This opinion will be unpublished and
may not be cited except as provided by
Minn. Stat. § 480A.08, subd. 3 (2002).
STATE OF MINNESOTA
IN COURT OF APPEALS
In the Matter of the
Civil Commitment of:
Lisa R. Pringle.
Filed January 28, 2003
Ramsey County District Court
File No. P801404
Mary M. Huot, Merriam Park Professional Offices, 1678 Selby Avenue, St. Paul, MN 55104 (for appellant Lisa R. Pringle)
Susan Gaertner, Ramsey County Attorney, Beth Gessner Sullivan, Assistant County Attorney, 50 West Kellogg Boulevard, Suite 315, St. Paul, MN 55102 (for respondent county)
Considered and decided by Peterson, Presiding Judge, Toussaint, Chief Judge, and Forsberg, Judge.
Appellant challenges her commitment as mentally ill and dangerous, arguing that (1) the district court failed to comply with the statutory requirements for commitment of a mentally ill and dangerous person and (2) her commitment is not justified by findings based on the evidence. Because we conclude that the district court complied with the statutory requirements and that appellant’s commitment is justified by findings based on the evidence, we affirm.
Appellant Lisa R. Pringle has a history of mental illness and dangerous behavior. In April 2000, Pringle received a medical discharge from the Marine Corps based on a diagnosis of bipolar disorder and borderline personality disorder. At that time, she reported that she had previously been diagnosed with bipolar disorder, a diagnosis that had resulted in six previous hospitalizations.
In August 2000, Pringle was admitted to Regions Hospital in St. Paul after assaulting her two sisters. She was again diagnosed with bipolar disorder. While hospitalized, Pringle was physically aggressive with staff members, on one occasion throwing a bedside table across a room and on another lifting a chair over her head and threatening to throw it at someone.
In September 2000, the district court ordered Pringle’s initial commitment as mentally ill. She was admitted to the Fergus Falls Regional Treatment Facility in October 2000 and was diagnosed with bipolar disorder. In a December 2000 psychological evaluation in connection with her initial commitment, Pringle was again diagnosed with bipolar disorder.
Pringle was readmitted to Regions in August 2001 after an incident in which she was found wandering her apartment complex with a knife in her hand. When the police responded, Pringle dropped the knife and ran toward one of the police officers, attempting to grab his gun. During her second stay at Regions, Pringle’s aggressive behavior included an attempted escape, the destruction of a shelf in her bathroom, and an assault on a doctor. She also made threats of physical violence toward hospital staff and exhibited “bizarre” behavior that included drinking water out of the toilet. Once again, Pringle was diagnosed with bipolar disorder.
After the August 2001 admission to Regions, Pringle waived her right to a hearing on a new petition for initial commitment, and the district court ordered Pringle committed as mentally ill. Pringle was admitted to the Minnesota Security Hospital (MSH). At the initial hearing on a subsequent petition for commitment as mentally ill and dangerous, the evidence included a report from Pringle’s treating psychiatrist at MSH and reports from two court-appointed examiners. Pringle’s treating psychiatrist, Jennifer Service, diagnosed Pringle with bipolar disorder, but Service noted that Pringle’s behavior had not “caused serious harm to others.” Service consequently recommended that Pringle be admitted as mentally ill only. One court-appointed examiner, Hector Zeller, diagnosed Pringle with bipolar disorder and impulse control disorder, noting that Pringle’s “psychosis appears to diminish her capacity to control her impulses and, therefore, makes her quite dangerous to others.” The other examiner, Maureen Hackett, diagnosed Pringle with bipolar disorder, intermittent explosive disorder, and probable personality disorder. Hackett opined that Pringle “certainly has a level of dangerousness that is constant and is to be taken quite seriously by her caregivers and acquaintances.”
During a 60-day evaluation period at MSH, Pringle continued to display aggressive behavior and was placed in “protective isolation” on nine occasions. Pringle physically assaulted three staff members, hit another patient and broke her glasses, “tore her room apart,” and attempted to escape from the hospital.
In May 2002, the district court held a review hearing on the petition for commitment as mentally ill and dangerous. The court incorporated the record from the initial hearing into the record of the review hearing. Zeller testified that, in his opinion, Pringle suffers from bipolar disorder, in remission at the time of the hearing, and borderline personality disorder. Zeller opined that both disorders are substantial psychiatric disorders “of thought, mood, [and] perception” that grossly impair Pringle’s judgment. Zeller also testified that, in his opinion, Pringle poses a danger to herself and others. A third court-appointed examiner, Thomas Alberg, testified that Pringle exhibits symptoms consistent with a diagnosis of bipolar disorder and borderline personality disorder. Alberg added that Pringle may still suffer from bipolar disorder even if some or all of her symptoms are in remission.
Two psychiatrists from MSH testified at the May 2002 hearing. Service, Pringle’s treating psychiatrist, changed her previous diagnosis and testified that, in her opinion, Pringle does not suffer from bipolar disorder. Michael Farnsworth agreed with Service’s opinion regarding bipolar disorder. Both Service and Farnsworth diagnosed Pringle with antisocial personality disorder, and they opined that she does not suffer from a major mental illness. But Service agreed with Zeller that bipolar disorder is a major mental illness committable under Minnesota’s commitment statute. Service and Farnsworth also testified that Pringle was receiving no neuroleptic medication and was only being treated by “containment” through protective isolation. Service testified, however, that Pringle could again be treated with neuroleptic medication.
