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In re MH 2012-003506

Court of Appeals of Arizona, First Division, Department D

July 30, 2013

IN RE MH 2012-003506

Not for Publication – Rule 28, Arizona Rules of Civil Appellate Procedure

Appeal from the Superior Court in Maricopa County Cause No. MH2012-003506 The Honorable Susan G. White, Judge Pro Tempore

William G. Montgomery, Maricopa County Attorney Phoenix Bruce P. White, Deputy County Attorney Anne C. Longo, Deputy County Attorney Attorneys for Appellee

Marty Lieberman, Office of the Legal Defender Phoenix Cynthia D. Beck, Deputy Legal Defender Attorneys for Appellant

MEMORANDUM DECISION

LAWRENCE F. WINTHROP, Judge

¶1 Appellant seeks relief from an order committing him to involuntary mental health treatment. He argues that the superior court erred in ordering him into treatment because Dr. Aaron Riley, one of the two required evaluating physicians, could not say to a degree of medical certainty that (1) his alleged disability was caused by a mental disorder as opposed to his cognitive disorders and (2) there was a reasonable prospect his condition was treatable.[1] Finding no error, we affirm.

FACTS AND PROCEDURAL HISTORY [2]

I. Petition for Court-Ordered Evaluation

¶2 Appellant, who has a long history of psychiatric treatment as well as antisocial and criminal behavior, lives with his father, who is his legal guardian and primary caregiver. In July 2012, Appellant was arrested and placed in jail, but after being found incompetent in a Rule 11 proceeding to stand trial, [3] he was transferred to Desert Vista Behavioral Health Center ("the Hospital").

¶3 On October 26, 2012, Dr. Payam Sadr filed a petition for court-ordered evaluation, alleging that while at the Hospital, Appellant had threatened medical staff, punched another hospital patient, and otherwise engaged in violent, intrusive, and inappropriate behavior, including urinating on the hospital floor and smearing feces. Appellant was purportedly experiencing auditory hallucinations and acting anxious, agitated, and irritable. He also was refusing psychiatric care, would not follow directions, and had no comprehension of his surroundings. Dr. Sadr concluded reasonable cause existed to believe Appellant has a mental disorder making him persistently or acutely disabled, gravely disabled, and a danger to others. The court issued a detention order for evaluation, and two physicians were assigned to separately evaluate him.

II. Petition for Court-Ordered Treatment

¶4 The physicians assigned to evaluate Appellant were Dr. David Fife and Dr. Riley. Dr. Fife filed a petition for court-ordered treatment accompanied by an affidavit documenting his evaluation, in which he concluded Appellant was "suffering from a mental disorder diagnosed as (Probable Diagnosis) Schizoaffective Disorder, bipolar type; Autism Spectrum Disorder; [and] Mild Mental Retardation (DSM Code) 295.7, 299.0, 317.0." (Emphasis omitted.) Dr. Fife concluded that, as a result, Appellant suffered from a mental disorder that rendered him persistently or acutely disabled, gravely disabled, and a danger to others.

¶5 In his affidavit summarizing his interview with Appellant, Dr. Fife noted Appellant's acknowledgement that he had punched another patient for no reason other than because he was "angry." Appellant also reported to Dr. Fife that he felt depressed, and he denied ever receiving psychiatric treatment, although such treatment was well-documented in his medical history, including at least five hospitalizations "for mood instability, aggression, and psychosis." Dr. Fife described Appellant's mood and affect as labile, and noted that he was disheveled, malodorous, unable to manage the activities of daily living without prompting, appeared to be responding to auditory hallucinations, and significantly delusional. Dr. Fife found that Appellant's insight and judgment were impaired, he had resisted voluntary psychiatric treatment, and he had no capacity to understand the advantages and disadvantages of accepting treatment, as manifested by the fact that he was at the time demonstrating psychosis by responding internally to voices and with mood instability. Dr. Fife opined that Appellant's symptoms were treatable if he complied with recommended treatment and could be stabilized in an inpatient treatment setting, and then he could be discharged to continue treatment on an outpatient basis. In his gravely disabled addendum, Dr. Fife noted in part that Appellant could not obtain food, prepare basic meals, care for his basic hygiene, or provide shelter, and did not even know how to respond in an emergency.

¶6 Dr. Riley also evaluated Appellant and concluded that Appellant suffered from a mental disorder that rendered him persistently or acutely disabled, gravely disabled, and a danger to others. Dr. Riley diagnosed Appellant's condition as "Schizoaffective disorder (295.70) Mild Mental Retardation (317)." (Emphasis omitted.) In his interview with Dr. Riley, Appellant's affect appeared flat and inappropriate, and he was minimally cooperative, blamed his "stupid mom" for his hospitalization, appeared internally preoccupied, and acknowledged he was experiencing auditory hallucinations. Appellant had also been refusing psychiatric care and was not fully cooperative ...


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