This opinion will be unpublished and
may not be cited except as provided by
Minn. Stat. § 480A.08, subd. 3 (2004).
STATE OF MINNESOTA
IN COURT OF APPEALS
In the Matter of the Civil Commitment
of: Anthony Grabowska.
Filed April 5, 2005
Hennepin County District Court
File No. MH-PR-04-000758
Kurt M. Anderson, P.O. Box 2434, Minneapolis, MN 55402 (for appellant Anthony Grabowska)
Amy Klobuchar, Hennepin County Attorney, John L. Kirwin, Assistant County Attorney, C-2000 Government Center, 300 South Sixth Street, Minneapolis, MN 55487 (for respondent)
Considered and decided by Lansing, Presiding Judge; Willis, Judge; and Stoneburner, Judge.
On appeal from his commitment as mentally ill, appellant argues that the evidence does not support the determination that he has a substantial psychiatric disorder that poses a substantial likelihood of physical harm to himself or others or that commitment is the least-restrictive alternative. Because the district court failed to make findings on crucial disputed questions of fact as to the likelihood of harm, we reverse and remand.
Appellant Anthony Grabowska, now age 20, suffers from bipolar disorder. In July 2004, Grabowska, who lived with his mother, became increasingly obsessed with religious delusions. He told his mother he saw Jesus’ grave after deer showed him the way. He warned her that she was not going to heaven and that she “needed to die” if she did not take care of her sins. Grabowska testified that he had seen people “choking” their dogs while walking them and that he told them, “You guys are Satan, you guys are devil worshipers.”
Grabowska also expressed other delusional beliefs. He believed that his mother was poisoning his food, and he would not eat the food she prepared. His weight at the time of his hospital admission was 89 pounds less than it had been six months earlier. He told his mother that he did not believe that she was his mother. He thought that his friends were putting blood in alcohol bottles. Grabowska obtained a job as a day laborer but quit after one day based on his belief that he had not been paid properly when the employer withheld taxes from his paycheck.
In late July 2004, Grabowska’s mother became increasingly concerned about Grabowska’s safety. She was afraid that others would harm him in reaction to his delusional statements and “preaching.” She called the police, who transported him to the hospital. Once hospitalized, Grabowska was described as being very restless, very anxious, and out of control. He was so loud that security was called so that he could be given medication. Grabowska preached his religious beliefs, did not respect other patients’ boundaries, and would not respond to redirection by staff. He threatened to sue staff members, although he did not threaten them physically. He became suspicious that the hospital’s water was being poisoned and that staff were tampering with his food.
Grabowska’s psychiatric social worker at the hospital was concerned that if he were discharged, Grabowska would harm himself by failing to take his medication, which could cause a psychotic break like the one that resulted in his admission to the hospital. During the last few days before the hearing, however, he complied more readily with his medication and showed some improvement. Further, his social worker believed that if he were discharged and living with his family, he might threaten them if they did not express agreement with his delusional beliefs. She also testified to Grabowska’s suspicions that his food was being poisoned and testified that she did not believe that he would be organized enough to take care of shelter, food, and clothing without his mother’s care.
Grabowska’s treatment team requested that he be committed to the 45-day program at Hennepin County Medical Center. The team concluded that Grabowska had only limited insight, and they believed that he would be unable to meet his needs outside a hospital setting because of his disorganized thinking resulting from his mental illness. The team further concluded that a less-restrictive setting, such as a group home, would be unable to care for him until his level of functioning improved.
Grabowska’s mother testified that she would be willing to have her son returned to her home but only after she was confident that he was stabilized. Grabowska testified that he did not want to return to his mother’s home but instead wanted to live with his girlfriend, who had access to two separate apartments in which they could live: she preferred to live with Grabowska at an apartment that she co-leased with a still-abusive ex-boyfriend, while Grabowska preferred that they live in an apartment with a female friend of the girlfriend.
The district court committed Grabowska as mentally ill to the Hennepin County Medical Center and the Anoka Metro Regional Treatment Center. This appeal followed.
D E C I S I O N
Whether the evidence is sufficient to show that the standards for commitment are met is a question of law considered de novo. In re Knops, 536 N.W.2d 616, 620 (Minn. 1995). Findings of fact will not be reversed unless clearly erroneous. In re McGaughey, 536 N.W.2d 621, 623 (Minn. 1995). The commitment must be supported by clear and convincing evidence. Minn. Stat. § 253B.09, subd. 1(a) (2004).
The district court must “find the facts specifically.” Id., subd. 2 (2004). “Where commitment is ordered, the findings of fact and conclusions of law shall specifically state the proposed patient’s conduct which is a basis for determining that each of the requisites for commitment is met.” Id. An appellate court will remand the matter if the findings are “wholly inadequate to support commitment,” even if such a determination is supported by the evidence. In re Danielson, 398 N.W.2d 32, 37 (Minn. App. 1986).
Grabowska does not dispute his diagnosis of bipolar disorder, but he contends that there is an insufficient showing of the likelihood of harm. A person who is mentally ill is defined, in relevant part, as one who has a substantial psychiatric disorder that “poses a substantial likelihood of physical harm to self or others as demonstrated by . . . a failure to obtain necessary food, clothing, shelter, or medical care as a result of the impairment” or “a recent attempt or threat to physically harm self or others.” Minn. Stat. § 253B.02, subd. 13(a)(1), (3) (2004). The requirement of a showing of a likelihood of harm is crucial because a mentally ill person’s confinement is unconstitutional if he is “dangerous to no one and can live safely in freedom.” O’Connor v. Donaldson, 422 U.S. 563, 575, 95 S. Ct. 2486, 2493 (1975).
