IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON
In the Matter of the Detention of No. 88003-9-I S.A. DIVISION ONE
UNPUBLISHED OPINION
HAZELRIGG, C.J. — S.A. appeals from the superior court order that
committed her for up to 180 days of involuntary treatment. She asserts that the
court did not have statutory authority to order such treatment and substantial
evidence does not support its order. We disagree and affirm.
FACTS
In late November 2024, a designated crisis responder (DCR) filed a petition
seeking to hospitalize S, a 14-year-old individual, for a short period for initial
evaluation and treatment. The DCR alleged that S had not showered in six
months, was urinating in her bedroom closet and would not allow her parents to
clean it, had not attended school in three years, had refused mental health and
medical treatment, had dental pain but refused to go to the dentist, barely ate any
food and, when she did, only ate sandwiches from a specific Starbucks café in
Seattle. 1 The DCR further contended that while meeting with S and her parents in
1 A later-submitted declaration in support of continued involuntary treatment of S stated
that at the time of her initial hospitalization, S had not brushed her teeth in six months and was engaging in ritualistic behaviors surrounding her food intake, including often spending up to $100 per day on Starbucks food and drinks. No. 88003-9-I/2
their home, S was “disheveled and highly malodorous,” with “greasy and matted”
hair. He also asserted that S had destroyed property inside of the home, regularly
assaulted her parents, and during his interview with them, assaulted him as well
as both of her parents. He stated that her “[f]amily indicated they are unable to
provide sufficient care at this time,” determined that she was gravely disabled, and
recommended that she be detained for involuntarily hospitalization.” On
December 1, Seattle Children’s Hospital admitted S for involuntary evaluation and
treatment.
On December 4, advanced registered nurse practitioner (ARNP) Jeffrey
Kljaich, a mental health provider with the hospital, filed a petition for an additional
14 days of involuntary evaluation and treatment for S. Kljaich alleged that while S
was hospitalized pursuant to the initial petition, she,
continued to exhibit many of the same symptoms that led to her initial detainment. She continued to refuse bathing herself even with bath wipes or a shower cap. She had several instances where she had urinated inappropriately on the floor due to fear that the toilet and restrooms here are contaminated and dirty, despite being cleaned nightly. She had two large mats in her hair that she refused staff to touch or begin to detangle. She saw no issue with the severity of her symptoms or behaviors.
He further stated that S had been “advised of the need for voluntary treatment,”
was “unwilling or unable to consent to necessary treatment,” and had been
“advised that involuntary commitment pursuant to this 14-day petition will result in
the loss of firearm rights.”
In late December, a commissioner of the trial court held a probable cause
hearing on the 14-day petition, with S represented by a guardian ad litem (GAL)
and legal counsel. As part of advising S regarding the potential loss of her right to
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possess firearms, the trial court ensured that S had a written copy of the
advisement and informed her, along with her GAL, as follows:
[I]f you don’t voluntarily agree to remain in the hospital, if, at the end of this hearing, the [c]ourt determines you will involuntarily remain in the hospital, you will lose your constitutional right to possess a firearm, and that right can only be reinstated with a court order. And I realize that that firearms advisement refers to RCW 71.05, but the provision in 71.34 is the same thing. So the advisements for minors is the same as the advisements for adults.
Then, during the State’s first witness’s testimony, S requested to speak with her
legal counsel, and following a private consultation, her counsel represented the
following to the court commissioner:
After discussion—further discussion with [S] and with her guardian ad litem . . . I do believe that we are able to discharge the guardian ad litem at this time and [S] would like to agree to the 14-day order.
(Emphasis added.)
The commissioner determined that S had agreed to the entry of a 14-day
involuntary commitment order and later entered a written order that she be
hospitalized for 14 days of involuntary treatment. The order specifically set forth
that S, “after consultation with counsel, voluntarily submitted [herself] to the
jurisdiction of the [c]ourt and agreed to the entry of an order of commitment for
behavioral health treatment.” The order also set forth that S was advised on the
record that she would be prohibited from possessing firearms, and “was provided
advisement on the record before she stipulated to agreed order.” S did not appeal
or otherwise challenge the entry of the 14-day commitment order.
