*1 of the Commitment Matter GPH, Appellant-Respondent,
v. M.D., GILES, Appellee-Petitioner.
David
No. 49A05-9101-CV-19. Indiana, Appeals of
Court
Fifth District.
Sept. 12, 1991.
Rehearing Denied Nov.
SHARPNACK, Judge. appeals regular
GPH from an order of Community commitment of him to North Hospital upon findings that he suffers paranoid schizophrenia from chronic dangerous to himself and dis- abled. We affirm. appeal,
GPH raises several issues on which we restate as follows: (1) Whether the evidence was sufficient support to finding trial court's involuntarily GPH should be commit- ted.
(2) Whether finding pa- a court's that a dangerous tient is or gravely disabled support is without when the record anyone does not reflect that involved proceedings attempt made an locate members or friends who with, willing help would be or be for, responsible patient. (8) Whether trial court violated GPH's constitutional to assist- ance of counsel when the court allowed appear at his hear- ing probable to determine cause with- out counsel.
(4) required adequate Whether no- tice of proceedings given GPH.
(5) Whether trial court violated process rights GPH's due when the court refused to allow GPH to waive court-appointed counsel for his hearing. (6) Whether the trial court committed er- by allowing ror Dr. Giles to have ac- records, cess to GPH's medical and to testify regarding specific information therein, contained when GPH had not employed physician. Dr. Giles as his (7) Whether the trial court committed er- by allowing ror testify Giles to concerning communications Dr. Giles had with GPH when Dr. Giles was acting treating physician. as GPH's Hay, Hay Oakes, Winston R. India- The facts are as follows. is a thir- napolis, appellant-respondent. male, ty-four-year degree old with a in elec- Myra Selby, Sherry C. A. Fabina-Abney, engineering, diagnosed trical who has been Ice, Miller, Ryan, Indianapolis, Donadio & suffering paranoid from chronic schizo- appellee-petitioner. phrenia since the onset of an acute illness hospital geney Community of 1987. GPH was detention to North Hos- in December approximate- pital, pursuant his mental illness for to Ind.Code ized for 16-14-9.1- again in 1987 and in the ly two weeks 7(a), alleging that her son suffered from a psychiatric of 1988. summer disorder and was Along application, himself. Hospi- with the and as committed to Carter *3 days. After release from tal for 90 16-14-9.1-7(a), required by IC. Dr. 1988, he Hospital in December of Carter physician's David Giles filed a statement out-patient as an at Gallahue was treated alleging may mentally that GPH ill and Community North Mental Health Center at dangerous reviewing to himself. After Hospital, served as a where David Giles application physician's both the and the psychiatrist and medical director. statement, the court authorized the emer- gency September detention of GPH. On Hospital, After his release from Carter 16-14-9.1-7(b), pursuant to L.C. § his mother. Ms. H testi- GPH lived with report, Dr. Giles submitted a statement and hearing fied at her son's final that toward indicating that GPH suffered from chronic the end of the summer in her son paranoid schizophrenia dangerous and was acutely again, ill onee became evidenced to himself. Dr. Giles recommended that peculiar during his behavior the last week Community Hospital GPH remain at North During August. that week in late Au- pending hearing a to determine whether medication, gust, refused to take his GPH mentally gravely GPH ill either and repeatedly turned his mother's electrical dangerous, disabled or and to determine bed, off, power on and his disassembled whether GPH needed continued involun- picnic and oftentimes sat outside at the tary The court detention. found that Dr. table, during evenings, burning can- report justified the Giles' continued deten- addition, dles. GPH burned and scat- GPH, and, pursuant tion of to I.C. 16-14- tape tered a video all mother's over his room, garage storage 9.1-7(e)(2), and and urinated pre- ordered GPH's continued hearing detention. The court set a final backyard presence of his mother hearing September date for 20 to determine particular and other members. Of mentally ill during concern to Ms. H this week the whether GPH was and either dangerous fact that disabled. The court GPH carried and fiddled a lot with knife, badly cutting represent appointed once his hand. also counsel to GPH at hearing, directed the sheriff to his final and 1, 1990, September the afternoon of On copy serve a of the order on GPH at Com- GPH, only clad in cut-offs and a hat awith Further, munity Hospital North. shoulders, draped his towel around wan- give directed the clerk to notice of the time country Rosemary