In re: B.S.

Citation: Not availableDocket: 19-789

Court: Court of Appeals of North Carolina; March 17, 2020; North Carolina; State Appellate Court

Original Court Document: View Document

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Respondent B.S. appeals an involuntary commitment order from Mecklenburg County District Court, which was issued on 3 April 2019. The court ordered him to undergo 30 days of inpatient treatment, followed by up to 90 days of outpatient treatment. Respondent challenges the trial court’s findings, arguing they do not substantiate the conclusion that he was dangerous to himself or others. He also contends that the split commitment violates N.C. Gen. Stat. 122C-271(b)(2) by exceeding the maximum 90-day period of commitment.

The procedural history details that on 15 March 2019, a magistrate received a petition alleging Respondent was mentally ill, dangerous, and a substance abuser. The petition cited instances of alcohol and marijuana abuse, noncompliance with medication for schizoaffective disorder-bipolar, inappropriate behavior towards children and neighbors, and animal cruelty. The magistrate ordered Respondent into custody for evaluation, which was conducted by Dr. S. Solimon on 16 March 2019. Dr. Solimon found Respondent dangerous and recommended 30 days of inpatient commitment.

At the commitment hearing on 3 April 2019, Dr. David Litchford testified about Respondent's mental health history, noting multiple past admissions and aggressive behavior. Respondent's recent admission was prompted by medication noncompliance, and he displayed erratic behavior upon arrival at the hospital, claiming to have a different identity and denying any history of aggression or psychiatric treatment.

The appellate court affirmed the trial court's determination of danger but remanded the case for a commitment period that adheres to the statutory maximum of 90 days.

Respondent's denial of his identity continues, displaying delusional, grandiose, and paranoid behavior. He alleged to his psychiatrist that he was hospitalized due to government intimidation affecting his political campaign. Respondent made multiple claims of abuse at BHC via calls and letters, expressing fear for his life and alleging mistreatment by Litchford, who denied making such statements. He exhibited aggressive behavior, necessitating forced medication during his stay due to his manic state, characterized by pressured speech and high energy. Despite this history, he refused medication upon discharge, asserting he did not have a mental illness and pleading the Fifth Amendment regarding his commitment to treatment. At a hearing, Respondent requested a DNA test to verify his identity, claiming to have triplet siblings and insisting he had not harmed himself or others.

In legal arguments, Respondent contends that the trial court's commitment order lacks sufficient evidence to support findings of him being dangerous to himself and others. Under North Carolina law, an inpatient commitment requires clear, cogent, and convincing evidence of mental illness and dangerousness. The court's findings of fact must be supported by competent evidence, with unchallenged findings being binding on appeal. It is the responsibility of the trier of fact to determine if the evidence meets the required burden of proof. The statute defines a person as dangerous to himself if he has demonstrated an inability to manage daily responsibilities or if there is a reasonable probability of serious physical debilitation without adequate treatment.

Behavior that is grossly irrational, uncontrollable, or inappropriate can create a prima facie inference that an individual cannot care for themselves, as per N.C. Gen. Stat. 122C-3(11)(a)(1) (2019). For involuntary commitment, a trial court is prohibited from basing its decision solely on an individual's history of mental illness; it must find a reasonable probability of imminent harm if treatment is not provided. There must be a connection between past behavior and potential future danger, although the specific term "reasonable probability of future harm" need not be used. Dangerousness to others is defined by past actions that inflicted or threatened serious bodily harm or created a substantial risk thereof, with previous dangerous behaviors considered in evaluating future risks.

In the case of In re Zollicoffer, the court found sufficient evidence of an individual's dangerousness to self based on a treating physician’s evaluation. The respondent had chronic paranoid schizophrenia, admitted to not following medication protocols, and required inpatient rehabilitation to manage his condition. The court noted that failure to care for one’s medical needs and personal safety qualifies as dangerousness to self. 

Findings in this case indicated that the respondent lacked the ability to make sound judgments regarding his daily responsibilities and required constant professional supervision. His behavior was grossly irrational, and he exhibited severely impaired insight and judgment. The respondent had a history of multiple psychiatric admissions, including a two-year stay following an assault during a commitment hearing. After being discharged in January 2019, he failed to engage in treatment or medication, leading to a rapid decline in his mental health, characterized by delusions, paranoia, and mania, with a risk of conflict and harm to others.

Respondent denies his identity and any history of mental illness or treatment. He claims he is not [B.S.] without DNA evidence to verify this. The trial court incorporated findings from Solimon’s examination and Litchford’s testimony, establishing that Solimon diagnosed Respondent with schizoaffective disorder. Observations included Respondent dragging his dog, alleged car break-ins, and a significant loss of reality perception impacting his judgment. These findings align with case law, indicating that Respondent posed a danger to himself and had a reasonable probability of imminent harm, satisfying the criteria of N.C. Gen. Stat. 122C-3(11)(a)(1)(I-II). The trial court determined Respondent required continuous supervision and medical care, was grossly delusional, and at risk of harm without treatment. Findings also indicated severe impairment in insight and judgment, justifying a commitment due to dangerousness to himself. 

Regarding the commitment duration, Respondent contends that the trial court exceeded the 90-day maximum statutory limit. The State argues the appeal is moot since the commitment order has expired, and claims Respondent waived appellate review by not objecting during the trial. However, the court found the State's arguments lacking merit, asserting that mandatory statutory provisions are subject to appellate review regardless of trial objections, referencing relevant case law to support that appeals from involuntary commitment judgments are permissible.

The statute limits the initial period of commitment to a maximum of 90 days, which raises concerns about the right to appeal if the commitment period expires before the appeal is resolved. To contest an improper commitment period, the Respondent must appeal under N.C. Gen. Stat. 122C–272. An improper commitment period is deemed reversible error, as established in case law. The court is authorized to order either outpatient or inpatient commitment, or a combination, but the total commitment cannot exceed 90 days. In this case, the trial court incorrectly ordered a total commitment of 120 days, comprising 30 days of inpatient and 90 days of outpatient treatment, which violates the statutory maximum. Consequently, the court reversed this commitment period while affirming the trial court's finding that the Respondent posed a danger to himself. The case is remanded for the trial court to establish a compliant commitment period. The decision is affirmed in part and reversed in part, with Judges STROUD and BERGER concurring.