On January 10, 2025, ARNP Alysse Craft, another treating provider at the
hospital, filed a petition to commit S for up to 180 days of further involuntary
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treatment. Craft alleged that S was gravely disabled because, as a result of a
mental disorder, she was in danger of serious physical harm resulting from a failure
to provide for her essential human needs of health or safety. Craft alleged that S
had obsessive-compulsive disorder (OCD) with contamination fears and was
unable to meet her basic hygiene needs or manage her food intake without
support. In a sworn declaration submitted in support of her petition, Craft stated,
[S] has expressed a strong aversion to touching objects she does not perceive as “clean,” and she believes that tap water is contaminated. Her compulsions include avoiding objects touched by others (such as chairs or door knobs), refusing to shower, wash her hands, or let water touch her skin, and requesting that others clean objects for her. She also insists on using only specific objects that she deems “clean.” There is also suspicion of additional obsessions, as [S] engages in ritualized behaviors with unclear purposes, such as walking in a peculiar pattern and refusing to allow her hair to be brushed or to brush her own hair.
Additionally, Craft declared,
Hospitalization remains necessary as [S] continues to be severely disabled and unable to meet her basic hygiene needs (such as showering and toileting) or manage her food intake without substantial support. If discharged to the community at this time, it is highly likely that she would revert to refusing showers, urinating in her bedroom, neglecting soiled clothing, and rejecting mental health care and medical treatment. Such poor hygiene poses significant health risks, including skin infections, breakdowns or lesions, dental infections, genitourinary infections, and systemic infections. If left untreated or if [S] continues to refuse medical care, these infections could ultimately lead to death. The risk of behavioral regression upon discharge is considerable.
ARNP Andrew Given, 2 a treating psychiatric nurse practitioner at the
hospital, also submitted a sworn declaration, similarly stating as follows:
Since admission, [S] has frequently presented as guarded, noncooperative, and her overall adherence to recommended
2 Given is also credentialed as a board-certified psychiatric-mental health nurse practitioner.
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treatment, including nutrition and hygiene expectations, has been variable. She often declines to engage in discussion of certain topics relevant to her care and wellbeing and frequently declines to meaningfully engage members of the clinical team. She has exhibited symptoms and behaviors consistent with Obsessive- Compulsive Disorder (OCD) including severe contamination fears and related ritualistic behaviors associated to nutrition (food, water), hygiene (showering, toileting, clothing and bedsheets), as well as particular objects and environments that are part of everyday life and functioning (utensils, chairs, bathrooms).
He further declared,
The severity of these symptoms and behaviors coupled with her limited insight prevents her from consistently meeting her own basic needs (including hygiene and nutrition). She remains severely impaired and requires consistent monitoring and significant support. There is a high likelihood of nonadherence to recommended treatment and decompensation at lower levels of care. Hospitalization remains warranted and ongoing managed treatment is necessary.
In late February, the court held a two-day hearing on Craft’s petition. The
State presented S’ medical records and the testimony of her mother and ARNP
Colleen Coyne, another treating provider with the hospital. S’ mother testified that
S spent “two years without eating at home at all” and had not gone to school for
about three years. She also explained that S was previously hospitalized for two
weeks in May 2024 and, when discharged from the hospital, S went back to not
eating, not showering, and got worse instead of getting better. She further
asserted that between May and November, S was not eating more than few bites
from sandwiches, did not shower, urinated in her bedroom closet, and was not
changing her clothing. S’ mother also testified that during S’ current
hospitalization, S was not eating the food or drinking what was provided to her, her
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recovery in the hospital was going “very slow,” and her mother believed that S was
“going to get worse if she c[ame] out” of the hospital.
S’ mother also stated that she and her husband had been visiting S at the
hospital, learning about her treatment and how to support her, had applied for
disability support, and that she would do her best to take care of S and keep her
safe. She further contended, however, that if S were discharged, S “has her own
mind and her opinion,” S was “going to do whatever she wants,” S “didn’t do
anything” following her last discharge from the hospital, and she was not sure
whether, if S were discharged, S “was going to go to school and do whatever she
is supposed to do.”
