employed for a substantial period of time at Boeing . . . the ability to do that, which he apparently doesn’t have the ability to do that right now, the testimony from the sister was that previously he has – not from the sister, but the information from the sister which apparently was provided to Ms. Monday and also to Ms. Folkestad because Ms. Monday testified that the DCR, Mr. Folkestad, had provided the information that was the same, consistent with what she had obtained, which was that he has – previously, was not delusional, not paranoid, able to attend to his ADLs[1] and be independent, and was an electrician.

The court found that the above facts demonstrate “a substantial deterioration from what

his routine functioning is, and this deterioration [is] the result of a mental health

disorder.” The court entered a written order committing S.N. for involuntary treatment

with findings of fact and conclusions of law on the same day as it’s oral ruling.

S.N. appeals. DISCUSSION

S.N. argues that there is insufficient evidence to sustain the trial court’s findings

that he was gravely disabled, and so the 14-day involuntary commitment order must be

reversed.

The burden of proof at a 14-day involuntary commitment hearing is

preponderance of the evidence. RCW 71.05.240(1), (4); see also In re Det. of A.F., 20

Wn. App. 2d 115, 125, 498 P.3d 1006 (2021). A person suffering from a mental

disorder can be found gravely disabled under two different statutory definitions. The

first definition requires the court to consider if the person “[i]s in danger of serious

physical harm resulting from a failure to provide for his or her essential human needs of

1 Activities of Daily Living. 5 86230-8-I/6

health or safety.” RCW 71.05.020(25)(a). Under the second definition, the court

considers if the person “manifests severe deterioration in routine functioning evidenced

by repeated and escalating loss of cognitive or volitional control over his or her actions

and is not receiving such care as is essential for his or her health or safety.” RCW

71.05.020(25)(b). The trial court’s written order with findings and conclusions found that

S.N. met both of the above definitions.

On review, we consider whether the trial court’s findings of fact are supported by

substantial evidence and if those findings support the court’s conclusions of law and

judgement. A.F., 20 Wn. App. 2d at 125 (citing In re Det. of T.C., 11 Wn. App. 2d 51,

56, 450 P.3d 1230 (2019)). The meaning of substantial evidence is a “quantum of

evidence sufficient to persuade a fair-minded person.” In re Det. of H.N., 188 Wn. App.

744, 762, 355 P.3d 294 (2015). When considering sufficiency of the evidence, we view

the evidence in the light most favorable to the State. In re Det. of B.M., 7 Wn. App. 2d

70, 85, 432 P.3d 45 (2019). This court does not review determinations by the trial court

as to witness credibility. H.N., 188 Wn. App. at 763.

A. RCW 71.05.020(25)(a)

The court found that S.N. was gravely disabled because of his “inability to

provide for his own health and safety in the community,” based on his paranoia and

need to sleep with a hammer.

The ITA requires that the State prove that S.N. “[i]s in danger of serious physical

harm resulting from a failure to provide for his or her essential human needs of health or

safety.” RCW 71.05.020(25)(a). Under this subsection, the State must “present recent,

tangible evidence of failure or inability to provide for such essential human needs as

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food, clothing, shelter, and medical treatment which presents a high probability of

serious physical harm within the near future unless adequate treatment is afforded.” In

re Det. of LaBelle, 107 Wn.2d 196, 204-05, 728 P.2d 138 (1986).

Here, there is no evidence that S.N. was unable to provide for his essential

needs. At the hearing, Monday testified that S.N. “has been eating well . . . he is getting

enough sleep . . . and he is caring for his hygiene just fine. He is able to make his

needs known.” There was no testimony that S.N.’s condo was in a state that suggested

he could not provide for his essential needs.

Monday testified that she was concerned that S.N. would not be able to provide

for his essential health and safety needs if he no longer had a job. First of all, the

record does not support that S.N. was unemployed. In fact, Monday testified that S.N.

had not been terminated from his job, but that his job was under investigation. Even so,

a lack of financial resources will not alone justify continued confinement in a mental

hospital. Id. at 210. Second, though S.N. demonstrated paranoid thinking, this was not

a manifestation of severe deterioration in routine functioning evidenced by repeated and

escalating loss of cognitive or volitional control over his or her actions. And there was

no evidence that S.N. was not receiving such care as is essential for his or her health or

safety.