During Service’s testimony, Pringle interrupted and wielded a piece of metal pipe. She had apparently pulled a showerhead out of the wall at MSH and secreted it into the courtroom in her clothing.
The district court concluded that Pringle is a mentally ill and dangerous person and ordered her committed for an indeterminate period of time. This appeal follows.
Pringle argues that the district court failed to comply with the statutory requirements for commitment of a mentally ill and dangerous person. She contends that (1) she is not receiving “active psychiatric treatment,” which she argues the statute requires, and (2) her behavior is volitional and therefore not the result of mental illness.
When reviewing a commitment, this court is limited to an examination of whether the district court complied with the requirements of the commitment act. In re Schaefer, 498 N.W.2d 298, 300 (Minn. App. 1993).
1. “Active Psychiatric Treatment”
Pringle contends that Minnesota law requires that a person who is committed as mentally ill and dangerous be receiving “active psychiatric treatment.” She argues that the trial court failed to comply with the statute because the only treatment she is receiving at MSH is protective isolation, which Pringle argues is not “active psychiatric treatment.”
Pringle cites Minn. Stat. § 253.017, subd. 1 (2002), which provides that “[t]he regional treatment centers shall provide active psychiatric treatment according to contemporary professional standards.” Section 253.017, however, governs regional treatment centers and does not discuss standards for civil commitment of the mentally ill and dangerous. See id. § 253.017. And Minn. Stat. § 253B.18 (2002), which prescribes procedures for commitment of the mentally ill and dangerous, does not require “active psychiatric treatment.” Pringle cites no authority for the proposition that section 253.017 governs commitment proceedings.
Further, the record supports the district court’s findings that treatment is available to Pringle. She has received neuroleptic medication in the past and Service testified that she could be offered such medication again. And as the district court noted, MSH is charged with both “holding in custody and caring for such persons with mental illness * * * as may be committed thereto * * * .” Minn. Stat. § 253.20 (2002) (emphasis added).
2. Dangerousness Resulting from Mental Illness
Pringle also contends that her dangerousness is not the result of mental illness. She points to testimony by the two MSH psychiatrists that Pringle has the ability to “turn her behaviors on or off.”
Minnesota law defines a “person who is mentally ill and dangerous to the public” as a person “(a) who is mentally ill; and (b) who as a result of that mental illness presents a clear danger to the safety of others * * *.” Id. § 253B.02, subd. 17 (2002) (emphasis added).
The district court explicitly found that Pringle’s acts were the result of her mental illness, and her past diagnoses are closely linked with examples of her dangerous behavior that are consistent with a diagnosis of mental illness. Pringle cites Service’s diagnosis that Pringle does not suffer from a mental illness. But the district court found that Pringle suffers from bipolar disorder and borderline personality disorder, and evidence of numerous past diagnoses of both disorders supports this finding. Further, both examiners at the initial hearing linked their diagnoses of Pringle’s mental illness to their opinions that she is dangerous.
Because Minn. Stat. § 253.017 does not govern the district court’s order to commit Pringle and because the district court complied with the statutory requirement that Pringle’s dangerousness be the result of mental illness, the court did not fail to comply with the statutory requirements for Pringle’s commitment as mentally ill and dangerous.
Pringle also argues that her commitment is not justified by findings based on the evidence. She contends that she has not been “clearly diagnosed” with a mental illness and that, even if she does suffer from bipolar disorder, it is in remission. Pringle does not argue that bipolar disorder and borderline personality disorder are not mental illnesses under the Minnesota’s commitment statute. Rather, she argues that the evidence is insufficient to support the district court’s findings regarding the illnesses from which she suffers.
Findings of fact justifying commitment will not be set aside “unless clearly erroneous, and due regard shall be given to the opportunity of the trial court to judge the credibility of the witnesses.” See Minn. R. Civ. P. 52.01; Schaefer, 498 N.W.2d at 300. When the district court’s findings of fact rest almost entirely on expert testimony, its evaluation of credibility is of particular significance. In re Knops, 536 N.W.2d 616, 620 (Minn. 1995).
Numerous past diagnoses of bipolar disorder and borderline personality disorder support the district court’s findings. Further, all of the court-appointed examiners diagnosed Pringle with bipolar disorder, and Zeller and Alberg agreed at the review hearing on a diagnosis of borderline personality disorder. While Service changed her diagnosis at the review hearing, she had previously diagnosed Pringle with bipolar disorder. The district court was free to assess the credibility of the various experts. Though Pringle argues that her bipolar disorder is in remission, Zeller testified that she remains mentally ill and that her symptoms could return at any time.
Pringle also argues that antisocial personality disorder, with which Service and Farnsworth diagnosed her, is not a mental illness under the statute. The district court, however, explicitly found that while Pringle may indeed suffer from antisocial personality disorder, such a diagnosis does not preclude a diagnosis of bipolar disorder and borderline personality disorder. Pringle’s commitment is therefore justified by findings based on the evidence.
* Retired judge of the Minnesota Court of Appeals, serving by appointment pursuant to Minn. Const. art. VI, § 10.