Coyne testified that she had evaluated S for the purpose of the 180-day
petition and, in doing so, had read S’ medical record and interviewed S, her
parents, and her treating providers. Coyne explained that S had working
diagnoses of OCD and “avoidant/restrictive food intake disorder.” Specifically, she
stated,
Obsessive[-]compulsive disorder is marked by really strong obsession. They can vary from person to person. For [S,] she has really strong ideas that water[,] all water[,] is contaminated and that by drinking water, by having water touch her skin or, you know, brushing her teeth using water that she will—that she will get sick or die or something negative will happen to her. The compulsive part of this disorder is the things that you do in order to help alleviate those obsessions. And in [S]’s case those compulsions are not wanting to shower, refusing to eat a wide variety of foods, refusing to change her clothing when she’s soiled herself, refusing to brush her teeth. And before coming to the hospital, it included going to the bathroom in her bedroom for quite a while because these fears were really, really strong.
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Coyne testified that during S’ hospitalization between December 2024 and
February 2025, S had gained weight, her nutritional markers were stable, and she
had intermittently demonstrated an ability to eat food, appropriately shower, and
use the toilet. She further stated, however, that S was receiving “hospital-grade
Boost[3] supplementation” for her nutritional needs, but continued to have
“intensely poor hygiene,” restrictive intake of food for days to weeks, and, although
she understood what her treatment providers were asking her to do, had “very
poor” insight into her obsessions and compulsions, including not agreeing that
“eating or completing her hygiene activities is necessary for her health or
wellness.” Coyne also explained that S had not consistently followed her
prescribed medication regimen or engaged with medical treatment “as recently as
yesterday and the day before,” continued to demand to exclusively eat food from
Starbucks, had refused to wear feminine hygiene products during menstruation,
and had refused to clean her bathroom or herself after an episode of incontinence.
Coyne testified that S “has become nearly dependent on the Boost nutritional
supplement” that hospital staff were providing to S “to prevent her from nutritional
deficit” and specified that S “would not have access to [it] outside of the hospital.”
Coyne additionally noted that “most recently [S] has actually been eating less of
her food than she had towards the beginning of hospitalization.”
Coyne further testified that a less restrictive treatment alternative (LRA) was
not appropriate for S because she “currently requires 24/7 staff to aid her in
meeting those basic needs of eating and showering, brushing her teeth, and to
3 Coyne described Boost as a “hospital grade formula” of “nutritional supplement.”
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encourage treatment,” and she “has very consistently shown that she has not
engage [sic] in treatment; she does not want to participate in improving her nutrition
or improving her hygiene needs.” Coyne also opined,
If [S] doesn’t receive treatment in the inpatient setting, I—I would expect her to return to previous behaviors: refusing to eat; refusing to shower, clean her body; refusing to brush her teeth; and urinating in her bedroom; refusing to attend medical or mental health appointments; refusing to attend school. And the consequences of all of those behaviors is putting [S] at serious risk for infections, including skin infections, dental infections, genitourinary infections, systemic infections. And when that’s coupled with refusal to engage in medical appointments virtually or present for medical appointments in person, it makes that risk even higher that, if she were to get an infection, she would not—parents would not be able to get her to present for treatment. She continues to—she continues to require hospital-level care to complete those basic needs. Left untreated with the refusal of hygiene activities, those kind of infections could ultimately lead to her death. And stopping eating for periods of time and then—refusing to eat for periods of time and then resuming eating at a higher— resuming eating sort of suddenly with a high amount of calories, which [S] has also done historically—that can also lead to medical destabilization. The biggest risk is refeeding syndrome which can lead to cardiac death.