dered into the home of hearing, along place and of the final with a Huffman, who was there alone at the time. order, to, others, among copy of the surprised Ms. Huffman was both and terri- counsel. stranger foyer. see in her fied to When GPH, she confronted he identified himself pre- September On the court held a GPH, abruptly turned and walked out liminary hearing to determine whether the front door. probable Community for there was cause Hospital North to detain GPH until his incident, again entered After that GPH hearing September 20. The final set for property Septem- onto Huffman's twice on probable court found cause to believe that Huffman, very upset, report- ber temporary commit- GPH was need of police. ed incidents to the On that both ment and ordered that GPH be detained day, necessary papers Ms. H filed the same pending hearing. The court di- his final Community to have her son detained in parties rected should receive notice Hospital emergency North on an basis as hearing. preliminary of the results being ill and himself. September At the 13, GPH, se, acting pro filed a motion to 4, 1990, September
On GPH's mother emer- application quash application strike made a written for GPH's emer- geney alleged tinuously lights That motion off the detention. turns his room. hearings furnished to GPH the notices Further, during hospital stay, unreadable, illegible were and thus that he stated believed his food had been give adequate notice of the failed to addition, poisoned, so he refused to eat. In addition, proceedings. In filed an an- GPH stated that believed medicine was statement, physician's poisonous, so he refused to take medi- swer to the detention, application time, and to During cation. this GPH refused to petition for court-ordered treatment hospital laboratory allow to run special conditions for commitment. him, possibly poi- tests on and he ate two sonous mushrooms or toadstools from the At the final courtyard secured but refused to take the objected appointment to the court's *4 him, suggested public represent vomiting. a defender to medicine to induce requested proceed that he be to allowed Dr. Giles believes mentally that GPH is pro se. After the court discussed the mat- ill, disabled, and, gravely is as a result of GPH, ter with the court continued the hear- thinking, GPH's disordered potentially is ing until October 2. dangerous to himself. Dr. Giles believes 27, September court,
On "after much incapable formulating that GPH is ideas reflection," about how GPH could care for himself. To ruled that not GPH would be permitted proceed Septem- pro to se. On knowledge, Dr. Giles's GPH has refused to ruling, ber its take of the medications that Dr. Giles before court advised public defender that she would be has ordered for generally him. GPH be- appointed represent GPH, to and directed lieves he will be fine without the medicine. ruling that GPH be notified medicine, With the Dr. Giles believes GPH prepared hearing of the need to be for a clearly, would be able to think more would October 2. better, require function and would less re- medicine, strictive Without Dr. On October the court held a to care. Giles believes that GPH would continue to ill, mentally determine whether GPH was beliefs, paranoia, suffer from delusional disabled, dangerous gravely and either or anxieties, fears and would be unable to temporary and in need of commitment. At function or to make reasonable decisions hearing, again objected having GPH to himself, potentially dangerous would do public represent a defender him and the himself, (such things eating to inanimate objection. court overruled GPH's Follow- ing testimony, the court issued an Order of objects substances), or toxic and could be- Regular finding resulting Commitment GPH mental- come malnourished with serious ill, ly gravely complications. to himself and medical disabled. Dr. Giles if believes GPH is not condition, treated for his chronic Dr. Giles testified at will not GPH's final get hospital setting. regu- out of the that GPH was admitted to his care at With Com- munity Hospital North on treatment, lar commitment and continued Dr. 1990, and that he had examined Giles believes that GPH would even- and treated daily throughout hospital tually stay. hospital be released from the and be diagnosed suffering out-patient Giles GPH as from treated as an for his incurable paranoid schizophrenia, chronic which he disease. testified is characterized a disorder of Sufficiency the Evidence
thinking. Dr. Giles stated that GPH often
paranoia,
has delusions of
unusual think-
We deal first with whether the evi
ing,
ability
diag-
and no
to understand his
support
dence was sufficient to
the trial
nosis and the disorder itself.
