E.M., Appellant-Defendant v. St. Vincent Stress Center, Appellee-Plaintiff (2025)

MEMORANDUM DECISION

[1] E.M. brings this expedited appeal challenging his temporary involuntary civil commitment to the St. Vincent Stress Center (“the Stress Center”), claiming there was insufficient evidence that he was gravely disabled.¹ We affirm.

Facts and Procedural History

[2] In early November 2024, E.M. had been living primarily in his truck, despite having access to substantial savings. His sister, D.R., provided support to E.M. by getting him food and allowing him to wash clothes at her home. On November 2, 2024, D.R. contacted police requesting a welfare check after E.M.’s truck had become disabled with a flat tire. When police officers arrived, E.M. insisted they were not real and he denied ownership of his truck. It took five officers to “peacefully” remove E.M. from the vehicle. Hr. at 09:32:40–:50. E.M. was then admitted to the Stress Center.

[3] On November 20, 2024, the trial court held a commitment hearing, which included testimony from D.R., E.M., and E.M.’s treating psychiatrist, Doctor Erika Cornett (“Dr. Cornett”). Dr. Cornett testified that E.M. “presents with ․ [a] very high level of irritability, suspiciousness, paranoia, multiple paranoid delusions that interfere with his ability to interact appropriately with staff and other patients.” Id. at 09:42:22–:40. Based on her observations and treatment of E.M., Dr. Cornett diagnosed E.M. with schizophrenia.

[4] There was evidence that E.M.’s paranoid beliefs persisted throughout his hospitalization. Dr. Cornett testified that E.M. would only eat meals while sitting in the doorway of his room due to fears about DNA collection and refused to drink water because he thought it contained harmful chemicals and oils. Dr. Cornett testified that, although E.M. took prescribed medication while hospitalized, she believed that E.M. lacked insight into why he needed treatment and “d[id] not believe he has a psychiatric illness.” Id. at 09:43:55–09:44:01. Dr. Cornett explained that this was E.M.’s second admission to the Stress Center in six months, with E.M. having been previously admitted in June 2024. Dr. Cornett testified that, during E.M.’s prior admission, the Stress Center “filed for a commitment and ended up withdrawing at the very end” because E.M. showed improvement with medication. Id. at 09:49:20–:30. However, after E.M. was discharged from the Stress Center, he did not refill his prescriptions. Dr. Cornett noted that E.M.’s condition was now taking longer to stabilize compared to his June 2024 admission, explaining that repeated episodes of untreated psychosis make it more difficult to stabilize the condition in the future. Dr. Cornett said that the Stress Center planned to stabilize E.M., then refer him for ongoing medication management and outpatient therapy.

[5] D.R. testified about helping E.M. by providing him food and allowing him to wash clothes at her home. She recounted that E.M.’s truck was filled with rotting food and trash, creating an odor she likened to “dead bodies.” Id. at 09:26:12–14. D.R. testified that E.M. initially refused to remove the trash, expressing concern that others would use the trash to collect his DNA and accuse him of murder. D.R. eventually convinced E.M. to let her help clean the truck. D.R. helped put the trash in bags. On the day police arrived for the welfare check, D.R. noticed that E.M. had not discarded the trash bags and there was “added trash” in E.M.’s truck. Id. at 09:28:15–24. D.R. discovered that the truck had been infested with maggots and fruit flies.

[6] E.M. testified in his own defense, explaining that he had over $12,000 in the bank and chose to sleep in his truck occasionally to save money on hotel rooms that cost more than $100 per night for just a few hours of sleep. E.M. testified in favor of discharge, asserting that he would continue taking prescribed medication and would allow the Stress Center to test him during regular outpatient visits. E.M. also testified about his plans to look for employment. E.M. testified that, before his recent admission to the Stress Center, he had been seeking employment and was on a waitlist for an apartment in Plainfield.

[7] At the conclusion of the hearing, the trial court found that E.M. was gravely disabled and ordered a temporary civil commitment to the Stress Center for a period not to exceed ninety days. E.M. now brings this expedited appeal.

Discussion and Decision

[8] E.M. challenges the sufficiency of the evidence supporting the trial court's finding that he was gravely disabled. Pursuant to Indiana Code section 12-26-2-5(e), there must be clear and convincing evidence supporting this finding.

[9] When reviewing the sufficiency of the evidence in civil commitment cases, we “will affirm if, ‘considering only the probative evidence and the reasonable inferences supporting [the statutory findings], without weighing evidence or assessing witness credibility, a reasonable trier of fact could find [the necessary elements] proven by clear and convincing evidence.’ ” Civil Commitment of T.K. v. Dep't of Veterans Affairs, 27 N.E.3d 271, 273 (Ind. 2015) (second alteration in original) (quoting Bud Wolf Chevrolet, Inc. v. Robertson, 519 N.E.2d 135, 137 (Ind. 1988)). Clear and convincing evidence requires proof that “the existence of a fact ․ [is] highly probable.” T.D. v. Eskenazi Health Midtown Cmty. Mental Health Ctr., 40 N.E.3d 507, 510 (Ind. Ct. App. 2015).

[10] To enter a civil commitment order, the trial court must find that “the individual is mentally ill and either dangerous or gravely disabled[.]” Ind. Code § 12-26-2-5(e). Here, E.M. does not dispute that he suffers from mental illness. Rather, he argues the evidence was insufficient to establish that he was gravely disabled. Indiana Code section 12-7-2-96 defines “gravely disabled” as:

[A] condition in which an individual, as a result of mental illness, is in danger of coming to harm because the individual:

(1) is unable to provide for that individual's food, clothing, shelter, or other essential human needs; or

(2) has a substantial impairment or an obvious deterioration of that individual's judgment, reasoning, or behavior that results in the individual's inability to function independently.

[11] Under the first prong, E.M. largely focuses on evidence of his financial resources, access to transportation, employability, and history of independent living, arguing this evidence indicates he was able to independently meet his essential human needs. See Appellant's Br. p. 7. E.M. emphasizes that he was able to afford hotel accommodations, suggesting that his choice to sleep in his truck instead of paying for a hotel room represented a rational economic decision rather than an inability to secure shelter. See id. E.M. directs us to T.D., where we held that a person's “decision to live in a hotel, alone, cannot support a finding of a grave disability because it is indisputable that a hotel is a form of ‘shelter.’ ” 40 N.E.3d at 512. Critically, however, in that case, there was no indication that the appellant allowed their chosen living environment to deteriorate to the point of being unsafe. Here, however, the evidence indicated that, despite having over $12,000 in savings, E.M. had been living in unsanitary conditions, surrounded by rotting waste that attracted maggots and fruit flies, creating what D.R. described as the smell of dead bodies. E.M.’s refusal to address these conditions stemmed from his expressed concern that others would use his DNA to accuse him of murder. Thus, the evidence reflects that E.M.’s mental illness prevented him from using available resources—financial or otherwise—to maintain minimally safe and sanitary living conditions.

[12] Turning to the second prong of the statutory inquiry regarding a person's impairment of judgment, E.M. maintains there was insufficient evidence that E.M. could not function independently without coming to harm due to his impaired judgment and behavior. He relies on A.B. v. St. Vincent Hospital and Health Care Center, Incorporated and other caselaw related to the proposition that there must be “more than paranoid beliefs and bizarre behavior to establish grave disability.” 240 N.E.3d 166, 172 (Ind. Ct. App. 2024). E.M. suggests that the evidence established that he exhibited symptoms of mental illness and “was not functioning at an optimal level,” but that the Stress Center “did not prove by clear and convincing evidence that E.M.’s choices posed a danger of [him] coming to harm.” Appellant's Br. p. 8. For the reasons earlier discussed, we disagree. That is, the Stress Center presented evidence of concrete ways in which E.M.’s symptoms prevented him from maintaining his health and safety. In particular, E.M.’s delusions about DNA collection prevented him from addressing hazardous living conditions. Furthermore, Dr. Cornett testified that E.M.’s condition was becoming more resistant to treatment, explaining that it was taking longer to stabilize E.M. as compared to when he was previously admitted to the Stress Center. The evidence of E.M.’s deteriorating response to treatment, combined with evidence of his lack of insight into his need for treatment—including a failure to refill prescribed medication after his prior hospitalization—indicated that the unhealthy, unsafe living conditions caused by E.M.’s mental illness would continue to worsen without intervention.

[13] All in all, the dispositive question is not whether E.M. had resources available but whether his mental illness prevented him from using those resources to maintain his basic health and safety. The evidence reflected that, despite available resources, E.M.’s mental illness created actual risks of harm so as to satisfy the statutory criteria for grave disability. To the extent E.M. focuses on favorable evidence, such as his own testimony regarding his employability, we note that our standard of review prevents us from reweighing the evidence. In light of the evidence most favorable to the judgment, we conclude that sufficient evidence supported the trial court's finding that E.M. was gravely disabled.

[14] Affirmed.

FOOTNOTES

1.   This expedited appeal is part of the two-year Marion County Expedited Mental Health Appeals Pilot Project, which the Indiana Supreme Court established to address the challenge that “[t]he typical duration of temporary mental health commitments often exceeds the standard appellate timeline.” In re Marion Cnty. Expedited Mental Health Appeals Pilot Project, No. 24S-MS-190, slip op. at 1 (Ind. July 16, 2024).

Foley, Judge.

Judges Brown and Weissmann concur. Brown, J. and Weissmann, J., concur.