This opinion will be unpublished and
may not be cited except as provided by
Minn. Stat. § 480A.08, subd. 3 (2004).
IN COURT OF APPEALS
In the Matter of the Civil Commitment
of Latasha Farrar.
Filed April 18, 2006
Hennepin County District Court
File No. 27-MH-PR-05-746
Gregory R. Solum,
Amy Klobuchar, Hennepin County Attorney, John L. Kirwin, Assistant County Attorney, 300 South Sixth Street, Minneapolis, MN 554587 (for respondent Hennepin County Medical Center)
Considered and decided by Shumaker, Presiding Judge; Lansing, Judge; and Halbrooks, Judge.
U N P U B L I S H E D O P I N I O N
On appeal from an order committing appellant to the Minnesota Security Hospital as mentally ill and dangerous, appellant contends that the district court erred by determining that she presents a clear danger to the safety of others because the court relied on an overt act that was relied on in a previous commitment as mentally ill and because there was insufficient evidence to show that she was likely to engage in harmful acts in the future, and in determining that less-restrictive commitment alternatives are not available.
On June 17, 2005, appellant Latasha Farrar was admitted to
the Hennepin County Medical Center (HCMC) inpatient psychiatry unit because she
had set off the fire alarm in her building in response to paranoid ideation. Upon admission she was “rambling
nonsensically,” describing manic-like symptoms, and making grandiose
statements. A security guard injured his
thumb trying to restrain her. A petition
to commit Farrar as mentally ill and for authorization to administer neuroleptic
medication (Jarvis petition) was filed on June 21, 2005, and a hearing was
scheduled for June 29, 2005. Jarvis v. Levine, 418 N.W.2d 139 (
On June 27, 2005, Farrar assaulted R.G., an HCMC nurse. An eyewitness stated that Farrar
entered the nursing station where [R.G.] was charting, she hit [R.G.] in the head as she was grabbing her hair. [R.G.’s] head and neck whipped back as she was being pulled out of her chair by her hair, and then pulled out from behind the nursing station. [Farrar] commented that [R.G] called security on her for no reason. [R.G] tried to move with [Farrar], and lost her footing. One of [R.G.’s] shoes came off. ([R.G.] screamed) . . . . [Farrar] still had a grip on [R.G.’s] hair. I started to pull [Farrar’s] fingers to loosen the grip she had on her hair. [Farrar] was trying to kick [the three staff people who intervened] during this time.
The assault resulted in R.G. suffering a cervical strain, needing pain medication and physical therapy, and missing six days of work. Farrar acknowledges that she assaulted R.G., but, according to Dr. Keul, Farrar’s last treating psychiatrist at HCMC, she “expresses no remorse for her assault and in fact blamed the nurse, stating that, ‘She put voodoo on me.’” After examining Farrar, Dr. Keul concluded that the assault was “without provocation” and that Farrar is in need of treatment and should be committed to a treatment facility.
Following the hearing on June 29, 2005, the district court authorized the use of neuroleptic medication (Jarvis order) and committed Farrar as mentally ill with a “severe psychotic disorder[.]” The court found that, because of her disorder, Farrar’s thinking is disorganized and contradictory and her behavior is erratic, bizarre, and grossly disturbed. Additionally, she poses a substantial likelihood of causing physical harm while being “hostile, uncooperative, loud and physically aggressive.” Before being transferred to the Anoka Metro Regional Treatment Center (AMRTC) under the order for commitment as mentally ill, Farrar exhibited aggressive behavior on several occasions. Twice she attacked other patients, and another time she attempted to attack the head nurse, who managed to get behind the nurses’ station and lock the door.
At AMRTC, Farrar also engaged in bizarre behavior. She described one doctor’s eyes as being like cameras, changing colors, and looking at her like she stole something. She also stated that this was similar to the way the nurse she assaulted at HCMC had looked at her. Furthermore, she was continually verbally aggressive toward other patients and showed signs of delusional beliefs. When she returned from a court appearance, she said that others could look into her thoughts.
After the hearing for commitment as mentally ill, HCMC continued to gather historical information about Farrar and filed another petition on July 20, 2005, to commit her as mentally ill and dangerous. Following a hearing on this petition, the district court ordered Farrar’s commitment as mentally ill and dangerous.
The record shows numerous occasions of assaultive behavior in Farrar’s history. During a previous commitment at AMRTC in 2004, she attacked a physician, kicked her in the stomach, threw her to the floor, and ripped up all of her daily progress notes. In 1992, while left alone to look after her younger brother, Farrar became frustrated by his crying and put a pillow over his face, contemplating suffocating him. But after a few seconds, she realized that her actions were wrong and she removed the pillow.
Farrar’s legal history includes an arrest for aggravated assault, terroristic threats and obstructing justice in 2000, and a charge of fifth-degree assault and obstructing legal process in 2004. The arrest in 2000 stemmed from an incident at a gas station in which Farrar pointed a knife at a woman, threatened to kill a man, punctured vehicle tires, and kicked a police officer in the leg during the arrest. She was arrested in 2004 because she physically assaulted her neighbor, and, while police were escorting her out of her apartment, she tried to punch a police officer and grazed him on the head. Following the fifth-degree assault, Farrar underwent a rule 20 evaluation and was committed after being found incompetent to stand trial because of mental illness.
Farrar’s mental-health history includes a diagnosis of schizoaffective disorder and cannabis abuse, and hospitalization on several occasions. She was hospitalized in 1996 while experiencing auditory and visual hallucinations, in 1998 for depression and suicidal ideation, in 2000 under a rule 20 evaluation, in 2003 when she agreed to treatment, and in 2004 after being charged with assault. During the 2004 hospitalization, Farrar attempted to attack a staff member in response to receiving bad news of some sort.
As a child, Farrar was a victim of emotional, sexual, and physical abuse. Before the age of 18, she was placed in foster care and was threatened at gunpoint by her uncle because she had hit her mother with a broom. She also had suicidal thoughts while holding a knife during an argument with her father. Farrar graduated from high school, attended Job Corps, and remained single without any children. She admits to having used marijuana and cocaine and having undergone treatment twice for chemical dependency.
Farrar contends that, during her stay at AMRTC, she became
stabilized by medication, “did a good job” in her diabetes- and anger-management
groups, and demonstrated insight into her prior behaviors. During the hearing on the petition for
commitment as mentally ill and dangerous, several experts gave opinions as to
the most appropriate course of treatment for Farrar. The district court found that Farrar’s
psychosis prevents her from recognizing that she is in control of the violent
acts that cause great harm to others and that this lack of insight makes it
impossible for her to develop coping mechanisms and strategies to prevent her
violent acts in the future. Farrar’s
mental illness and history of prior violent acts led the district court to
conclude that she presents “a clear and present danger to the safety of others”
and needs to be in a treatment facility to keep herself and others safe. The court found that alternatives to
commitment described during the hearing are unsuitable to Farrar’s needs and
condition. Additionally, after
considering alternative treatments—including but not limited to community-based
nonresidential treatment, community residential treatment, partial
hospitalization, acute-care hospitalization, and regional treatment services—the
court determined that the
D E C I S I O N
challenges the district court’s order committing her as mentally ill and
dangerous. On appeal from a civil commitment,
the reviewing court is limited to determining whether the district court complied
with the statutory law and whether its conclusions of law are justified by its
findings. In re Knops, 536 N.W.2d 616, 620 (
Mentally Ill and Dangerous
Minnesota law defines a mentally ill and dangerous person as one who is mentally ill and who, because of that mental illness, presents a “clear danger to the safety of others” revealed by the fact that “(i) the person has engaged in an overt act causing or attempting to cause serious physical harm to another and (ii) there is a substantial likelihood that the person will engage in acts capable of inflicting serious physical harm on another.” Minn. Stat. § 253B.02, subd. 17 (2004).
A mentally ill person
is one who has a chemical disorder or suffers from a substantial psychotic
disorder affecting thought, mood, perception, orientation, or memory, resulting
in a gross impairment in judgment, behavior, capacity to recognize reality, or
to reason or understand.
is a key difference between commitment as mentally ill and commitment as mentally
ill and dangerous. “The supreme court
has cautioned that courts must pay due respect to the difference between the
less-serious conduct required for commitment as mentally ill and the
more-serious conduct required for indeterminate commitment as mentally ill and
dangerous.” In re Civil Commitment of Carroll, 706 N.W.2d 527, 530 (
Clear Danger to the Safety of Others
Farrar’s first contention on appeal is that the district court erred in basing its commitment of her as mentally ill and dangerous on the June 27, 2005 assault, which it had relied on earlier when it committed her as mentally ill. She asserts that the district court erroneously relied primarily on the fact that R.G.’s physical injuries were more severe than had been known at the hearing for commitment as mentally ill.
But HCMC maintains that it decided to proceed with the hearing on the petition for commitment as mentally ill and the Jarvis hearing that were scheduled two days after the assault for reasons other than the extent of R.G.’s injuries. HCMC disagrees with Farrar’s contention that R.G.’s physical injuries were later found to be more severe than had been known at the hearing. Instead, HCMC asserts that the extent of R.G.’s injuries was well known before the hearing because she felt pain and was diagnosed with a cervical strain on the same day as the assault. In fact, the morning before the hearing, R.G. was not able to get out of bed because of the pain in her neck.
HCMC decided to proceed with the scheduled hearing in order to obtain the neuroleptic-medication order. Because Farrar was placed on nonconsensual neuroleptic medication on an “emergency” basis immediately following the June 27, 2005 assault, the only way HCMC could continue administering the medication was by obtaining a commitment order. See Minn. Stat. § 253B.092, subds. 1, 8 (2004) (stating that neuroleptic medication court order is only available for committed patients).
Additionally, HCMC employs a more comprehensive procedure for filing petitions for commitment as mentally ill and dangerous than for petitions for commitment as mentally ill. To file a petition for commitment as mentally ill and dangerous, records regarding the patient’s treatment and behavioral history are gathered to the extent possible; a team considers a possible petition for commitment as mentally ill and dangerous; and an evaluation is obtained from at least one additional psychiatrist. HCMC took more than two weeks following the assault to obtain the additional information needed to file the petition for commitment as mentally ill and dangerous, although an order to allow administration of neuroleptic drugs was granted at the hearing for commitment as mentally ill only two days after the assault.
does not cite any legal authority that would prohibit HCMC from pursuing a petition
for commitment as mentally ill and dangerous after a hearing and commitment as
mentally ill. The district court did not
err by allowing petitioner to bring a petition for commitment as mentally ill
and dangerous because, as the court stated at the hearing, although this
“appears to be a case of first impression,” double jeopardy and res judicata do
not apply. See In re Civil Commitment of Martin, 661 N.W.2d 632, 641 (
second contention is that the district court erred in finding that her overt
act or assault upon R.G. was sufficiently serious to satisfy the statute for
commitment as mentally ill and dangerous.
She argues that because the act of grabbing the nurse’s hair and pulling
her out of the nurses’ station had already been determined by the district
court to have been “a recent attempt or threat to physically harm another” and
to be “a substantial likelihood of physical harm[,]” a later finding that the
nurse was more seriously injured does not justify redefining the act as
“causing or attempting to cause serious physical harm to another” and
presenting “a clear danger to the safety others” because the overt act is not
defined by the resulting harm. We
disagree. See In re Jasmer, 447 N.W.2d 192, 195-96 (
there is sufficient evidence to prove that an overt act took place is a legal
question subject to de novo review. Knops, 536 N.W.2d at 620. In cases involving commitment as mentally ill
and dangerous, the meaning of the word “serious” is limited to its common
assault against the nurse on June 27, 2005, is similar in nature to the acts in
Carroll, 706 N.W.2d at 528-29, which upheld
commitment as mentally ill and dangerous.
In that case, the patient assaulted two mental-health workers.
Farrar contends that, because the assault took place in a psychiatric facility, it was not as serious as it would have been if it had taken place in public because medical staff are better trained to handle inappropriately aggressive behavior. But caselaw clearly shows that a commitment as mentally ill and dangerous may be based on attacks that take place in treatment facilities. See Carroll, 706 N.W.2d at 531.
Additionally, because the statute for commitment as mentally ill and dangerous does not require the act to be recent, it was appropriate for the court to take into account Farrar’s prior acts of aggression and assault in committing her as mentally ill and dangerous. Minn. Stat. § 253B.02, subd. 17; In re Welfare of Hofmaster, 434 N.W.2d 279, 281 (Minn. App. 1989) (holding that overt dangerous act that occurred 11 years earlier was sufficient to support the mentally ill and dangerous commitment).