finding
court's
that GPH should be involun
Specifically,
tarily
reviewing
committed.
a claim of
GPH believes
there is
electricity
adversely
in the air
which
af-
case,
insufficient evidence in a commitment
himself,
protect
keep
fects his brain. To
in mind
GPH we
that commitment
only
upon
ordered
if the elements
something
wears
around his
head and con-
by volved
proven
attempt
proceedings
is ordered are
made an
family
or friends who
locate
members
evidence,
con
to
convincing
and we
clear
with,
willing
help
respon
most favorable
or be
only
evidence
would be
sider
for,
patient.
sible
in
along with all favorable
judgment,
v. State
therefrom.
Jones
ferences
in the
argues that
the evidence
N.E.2d
Ind.App., 477
attempts
to determine
is silent as
record
community
had
or
whether GPH
16-14-9.1-3(a), a
to I.C.
Pursuant
him.
contends
support available to
is
disabled
person
ill
who
Supreme Court has held
that the
involuntarily detained
dangerous may be
constitutionally confine
cannot
a state
is de
"Gravely disabled"
or committed.
non-dangerous
individual
more
without
16-14-9.1-1(b) as
in I.C.
fined
surviving safely
capable
is
who
individual, as a
condition which
help of
by himself or with the
freedom
illness,
danger
result of mental
responsible family members
willing and
individual:
coming
harm
because
or friends.
that individu-
(1)
provide
Is unable
(1975), 422 U.S.
v. Donaldson
O'Connor
shelter,
es-
food, clothing,
or other
al's
563, 576,
L.Ed.2d
S.Ct.
or,
needs;
sential human
next cites In the Matter
407. GPH
*5
impairment or an
(2)
aHas
substantial
Linderman
the Commitment
of
individual's
deterioration of that
obvious
1140, 1141, for the
Ind.App., 417 N.E.2d
re-
reasoning, or
that
judgment,
behavior
"the
rests with the
proposition that
burden
inability to fune-
in the individual's
sults
attempt has
prove
to
a reasonable
State
independently.
tion
to contact
members
made
been
16-14-
defined in 1.0.
"Dangerous" is
§
one
argues that no
regard." GPH
this
9.1-1(c) as
he had
attempted to determine whether
as a
an individual
a condition which
support
community
or
family members
presents a sub-
mental illness
result of
argues that be
to him. GPH
available
will harm
risk that the individual
stantial
omission,
finding
the court's
cause of this
individual or others.
fail.
gravely
must
he was
disabled
that
note, first,
not clear and
argues
agree.
that there was
We
do not
We
proof in
requirement
he was dan-
for such
convincing evidence either that
is no
there
others,
he
or to
or that
gerous to himself
16-14-
statutes.
I.C.
the commitment
asking
is
us to
gravely disabled. GPH
seq.
9.1-1 et
evidence,
cannot do.
reweigh
which we
the com-
mother commenced
GPH's own
supported
is
court's decision
The trial
his hear-
testifying at
proceedings,
mitment
Giles,
testimony
The
the evidence.
"so relieved"
have been
ing that she would
sufficient,
is
would have been
which alone
hospital
to the
police had taken GPH
if the
testimony
by the
of both
supported
further
him. The
they
take care of
would
where
and Ms. Huffman.
mother
GPH's
lived was
with whom GPH
family member
court nor
Neither the
already involved.
convincing evi-
was clear and
As there
all
responsibility to contact
had a
Dr. Giles
ill,
that he
that GPH was
dence
at-
friends in an
relatives and
of GPH's
himself,
harm to
risk of
posed a substantial
would either
find someone who
tempt to
disabled,
gravely
a com-
he was
and that
for,
with,
responsible
GPH.
or be
help
affirm the
appropriate. We
mitment was
mother,
family was
Through GPH's
issue.
decision on this
trial court's
proceedings to commit
on notice as
Family
GPH.
