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In re Civil Commitment of A.M.

Court of Appeals of Indiana

December 13, 2018

In the Matter of the Civil Commitment of A.M., A.M. Appellant-Respondent,
Community Health Network, Inc., Appellee-Petitioner.

          Appeal from the Marion Superior Court Trial Court Cause No. 49D08-1802-MH-7271 The Honorable Kelly M. Scanlan, Commissioner

          Attorneys for Appellant Valerie K. Boots Marion County Public Defender Agency - Appellate Division Indianapolis, Indiana Joel M. Schumm Indianapolis, Indiana

          Attorneys for Appellee Jenny R. Buchheit Stephen E. Reynolds Gregory W. Pottorff Ice Miller, LLP Indianapolis, Indiana

          Mathias, Judge.

         [¶1] A.M. appeals the Marion Superior Court's order of temporary involuntary commitment. A.M. raises two arguments, which we restate as:

I. Whether the order is defective because it was only signed by the master commissioner, and not the trial judge; and,
II. Whether the temporary involuntary commitment was supported by clear and convincing evidence of grave disability.

         [¶2] We affirm.

         Facts and Procedural History

         [¶3] A.M. is a forty-eight-year-old woman who suffers from a schizophrenia spectrum disorder.[1] On or about February 21, 2018, A.M. was in the lobby of an Indianapolis Hampton Inn and was exhibiting disorganized behavior and thoughts. After concluding that A.M. needed medical treatment, a law enforcement officer transported her to Community North Hospital ("the Hospital").

         [¶4] A.M. was examined by Dr. Shilpa Puri, and on February 22, 2018, the Hospital filed an Application for Emergency Detention. The Hospital alleged that A.M. was suffering from a psychiatric disorder "which substantially disturbs her thinking, feeling or behavior and impairs her ability of function." Appellant's App. p. 12. The Hospital specifically alleged that A.M. was either dangerous to herself or others or gravely disabled "as evidenced by disorganized behavior and thoughts and paranoid delusions. [A.M.] was very disheveled and malodorous upon admission indicating that she has not been taking care of her hygiene. She has been refusing all medication and labs." Id.

         [¶5] Five days later, the Hospital filed a "Report Following Emergency Detention" and alleged that A.M. was suffering from "unspecified schizophrenia spectrum and other psychotic disorder and is dangerous[.]" Id. at 14. The Hospital recommended that A.M. be detained pending the hearing. The accompanying physician's statement alleged that A.M. was both dangerous to herself and others and gravely disabled. Dr. Puri believed that A.M. was "in need of custody, care, or treatment in an appropriate facility," that "[o]utpatient treatment would be adequate," and "[c]ommitment would not be necessary if this person were taking medication." Id. at 17. Dr. Puri advised that A.M. refused to begin voluntary treatment. Therefore, the Hospital requested a temporary involuntary commitment not to exceed ninety days.

         [¶6] The commitment hearing was held on March 1, 2018, before Commissioner Scanlan. Dr. Puri testified that when A.M. was admitted to the Hospital, she "was jumping from topic to topic" and displayed "very disorganized behavior." Tr. p. 6.

She would throw a bunch of food and jigsaw piece[s] all over her room. She wasn't showering, taking care of her hygiene. She was expressing grandiose delusions about her being on a neuro-science committee for Eli Lilly. Traveling to different countries for conferences. As well as paranoid delusions about the police being after her.


         [¶7] Dr. Puri examined A.M. eleven times from February 22 to March 1, 2018, including the morning of the hearing. She diagnosed A.M. with unspecified schizophrenia based on the following observations:

[T]he patient was displaying very disorganized thoughts, jumping from topic to topic, no clear condition there. Disorganized behavior including the jigsaw puzzles and food being spread out all over her room. She would intermittently yell on the unit, for no apparent reason. She has been seen talking to her food. Been seen talking to herself, having auditory hallucinations as well as those grandiose delusions and the paranoid delusions that I mentioned earlier.

Id. at 7. Dr. Puri testified that A.M. lacks insight into her mental illness, which "affect[s] her ability to seek care" and take medications. Id. at 8. Dr. Puri stated that A.M. missed sixteen doses of her medication. Id. Dr. Puri does not believe that A.M. will take medication unless she is hospitalized.

         [¶8] Dr. Puri also testified that A.M. is not able to provide herself with food, clothing and shelter.[2] She was not aware whether A.M. had income or a place to live prior to her hospital admission, and A.M. was not employed. A.M.'s appearance is "disheveled," and she does not shower or brush her teeth. Id. at 8-9. To the doctor's knowledge, A.M. does not have anyone who can assist her in meeting her basic needs.

         [¶9] The following exchange occurred at the hearing concerning the extent of A.M.'s mental illness:

Question: Does Miss M suffer a substantial impairment or an obvious deterioration of her judgment, reasoning or behavior that results in her ...

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