In re: P.A.
2018 Ohio 2314
Ohio Ct. App.2018Background
- P.A., a 35-year-old woman diagnosed with bipolar disorder/psychotic symptoms, was admitted to Twin Valley on August 17, 2017 as incompetent to stand trial and homeless with recent assaultive and erratic behavior.
- Twin Valley clinicians filed an affidavit of mental illness (Sept. 12, 2017) and an application to authorize forced psychotropic medication, alleging P.A. was psychotic, lacked capacity for treatment decisions, posed risk to self/others, and could not meet basic needs.
- A magistrate found probable cause, ordered continued detention, appointed counsel and a court psychiatrist, and scheduled a full hearing.
- At the September 15, 2017 full hearing, Dr. Bates (court doctor) and Dr. Davis (treating psychiatrist) testified that P.A. had a psychotic disorder, lacked treatment capacity, presented danger and inability to meet basic needs, and would likely improve with antipsychotics.
- The magistrate committed P.A. for 90 days and authorized forced medication; the probate court adopted the magistrate’s decisions over P.A.’s objections.
- P.A. appealed, arguing (1) erroneous involuntary commitment and (2) erroneous authorization of forced psychotropic medication.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether record supported involuntary commitment under R.C. 5122.01(B) | P.A.: not a "mentally ill person subject to court order"; commitment improper | State/Twin Valley: evidence showed substantial mental disorder, gross impairment, danger and inability to meet basic needs | Court: affirmed commitment; competent, credible evidence satisfied clear-and-convincing standard |
| Whether court properly authorized forced psychotropic medication (Steele factors) | P.A.: (no developed argument presented on appeal) | Clinicians: P.A. lacked capacity to consent, benefits outweigh risks, no less intrusive effective alternative | Court: affirmed authorization; testimony supported all Steele prongs |
Key Cases Cited
- In re Miller, 63 Ohio St.3d 99 (Ohio 1992) (affidavit of mental illness must state facts establishing probable cause)
- State v. Schiebel, 55 Ohio St.3d 71 (Ohio 1990) (appellate review of clear-and-convincing findings tests adequacy of evidence)
- Eastley v. Volkman, 132 Ohio St.3d 328 (Ohio 2012) (standard for weighing credibility and deference to factfinder in civil cases)
- Steele v. Hamilton Cty. CMH Bd., 90 Ohio St.3d 176 (Ohio 2000) (three-part test permitting forced psychotropic medication)
- Burton, 11 Ohio St.3d 147 (Ohio 1984) (use totality-of-the-circumstances factors in involuntary commitment determinations)