IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON
In the Matter of the Detention of No. 88404-2-I
C.L., DIVISION ONE
Appellant. UNPUBLISHED OPINION
DÍAZ, J. — A trial court committed C.L. to 14 days of involuntary detention
pursuant to the involuntary treatment act (ITA), ch. 71.05 RCW. C.L. now argues
the State failed to adduce sufficient evidence proving she was gravely disabled.
Disagreeing, we affirm.
I. BACKGROUND
In January 2025, C.L.’s daughter called a King County designated crisis
responder (DCR), who came to C.L.’s home and then filed a petition for a 120-hour
initial detention under RCW 71.05.153. Valley Cities Recovery Place Kent (Valley
Cities), to which C.L. was admitted, then sought to commit C.L. for 14 more days.
On June 25 and 26, the court held a hearing on the petition. 1 After hearing
1 The record does not indicate what caused the delay between the initial petition
for detention, filed in January 2025, and the hearing on the 14-day commitment No. 88404-2-I/2
testimony from C.L.’s daughter and a Valley Cities mental health counselor, the
court found that C.L. was gravely disabled. And the court found that a less
restrictive alternative treatment was not in C.L.’s best interest. The court ordered
an additional 14 days of involuntary treatment. C.L. timely appeals.
II. ANALYSIS
Pursuant to RCW 71.05.240, a court must hold a probable cause hearing
on a petition requesting an order for up to 14 days of involuntary treatment and
may only enter such an order if, at the conclusion of the hearing:
the court finds by a preponderance of the evidence that a person detained for behavioral health treatment, as the result of a behavioral health disorder, . . . is gravely disabled, and, after considering less restrictive alternatives to involuntary detention and treatment, finds that no such alternatives are in the best interests of such person or others[.]
RCW 71.05.240(4)(a) (emphasis added).
The ITA further provides two alternate definitions of “gravely disabled,”
namely:
a condition in which a person, as a result of a behavioral health disorder:
(a) [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; or (b) 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).
The court found that C.L. was gravely disabled under both RCW
held 6 months later. 2 No. 88404-2-I/3
71.05.020(25)(a) and (b). This court reviews whether substantial evidence
supports the trial court’s findings of fact, and whether the findings then support the
conclusions of law. In re Det. of LaBelle, 107 Wn.2d 196, 209, 728 P.2d 138
(1986). “‘Substantial evidence is a quantum of evidence sufficient to persuade a
fair-minded person.’” In re Det. of A.F., 20 Wn. App. 2d 115, 125, 498 P.3d 1006
(2021) (quoting In re Det. of H.N., 188 Wn. App. 744, 762, 355 P.3d 294 (2015)).
“We do not review a trial court’s decision regarding witness credibility or the
persuasiveness of the evidence.” Id. We hold that there was substantial evidence
to support the finding of grave disability under the standard set out by RCW
71.05.020(25)(b), with regard to both of its subparts, as follows. 2
As to the first part of the standard under RCW 71.05.020(25)(b), C.L. claims
the record did not support the court’s finding that she “had an escalating loss or
deterioration in routine functioning.” We disagree.
Her daughter testified that although C.L. has experienced religious
delusions for many years, she was relatively stable for about seven years. She
was able to converse and spend time with family. She would communicate about
her medication.
In May of 2024, C.L. was hospitalized because she stopped showering and
eating properly. She had stopped letting her daughter bring her groceries,
accusing her of being “evil” and not really being her daughter. She received a
diagnosis of paranoid schizophrenia. She was prescribed medication during her
2 Because RCW 71.05.020(25) sets out two equally valid bases for finding a person
gravely disabled, we need not additionally assess the extent of the evidence in the record of grave disability according to RCW 71.05.020(25)(a). 3 No. 88404-2-I/4
hospital stay and then released. After her release, she stopped taking her
medication.
C.L. again began experiencing religious delusions. She stopped sleeping
and showering. She stopped accepting food from her daughter and lost significant
weight. She clogged all her toilets and “started using the bathroom in garbage
bags.” She dumped water “all over the floors to the point where the floors are
caving in.” She destroyed her mobile home to the point that the city of Kenmore
condemned it so that “no one is allowed to occupy it in its current state.” From this
evidence, a reasonable person could conclude that C.L. had experienced “a
deterioration in routine functioning.” RCW 71.05.020(25)(b).
