NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37 IN THE INTEREST OF T.R. IN THE SUPERIOR COURT OF PENNSYLVANIA APPEAL OF: T.R. No. 545 MDA 2013 Appeal from the Order March 18, 2013 In the Court of Common Pleas of Centre County Civil Division at No(s): 1995-3011 BEFORE: PANELLA, J., MUNDY, J., and MUSMANNO, J. MEMORANDUM BY PANELLA, J.: FILED OCTOBER 24, 2013 T.R. appeals from the order entered on March 18, 2013, that committed him to involuntary outpatient treatment for an additional 180-day period pursuant to Section 305 of the Mental Health Procedures Act of 1976 (Act), 50 P.S. 7305 ( Additional periods of court-ordered involuntary treatment ). We affirm. For years, T.R., a paranoid schizophrenic, has been subject to courtordered involuntary outpatient treatment. Without it, and the assistance of a case manager, he cannot attend to his most basic needs. Most recently, on March 13, 2013, Thomas Parker, T.R. s Blended Case Manager, of the Centre County Office of Mental Health and Intellectual Disabilities, filed an application for the extended involuntary treatment of T.R. A hearing on the application before a Mental Health Review Officer was
held the same day. A previous order of involuntary outpatient treatment had been issued and the present application seeks a continuation of that treatment. At the hearing, Parker and Ellen Johnson, M.D., T.R. s psychiatrist, testified. Counsel represented T.R. at the hearing. At the conclusion of the hearing, the Mental Health Review Officer, William G. Tressler, Esquire, concluded that it was shown by clear and convincing evidence that T.R. is severely mentally disabled within the meaning of Section 305, that as a result of mental illness he remains a clear and present danger to himself, and that he is unable to provide for his own safety and well[-]being... without the continued assistance of others. Report of Mental Health Review Officer, 3/15/13, at 3 (unnumbered). The Mental Health Review Officer recommended that the trial court find that T.R. is severely mentally disabled and in need of involuntary treatment and that he be committed to an outpatient treatment facility for 180 days. After reviewing the hearing transcript, the report of the Mental Health Review Officer, and the petition, the trial court entered an order finding that T.R. is in need of care and directing that he be committed to outpatient treatment for 180 days. This timely appeal followed. On appeal, T.R. claims that there is insufficient evidence to establish that he presented a danger to himself or others to compel his involuntary treatment under the law. We disagree. - 2 -
In reviewing a trial court order for involuntary commitment, we must determine whether there is evidence in the record to justify the court's findings. In re T.T., 875 A.2d 1123, 1126 (Pa. Super. 2005) (citing Commonwealth ex rel. Gibson v. DiGiacinto, 439 A.2d 105, 107 (Pa. 1981)). Although we must accept the trial court's findings of fact that have support in the record, we are not bound by its legal conclusions from those facts. Id. (citing DiGiacinto). T.R. was committed pursuant to 50 P.S. 7305, which provides that following the expiration of a period of involuntary treatment, an additional period of treatment not exceeding 180 days may be ordered on findings as required by sections 304(a) and (b). Pursuant to 50 P.S. 7304, in order for an individual to be involuntarily recommitted the petitioner must show by clear and convincing evidence that the individual continues to pose a clear and present danger of harm to himself or to others. Commonwealth v. Helms, 506 A.2d 1384, 1387 (Pa. Super. 1986). A clear and present danger to himself may be shown by establishing, among other things, that the person has acted in such manner as to evidence that he would be unable, without care, supervision and the continued assistance of others, to satisfy his need for nourishment, personal or medical care, shelter, or selfprotection and safety... 50 P.S. 7301(b)(2)(i). See DiGiacinto, 439 A.2d at 107 ( In the absence of... an overt act [attempted suicide, selfmutilation], actions indicating inability to satisfy his own need for - 3 -
nourishment, personal or medical care, shelter, or self-protection and safety must be shown. ). Moreover, the holding in In re S.B., 777 A.2d 454 (Pa. Super. 2000), provides guidance in regard to our decision here. Where... there is clear and convincing evidence that an individual presents a clear and present danger to himself, in that within the past thirty days the individual has acted in a manner which suggests that he would be unable to satisfy his need for nourishment, personal or medical care, self-protection and safety without the assistance of others, such that there is a reasonable probability that death, serious bodily injury, or serious physical debilitation would occur, no demonstration of an overt act is necessary to involuntarily commit the individual under Section 303 of the Act. This holding is the only logical result in that where an individual previously has been committed and under the supervision of mental health care providers,... the goal of the providers is to prevent additional overt acts which present a clear and present danger to the individual. Their success in doing so does not mandate a finding that the individual is in no further need of treatment. Id., at 459. At the hearing, Dr. Johnson testified that T.R. is diagnosed as having chronic paranoid schizophrenia. See N.T., Hearing, 3/13/13, at 10. Dr. Johnson stated that T.R. has extremely impaired judgment that has him believing that a magic elixir will keep him alive and that, as such, he does not need to attend to any other real basic piece of his health. Id. She testified that he eats without regard to his health and refuses medical care. See id., at 11. Left on his own, without the supervision of Parker, T.R. s Blended Case Manager, Dr. Johnson opined that T.R. would not attend to his - 4 -
basic needs. See id., at 11-13. Dr. Johnson testified that there was a reasonable probability that T.R. would so neglect his needs that it would lead to his death, disability or serious debilitation. See id., at 13. Thomas Parker testified that he has worked with T.R for four years. See id., at 20. Parker helps him with getting his injections, medications, housing, and scheduling nurse visitation. See id. Parker noted that T.R. strongly dislikes medications as he thinks they re the work of Satan and that they re causing all of his problems. Id. Based on the foregoing testimony, we conclude that the evidence supports the trial court s findings. The evidence shows that T.R. is a clear and present danger to himself as he is unable, without assistance, to properly care for himself. Order affirmed. Judgment Entered. Joseph D. Seletyn, Esq. Prothonotary Date: 10/24/2013-5 -