Because the record is devoid of any evidence that S.N. was unable to meet his

essential needs, we agree with S.N. that the finding that he was gravely disabled under

RCW 71.05.020(25)(a) is not supported by the evidence.

B. RCW 71.05.020(25)(b)

S.N. also argues that he did not “manifest[] severe deterioration in routine

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functioning” because the State failed to introduce substantial, non-hearsay evidence as

to his baseline functioning.

The ITA alternatively defines a condition of grave disability as one where the

person “manifests severe deterioration in routine functioning evidenced by repeated and

escalating loss of cognitive or volitional control over his or her actions and is not

receiving such care as is essential for his or her health or safety.” RCW

71.05.020(25)(b).

Involuntary commitment may be justified under this second meaning of “gravely disabled” if a person’s mental condition has stabilized or minimally improved as the result of an initial commitment, but the person would not receive such care as is essential for his health or safety if released (i.e., his condition would severely deteriorate if released). Commitment under this second definition is also justified if the individual is unable, because of severe deterioration of mental functioning, to make a rational decision with respect to his need for treatment.

In re Det. of R.A.W., 104 Wn. App. 215, 224, 15 P.3d 705 (2001) (citing former RCW

71.05.020(1)(b) (2000)).

The Washington Supreme Court recognized that legislative intent for this

alternative definition of grave disability was to pivot away from policies that prevented

care for chronically ill persons “until they had decompensated to the point that they were

in ‘danger of serious . . . harm,’” which had previously presented a “revolving door”

treatment problem because intervention could not be offered “before a mentally ill

person’s condition reache[d] crisis proportions.” LaBelle, 107 Wn.2d at 206-07 (citing

former RCW 71.05.020(1)(b) (1979)). To that end, the Court has held that a strict

reading of this test could

result in absurd and potentially harmful consequences, for a court would be required to release a person whose condition, as a result of the initial commitment, has stabilized or improved minimally—i.e., is no longer “escalating”

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—even though that person otherwise manifests severe deterioration in routine functioning and, if released, would not receive such care as is essential for his or her health or safety.

Id. at 207. But the State must show evidence of “recent proof of significant loss of

cognitive or volitional control” and “a factual basis for concluding that the individual is

not receiving or would not receive, if released, such care as is essential for his or her

health or safety.” Id. at 208.

Here, the court held that testimony about S.N.’s job and his current

unemployment along with testimony about S.N.’s recent delusions and paranoia

demonstrate “a substantial deterioration from what his routine functioning is, and this

deterioration in the result of a mental health disorder.”

Monday testified that S.N.’s delusions and paranoia were still present but

appeared to have lessened and were not as elaborate as they were previously.

Monday explained that “[w]e would like to see him taking [the medication] regularly

before making any changes.” However, there is no evidence that S.N. would

decompensate such that S.N. would not receive care as is essential for his health or

safety. “It is not enough to show that care and treatment of an individual’s mental illness

would be preferred or beneficial or even in his best interests. To justify commitment,

such care must be shown to be essential to an individual’s health or safety and the

evidence should indicate the harmful consequences likely to follow if involuntary

treatment is not ordered.” Id. at 208. “[M]ental illness alone is not a constitutionally

adequate basis for involuntary commitment.” Id. at 201.

Lastly, though S.N. slept with a hammer, he testified it was because he felt he

was in harms way. And while he expressed a desire to obtain a firearm, he

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acknowledged that he was barred from doing so because of a protection order and

would have to go to court in order to be permitted to obtain a firearm. This is not

evidence of a loss of cognitive or volitional control. There is “no constitutional basis for

confining . . . [mentally ill] persons involuntarily if they are dangerous to no one and can

live safely in freedom.” Id. at 207 (quoting O’Connor v. Donaldson, 422 U.S. 563, 575,

95 S. Ct. 2486, 45 L. Ed. 2d 396 (1975)). Monday’s testimony, while based on recent

observations, tends only to prove that S.N. was still suffering from a mental disorder; it

does not establish by a preponderance of evidence of grave disability as a result of the

mental disorder.

We remand for the trial court to vacate the 14-day commitment order.

WE CONCUR: