This opinion will be unpublished and may
not be cited except as provided by
Minn. Stat. ß 480A.08, subd. 3 (1998).
STATE OF MINNESOTA
IN COURT OF APPEALS
In the Matter of: Rebecca Siegel,
Filed November 30, 1999
Hennepin County District Court
File No. P09960221
Terry L. Hegna, 961 Grand Avenue, St. Paul, MN 55105 (for appellant Siegel)
Amy Klobuchar, Hennepin County Attorney, Thomas G. Lavelle, Assistant County Attorney, A-2000 Government Center, Minneapolis, MN 55487 (for respondent county)
Considered and decided by Lansing, Presiding Judge, Shumaker, Judge, and Halbrooks, Judge.
U N P U B L I S H E D O P I N I O N
Rebecca Siegel appeals a district court order determining that she is mentally ill and committing her to the Hennepin County Medical Center and Anoka Metro Regional Treatment Center. Because the district court did not clearly err in its findings and because the findings support the courtís conclusion that Siegel poses a substantial likelihood of physical harm to herself, we affirm.
Police picked up Rebecca Siegel at a Greyhound Bus depot in May 1999 after depot employees reported that she had spent more than 18 hours in the terminal. The employees indicated that Siegel appeared confused and unable to decide whether to get on a bus. Police took Siegel to the Hennepin County Medical Center (HCMC), where she was placed under a transportation hold and given a psychiatric evaluation. HCMC staff described Siegel as distressed, suspicious, and hypervigilant of people around her. Doctors diagnosed Siegel with psychosis NOS (not otherwise specified) versus schizophreniform disorder versus paranoid disorder.
After a commitment hearing, the district court determined that Siegel was mentally ill. The court further found Siegel was unable to provide for her daily needs and posed a danger of harm to herself and others. The court also authorized the use of neuroleptic medication. Siegel appeals the commitment order and requests that if the commitment order is reversed, the order authorizing neuroleptic drugs be reversed as contingent on the commitment order.
D E C I S I O N
When reviewing a commitment order, this court will not set aside the district courtís fact findings except for clear error. In re McGaughey, 536 N.W.2d 621, 623 (Minn. 1995). We independently review whether the findings are sufficient to support the statutory requirements for involuntary civil commitment. See id.
Under the Minnesota Commitment Act, a district court may order commitment when it finds, by clear and convincing evidence, that the proposed patient is mentally ill and that no less-restrictive alternative is available that will meet the patientís needs. Minn. Stat. ß 253B.09, subd. 1 (1998). To find a person mentally ill, the court must make a two-part determination. The court must find, first, that a person has an organic or psychiatric disorder evidenced by grossly disturbed behavior or faulty perception and, second, that the person "poses a substantial likelihood of physical harm to self or others." Minn. Stat. ß 253B.02, subd. 13(a) (1998).
Siegel does not contest the district courtís finding that she has an organic or psychiatric disorder that meets the commitment standard. Neither does she challenge the courtís finding that the least restrictive alternative is commitment to HCMC with backup commitment to the Anoka-Metro Regional Treatment Center, nor the order authorizing neuroleptic medication, except to the extent of its contingency on the commitment order. Siegelís direct challenge is to the sufficiency of the evidence to show that she poses a substantial likelihood of harm to herself or others.
The Minnesota Supreme Court has emphasized that the statutory requirement of substantial likelihood must be demonstrated by an overt failure to obtain necessary food, clothing, shelter, or medical care or, alternatively, by a recent attempt or threat to harm self or others. McGaughey, 536 N.W.2d at 623; Enberg v. Bonde, 331 N.W.2d 731, 736-38 (Minn. 1983); Minn. Stat. ß 253B.02, subd. 13(a). The court has cautioned that speculation on whether a person will, in the future, fail to obtain necessary food, clothing, shelter, or medical care is not sufficient to justify civil commitment. McGaughey, 536 N.W.2d at 623. The court has conjointly recognized, however, that commitment need not be delayed until irreparable harm is suffered when the danger of a personís condition has already become evident. Id.; see also In re Terra, 412 N.W.2d 325, 328 (Minn. App. 1987); In re Harvego, 389 N.W.2d 266, 268 (Minn. App. 1986).
The district court found a substantial likelihood of danger to self or others based on the testimony of a social worker from HCMC, the courtís examiner, and Siegelís father. Both the social worker and the courtís examiner testified that Siegel suffers from significant and pervasive thought-blocking that inhibits her ability to care for herself on a daily basis. The courtís examiner explained that Siegel did not have ability to "formulate any kind of plan for the next 24 hours of her life."
Siegelís father testified that Siegelís psychological problems date back to high school. In college, she expressed fears that she was being poisoned by environmental toxins. Because of her fear of environmental toxins, Siegel has wandered across the country for the last ten years, leaving apartments and other places she believes are toxic. Siegelís father testified that she has slept on doorsteps and asked strangers for places to stay. He also testified that he and his wife recently have stopped making payments to Siegel from a trust fund that had been her only source of income. It is undisputed that Siegel is unable to hold a job.
The court, relying on the testimony of Siegelís father and the court examiner, found that Siegelís longstanding psychiatric disorder has progressed to the point that she is unable to make simple, routine decisions or to formulate plans for meeting basic needs or maintaining personal safety. The court further found that Siegel is endangered by her denial of a mental disorder and her unwillingness to obtain treatment or appropriate medical care. Siegel has instead sought potentially dangerous nonstandard medical cures, including the implantation of a shunt in a vein near her heart in order to receive vitamins intravenously.
Siegel argues that the record does not demonstrate any overt failure to obtain necessary food, clothing, shelter, or medical care. We disagree. Siegel has been homeless, slept on strangersí doorsteps, and asked them for places to stay. She has abandoned the apartments she has been able to rent because of her fear of toxins. This pattern of behavior, coupled with her recent 18-hour stay in a bus station, demonstrates a failure to obtain necessary shelter. There is also evidence in the record that Siegel had low, although borderline, albumin levels when admitted to HCMC and that she had low potassium in a San Antonio hospital earlier this year. Although there has been no nutritional crisis, this evidence tends to demonstrate that Siegel has failed to obtain necessary food. Finally, evidence that Siegel has refused medication for her mental illness and that she has sought nonstandard and dangerous medical procedures tends to show that she has failed to obtain necessary medical care.
The district court also based its commitment order on allegations that Siegel had pulled a knife and brandished scissors at a San Antonio hospital in early 1999. Siegelís father testified about this incident, but he had no first-hand knowledge of the incident and could not identify the person who gave him the information. An inference drawn from unattributed hearsay is speculative and may not be sufficient to meet the clear and convincing standard of the Commitment Act. The courtís findings on Siegelís failure to obtain necessary food, shelter, and medical care, however, are sufficient to support the legal conclusion that Siegel poses a substantial likelihood of harm to herself. Consequently, we need not determine whether she poses a likelihood of harm to others.