The commissioner granted the petition, issued oral and written findings of
fact and conclusions of law, and entered an order that committed S for up to 180
additional days of involuntary treatment. S subsequently filed a motion to revise
the commissioner’s order, which the superior court denied. The court ruled that its
order was based on the “findings and conclusions of the commissioner which the
[c]ourt affirms and adopts as its own” and further ruled,
The [c]ourt agrees with and adopts the [c]ommissioner’s detailed and well-reasoned order. Key aspects of this matter include the harmful consequences established at the hearing and the principle
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established in LaBelle[4] that the risk of serious physical harm need not be “imminent” at the time of the hearing.
S timely appealed.
ANALYSIS
This matter comes before us on an appeal from the superior court’s order
denying S’ motion to revise the court commissioner’s order that committed her for
involuntary treatment for a period up to 180 days.
As a general matter, we have recognized,
[u]nder RCW 2.24.050, the findings and orders of a court commissioner not successfully revised become the orders and findings of the superior court. A revision denial constitutes an adoption of the commissioner’s decision, and the court is not required to enter separate findings and conclusions. In re Marriage of Williams, 156 Wn. App. 22, 27-28, 232 P.3d 573 (2010). On appeal, this court reviews the superior court’s ruling, not the commissioner’s. [In re Marriage of] Stewart, 133 Wn. App. [545,] 550, [137 P.3d 25 (2006)].
Maldonado v. Maldonado, 197 Wn. App. 779, 789, 391 P.3d 546 (2017). 5
On appeal, S presents several bases on which she asserts that the trial
court erred when it entered the 180-day commitment order herein. None are
availing.
4 In re Det. of Labelle, 107 Wn.2d 1 96, 728 P.2d 138 (1986) 5 We note that S correctly contends that although her 180-day commitment period has
elapsed, the matter is not moot. As identified in her briefing, this court has recognized that “[a]ppeals involving involuntary commitments are not moot because prior involuntary commitment orders have potential collateral consequences.” In re Det. of A.M., 17 Wn. App. 2d 321, 324 n.1, 487 P.3d 531 (2021).
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I. Challenge to Validity of 14-Day Involuntary Treatment Order
S asserts for the first time on appeal that the trial court erred when it entered
the 180-day involuntary treatment order because no valid 14-day involuntary
treatment order was entered in this case. For several reasons S’ assertion fails.
As a preliminary matter, S does not present us with argument or authority
in support of the proposition that we may consider this error which she raises for
the first time on review. Under RAP 2.5(a), we
may refuse to review any claim of error which was not raised in the trial court. However, a party may raise the following claimed errors for the first time in the appellate court: . . . (3) manifest error affecting a constitutional right.
Here, S did not challenge or otherwise appeal the 14-day commitment order.
Additionally, during the proceedings on the 180-day commitment petition, S did not
challenge the validity of the 14-day commitment order as a necessary predicate
for the subsequent ITA order either in her closing argument to the commissioner
or her motion to revise the commissioner’s order granting the 180-day petition. 6
Her failure to raise this issue in the trial court deprived both the trial court
and the State of the opportunity to respond to, and potentially correct, this alleged
error. See State v. Johnson, 119 Wn.2d 167, 171, 829 P.2d 1082 (1992).
6 S also asserts, for the first time on appeal, that the court improperly deprived her of the
constitutional right to possess firearms when it entered the 180-day involuntary treatment commitment order against her. Although she presents analysis in support of manifest error under RAP 2.5(a), we need not address this contention because no error exists. Her briefing explicitly concedes that the “court properly advised her of potential consequences to her firearm rights” at her hearing on the 14-day petition and the remainder of her assertion is predicated on the alleged invalidity of the court’s 14-day commitment order. Given that she does not dispute that she was properly advised pursuant to the 14-day commitment proceeding and the statute that governs 180-day commitments, RCW 71.34.750, does not require further advisement as to the loss of firearms rights in a hearing on such a petition, she fails to demonstrate any error.
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Additionally, her appellate briefing does not present any argument or analysis in
support of the proposition that such an alleged error is one of constitutional
magnitude such that we may consider for the first time on appeal under RAP
2.5(a). 7 Therefore, we decline to review this claim of error.
