IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON
In the Matter of the Detention of ) No. 80825-7-I B.F. ) ) DIVISION ONE STATE OF WASHINGTON, ) ) Respondent, ) ) v. ) UNPUBLISHED OPINION ) B.F., ) ) Appellant. )
BOWMAN, J. — B.F. appeals his 14-day involuntary commitment for
mental health treatment under RCW 71.05.020(22)(b),1 arguing insufficient
evidence supports the court’s finding that he was “gravely disabled” and the court
deprived him of his constitutional right to a jury trial. We affirm.
FACTS
B.F. worked as a delivery driver for United Parcel Service (UPS) for over
20 years. In summer 2019, B.F. began suspecting people were following him on
his delivery route. At first, B.F. thought that UPS assigned a “safety team” to
follow him, but his boss denied it. Then B.F. wondered if an insurance company
investigator was watching him to gather evidence in a pending injury claim. His
1Unless otherwise noted, all citations to chapter 71.05 RCW throughout this opinion are to the former statutes in effect in 2019.
Citations and pin cites are based on the Westlaw online version of the cited material. No. 80825-7-I/2
sister, an attorney, inquired and learned that the insurance company was not
following B.F.
Despite his sister’s reassurances, B.F. continued to believe that people
and cars were following him. During a shift in late August, B.F. became so
concerned and distracted by thoughts of being followed that he called his boss
and asked to be taken off the road. B.F. then took medical leave from his job to
figure out what was happening to him. Soon after taking leave, B.F. was unable
to pay rent on his new apartment. The manager evicted him and he began living
in his car.
Over the next few months, his family members saw a decline in his
behavior and appearance. B.F.’s brother-in-law Terran2 noticed “significant
changes” in B.F. in September and October. B.F. had always been committed to
his job, exercised, and took care of his mother. But B.F. became paranoid and
delusional over the summer and fall. B.F.’s eating habits changed and he lost 30
to 40 pounds. His hygiene began to suffer and he looked “disheveled.”
According to Terran, B.F. was once “somebody who cares a lot about his
appearance. He always makes sure that he is . . . well-groomed . . . . He’s
always put together very well and just lately he stinks.”
Terran testified that B.F. seemed “scattered” and “ramble[d] on sometimes
incoherently.” He described B.F.’s increasing paranoia:
When he left work, he said that he was being followed by a couple of people, and that has since escalated. He said six people [were] following him, then it was 18 people. Now he is indicating that he
2 We use only the first names of B.F.’s family members to protect his identity.
2 No. 80825-7-I/3
believes that airplanes are following him, that . . . people walk by with dogs, if a dog barks, he thinks those people are being sent to watch him. If anybody coughs, he believes those people are being sent to watch him. Just extreme, extremely strange behavior that has been concerning.
B.F. also began making concerning statements that he would have to kill himself
or someone else. In October, he brandished a large hunting knife and told
Terran that “somebody is going to die today, I’m going to have to kill somebody
because I’m going to protect myself.”
B.F.’s sister Blen said that B.F. became “very panicky and very erratic”
starting late summer and that he recently lost a lot of weight and stopped
showering. She became very concerned in late October when B.F. told her that
“the knife that he has is not good enough. . . . [T]hey are attacking him now and
he has to protect himself and he is going to purchase a gun.” He also said, “[I]t is
going to be them or me.” Blen was very worried that B.F. would attack and hurt
someone.
On October 28, 2019, B.F.’s family called 911 due to his increasing
paranoia. Police took B.F. to the Valley Medical Center Emergency Department
for a mental health evaluation. At the emergency room, B.F. “present[ed] with
paranoia; believing cars/people/airplanes and drones are following him.” He
displayed “fast and pressured” speech and “racing thoughts.” The State
petitioned to detain B.F. for involuntary mental health treatment, stating that B.F.
presented “as an imminent risk of serious harm to himself, to others, and as
gravely disabled due to his paranoid delusions, obsessions and impaired
judgment.”
3 No. 80825-7-I/4
After an initial 72-hour detention, the State petitioned to detain B.F. for up
to an additional 14 days of involuntary inpatient treatment, alleging that B.F. was
suffering from a mental disorder resulting in a likelihood of serious harm to
himself or others and that he was gravely disabled. The State alleged that B.F.
remained symptomatic and required more inpatient treatment in a psychiatric
hospital “to stabilize his functioning through pharmacological and
psychotherapeutic interventions.”