Prove Lack
Failure to
Support
or Other
upon
incorrectly
Donaldson
relies
argument. The Court
support his
to
Second,
deal with whether
we
testimony presented
noted
dangerous Donaldson
finding
patient
that a
is
court's
patient had
that the
demonstrated
at trial
must fail when
disabled
during his
danger
others either
no
to
anyone
posed
in
reflect
does not
record
any
point
confinement or at
other
in his
responsibility
provid-
have taken on the
Donaldson,
ing
life.
at
785 guard necessary to protection authority tial themselves; also has the state of deprivation against any unwarranted the com- protect police power its under allegedly mentally ill indi- liberty of of dangerous tendencies munity from the vidual. ill. are some who at 386. Id. 418, (1979), 441 U.S. v. Texas
Addington 323, 1809, 1804, 60 L.Ed.2d 426, 99 S.Ct. state, carrying parens out its The Mar Court v. Criminal In State periods set out role for the limited patrigce 632, 648, 130 (1955), Ind. County statute, ion fur- emergency detention in the our justice of inter- the chief governmental substantial N.E.2d thers the court, concurring opinion, ex in a supreme mentally ill and of caring for the ests of power patrice porens the state's plained from harm. public Because protecting as follows: carefully to the adhered trial court is denied com- by jury temporary trial fact that measures of protective
The the de- determining whether the issue statute, and because mitment psychopathic of his timely sexual notice is a criminal effective and gave fendant temporary commit- 1949, ch. rights pursuant make not person does [Acts statute, ade- find that GPH was Legisla- ment unconstitutional. § 1] we psy- recognize that a against an unwarrant- attempted safeguarded quately ture Thus, mental defective. even person liberty,. is a his chopathic deprivation of ed equity, jurisdiction the ancient Under detention statute though the control right within to counsel at defectives were mental does not afford GPH hearing, we determine preliminary representing the Crown his of the chancellor omitted) (citations patrice. parens uphold it. The and we is valid the statute state, exercising porens patriae role its the issue already faced courts have Our period specified finite and for the power in patriae parens of the state's statute, may limit an emergency detention rights of constitutional light of the right patient's constitutional alleged mental In In the Matter Commit- mentally ill. trial findthat the Wetherefore to counsel. Ind.App. Binkley ment of GPH's constitu- did not violate court here district, first N.E.2d of counsel to assistance tional process re- considering due whether appear at allowing during proof highest standard quires the counsel. hearing without *7 personal proceeding, where a commitment stake, stated: liberty is at Notice Sufficiency of undertakes State, patrice parens re Fourth, whether deal with we treating the men- of task the beneficent proceed notice of the adequate quired and power pro- ill, police its and under tally given to GPH. ings was harm. These are public from tects the 16-14-9.1- I.C. us to objectives which directs valid, necessary state too strict a thwarted alleged should not be person a 9(e)(1) argues and right to receive the proof. mentally of ill has burden be temporary person's the adequate notice of 411 (1980), Ind.App., v. In F.J. State that the individual hearing so commitment considered fourth district the N.E.2d may prepare attorneys or the individual's who, like individual from an appeal contends that did hearing. GPH on an GPH, detained had been notice of his commit- adequate receive not temporarily committed. then and basis he was furnished hearing because ment there stated The court applica- his mother's illegible copies of with custody already ... is someone where emergency detention for his tion committed, only a temporarily and then state- physician's accompanying Giles's protective mea- adherence careful ment. 16-14-9.1-9(d), (e), (£),com- of I.C. sures the Commitment In the Matter of In timely notice with effective bined of of 301, 382 Ind.App. (1978), 178 Binkley the substan- afford rights ... will such 786 explained first district Denial
N.E.2d
Waiver
Counsel
of
of
alleged
patient
notice to an
mental
of
when
Fifth,
consider
we
whether
trial court
temporary commitment
would
their
right
violated GPH's constitutional
to due
constitutionally
The court
sufficient.
be
process when the court refused to allow
notice,
Binkley's
found that
which was
court-appointed
GPH to waive his
counsel
time,
writing
place
and set forth
hearing.
for his commitment
purpose
hearing, passed "the due
of the
argues
the trial court abused
Ind.App.