The supreme court has cautioned that the statute “clearly requires that the substantial likelihood of physical harm must be demonstrated by an overt failure” to obtain necessities or by a recent attempt or threat to harm self or others and that mere speculation is insufficient. McGaughey, 536 N.W.2d at 623. On the other hand, it is not necessary that “the person must either come to harm or harm others before commitment as a mentally ill person is justified.” Id. Instead, the “statute requires only that a substantial likelihood of physical harm exists.” Id.
The district court found that Grabowska’s condition poses a substantial likelihood of harm to self and others based on the following findings:
[Grabowska’s] suspiciousness and grandiosity render him unable to provide for himself in the community. He complains that an employer cheated him when he worked an eight hour shift for $10 per hour and received only $55.00. Rather than discuss it with the employer, where withholding and social security deductions may have been explained to him, he refused to go back. [Grabowska] is suspicious of the intentions of those who are trying to assist him. [Grabowska’s] loud and unwelcome preaching to others, which has involved name calling and dire warnings of negative consequences, frightens people and makes him vulnerable to their reactions.
Grabowska first contends that these findings do not show that his condition poses a substantial likelihood of physical harm, shown by a failure to obtain necessary food, clothing, shelter, or medical care, as required by Minn. Stat. § 253B.02, subd. 13(a)(1). See In re Johnson, 349 N.W.2d 364, 365 (Minn. App. 1984). In Johnson, this court upheld commitment when Johnson stopped eating, lost 20 pounds in less than a month, became feeble, drank excessively, and was in jeopardy for his life when he entered the hospital. Grabowska, however, contends that he was not malnourished, deteriorating physically, or drinking excessively, and he argues that the district court erroneously speculated that his suspiciousness and grandiosity may render him unable to provide for himself in the community.
We agree with Grabowska that the findings regarding his inability to obtain necessities are insufficient, although there is evidence in the record that Grabowska may have been unable to provide himself with necessities. First, Grabowska lost 89 pounds during the six months before his admission to the hospital. He explained at the hospital that this was due to an “eating disorder” caused by stress and depression. The doctor who examined Grabowska noted that he suffered from weight loss, probably related to psychiatric problems. Grabowska asserted that he had always been a “skinny kid” until he was jailed at 16 and placed in 23-hour-per-day lockdown. When asked about his suspiciousness about food or water, he testified, “I eat if I can.” But the district court made no specific findings on any of these facts.
Second, there was evidence that Grabowska had not been taking his medication consistently, which caused the psychosis that precipitated his hospital admission, and that he had been refusing medication until shortly before the hearing. Failure to take medication is often cited as a factor showing inability to provide necessities. See In re Fusa, 355 N.W.2d 456, 457 (Minn. App. 1984) (citing patient’s failure to take medication, along with assaultive behavior and failure to maintain personal hygiene as evidence of substantial likelihood of harm). But, again, the district court made no findings on this evidence.
Next, Grabowska argues that there are also insufficient findings regarding whether his condition poses a likelihood of physical harm to himself or others through a recent attempt or threat to physically harm self or others as required by Minn. Stat. § 253B.02, subd. 13(a)(3). As noted earlier, the district court found that Grabowska’s “loud and unwelcome preaching to others, which has involved name calling and dire warning of negative consequences, frightens people and makes him vulnerable to their reactions.” This court has recognized that an individual may meet the substantial-likelihood-of-harm standard in part by behaving in a way that is likely to outrage others and provoke an attack on himself. In re Gonzalez, 456 N.W.2d 724, 729 (Minn. App. 1990). In Gonzalez, the appellant’s provocative behavior toward others was a factor considered in determining that he was likely to harm himself or others, along with the facts that he had made a threatening phone call, that he had failed to apply for medical assistance, and that he had demonstrated an inability to provide shelter. Id.; see also In re Martin, 458 N.W.2d 700, 704-05 (Minn. App. 1990) (finding likelihood of harm when, in a paranoid state, appellant became threatening by yelling and using profanity, was easily provoked, would engage in provocative behavior in the community if not treated with medication, and threatened to assault others).
Grabowska admits that he had loud confrontations with others. But he contends there was no proof of a recent incident in which he had attempted or threatened to physically harm himself or others, as required by Minn. Stat. § 253B.02, subd. 13(a)(3). He asserts that the plain meaning of “physical harm” does not include behavior that is merely disturbing or socially unacceptable. See Minn. Stat. § 645.08(1) (2004) (directing application of plain meaning of statute). He cites McGaughey, in which the supreme court held that there was insufficient evidence to support a commitment when the appellant made inappropriate sexual comments while following nurses, masturbated near the head of a patient, and placed his head on the chest of a female patient. 536 N.W.2d at 623-24.
Grabowska contends instead that he is merely a religious person practicing Christianity who sometimes repeats “scriptures” from the Bible and that this alone does not show a threat or an attempt to harm himself or others. He states that when he believed that he was denied just compensation by his employer, rather than threatening him or attempting to physically harm him, Grabowska walked away from the situation without conflict. When his preaching led to an altercation between his mother and him, he walked away without further conflict. Finally, Grabowska voiced frustrations with the hospital by threatening lawsuits, but he did not threaten or attempt to physically harm staff, patients, or himself. We agree that Grabowska’s verbal confrontations with others, without more, are insufficient to show that there is a substantial likelihood of physical harm to himself or others, as required by the statute.
Because the findings regarding the substantial likelihood of physical harm made by the district court are insufficient to support Grabowska’s commitment and because there is evidence in the record of such a likelihood, the matter must be reversed and remanded for further findings. See Danielson, 398 N.W.2d at 37 (reversing and remanding for findings). In light of our remand, we do not reach the issue of whether the evidence supports the determination that commitment as mentally ill to Hennepin County Medical Center and Anoka Metro Regional Center was the least-restrictive alternative.
Reversed and remanded.