A court commissioner held a probable cause hearing, taking testimony
from Terran, Blen, and B.F. Clinical psychologist Dr. Robert Beatty also testified
at the hearing. Dr. Beatty concluded that B.F. had a “working diagnosis” of
“bipolar one, most recent episode manic, with psychotic features.” Dr. Beatty
testified:
[B.F.] was pretty clearly manic when he was brought into the emergency department. The decreased sleep, the hyper vigilance. There was also the psychotic part of it, the delusions, and probably hallucinations. He saw people following him around. So it is not just he believed they were following him around, but he actually saw people following him. He saw cars following him.
Dr. Beatty explained that B.F. was making decisions based on delusions
of people following him, including carrying a knife, thinking about getting other
forms of protection, and changing the way he drove. According to Dr. Beatty,
B.F. was responding well to treatment with a mood stabilizer and an
antipsychotic medication since admitted to the hospital. B.F. no longer saw
people following him but continued to have delusions. Dr. Beatty remained
4 No. 80825-7-I/5
concerned about B.F.’s persistent belief that he was being followed:
[H]e has that firmly held belief and he is making decisions based off of it, including carrying weapons and attempting to obtain — or intending to obtain more weapons, that is a very dangerous situation, and it is a significant departure from the level of cognitive and volitional ability he demonstrated during his time working for UPS as indicated by both him and the testimony of his family.
Dr. Beatty believed that without further treatment, B.F. was at risk of
ongoing paranoid delusions, raising the possibility that “if he is in a less
structured setting, he will perceive a passerby to be in on the delusion and use
the hunting knife.” Dr. Beatty was concerned that “untreated, the symptoms will
continue to sort of overwhelm [B.F.’s] ability to cope and adapt to the vagaries of
life up to and including providing for food, clothing, and shelter.” Dr. Beatty did
not recommend less restrictive treatment because he was “sure” that B.F.’s
delusions would persist “if he were discharged today,” and that “[a]t this point
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. 80825-7-I B.F. ) ) DIVISION ONE STATE OF WASHINGTON, ) ) Respondent, ) ) v. ) UNPUBLISHED OPINION ) B.F., ) ) Appellant. )
BOWMAN, J. — B.F. appeals his 14-day involuntary commitment for
mental health treatment under RCW 71.05.020(22)(b),1 arguing insufficient
evidence supports the court’s finding that he was “gravely disabled” and the court
deprived him of his constitutional right to a jury trial. We affirm.
FACTS
B.F. worked as a delivery driver for United Parcel Service (UPS) for over
20 years. In summer 2019, B.F. began suspecting people were following him on
his delivery route. At first, B.F. thought that UPS assigned a “safety team” to
follow him, but his boss denied it. Then B.F. wondered if an insurance company
investigator was watching him to gather evidence in a pending injury claim. His
1Unless otherwise noted, all citations to chapter 71.05 RCW throughout this opinion are to the former statutes in effect in 2019.
Citations and pin cites are based on the Westlaw online version of the cited material. No. 80825-7-I/2
sister, an attorney, inquired and learned that the insurance company was not
following B.F.
Despite his sister’s reassurances, B.F. continued to believe that people
and cars were following him. During a shift in late August, B.F. became so
concerned and distracted by thoughts of being followed that he called his boss
and asked to be taken off the road. B.F. then took medical leave from his job to
figure out what was happening to him. Soon after taking leave, B.F. was unable
to pay rent on his new apartment. The manager evicted him and he began living
in his car.
Over the next few months, his family members saw a decline in his
behavior and appearance. B.F.’s brother-in-law Terran2 noticed “significant
changes” in B.F. in September and October. B.F. had always been committed to
his job, exercised, and took care of his mother. But B.F. became paranoid and
delusional over the summer and fall. B.F.’s eating habits changed and he lost 30
to 40 pounds. His hygiene began to suffer and he looked “disheveled.”
According to Terran, B.F. was once “somebody who cares a lot about his
appearance. He always makes sure that he is . . . well-groomed . . . . He’s
always put together very well and just lately he stinks.”