In response, C.L. argues that the evidence does not support such a finding
because C.L. had improved since she was initially admitted to Valley Cities. She
argues that because she had improved, any evidence of deterioration is not
sufficiently recent.
C.L. is correct that both her daughter and the Valley Cities counselor
testified that her symptoms had improved somewhat since she entered the facility.
But even the day before the hearing, she told the counselor that “the devil had
made her clog the toilet and that, again, demonic forces were at play during these
events.” This delusion, in context of her previous unsafe behavior resulting from
similar delusions, is substantial evidence to support the court’s conclusion that C.L.
still had “substantially deteriorated in her functioning,” including recent proof of
significant loss of cognitive control. LaBelle, 107 Wn.2d at 208.
C.L. also expressed that she would stop taking medication if released. Our
4 No. 88404-2-I/5
Supreme Court held in LaBelle that the statute allows the State to “treat
involuntarily those discharged patients who, after a period of time in the
Free access — add to your briefcase to read the full text and ask questions with AI
IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON
In the Matter of the Detention of No. 88404-2-I
C.L., DIVISION ONE
Appellant. UNPUBLISHED OPINION
DÍAZ, J. — A trial court committed C.L. to 14 days of involuntary detention
pursuant to the involuntary treatment act (ITA), ch. 71.05 RCW. C.L. now argues
the State failed to adduce sufficient evidence proving she was gravely disabled.
Disagreeing, we affirm.
I. BACKGROUND
In January 2025, C.L.’s daughter called a King County designated crisis
responder (DCR), who came to C.L.’s home and then filed a petition for a 120-hour
initial detention under RCW 71.05.153. Valley Cities Recovery Place Kent (Valley
Cities), to which C.L. was admitted, then sought to commit C.L. for 14 more days.
On June 25 and 26, the court held a hearing on the petition. 1 After hearing
1 The record does not indicate what caused the delay between the initial petition
for detention, filed in January 2025, and the hearing on the 14-day commitment No. 88404-2-I/2
testimony from C.L.’s daughter and a Valley Cities mental health counselor, the
court found that C.L. was gravely disabled. And the court found that a less
restrictive alternative treatment was not in C.L.’s best interest. The court ordered
an additional 14 days of involuntary treatment. C.L. timely appeals.
II. ANALYSIS
Pursuant to RCW 71.05.240, a court must hold a probable cause hearing
on a petition requesting an order for up to 14 days of involuntary treatment and
may only enter such an order if, at the conclusion of the hearing:
the court finds by a preponderance of the evidence that a person detained for behavioral health treatment, as the result of a behavioral health disorder, . . . is gravely disabled, and, after considering less restrictive alternatives to involuntary detention and treatment, finds that no such alternatives are in the best interests of such person or others[.]
RCW 71.05.240(4)(a) (emphasis added).
The ITA further provides two alternate definitions of “gravely disabled,”
namely:
a condition in which a person, as a result of a behavioral health disorder:
(a) [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; or (b) 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).
The court found that C.L. was gravely disabled under both RCW
held 6 months later. 2 No. 88404-2-I/3
71.05.020(25)(a) and (b). This court reviews whether substantial evidence
supports the trial court’s findings of fact, and whether the findings then support the
conclusions of law. In re Det. of LaBelle, 107 Wn.2d 196, 209, 728 P.2d 138
(1986). “‘Substantial evidence is a quantum of evidence sufficient to persuade a
fair-minded person.’” In re Det. of A.F., 20 Wn. App. 2d 115, 125, 498 P.3d 1006
(2021) (quoting In re Det. of H.N., 188 Wn. App. 744, 762, 355 P.3d 294 (2015)).
“We do not review a trial court’s decision regarding witness credibility or the
persuasiveness of the evidence.” Id. We hold that there was substantial evidence
to support the finding of grave disability under the standard set out by RCW
71.05.020(25)(b), with regard to both of its subparts, as follows. 2
As to the first part of the standard under RCW 71.05.020(25)(b), C.L. claims
the record did not support the court’s finding that she “had an escalating loss or
deterioration in routine functioning.” We disagree.
Her daughter testified that although C.L. has experienced religious
delusions for many years, she was relatively stable for about seven years. She
was able to converse and spend time with family. She would communicate about
her medication.