II. Substantial Evidence Supports 180-Day Commitment Order
S next contends that the trial court separately erred when it entered the 180-
day commitment order because the trial record does not contain substantial
evidence to support the entry of such an order. We disagree.
RCW 71.34.750(6) provides,
For one hundred eighty-day commitment: (a) The court must find by clear, cogent, and convincing evidence that the minor: (i) Is suffering from a mental disorder or substance use disorder; (ii) Presents a likelihood of serious harm or is gravely disabled; and (iii) Is in need of further treatment that only can be provided in a one hundred eighty-day commitment.
Our Supreme Court has instructed that the clear, cogent, and convincing
evidence standard
means the ultimate fact in issue must be shown by evidence to be “highly probable.” See In re [Interest of] Pawling, 101 Wn.2d 392, 399, 679 P.2d 916 (1984); In re [Welfare of] Sego, 82 Wn.2d 736, 513 P.2d 831 (1973). Generally, where the trial court has weighed the evidence, appellate review is limited to determining whether substantial evidence supports the findings and, if so, whether the findings in turn support the trial court’s conclusions of law and judgment. Ridgeview Properties v. Starbuck, 96 Wn.2d 716, 719, 638 P.2d 1231 (1982). However, where the State must prove its
7 Although S’ briefing does present analysis and application of RAP 2.5(a) with regard to
an alleged error concerning the trial court’s advisement of her continued loss of her constitutional right to possess firearms at the 180-day commitment petition hearing, she does not present such analysis with regard to her assignment of error regarding the 14-day order.
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case by clear, cogent and convincing evidence, the evidence must be more substantial than in the ordinary civil case in which proof need only be by a preponderance of the evidence, In re [Welfare of] Hall, 99 Wn.2d 842, 849, 664 P.2d 1245 (1983); in other words, the findings must be supported by substantial evidence in light of the “highly probable” test. In re Pawling, supra at 399. Accordingly, we will not disturb the trial court’s findings of “grave disability” if supported by substantial evidence which the lower court could reasonably have found to be clear, cogent and convincing.
In re Det. of LaBelle, 107 Wn.2d 196, 209, 728 P.2d 138 (1986).
Additionally, we have recognized,
“‘Substantial evidence’ is the quantum of evidence sufficient to persuade a fair-minded person” that the premise is true. In re Det. of H.N., 188 Wn. App. 744, 762, 355 P.3d 294 (2015). Furthermore, when evaluating the sufficiency of the evidence, we consider the evidence in the light most favorable to the [p]etitioners. In re Det. of B.M., 7 Wn. App. 2d 70, 85, 432 P.3d 459, review denied, 193 Wn.2d 1017 (2019).
In re Det. of A.M., 17 Wn. App. 2d 321, 330, 487 P.3d 531 (2021).
On appeal, S does not dispute that she was suffering from a mental disorder
during the time in question. Therefore, it is uncontested that S was suffering from
OCD and avoidant or restrictive food intake disorder. Rather, S contends that the
trial record does not contain substantial evidence supporting the two remaining
statutory requirements on which the court relied: that she was gravely disabled,
RCW 71.34.750(6)(ii), and that she was in need of further treatment that could only
be provided in a 180-day commitment, RCW 71.34.750(6)(iii). As analyzed infra,
neither contention establishes an entitlement to appellate relief.
A. Substantial Evidence Supports that S was Gravely Disabled
RCW 71.34.020(27) defines a “[g]ravely disabled minor,” in relevant part,
as “a minor who, as a result of a behavioral health disorder, (a) is in danger of
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serious physical harm resulting from a failure to provide for [their] essential human
needs of health or safety.” According to our Supreme Court, subsection (a)
requires
recent, tangible evidence of failure or inability to provide for such essential human needs as food, clothing, shelter, and medical treatment which presents a high probability of serious physical harm within the near future unless adequate treatment is afforded. Furthermore, the failure or inability to provide for these essential needs must be shown to arise as a result of mental disorder and not because of other factors.
