MEMORANDUM DECISION Pursuant to Ind. Appellate Rule 65(D), this Memorandum Decision shall not be FILED regarded as precedent or cited before any Aug 12 2019, 9:03 am court except for the purpose of establishing CLERK the defense of res judicata, collateral Indiana Supreme Court Court of Appeals estoppel, or the law of the case. and Tax Court
ATTORNEY FOR APPELLANT ATTORNEYS FOR APPELLEE Donald R. Shuler Curtis T. Hill, Jr. Barkes, Kolbus, Rife & Shuler, LLP Attorney General of Indiana Goshen, Indiana Natalie F. Weiss Deputy Attorney General Indianapolis, Indiana
IN THE COURT OF APPEALS OF INDIANA
In the Matter of the Civil August 12, 2019 Commitment of: Court of Appeals Case No. 19A-MH-392 M.L., Appeal from the Elkhart Superior Appellant-Respondent, Court v. The Honorable Teresa L. Cataldo, Judge Oaklawn Psychiatric Services, The Honorable Eric S. Ditton, Magistrate Appellee-Petitioner. Trial Court Cause No. 20D03-1807-MH-553
Najam, Judge.
Court of Appeals of Indiana | Memorandum Decision 19A-MH-392 | August 12, 2019 Page 1 of 8 Statement of the Case [1] M.L. appeals from the trial court’s order that his involuntary commitment to
Oaklawn Psychiatric Services (“Oaklawn”) be renewed for one year. M.L.
presents a single issue for our review, namely, whether Oaklawn presented
sufficient evidence to support a conclusion that he is either dangerous to others
or gravely disabled.
[2] We affirm.
Facts and Procedural History [3] This Court set out the facts relevant to this appeal in a recent appeal from a
previous commitment:
M.L. has a lengthy history of hospitalizations for mental illness. Most recently, M.L. was involuntarily committed under a regular commitment on February 29, 2016, following an emergency detention on February 17, 2016. The emergency detention was sought because M.L. was threatening to kill his landlord after M.L. was evicted. . . .
. . . On September 20, 2017, Dr. Manana Gegeshidze, M.L.’s treating psychiatrist at Oaklawn since 2016, filed an application for transportation and detention, requesting M.L. be taken to Memorial Epworth Hospital because he was paranoid and delusional, had threatened to harm or kill neighbors, had shoved a neighbor, and had been observed several times carrying a butcher’s knife around his apartment complex. . . .
As of February 28, 2018, M.L. had been released back to outpatient treatment at Oaklawn. A report issued on that day indicated that M.L. continued to have paranoid and delusional
Court of Appeals of Indiana | Memorandum Decision 19A-MH-392 | August 12, 2019 Page 2 of 8 thoughts towards others and would not comply with treatment unless subject to a commitment. On March 1, 2018, M.L.’s regular commitment was continued on an outpatient basis without a hearing. On March 26, 2018, M.L. requested a review or dismissal of his commitment, and a hearing was held on April 9, 2018.
Dr. Gegeshidze testified at the hearing that M.L. suffers from chronic schizophrenia, auditory hallucinations, and somatic hallucinations, which include his belief that he has chips inserted in his thumbs, is pregnant, has babies, and is being controlled by outside forces. M.L. has experienced at least one catatonic episode. When Dr. Gegeshidze began treating M.L., he had incoherent speech, inappropriate affect and behavior, persecutory delusions, and psychotic behavior. Although his symptoms have improved while he has been in outpatient treatment pursuant to his commitment, he continues to be delusional. M.L.’s delusions include that he is being controlled by the CIA, the mafia, and aliens. M.L. believes that aliens have put a uterus in his stomach to grow alien babies.
***
The trial court also heard evidence relating to M.L.’s history of violence, including evidence that it dates back to at least 1994, when he committed an assault resulting in serious injury. In 2001, while admitted to the Federal Medical Center in Rochester, Minnesota, M.L. twice again assaulted people and seriously injured them. On three separate occasions, M.L. has threatened others with bodily harm. In November, 2017, M.L. was readmitted to the hospital for inpatient care because he threatened his neighbor. Most recently, in March 2018, M.L. threatened to kill his neighbor, this time talking about obtaining a gun. M.L. told Dr. Gegeshidze that he was a very violent man, he has harmed other people, is going to harm others, and is going to kill others. Dr. Gegeshidze testified that she saw a difference in M.L. at this point because he was talking about getting a gun.
Court of Appeals of Indiana | Memorandum Decision 19A-MH-392 | August 12, 2019 Page 3 of 8 Dr. Gegeshidze opined that M.L. is a “very dangerous man” and that commitment was still necessary because of M.L.’s noncompliance with his anti-psychotic medication protocols and his history of violence.
