In RE: S.M. Appeal Of: S.M.
176 A.3d 927
| Pa. Super. Ct. | 2017Background
- S.M. was involuntarily committed to psychiatric treatment; the trial court ordered 180 days total (30 inpatient, 150 outpatient) on May 25, 2016 after a de novo review of an MHRO certification. S.M. appealed.
- The County relied at hearing on the treating psychiatrist’s concern that S.M. stopped taking prescribed medications and on testimony that in Dec. 2015 S.M. went several days without eating or sleeping and used racial slurs at a step-down facility, prompting readmission.
- The trial court’s written opinion referenced a "20-year history of violent and aggressive behavior," but the certified record did not contain documentary or testimonial proof of that history; the County included an extra-record appendix to its brief which the appellate court refused to consider.
- The MHPA requires clear-and-convincing evidence that a person is ‘‘severely mentally disabled’’ and poses a ‘‘clear and present danger’’ to self or others to support involuntary commitment and imposes heightened procedural protections for successive commitments (sections 302–305).
- The Superior Court concluded the certified record lacked sufficient evidence to prove by clear and convincing evidence that S.M. posed a clear and present danger to herself under the MHPA, and reversed the commitment order; the County may refile with appropriate evidence.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether record contained sufficient evidence for 305 recommitment | S.M.: County failed to prove by clear & convincing evidence she posed a clear-and-present danger to herself (no suicide/ mutilation attempts; medication noncompliance alone insufficient) | County: evidence of medication refusal, functional decline (not eating/sleeping) and institutional behavior, plus prior long history of violence, justified recommitment | Reversed — certified record did not contain clear & convincing evidence of clear-and-present danger to self; trial court relied on unproven history not in record |
| Whether trial court properly considered S.M.’s long-term commitment history | S.M.: disputed; history not in certified record so cannot support current commitment | County: trial court could take judicial notice and the County appended history in brief | Held: appellate court will not consider extra-record materials; no indication judicial notice was taken; history could not be relied on |
| Whether evidence of medication noncompliance alone suffices for involuntary commitment | S.M.: noncompliance alone, without proof of likely death/serious harm, is insufficient | County: noncompliance led to functional deterioration and risk, supporting commitment | Held: testimony showed medication noncompliance and symptoms but did not establish reasonable probability of death/serious bodily injury within 30 days required by MHPA; insufficient |
| Admissibility/record limitations on appellate review | S.M.: appellate review limited to certified record; extra-record appendix not permissible | County: urged consideration of extra-record commitment history | Held: appellate review limited to certified record; extras in briefs cannot be considered |
Key Cases Cited
- Addington v. Texas, 441 U.S. 418 (U.S. 1979) (civil commitment requires due process and heightened evidentiary standard)
- Romett v. Commonwealth, 538 A.2d 1339 (Pa. Super. 1988) (recommitment may rely on prior commitment conduct if in record; standard for extending treatment)
- In re Involuntary Commitment of Barbour, 733 A.2d 1286 (Pa. Super. 1999) (commitment hearings require strict compliance with evidentiary rules given liberty interest)
- In re S.L.W., 698 A.2d 90 (Pa. Super. 1997) (balance between individual liberty and state's interest in treatment under MHPA)
- In re S.T.S., Jr., 76 A.3d 24 (Pa. Super. 2013) (definition and application of clear-and-convincing evidence standard)