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In re L. M.

Court of Appeals of Oregon

October 9, 2019

In the Matter of L. M., a Person Alleged to have Mental Illness.
L. M., Appellant. 299 Or.App. 710 STATE OF OREGON, Respondent,

          Submitted November 29, 2018

          Lane County Circuit Court 17CC04823; Janet A. Klapstein, Judge pro tempore.

          Joseph R. DeBin and Multnomah Defenders, Inc., fled the brief for appellant.

          Ellen F. Rosenblum, Attorney General, Benjamin Gutman, Solicitor General, and Robert M. Wilsey, 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 Health Authority for an additional period not to exceed 180 days. On appeal, appellant asserts that the trial court erred in determining that he was unable to provide for his basic needs because he had a history of resisting medical treatment. Held: The record was insufficient to support a finding that appellant's mental disorder left him unable to provide for his basic needs.

          [299 Or.App. 711] HADLOCK, P. J.

         Appellant was committed to the Oregon Health Authority because of mental illness in 2017 and, in the proceeding that is the subject of this appeal, was committed in early 2018 for an additional period of up to 180 days. The trial court based that commitment exclusively on the basis that appellant continued to be mentally ill because his mental disorder left him unable to provide for his basic needs. On appeal from the order of continued commitment, appellant argues that the record does not support the trial court's basic-needs determination. We agree and, accordingly, reverse.

         We describe the facts in the light most favorable to the trial court's order. State v. M. G., 296 Or.App. 714, 715, 440 P.3d 123 (2019). At the time of the January 2018 continued-commitment hearing, appellant was housed at the Oregon State Hospital. He was 21 years old and would turn 22 in March. Appellant's treating psychiatrist testified that information from appellant's family indicated that appellant had "probably been psychotic and ill since the age of 18."[1] Before his initial commitment in 2017, appellant lived with his family. He often wandered away from home, sometimes returning only partly dressed. At least once, his family members found him lying on a sidewalk near busy streets. He drank "household cleaner, such as Pine-Sol," and had other disorganized behaviors. Appellant's family members attempted "numerous times" to get him help, including by taking him to appointments, the nature of which is not described in the record. Appellant once jumped from a moving car to avoid going to an appointment. He also jumped from second-floor balconies and ran to avoid appointments. In the past, appellant has become "very psychotic" when not medicated, has [299 Or.App. 712] had "multiple run-ins with the law," and has pushed family members and destroyed property. Appellant was unkempt and, in the six months before his initial hospitalization, he lost 30 pounds. However, the record does not reflect whether that weight loss created any medical concerns.

         In the summer of 2017, appellant "sustained a laceration to his hand and to his arm," and his family found him "with pools of blood." Appellant would not go with his family to the hospital, so they called 9-1-1 and had him taken in for treatment, which included staples. When it was time for the staples to be removed, it took three family members to get him to the hospital to have that done. While there, family members were able to have appellant psychiatrically admitted, and he was hospitalized for about two weeks. Appellant was given medications and sent home, but he disappeared two days later. Appellant returned home within a few days, "but he was only wearing paper bottom scrubs" and "had EKG stickers all over his chest and he had an IV-line in his arm." Appellant's initial commitment followed.

         While hospitalized on that commitment order, appellant needed round-the-clock supervision for such things as administration of medications and attending to his hygiene and grooming, despite being on a medication regime. He needed constant reminders to change clothing and do laundry and was oblivious when he spilled liquids on himself. He often threw out the food he was given and then rummaged through trash for scraps. However, although appellant has some nonpsychiatric medical conditions, none of them pose a risk to his personal safety or his life, and he is "very healthy."

         Appellant's psychiatrist does not believe that appellant will continue taking medications if he is released into an unsupervised setting. Without medications, appellant would "decompensate further" and his symptoms "would become much worse." In the psychiatrist's view, appellant would not be able to "take care of his basic needs" and "could possibly become physically aggressive." The psychiatrist does not believe that appellant is ready to leave the hospital. Appellant's family is "incredibly supportive," but he can no longer live with his mother because, when he did, "there was [299 Or.App. 713] a lot of property destruction at the apartment," and she was evicted.

         The trial court announced its ruling at the end of the hearing, explaining the specific reasons that it found appellant unable to provide for his basic needs. First, the court noted that it was not basing its ruling on the evidence regarding appellant's eating and hygiene behaviors. Rather, the court's ruling was essentially based on appellant's history of being "actively resistant to seeking medical attention":

"So were he to be harmed, hit by a car, injured, he not only would not know how to seek medical attention, but would be actively resistant to medical attention, and I agree that he has a history of refusing hospitalization on a number of occasion[s], even to the extent that he's jumping off balconies, out of moving cars. I ...

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