Future Physical Harm to Another
Farrar next contends that, because she was successful in her treatment at AMRTC, the court erred in concluding that she was substantially likely to engage in acts in the future that will endanger others.
In order to commit a person as mentally ill and dangerous, the petitioner must prove by clear and convincing evidence that there is a substantial likelihood that in the future that person “will engage in acts capable of inflicting serious physical harm on another.” Minn. Stat. § 253B.02, subd 17. The district court may determine whether a person remains a clear danger to others by relying on that person’s entire history, including past harmful acts. Hofmaster, 434 N.W.2d at 281. The district court properly did so with respect to Farrar.
factors that indicate Farrar’s likelihood of danger in the future include past
dangerous behavior; lack of insight into her own illness and actions and
ability to control her behavior; and, the most important risk factor,
medication noncompliance. It is undisputed
that Farrar has engaged in assaultive and inappropriately aggressive behavior
in the past. Additionally, although
there was conflicting testimony regarding whether or not she has gained insight
into her behavior, the district court concluded that her illness prevents her
from being able to gain insight into her situation. The district court is entitled to resolve
factual conflicts and has done so properly here. See
Most importantly, Farrar has a history of medication noncompliance. She contends that she has been successful in her treatment at AMRTC by stabilizing her behavior. But her behavior has become stabilized during hospitalization at AMRTC because she has been involuntarily receiving neuroleptic medication under a Jarvis order. Because she has received the medication consistently every two weeks, it has stabilized her aggressive and inappropriate behavior.
The four expert witnesses who testified at the hearing were Dr. Thomas Keul, M.D., staff psychiatrist at HCMC; Dr. Ray Conroe, Ph.D., licensed psychologist; Dr. Thomas Alberg, Ph.D., licensed psychologist; and Roy Gorza, appellant’s social worker at AMRTC. All of the witnesses except Gorza testified that Farrar satisfies the future-dangerous-conduct requirement. Although Farrar disagrees with the experts, she has failed to show that they lack credibility. Because there is ample evidence in the record, including expert testimony, to support the district court’s finding that Farrar poses a substantial likelihood of future harm, the court’s conclusion was not clearly erroneous.
Farrar’s final contention is that the district court erred by failing to acknowledge evidence of less-restrictive alternatives. The record shows that, although less-restrictive alternatives exist, none is appropriate to address Farrar’s mental-health needs.
to the Minnesota Commitment and Treatment Act, a court shall commit a patient
that it finds mentally ill and dangerous “to a secure treatment facility unless
the patient establishes by clear and convincing evidence that a less restrictive
treatment program is available that is consistent with the patient’s treatment
needs and the requirements of public safety.”
Minn. Stat. § 253B.18, subd. 1(a) (2004). One secure treatment facility is “the
disputes the court’s statement that “[n]o evidence was presented that another
secure treatment facility or any other treatment facility would accept [Farrar]
under commitment.” She argues that there
was clear and convincing evidence presented at the hearing on the petition for
commitment as mentally ill and-dangerous to show that the treatment and
discharge plan prepared by the AMRTC treatment team was less restrictive and an
appropriate alternative to commitment at the Minnesota Security Hospital. During the hearing on the petition for
commitment as mentally ill and dangerous, Gorza testified that Farrar
has been doing well enough for the treatment team to decide on a two-step
treatment plan. The treatment plan
involves transfer to an intensive regional treatment center where she could
remain for up to 90 days, after which she would be discharged back into the
community with medication monitoring, outpatient psychiatry, and visiting-nurse
services. But Dr. Conroe was not optimistic about the
discharge plan and recommended that Farrar be committed as
mentally ill and dangerous. Gorza
testified that a provisional discharge would be more successful this time than
it has been in the past because during her stay at AMRTC her behavior was
“appropriate” and she had gained more insight.
But he admitted that his knowledge of Farrar’s history and
the treatment program at the
After hearing all the
testimony, the district court determined that “[n]one but the
careful review of the record leads this court to the conclusion that the
district court was not clearly erroneous in determining that committing Farrar to