State
01-15-00784-CV
| Tex. App. | Nov 13, 2015Background
- Appellant E.S.R., a 59‑year‑old male, was detained after his father alleged E.S.R. threatened to kill his parents and attempted to obtain a firearm; emergency detention and protective custody orders issued in late August 2015.
- Two hospital physicians examined E.S.R. on August 26, 2015, diagnosing psychosis/schizophrenia and completing certificates supporting temporary involuntary mental‑health services; one physician also filed a petition to administer psychoactive medication.
- At the September 3, 2015 hearing, only Dr. Alric D. Hawkins testified for the State; he had treated E.S.R. for about a week and testified to paranoid delusions, disorganized behavior, refusal of medication, irritability, and that E.S.R. posed a risk of harm to others and would deteriorate without treatment.
- Dr. Hawkins acknowledged uncertainty about the precise diagnosis (schizophrenia vs. schizoaffective), lack of knowledge regarding prior medication history, and the possible impact of an untreated seizure disorder.
- The trial court found by clear and convincing evidence that E.S.R. was mentally ill and, as a result, was likely to cause serious harm to others and was experiencing severe distress/deterioration and unable to make informed treatment decisions; it ordered temporary involuntary inpatient services and psychoactive medication.
- Appellant appealed, arguing legal and factual insufficiency of the evidence to support both the involuntary‑commitment order and the order to administer psychoactive medication.
Issues
| Issue | Appellant's Argument | Harris County's Argument | Held (trial court) |
|---|---|---|---|
| Legal/factual sufficiency of evidence for temporary involuntary commitment under Tex. Health & Safety Code §574.034 | Evidence is legally and factually insufficient; Dr. Hawkins’ testimony lacked specific recent overt acts or a continuing pattern tying behavior to statutory criteria | State relied on physicians’ exams, family reports of threats and firearm request, and expert opinion to satisfy the statute | Trial court found by clear and convincing evidence that E.S.R. was mentally ill and met statutory criteria for commitment (risk of harm to others; severe distress/deterioration; inability to make informed decisions) |
| Sufficiency of evidence for order to administer psychoactive medication under Tex. Health & Safety Code §574.106 | Because commitment order lacks sufficient evidence, the medication order (which depends on a valid commitment) is likewise unsupported; expert opinion lacked factual basis about past medication response | State argued court‑ordered medication was appropriate because patient lacked capacity and medication was in his best interest, with no less‑restrictive alternative | Trial court found E.S.R. lacked capacity and that medication was in his best interest and ordered psychoactive medication |
Key Cases Cited
- State v. Addington, 588 S.W.2d 569 (Tex. 1979) (defines clear and convincing standard)
- State v. Lodge, 608 S.W.2d 910 (Tex. 1980) (procedural aspects of mental‑health commitment appeals)
- Johnstone v. State, 22 S.W.3d 408 (Tex. 2000) (preservation of sufficiency challenges in commitment cases)
- J.M. v. The State of Texas, 178 S.W.3d 185 (Tex. App.—Houston [1st Dist.] 2005) (heightened sufficiency review for clear and convincing evidence)
- K.E.W. v. State, 315 S.W.3d 16 (Tex. 2010) (words can constitute overt acts under commitment statute)
- T. G. v. State, 7 S.W.3d 248 (Tex. App.—Dallas 1999) (expert testimony must be grounded in factual basis relating overt acts to statutory criteria)
- Armstrong v. State, 190 S.W.3d 246 (Tex. App.—Houston [1st Dist.] 2006) (refusal to take medication often insufficient alone to show overt act or deterioration)
- In re F.M., 183 S.W.3d 489 (Tex. App.—Houston [14th Dist.] 2005) (expert conclusions must be supported by factual basis to meet commitment standard)