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In re S. T.

Court of Appeals of Oregon

October 9, 2019

In the Matter of S. T., a Person Alleged to have Mental Illness.
S. T., Appellant. 299 Or.App. 696 STATE OF OREGON, Respondent,

          Submitted September 6, 2018

          Marion County Circuit Court 6635; Daniel J. Wren, Judge pro tempore.

          Alexander C. Cambier and Multnomah Defenders, Inc., fled the brief for appellant.

          Ellen F. Rosenblum, Attorney General, Benjamin Gutman, Solicitor General, and Christopher A. Perdue, Assistant Attorney General, fled the brief for respondent.

          Before Hadlock, Presiding Judge, and DeHoog, Judge, and Aoyagi, Judge.

         Case Summary: Appellant in this civil commitment case appeals an order continuing his commitment to the Oregon State Hospital for an additional period not to exceed 180 days. On appeal, appellant asserts that the trial court erred in determining that he still has a mental illness and is in need of further treatment because his mental disorder makes him dangerous to others. Held: The record was sufficient to support a finding that appellant required commitment because he was likely to stop taking his medications if he were not hospitalized and would be a danger to others if not treated.

          [299 Or.App. 697] HADLOCK, P. J.

         Appellant was committed to the Oregon Health Authority in 2016 because of mental illness and, in the proceeding that is the subject of this appeal, the trial court continued the commitment on the ground that appellant "still has mental illness *** and is in need of further treatment." The court's determination was based on a finding that appellant's mental disorder makes him dangerous to others. Appellant challenges that determination on appeal. For the reasons below, we reject appellant's arguments and, accordingly, affirm.

         In a continued-commitment proceeding of the kind involved here, the trial court's task is to "determine whether the person is still a person with mental illness and is in need of further treatment." ORS 426.307(6); see also State v. M. G., 296 Or.App. 714, 717, 440 P.3d 123 (2019) (explaining continued-commitment process). As pertinent here, "person with mental illness" is defined to include a person who, because of a mental disorder, is "[d]angerous to *** others." ORS 426.005(1)(f). A person is dangerous to others, for purposes of the commitment statutes, if the person's mental disorder makes the person "highly likely to engage in future violence toward others, absent commitment." State v. S. E. R., 297 Or.App. 121, 122, 441 P.3d 254 (2019). "Because the standard of proof in a civil commitment case is the clear-and-convincing-evidence standard, the evidence supporting commitment must be sufficient to permit the rational conclusion that it is highly probable that the person poses a danger to * * * others." Id. Accordingly, "the evidence must supply a concrete and particularized foundation for a prediction of future dangerousness absent commitment." Id. (internal quotation marks omitted).

         In reviewing a trial court's decision to determine whether those standards were met, "we view the evidence, as supplemented and buttressed by permissible derivative inferences, in the light most favorable to the trial court's disposition and assess whether, when so viewed, the record was legally sufficient to permit that outcome." Dept. of Human Services v. N. P., 257 Or.App. 633, 639, 307 P.3d 444 (2013); [299 Or.App. 698] see S. E. R., 297 Or.App. at 122 (applying that standard in the commitment context).

         The sole witness at appellant's continued-commitment hearing was Dr. Shad, who is a treating psychiatrist for appellant at the Oregon State Hospital. Dr. Shad testified that appellant's psychiatric problems started when appellant was 49 or 50 years old, a few years before the hearing. Appellant has been diagnosed with schizophrenia. In addition, medical imaging shows that a particular lobe of appellant's brain is "completely missing." That imaging, along with appellant's particular history, [1] indicate that he may have a kind of dementia called Pick's Disease. According to Dr. Shad, individuals with that kind of dementia "present with personality changes, like sexual dis-inhibitions [and] behavioral dis-inhibitions." Dr. Shad testified that appellant's "personality changes can be explained more on the basis of this anatomical presentation we are seeing, rather than schizophrenia by itself." Before starting to present signs of Pick's Disease, appellant had no history of mental disorder.

         Appellant initially was hospitalized in Coos County and later was transferred to the state hospital. In October 2016, appellant once called another patient a "golden good boy," a scuffle broke out, and appellant punched the other patient in the face. In December 2016, another patient accused appellant of stealing his gloves; the two men exchanged punches, with appellant yelling, "I'm going to shoot you." Dr. Shad testified that those incidents of aggression "absolutely" reflect behavioral issues stemming from the changes in the structure of appellant's brain.

         Dr. Shad acknowledged that appellant had engaged in only a few acts of aggression, but testified that "the reason for that could be that [appellant] is being treated all this [299 Or.App. 699] time with medications" that could be "checking this behavior." Dr. Shad had no doubt, however, that the "very complete evidence of brain change" is associated with appellant's "personality changes." Dr. Shad's "biggest concern" centered on the fact that additional neurological changes that occur with advancing age "can further complicate [appellant's] behavior."

         Dr. Shad testified about the medications that appellant takes at the state hospital. There is "no ideal approved drug for this condition which he has." However, appellant is given antidepressants, for which there is some evidence of efficacy, and antipsychotic medications that are used to treat the delusional and psychotic aspects of his illness. Appellant still has a number of delusions despite being on medication, possibly because of the changes to his brain. ...

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