LaBelle, 107 Wn.2d at 204-05 (emphasis added). 8
Here, the trial court concluded that S was gravely disabled as a result of her
mental health diagnoses such that she was at a substantial risk of harm because
of her inability to provide for her own essential needs of health and safety. As an
initial matter, the court found that S engaged in the following behavior while at
home for at least six months prior to her December 2024 hospitalization: either she
or her parents reported that she was not eating food or drinking water provided to
her other than small bites of Starbucks sandwiches; she was urinating on the floor
or in her closet; she did not wash her hands, brush her teeth, or shower because
she did not like the feeling of water on her skin; she would only defecate in the
toilet if her mother cleaned the bathroom before she used the toilet; she would not
change her clothes, and she exhibited both noticeable body odor and matted,
8 Although the matter before us is governed by the provisions of chapter 71.34 RCW and
the court’s decision in LaBelle regarded chapter 71.05 RCW, which concerns involuntary commitment for adults, not minors, the definitional language therein is effectively identical to that set forth in chapter 71.34 RCW. See LaBelle, 107 Wn.2d at 201-02; compare RCW 71.05.020(25), with RCW 71.34.020(27).
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greasy hair. The court further found that S had been hospitalized in May 2024 but
when she returned home, those behaviors continued.
The court also found that S continued to present active symptoms of her
disorders over the course of her current hospitalization, including not wanting to
drink, touch, or shower in water due to her pervasive belief that all water is
contaminated, refusal to eat a wide variety of foods, change her clothes, brush her
teeth, or engage in dental care, and a consistent lack of cooperation with hospital
staff. Additionally, the court found that S repeatedly reported to her healthcare
providers that she had historically resisted bathing and disliked water on her body
and her belief that the bathroom toilet seat was dirty and it would be cleaner for
her to urinate on the floor. The court specifically found that S
continues to express fear of touching objects because she believes that they are unclean. She continues to engage in a ritualized behavior as she refuses to brush her hair or allow anybody else to brush it. She recently urinated in her bed while she was fully clothed and couldn’t explain why. She continues to skip meals.
The court further found that although S’ condition was improving on
prescribed medications and she had showered at times, S did not consistently
participate in treatment or follow her prescribed medication regimen, was not
properly attending to her activities of daily living, refused to wear hygienic products
or underwear during menstruation, refused to clean her own bathroom, and did not
understand the impact that failing to attend to such activities would have on her
health. The court therefore concluded that S was “clearly placing her health at risk
due to her behavioral health disorder.”
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Taking the evidence in the light most favorable to the State, the record
contains ample evidence supporting that as a result of S’ behavioral health
disorders, there was a high probability that she was in danger of serious physical
harm resulting from a failure to provide for her essential human needs of health or
safety. The record reflects that even in a highly structured environment and only
days prior to the hearing on the 180-day commitment petition, she was unable to
consistently secure her nutritional or hygienic needs and did not consistently follow
her designated treatment, engage in hygienic behavior, or understand the health
risks associated with such conduct.
Furthermore, the record supports the conclusion that such a circumstance
“presents a high probability of serious physical harm within the near future unless
adequate treatment is afforded.” See LaBelle, 107 Wn.2d at 205. Specifically, the
record included sworn declarations and testimony by S’ medical providers that her
inconsistent eating could result in refeeding syndrome, which could lead to cardiac
death, and her poor hygiene combined with her refusal to engage in medical
treatment put her at serious risk of skin, dental, genitourinary, and systemic
infections, which could also result in her death if left untreated in the context of her
unhygienic conduct. Given all of this, substantial evidence supported the trial
court’s determination that S was gravely disabled. 9 Accordingly S’ assertion fails.
