In the Matter of the Civil Commitment of B.J. v. Eskenazi Hospital/Midtown CMHC (mem. dec.)
2016 Ind. App. LEXIS 412
| Ind. Ct. App. | 2016Background
- B.J. was emergency-detained at Eskenazi in Aug. 2015 after clinicians reported psychosis, threats, and prior violent conduct; initially temporarily committed.
- He received outpatient temporary commitment, missed two appointments, was briefly readmitted, had medication dose increased, and received monthly haloperidol injections which he accepted.
- Eskenazi petitioned to convert the temporary commitment to a regular (longer-term) involuntary commitment; Dr. Mary Salama testified B.J. had delusional (persecutory) disorder, substance abuse, and lacked insight.
- Dr. Salama opined B.J. could become dangerous or unable to meet basic needs if he stopped treatment, but her statements were largely predictive/hypothetical and she admitted B.J. had current family support and was compliant with injections.
- B.J. testified he worked ~70 hours/week as a car broker, could care for himself (dress, shower, travel), lived with parents temporarily, planned to continue treatment voluntarily, and said missed appointments were due to work.
- The trial court ordered a regular commitment citing lack of insight, prior escalation requiring increased medication, and perceived risk; the Court of Appeals reversed for insufficient evidence of grave disability (and insufficient evidence of dangerousness).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether evidence supported involuntary regular commitment under statute | B.J. lacked sufficient evidence of "gravely disabled" status; commitment violates due process | Eskenazi: clear and convincing evidence of grave disability, or alternatively dangerousness, justified commitment | Reversed — insufficient evidence of grave disability; also insufficient to establish dangerousness |
Key Cases Cited
- T.K. v. Dep’t of Veterans Affairs, 27 N.E.3d 271 (Ind. 2015) (requires clear-and-convincing proof of grave disability; refusal of treatment or threats alone insufficient where ability to meet basic needs is shown)
- T.D. v. Eskenazi Midtown Cmty. Mental Health Ctr., 40 N.E.3d 507 (Ind. Ct. App. 2015) (clarifies clear-and-convincing evidentiary standard for commitment)
- Commitment of J.B. v. Midtown Mental Health Ctr., 581 N.E.2d 448 (Ind. Ct. App. 1991) (discusses due process and evidentiary requirements in civil commitment)
- M.L. v. Meridian Servs., Inc., 956 N.E.2d 752 (Ind. Ct. App. 2011) (criticized for applying an overly deferential standard in commitment reviews)