M.L. acknowledged at the hearing that he threatened to kill his neighbor because she “is pushing me to the limit.” He also testified that he wanted the commitment vacated because he does not think “Oaklawn should have that much power or authority to delegate me to Evansville or Richmond without due process of the law.” Following the hearing, the trial court ordered that M.L.’s commitment to Oaklawn be continued for a period to exceed ninety days. The trial court found that M.L. suffers from a mental illness pursuant to Indiana Code section 12-7-2-130 and poses a danger to others pursuant to Indiana Code section 12-7-2- 53.
M.L. v. Oaklawn OSJ, No. 18A-MH-1114, 2018 WL 5578872, at *1-2 (Ind. Ct.
App. Oct. 30, 2018) (citations omitted).
[4] On September 25, 2018, the trial court held a status hearing and authorized
M.L.’s “future placement at a state psychiatric hospital (SPH) if warranted.”
Appellant’s App. Vol. 2 at 127. During another status hearing on February 12,
2019, the trial court heard testimony from M.L.’s treating physician, Dr. Josh
Mathew, as well as from M.L. Dr. Mathew recommended that M.L. be placed
at Richmond State Hospital because M.L. “remains quite psychotic and
paranoid and continues to express a lot of the delusional thoughts that he has
been before, despite some adjustments in treatment.” Tr. Vol. 2 at 14. Dr.
Mathew testified further:
Court of Appeals of Indiana | Memorandum Decision 19A-MH-392 | August 12, 2019 Page 4 of 8 [M.L.] continues to feel like staff are calling him names and harming him. He’s described the thought that he feels like people are ejaculating in his mouth every morning, that he has female body parts. He doesn’t want to take a medicine because he thinks it will mess up pregnancies, which he’s claimed to have hundreds of, and other delusional thought content. Given . . . the lack of significant change, we feel that he needs to be . . . returned to the state hospital.
Id. In particular, Dr. Mathew testified that M.L. is a danger to others and is
gravely disabled, and he explained:
Since we had last talked, there have been incidents where he’s touched a female inappropriately; he’s claimed that he’s done it more than that. And he explained to me that he felt like that women were trying to seduce him and sleeping with him, and those kind of thoughts or beliefs lead to much risk coming down the road as far as that repeating in the group homes again.
Id. at 15.
[5] M.L., under oath, interjected during the hearing to state that he had given birth
to “80 to 100” babies since 1992, which is when “the uterus was put in” him.
Id. at 20. M.L. also told the court that “alien physicians” had recently removed
his uterus. Id. at 20-21. Finally, M.L. stated:
I have neural implants in my brain. All I know is what the CIA and the aliens tell me. I mean, . . .
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MEMORANDUM DECISION Pursuant to Ind. Appellate Rule 65(D), this Memorandum Decision shall not be FILED regarded as precedent or cited before any Aug 12 2019, 9:03 am court except for the purpose of establishing CLERK the defense of res judicata, collateral Indiana Supreme Court Court of Appeals estoppel, or the law of the case. and Tax Court
ATTORNEY FOR APPELLANT ATTORNEYS FOR APPELLEE Donald R. Shuler Curtis T. Hill, Jr. Barkes, Kolbus, Rife & Shuler, LLP Attorney General of Indiana Goshen, Indiana Natalie F. Weiss Deputy Attorney General Indianapolis, Indiana
IN THE COURT OF APPEALS OF INDIANA
In the Matter of the Civil August 12, 2019 Commitment of: Court of Appeals Case No. 19A-MH-392 M.L., Appeal from the Elkhart Superior Appellant-Respondent, Court v. The Honorable Teresa L. Cataldo, Judge Oaklawn Psychiatric Services, The Honorable Eric S. Ditton, Magistrate Appellee-Petitioner. Trial Court Cause No. 20D03-1807-MH-553
Najam, Judge.
Court of Appeals of Indiana | Memorandum Decision 19A-MH-392 | August 12, 2019 Page 1 of 8 Statement of the Case [1] M.L. appeals from the trial court’s order that his involuntary commitment to
Oaklawn Psychiatric Services (“Oaklawn”) be renewed for one year. M.L.
presents a single issue for our review, namely, whether Oaklawn presented
sufficient evidence to support a conclusion that he is either dangerous to others
or gravely disabled.
[2] We affirm.
Facts and Procedural History [3] This Court set out the facts relevant to this appeal in a recent appeal from a
previous commitment:
M.L. has a lengthy history of hospitalizations for mental illness. Most recently, M.L. was involuntarily committed under a regular commitment on February 29, 2016, following an emergency detention on February 17, 2016. The emergency detention was sought because M.L. was threatening to kill his landlord after M.L. was evicted. . . .
. . . On September 20, 2017, Dr. Manana Gegeshidze, M.L.’s treating psychiatrist at Oaklawn since 2016, filed an application for transportation and detention, requesting M.L. be taken to Memorial Epworth Hospital because he was paranoid and delusional, had threatened to harm or kill neighbors, had shoved a neighbor, and had been observed several times carrying a butcher’s knife around his apartment complex. . . .
As of February 28, 2018, M.L. had been released back to outpatient treatment at Oaklawn. A report issued on that day indicated that M.L. continued to have paranoid and delusional
Court of Appeals of Indiana | Memorandum Decision 19A-MH-392 | August 12, 2019 Page 2 of 8 thoughts towards others and would not comply with treatment unless subject to a commitment. On March 1, 2018, M.L.’s regular commitment was continued on an outpatient basis without a hearing. On March 26, 2018, M.L. requested a review or dismissal of his commitment, and a hearing was held on April 9, 2018.
Dr. Gegeshidze testified at the hearing that M.L. suffers from chronic schizophrenia, auditory hallucinations, and somatic hallucinations, which include his belief that he has chips inserted in his thumbs, is pregnant, has babies, and is being controlled by outside forces. M.L. has experienced at least one catatonic episode. When Dr. Gegeshidze began treating M.L., he had incoherent speech, inappropriate affect and behavior, persecutory delusions, and psychotic behavior. Although his symptoms have improved while he has been in outpatient treatment pursuant to his commitment, he continues to be delusional. M.L.’s delusions include that he is being controlled by the CIA, the mafia, and aliens. M.L. believes that aliens have put a uterus in his stomach to grow alien babies.
***
The trial court also heard evidence relating to M.L.’s history of violence, including evidence that it dates back to at least 1994, when he committed an assault resulting in serious injury. In 2001, while admitted to the Federal Medical Center in Rochester, Minnesota, M.L. twice again assaulted people and seriously injured them. On three separate occasions, M.L. has threatened others with bodily harm. In November, 2017, M.L. was readmitted to the hospital for inpatient care because he threatened his neighbor. Most recently, in March 2018, M.L. threatened to kill his neighbor, this time talking about obtaining a gun. M.L. told Dr. Gegeshidze that he was a very violent man, he has harmed other people, is going to harm others, and is going to kill others. Dr. Gegeshidze testified that she saw a difference in M.L. at this point because he was talking about getting a gun.
Court of Appeals of Indiana | Memorandum Decision 19A-MH-392 | August 12, 2019 Page 3 of 8 Dr. Gegeshidze opined that M.L. is a “very dangerous man” and that commitment was still necessary because of M.L.’s noncompliance with his anti-psychotic medication protocols and his history of violence.
M.L. acknowledged at the hearing that he threatened to kill his neighbor because she “is pushing me to the limit.” He also testified that he wanted the commitment vacated because he does not think “Oaklawn should have that much power or authority to delegate me to Evansville or Richmond without due process of the law.” Following the hearing, the trial court ordered that M.L.’s commitment to Oaklawn be continued for a period to exceed ninety days. The trial court found that M.L. suffers from a mental illness pursuant to Indiana Code section 12-7-2-130 and poses a danger to others pursuant to Indiana Code section 12-7-2- 53.
M.L. v. Oaklawn OSJ, No. 18A-MH-1114, 2018 WL 5578872, at *1-2 (Ind. Ct.
App. Oct. 30, 2018) (citations omitted).
[4] On September 25, 2018, the trial court held a status hearing and authorized
M.L.’s “future placement at a state psychiatric hospital (SPH) if warranted.”
Appellant’s App. Vol. 2 at 127. During another status hearing on February 12,
2019, the trial court heard testimony from M.L.’s treating physician, Dr. Josh
Mathew, as well as from M.L. Dr. Mathew recommended that M.L. be placed
at Richmond State Hospital because M.L. “remains quite psychotic and
paranoid and continues to express a lot of the delusional thoughts that he has
been before, despite some adjustments in treatment.” Tr. Vol. 2 at 14. Dr.
Mathew testified further:
Court of Appeals of Indiana | Memorandum Decision 19A-MH-392 | August 12, 2019 Page 4 of 8 [M.L.] continues to feel like staff are calling him names and harming him. He’s described the thought that he feels like people are ejaculating in his mouth every morning, that he has female body parts. He doesn’t want to take a medicine because he thinks it will mess up pregnancies, which he’s claimed to have hundreds of, and other delusional thought content. Given . . . the lack of significant change, we feel that he needs to be . . . returned to the state hospital.
Id. In particular, Dr. Mathew testified that M.L. is a danger to others and is
gravely disabled, and he explained:
Since we had last talked, there have been incidents where he’s touched a female inappropriately; he’s claimed that he’s done it more than that. And he explained to me that he felt like that women were trying to seduce him and sleeping with him, and those kind of thoughts or beliefs lead to much risk coming down the road as far as that repeating in the group homes again.
Id. at 15.
[5] M.L., under oath, interjected during the hearing to state that he had given birth
to “80 to 100” babies since 1992, which is when “the uterus was put in” him.
Id. at 20. M.L. also told the court that “alien physicians” had recently removed
his uterus. Id. at 20-21. Finally, M.L. stated:
I have neural implants in my brain. All I know is what the CIA and the aliens tell me. I mean, . . . I’ve explained this to the court. My attorneys have explained this to the court that all I know concrete as far as evidence is concerned is what the Central Intelligence Agency and the aliens and the mafia and the Department of Defense advise me on what to think and what to believe and what to expect and what to ignore.
Court of Appeals of Indiana | Memorandum Decision 19A-MH-392 | August 12, 2019 Page 5 of 8 Id. at 23. At the conclusion of the hearing, the trial court renewed M.L.’s
commitment to either a state psychiatric hospital or inpatient treatment at
Oaklawn for one year. This appeal ensued.
Discussion and Decision [6] M.L. contends that Oaklawn presented insufficient evidence to sustain the
continuation of his involuntary commitment. The petitioner in a mental health
commitment proceeding must prove by clear and convincing evidence that the
person is mentally ill and either dangerous or gravely disabled and that
detention or commitment of the person is appropriate. Ind. Code § 12-26-2-5(e)
(2019). “In reviewing the sufficiency of the evidence supporting a
determination made under the statutory requirement of clear and convincing
evidence, an appellate court will affirm if, ‘considering only the probative
evidence and the reasonable inferences supporting it, without weighing
evidence or assessing witness credibility, a reasonable trier of fact could find
[the necessary elements] proven by clear and convincing evidence.’” T.K. v.
Dept. of Veterans Affairs (In re Commitment of T.K.), 27 N.E.3d 271, 273 (Ind.
2015) (quoting Bud Wolf Chevrolet, Inc. v. Robertson, 519 N.E.2d 135, 137 (Ind.
1988)). We look to the evidence most favorable to the trial court’s decision and
draw all reasonable inferences therefrom. R.P. v. Optional Behavior MHS (In re
Commitment of R.P.), 26 N.E.3d 1032, 1035 (Ind. Ct. App. 2015).
[7] M.L. does not dispute that he is mentally ill. Rather, he contends that Oaklawn
presented insufficient evidence to sustain the trial court’s findings that he poses
Court of Appeals of Indiana | Memorandum Decision 19A-MH-392 | August 12, 2019 Page 6 of 8 a danger to others and that he is gravely disabled. Because the statute is written
in the disjunctive, and in light of the evidence, we need only address whether
the evidence is sufficient to prove that M.L. is a danger to others. See I.C. § 12-
26-2-5(e).
[8] “Dangerous” is defined by Indiana Code Section 12-7-2-53 as “a condition in
which an individual as a result of mental illness, presents a substantial risk that
the individual will harm the individual or others.” It is well established that “a
trial court is not required to wait until harm has nearly or actually occurred
before determining that an individual poses a substantial risk of harm to
others.” J.B. v. Cmty. Hosp. N. (In re Commitment of J.B.), 88 N.E.3d 792, 796
(Ind. Ct. App. 2017). The evidence must indicate “that the behavior used as an
index of a person’s dangerousness would not occur but for the person’s mental
illness.” B.M. v. Ind. Univ. Health (In re Commitment of B.M.), 24 N.E.3d 969, 972
(Ind. Ct. App. 2015), trans. denied.
[9] On appeal, M.L. asserts that Oaklawn did not present evidence to show the
“necessary causal connection between M.L.’s mental illness and being
dangerous to himself [or] others.” Appellant’s Br. at 10. But Dr. Mathew
testified that M.L. suffered from delusional thoughts; that M.L. “felt” like
women “were trying to seduce him”; and that M.L. had touched women
inappropriately. Tr. at 15. That testimony clearly shows that M.L. has harmed
women as a result of his mental illness. And Dr. Mathew testified that there
was “much risk” associated with that behavior going forward in terms of M.L.
not being able to be placed back in a group home. Id. Further, the evidence
Court of Appeals of Indiana | Memorandum Decision 19A-MH-392 | August 12, 2019 Page 7 of 8 shows that M.L. has a long history of serious mental illness and violence and
threatened violence against others. We cannot say that the trial court’s finding
that M.L. poses a danger to others is clearly erroneous. Accordingly, we hold
that the trial court did not err when it renewed M.L.’s commitment for one
year.
[10] Affirmed.
Bailey, J., and May, J., concur.
Court of Appeals of Indiana | Memorandum Decision 19A-MH-392 | August 12, 2019 Page 8 of 8