9 S nevertheless relies on the evidence indicating that while hospitalized, she maintained
a healthy weight and her lab work was unremarkable in support of the notion that her health and safety were not in imminent risk. However, that some of S’ health markers were somewhat stable while she was hospitalized does not meaningfully impact the evidence presented in the trial court reflecting a high likelihood that her inappropriate eating habits and unhygienic conduct, if left untreated, presented a high probability of serious physical harm within the near future. Indeed, S does not contest that if she did not address her conduct, it could result in a syndrome resulting in her death or if she became infected at any point, that such an infection could result in her death. Further, substantial evidence review does not consider whether the record could support some
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B. Substantial Evidence Supports that S Needed Further Treatment that Could Be Provided Only in 180-Day Hospitalization
As set forth supra, “[f]or one hundred eighty-day commitment: (a) The court
must find by clear, cogent, and convincing evidence that the minor: . . . (iii) Is in
need of further treatment that only can be provided in a one hundred eighty-day
commitment.” RCW 71.34.750(6). Subsection 8 of that provision states,
If the court finds that the criteria for commitment are met and that less restrictive treatment in a community setting is not appropriate or available, the court shall order the minor committed to the custody of the director for further inpatient mental health treatment . . . . If the court finds that a less restrictive alternative is in the best interest of the minor, the court shall order less restrictive alternative treatment upon such conditions as necessary.
RCW 71.34.750(8)(a) (emphasis added).
Here, the trial court found that a less restrictive environment was not
appropriate for S and she was in need of further treatment that could be provided
only by way of a 180-day commitment. This was so, the court found, because S’
condition had not stabilized and she had become dependent on a hospital-grade
supplement for her nutritional intake that could not be provided outside of a hospital
setting. The court further found that she had not previously followed through with
her promises to engage in her activities of daily living while at home and she had
previously returned home from a two-week May 2024 hospitalization only to revert
to her prior behaviors. In addition, the court found that S was not capable of
independently securing her medicinal, hygienic, and nutritional needs even in the
other finding or conclusion by the trial court but, rather, whether the determination reached by the court is properly supported. See In re Pers. Restraint of Reyes, 21 Wn. App. 2d 353, 374, 505 P.3d 1234 (2022) (“Even if there is conflicting evidence, we will not disturb findings of fact that are supported by substantial evidence.”). Thus, S’ claim fails.
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context of the highly structured environment of inpatient treatment and with her
parents’ help. The court further found that S required a “higher level of care than
her parents can provide at home at this time,” and her mother did not testify that
she was ready to take S home but, rather, testified that “if [S] were released at this
time, that she believes that [S] will be worse when she gets home because she is
not doing well now.”
Taking the evidence in the light most favorable to the State, the record
plainly contains evidence supporting the court’s determination that it is highly
probable that the treatment needed by S was that which could only be provided in
a 180-day commitment. The record reflects that even in the highly structured
environment of an inpatient hospitalization, with her parents’ support while
hospitalized, she was unable to stabilize her behavioral health disorders, required
a higher level of care than her parents could provide at home, and, from her
parents’ own admission, her condition would worsen if she were discharged and
returned home. Indeed, as the court found, this “does not bode well for compliance
with a less restrictive treatment order at this time.” Thus, substantial evidence
supports the trial court’s determination herein. 10 Accordingly, the trial court did not
10 S nevertheless repeatedly asserts that no evidence was introduced in the trial court in
support of the statutory requirement that she was in need of further treatment that could only be provided in a 180-day commitment. We disagree. The trial court record plainly reflects that treatment options less restrictive than a 180-day commitment were not appropriate for her at that time, and it logically follows that a 180-day hospitalization was the only appropriate treatment option remaining. S also asserts that the trial court failed to meaningfully consider an LRA. Again, we disagree. As reflected by the analysis, supra, the court plainly considered but rejected such an alternative in light of the S’ unstable condition despite her hospitalization and significant parental support while hospitalized as well as her parents’ admission that they were unable to provide adequate support for her at home and her condition would likely worsen if she were discharged home. Lastly, S contends asserts that the trial court erred because RCW 71.34.010(2) and RCW 71.34.750 require that courts offer less restrictive alternatives for treatment to children. Because
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err when it ordered that S be hospitalized for up to 180 days of involuntary
Affirmed.
WE CONCUR:
she does not offer persuasive statutory interpretation or decisional authority in support of such a requirement and because such provisions plainly do not mandate as much, S’ assertion fails.
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