178
at
process
Binkley,
muster."
by refusing
its discretion
to allow
304,
737 all indicated Lanett was certificates which citing v. Zerbst at Johnson 509 N.E.2d behavior, ill; 82 L.Ed. (1938), 58 S.Ct. courtroom 304 U.S. Lanett's lying and included several outbursts (1979), 180 Ind. 1461; v. McDandal State floor; and, the prostrate 216. The trial court the courtroom 390 N.E.2d App. judge presided over both fact that the same the waiver was must determine whether hearing and the final probable the cause Therefore, the tri knowing voluntary. and for court-ordered mental health servic trial showing a record judge "must establish al es, thereby enabling pull him to from facts of the made aware that the defendant was probable had heard in the cause nature, extent, right the importance of against allowing Lanett to waive to decide waiving it." consequences of and the counsel. Id. Kirkham, N.E.2d at 892. 509 S.Y., decision In the trial court Matter that Kirkham was year In the same affirmed on the to allow waiver was decided, District South the U.S. Court ground patient the that v. Duck Bend considered Haovrilenko requesting an ex- county the (N.D.Ind.1987), knew worth, F.Supp. 454 commitment; of habeas he knew the ele- petition a for a writ tension which was involuntary an required ments obtain petitioner argued that he corpus where the applicable commitment and the burden assistance of counsel was denied effective through jury case, proof; he had been a deciding sentencing. In that at his he would have to follow trial and knew a dealt with the issue when attorney. the same rules as se, may proceed pro and stated defendant following: S.Y., at 329. 457 N.W.2d Thus, proceeds pro defendant a before Further, court found that "[the (1) se, court must ascertain: determina supports record the trial court's voluntarily, knowingly, and in- competent represent defendant tion that S.Y. counsel; right telligently waived his himself," noting the record revealed (2) charges that he understood college and was years had two that S.Y. magnitude against him and English Id. literate and fluent and, (8) that he under- only significant is potential penalty; court stated "[the expected to han- stood that he would be possessed 'psycho a sue is whether [S.Y.] his defense in accordance with dle disability significantly af logical which ... procedure. evidence and normal rules of possi ability a his to communicate fect[ed] that a It is axiomatic omitted] Id., [citations jury.'" citing Pick defense to the ble represent himself in a may (1980), defendant 96 Wis.2d ens v. State proceeding. criminal N.W.2d 601.
Id. at 461.
determining
person
a
In
whether
pro
were faced counsel in a commitment
waive
jurisdictions
other
Two
patient
must be wheth
ceeding, principal
issue of when a mental
concern
with the
making
capable of
such
right
patient
to counsel have
er the
may validly waive
us,
reviewing
case before
analy
In
criminal
decision.
applied the above-mentioned
evidence
there is substantial
we find that
(1988),
their cases. Lonett v. State
sis to
finding that
support
the trial court's
Tex.App., 750 S.W.2d
Matter of
voluntarily and
knowingly,
could not
App., 156 Wis.2d
S.Y.
to counsel.
intelligently
waive
Lonett,
the trial court
N.W.2d
*9
psychia
that GPH's
The evidence indicates
allow
of counsel was
decision to not
waiver
September 20 that GPH
trist testified on
because,
record,
ap
the
it
from
affirmed
delusions; that
paranoia and
found
suffered from
"the court could have
peared that
to ob
opportunity
the
judge
trial
had
capable of know
the
Ms. Lanett was not
prelimi
the
at both
waiving
right to
serve GPH's demeanor
intelligently
her
ingly and
Sep
proceeding of
nary hearing and at the
at
court-appointed counsel." 750 S.W.2d
presid
con
appellate
20;
by also
court
Specifically,
judge,
305.