Terran testified that B.F. seemed “scattered” and “ramble[d] on sometimes
incoherently.” He described B.F.’s increasing paranoia:
When he left work, he said that he was being followed by a couple of people, and that has since escalated. He said six people [were] following him, then it was 18 people. Now he is indicating that he
2 We use only the first names of B.F.’s family members to protect his identity.
2 No. 80825-7-I/3
believes that airplanes are following him, that . . . people walk by with dogs, if a dog barks, he thinks those people are being sent to watch him. If anybody coughs, he believes those people are being sent to watch him. Just extreme, extremely strange behavior that has been concerning.
B.F. also began making concerning statements that he would have to kill himself
or someone else. In October, he brandished a large hunting knife and told
Terran that “somebody is going to die today, I’m going to have to kill somebody
because I’m going to protect myself.”
B.F.’s sister Blen said that B.F. became “very panicky and very erratic”
starting late summer and that he recently lost a lot of weight and stopped
showering. She became very concerned in late October when B.F. told her that
“the knife that he has is not good enough. . . . [T]hey are attacking him now and
he has to protect himself and he is going to purchase a gun.” He also said, “[I]t is
going to be them or me.” Blen was very worried that B.F. would attack and hurt
someone.
On October 28, 2019, B.F.’s family called 911 due to his increasing
paranoia. Police took B.F. to the Valley Medical Center Emergency Department
for a mental health evaluation. At the emergency room, B.F. “present[ed] with
paranoia; believing cars/people/airplanes and drones are following him.” He
displayed “fast and pressured” speech and “racing thoughts.” The State
petitioned to detain B.F. for involuntary mental health treatment, stating that B.F.
presented “as an imminent risk of serious harm to himself, to others, and as
gravely disabled due to his paranoid delusions, obsessions and impaired
judgment.”
3 No. 80825-7-I/4
After an initial 72-hour detention, the State petitioned to detain B.F. for up
to an additional 14 days of involuntary inpatient treatment, alleging that B.F. was
suffering from a mental disorder resulting in a likelihood of serious harm to
himself or others and that he was gravely disabled. The State alleged that B.F.
remained symptomatic and required more inpatient treatment in a psychiatric
hospital “to stabilize his functioning through pharmacological and
psychotherapeutic interventions.”
A court commissioner held a probable cause hearing, taking testimony
from Terran, Blen, and B.F. Clinical psychologist Dr. Robert Beatty also testified
at the hearing. Dr. Beatty concluded that B.F. had a “working diagnosis” of
“bipolar one, most recent episode manic, with psychotic features.” Dr. Beatty
testified:
[B.F.] was pretty clearly manic when he was brought into the emergency department. The decreased sleep, the hyper vigilance. There was also the psychotic part of it, the delusions, and probably hallucinations. He saw people following him around. So it is not just he believed they were following him around, but he actually saw people following him. He saw cars following him.
Dr. Beatty explained that B.F. was making decisions based on delusions
of people following him, including carrying a knife, thinking about getting other
forms of protection, and changing the way he drove. According to Dr. Beatty,
B.F. was responding well to treatment with a mood stabilizer and an
antipsychotic medication since admitted to the hospital. B.F. no longer saw
people following him but continued to have delusions. Dr. Beatty remained
4 No. 80825-7-I/5
concerned about B.F.’s persistent belief that he was being followed:
[H]e has that firmly held belief and he is making decisions based off of it, including carrying weapons and attempting to obtain — or intending to obtain more weapons, that is a very dangerous situation, and it is a significant departure from the level of cognitive and volitional ability he demonstrated during his time working for UPS as indicated by both him and the testimony of his family.
Dr. Beatty believed that without further treatment, B.F. was at risk of
ongoing paranoid delusions, raising the possibility that “if he is in a less
structured setting, he will perceive a passerby to be in on the delusion and use
the hunting knife.” Dr. Beatty was concerned that “untreated, the symptoms will
continue to sort of overwhelm [B.F.’s] ability to cope and adapt to the vagaries of
life up to and including providing for food, clothing, and shelter.” Dr. Beatty did
not recommend less restrictive treatment because he was “sure” that B.F.’s
delusions would persist “if he were discharged today,” and that “[a]t this point
[B.F.] is not able to exercise the sort of executive function necessary to be safe in
the community.”
B.F. testified that he no longer believed that people are following him. He
denied any significant weight loss and attributed his minimal sleep to
homelessness. B.F. said he secured housing with a coworker and he planned to
return to work at UPS in a role other than delivery driver. He told the court he
had an appointment with a psychiatrist, intended to take his bipolar medication,
and would return to the hospital if he became concerned about people following
him.