In May of 2024, C.L. was hospitalized because she stopped showering and
eating properly. She had stopped letting her daughter bring her groceries,
accusing her of being “evil” and not really being her daughter. She received a
diagnosis of paranoid schizophrenia. She was prescribed medication during her
2 Because RCW 71.05.020(25) sets out two equally valid bases for finding a person
gravely disabled, we need not additionally assess the extent of the evidence in the record of grave disability according to RCW 71.05.020(25)(a). 3 No. 88404-2-I/4
hospital stay and then released. After her release, she stopped taking her
medication.
C.L. again began experiencing religious delusions. She stopped sleeping
and showering. She stopped accepting food from her daughter and lost significant
weight. She clogged all her toilets and “started using the bathroom in garbage
bags.” She dumped water “all over the floors to the point where the floors are
caving in.” She destroyed her mobile home to the point that the city of Kenmore
condemned it so that “no one is allowed to occupy it in its current state.” From this
evidence, a reasonable person could conclude that C.L. had experienced “a
deterioration in routine functioning.” RCW 71.05.020(25)(b).
In response, C.L. argues that the evidence does not support such a finding
because C.L. had improved since she was initially admitted to Valley Cities. She
argues that because she had improved, any evidence of deterioration is not
sufficiently recent.
C.L. is correct that both her daughter and the Valley Cities counselor
testified that her symptoms had improved somewhat since she entered the facility.
But even the day before the hearing, she told the counselor that “the devil had
made her clog the toilet and that, again, demonic forces were at play during these
events.” This delusion, in context of her previous unsafe behavior resulting from
similar delusions, is substantial evidence to support the court’s conclusion that C.L.
still had “substantially deteriorated in her functioning,” including recent proof of
significant loss of cognitive control. LaBelle, 107 Wn.2d at 208.
C.L. also expressed that she would stop taking medication if released. Our
4 No. 88404-2-I/5
Supreme Court held in LaBelle that the statute allows the State to “treat
involuntarily those discharged patients who, after a period of time in the
community, drop out of therapy or stop taking their prescribed medication and
exhibit ‘rapid deterioration in their ability to function independently.’” 107 Wn.2d at
206 (quoting Durham & LaFond, The Empirical Consequences and Policy
Implications of Broadening the Statutory Criteria for Civil Commitment, 3 Yale L. &
Pol’y Rev. 395, 410 (1985)). By adding this prong of the statute, the legislature
intended to “provide the kind of continuous care and treatment that could break the
cycle” of release and rehospitalization. Id. at 206. The court may rightly not
“release a person whose condition, as a result of the initial commitment, has
stabilized or improved minimally . . . 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. The court therefore
was not, as C.L. argues, required to release her because her symptoms showed
some improvement.
The court in this case properly considered C.L.’s “prior decompensation
when not under treatment and discontinuing [her] medication, [her] dangerous
behavior as a result of [her] serious mental disorder when not medicated, [her] lack
of appreciation for the necessity of taking [her] medication, [her] stated intent to
discontinue medication unless ordered by the court, and the very high probability
that [her] behavior will once again become dangerous . . . if not under court order
to take [her] medication.” In re Det. of C.K., 108 Wn. App. 65, 77, 29 P.3d 69
(2001). We hold that there was a sufficient basis for a rational person to conclude
5 No. 88404-2-I/6
it was more likely than not that C.L. manifested “severe deterioration in routine
functioning evidenced by repeated and escalating loss of cognitive or volitional
control over his or her actions and [was] not receiving such care as [was] essential
for his or her health or safety.” RCW 71.050.020(25)(b). 3
We therefore conclude that substantial evidence supports the court’s finding
that C.L. was gravely disabled.
III. CONCLUSION
We affirm the trial court’s order.
WE CONCUR:
3 C.L. does not argue that the court lacked evidence for the second element of
RCW 71.05.020(25)(b), which requires that she was “not receiving such care as is essential for his or her health or safety.” To meet its burden, the State must prove that “‘the individual is unable, because of severe deterioration of mental functioning, to make a rational decision with respect to his need for treatment.’” C.K., 108 Wn. App. at 74 (emphasis omitted) (quoting LaBelle, 107 Wn.2d at 208). For the sake of completeness, we hold that there is ample evidence supporting the court’s finding that C.L. would not receive essential care outside the hospital for substantial evidence, including that her plan was to return to living independently in her mobile home even though the “home . . . [had] been condemned” and that she planned to stop taking her medication. 6