tember
hearing, heard
ing
following:
psychiatric
over GPH's
three
sidered the
testimony
witnesses,
from two
one of
presented
Evidence
at GPH's final hear-
mother,
ing
was
concerning
indicates that Dr.
psychia-
Giles was a
health;
judge
trist
GPH's mental
that the trial
and the medical director at Gallahue
indicated she had
Mental Health Center at Community Hospi-
reservations
about
whether GPH
could handle his own defense
addition,
that,
tal.
Dr.
Giles testified
4, 1990,
beginning
in
on
accordance with the rules of
he had
evidence
and,
procedure;
judge
daily.
and
treated and examined GPH
was
Even
though Dr. Giles
represent
employed by
concerned that GPH's desire to
was not
GPH,
requirements
Dr. Giles met the
set
might
symptom
himself
be a
of his illness.
16-4-8-8.1(£)(1),
out in
There is
1.0.
sufficient evidence on the record
and was thus
§
statutorily
incapable
to indicate that GPH
authorized to have
access to
knowingly, voluntarily
GPH's records.
intelligently
and
waiving
to counsel.
(1972),
In Smith v. State
259 Ind.
supreme
285 N.E.2d
our
court
Use Medical Records at Trial
considered the issue of whether the trial
Sixth, we deal with whether the tri
court should have excluded
testimony
by
al court committed
allowing
error
Dr.
appointed
two court
expert witnesses
Giles to have access to
medical
testimony
where the
part
in
based
records,
testify
and to
regarding specific
experts
information
gained
hospi
from
therein,
information contained
when GPH
reports.
tal
The court in Smith stated
had
employed
not
Dr.
physi
Giles as his
that,
reports
while medical
that contain ob
cian.
expert
servations
opinions
about an
sanity
insanity
individual's
or
may not be
GPH first contends that he did not waive
directly
evidence,
admitted
into
another ex
records,
access
to his medical
thus his
pert may
reports
use the
to formulate his
records should not have been disclosed to
opinion
or her
sanity.
as to the individual's
Dr. Giles
employ
because he did not
Dr.
whether during treat- Giles had with GPH concerning testify communica Dr. Giles ment. Dr. had GPH when tions Dr. Giles with treating physi acting as GPH's Giles was AFFIRMED.
cian. more than argues that Dr. Giles did HOFFMAN, J., concurs. purposes of the com- just examine GPH RUCKER, J., sepa- in result with concurs Dr. proceeding. GPH notes that mitment opinion. rate daily had contact with between Giles 2, during and October treating acted as GPH's time Dr. Giles RUCKER, concurring Judge, in result court physician. GPH contends that separate opinion. with disallowed information should have majority opin- I concur in result with the through contact gained such based Giles court determined GPH was ion. The trial physician-patient privilege. GPH ar- there- gravely disabled both allowed gues that the court erred when it involuntary commit- by justifying GPH's testify treating physi- Dr. Giles to in this case is agree ment. I the evidence expert witness. cian and as an gravely dis- GPH is sufficient to establish overlaps with the issue of con- This issue However, unpersuaded I am there abled. analyze it in a similar fidentiality, and we convincing evidence demon- is clear and principle applies to manner. The same risk" strating presents a "substantial testimony regarding informa- physician's others. Ind. harm himself or that he will patient's mental contained within a tion 16-14-9.1-1(c). Code § applies testimony re- medical records physician garding communications that the during patient's patient
had with physi- If do not allow phase.
treatment we mentally ill to care for the
cians who they information that
present as evidence through personal contact with the
obtain pur- defeat the essential
patient, we will commitment statute.
pose of the hearing, very commitment
At GPH's health. The state-
issue was GPH's mental repeated at GPH's
ments that Dr. Giles to the issue of went