5 No. 80825-7-I/6
The court found that B.F. “has a mental disorder that substantially affects
his volitional and cognitive functioning.” It concluded that B.F. had “shown a
substantial deterioration of functioning.” The court stated:
This was a very high functioning man. He had a responsible job with UPS as a driver. He has a long history of safe driving. And all of a sudden he can’t even drive for UPS and finish his route. He is clearly affected and deteriorated. The family describes the deterioration of his eating habits, and he in fact admits the deterioration in his sleep. He is at the point where his [sic] not able to maintain housing. He is not able to get adequate sleep, but he has trouble [indiscernible] because he is losing weight.[3]
The commissioner entered findings of fact and conclusions of law
following the probable cause hearing. The court noted, “The Respondent has
also taken various steps based on these delusions, including taking [medical]
leave from his job, losing his housing, obtaining a knife to protect himself and
expressing the desire to obtain a gun to protect himself.” The court found B.F.
presented a safety risk to himself “because he might act” on the delusions that
people are following him, endangering himself and others. The court concluded
that B.F. needed inpatient treatment because he continued to have symptoms
and needed the structure of a hospital to prevent risk to himself or others. The
commissioner “found by a preponderance of the evidence” that B.F. was “gravely
disabled under prong (b)”4 and ordered up to 14 days of inpatient treatment.
B.F. moved for revision of the commissioner’s decision. A superior court
judge denied the motion. B.F. appeals.
3 Second alteration in original. 4 RCW 71.05.020(22).
6 No. 80825-7-I/7
ANALYSIS
Gravely Disabled
B.F. claims the evidence presented at the probable cause hearing does
not support his commitment for treatment. Specifically, B.F. argues the evidence
does not establish repeated cycles of deterioration as needed for a finding of
“gravely disabled” under RCW 71.05.020(22)(b). The State contends that
“evidence of prior hospitalization or police involvement — repeated occurrences
of stabilization and treatment —” is not required for involuntary commitment as
“gravely disabled” under prong (b) of the statute. We agree with the State.
To commit a person for 14 days of involuntary treatment, the court must
hold a probable cause hearing and find
by a preponderance of the evidence that such person, as the result of a mental disorder . . . , presents a likelihood of serious harm, or 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(3)(a). Because the trial court weighed the evidence, we limit our
review to whether substantial evidence supports the court’s findings of fact and
whether those findings support the conclusions of law and judgment. In re Det.
of LaBelle, 107 Wn.2d 196, 209, 728 P.2d 138 (1986).
Here, the State alleged that B.F. was “gravely disabled” under prong (b) of
RCW 71.05.020(22), which provides:
“Gravely disabled” means a condition in which a person, as a result of a mental disorder, or as a result of the use of alcohol or other psychoactive chemicals: . . . 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.
7 No. 80825-7-I/8
To show that a person is “gravely disabled” under RCW 71.05.020(22)(b),
the State must provide evidence of severe deterioration of routine functioning,
which
must include recent proof of significant loss of cognitive or volitional control. In addition, the evidence must reveal 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.
LaBelle, 107 Wn.2d at 208. The State must also show that the individual is
“unable, because of severe deterioration of mental functioning, to make a rational
decision with respect to his need for treatment.” LaBelle, 107 Wn.2d at 208.
B.F. emphasizes language in LaBelle to argue that prong (b) of the statute
defining “gravely disabled”5 applies to only “ ‘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.’ ” LaBelle, 107 Wn.2d at 207. According to B.F., the State must
prove “repeated loss of control,” including “evidence of hospitalizations or police
involvement due to repeated ‘rapid deterioration,’ ” to commit him under RCW
71.05.020(22)(b). But B.F. quotes LaBelle out of context. The full text to which
B.F. refers reads:
The definition of gravely disabled in RCW 71.05.020[(22)](b) was added by the Legislature in 1979. It was intended to broaden the scope of the involuntary commitment standards in order to reach those persons in need of treatment for their mental disorders who did not fit within the existing, restrictive statutory criteria. By incorporating the definition of “decompensation,” which is the progressive deterioration of routine functioning supported by
5 LaBelle cites to former RCW 71.05.020(1) (1979), the subsection of the statute defining
“gravely disabled” at the time.
8 No. 80825-7-I/9
evidence of repeated or escalating loss of cognitive or volitional control of actions, RCW 71.05.020[(22)](b) permits 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.”
LaBelle, 107 Wn.2d at 205-066 (quoting Mary L. Durham & John Q. LaFond, The
Empirical Consequences & Policy Implications of Broadening the Statutory
Criteria for Civil Commitment, 3 Yale L. & Pol’y Rev. 395, 410 (1985)).
Contrary to B.F.’s assertion, neither RCW 71.05.020(22)(b) nor the
relevant case law requires a prior hospitalization as an element for finding a
person to be gravely disabled. See In re Det. of D.W., 6 Wn. App. 2d 751, 758-
59, 431 P.3d 1035 (2018).7 Instead, the Labelle court was highlighting a new
population of patients served by the expanded scope of involuntary commitment.
Indeed, the court affirmed the commitment of two appellants (LaBelle and
Trueblood) under RCW 71.05.020(22)(b) with no evidence of repeated
hospitalization or loss of control. LaBelle, 107 Wn.2d at 209-10, 214-16. In
doing so, it recognized that the trial court need only find that a patient
experienced “recent” loss of cognitive or volitional control due to a mental
disorder, is unable to make rational choices about treatment, and lacks the
6 Citations omitted. 7 B.F. argues we should disregard D.W. because the court held that “subsection (b) [of
the statute] was proved by ‘ [“]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,[”] ’ ” and that “this was a clear misattribution” of subsection (a) of RCW 71.05.020(22) (a person is gravely disabled under prong (a) if the person is “in danger of serious physical harm resulting from a failure to provide for his or her essential human needs of health or safety”). D.W., 6 Wn. App. 2d at 757 (quoting LaBelle, 107 Wn.2d at 204-05). But B.F. conflates the holding of D.W., which clearly addresses the elements of subsection (b). The misattribution to which B.F. refers is in an opening paragraph of the analysis and has no impact on the court’s holding. See D.W., 6 Wn. App. 2d at 756-57.
9 No. 80825-7-I/10
essential care needed for their own health or safety if released. LaBelle, 107
Wn.2d at 208.
Here, the record shows that B.F. was making decisions based on
delusions caused by his mental impairment. B.F. carried a knife and mentioned
getting a gun to protect himself. He said he would have to kill either himself or
someone else. Dr. Beatty expressed concern that B.F. might react violently in
response to his delusions. Additionally, B.F. was unable to maintain his job and
housing. He lost a significant amount of weight and his personal hygiene
declined significantly. Dr. Beatty testified that without further treatment, B.F.’s
“symptoms will continue to sort of overwhelm his ability to cope and adapt to the
vagaries of life.” For these reasons, Dr. Beatty believed B.F. needed the
structure of the hospital and further intervention to abate the delusions.
Substantial evidence supports the court’s findings and conclusions that
B.F. was “gravely disabled” under prong (b) of RCW 71.05.020(22) and required
further hospitalization. A less restrictive alternative was not appropriate because
substantial evidence established that B.F.’s delusions would persist if the hospital
discharged him and that a structured environment was necessary to prevent him
from possibly acting on them. We affirm the trial court’s order of commitment for
up to 14 days of inpatient treatment.
Right to a Jury Trial
B.F. contends that he “was deprived of his constitutional right to trial by
jury on a 14-day commitment petition.” He argues that the right to a jury trial for
involuntary commitment existed at the time of statehood in 1889 and article I,
10 No. 80825-7-I/11
section 21 of the Washington State Constitution preserves that right. But we
rejected B.F.’s argument in In re Detention of S.E., 199 Wn. App. 609, 400 P.3d
1271 (2017), review denied, 189 Wn.2d 1032, 407 P.3d 1152 (2018). After
extensive historical analysis, we concluded:
[T]here was no proceeding in 1889 to which the jury trial right attached akin to the proceeding referenced as a probable cause hearing in RCW 71.05.240. Accordingly, the Washington Constitution does not require that a jury be seated to determine the issues presented in a probable cause hearing commenced pursuant to RCW 71.05.240.
S.E., 199 Wn. App. at 627-28. We decline B.F.’s request to reconsider this
decision.
Because sufficient evidence supports the court’s finding that B.F. was
gravely disabled and he had no right to a jury trial, we affirm the 14-day
commitment order.
WE CONCUR: