IN RE: the Civil Commitment of M.A. (2025)

MEMORANDUM DECISION

Case Summary

[1] M.A. appeals her involuntary regular commitment, arguing the evidence is insufficient to establish that she was “gravely disabled” at the time of the commitment hearing. Finding the evidence sufficient, we affirm.

Facts and Procedural History

[2] In July 2024, M.A. visited her doctor, who recommended that she seek treatment at St. Vincent Stress Center in Indianapolis for mania and psychosis. M.A. was admitted to St. Vincent on July 25 as a voluntary patient. Upon admission, M.A. presented with a lack of sleep (about five days), rapid and disorganized thought processes, inability to speak in sequential form, and paranoia. M.A.’s psychiatrist was Dr. Erika Cornett, who had treated her in the past. Dr. Cornett diagnosed M.A. with cannabis-induced psychosis and bipolar disorder unspecified. According to Dr. Cornett, M.A.’s psychosis resulted from her use of high-potency cannabis products, including “moon rock” and marijuana dipped in formaldehyde. Tr. p. 8.

[3] On August 15, St. Vincent applied for emergency detention of M.A., alleging that she was mentally ill and gravely disabled. The trial court granted the application that same day. The next day, St. Vincent requested a hearing for a regular commitment. The trial court set a hearing for August 28.

[4] At the hearing, Dr. Cornett testified that M.A. has a dual diagnosis, meaning she has both a substance-use disorder and another psychiatric illness, and that the only residential facility that would treat M.A.’s dual diagnosis was Richmond State Hospital, which required a regular commitment. Dr. Cornett noted that M.A. had two prior hospitalizations at St. Vincent for cannabis-induced psychosis, and each time she was admitted, it took longer for her to stabilize and recover from the psychosis. For her March 2023 hospitalization, it took M.A. seven days to recover. And for her April 2023 hospitalization, it took her fourteen days to recover. At the time of the August 28, 2024 hearing, which was over thirty days after she was admitted on July 25, M.A. was still experiencing “residual symptoms” from the psychosis. Id. at 21. Dr. Cornett had “grave” concerns that if M.A. used marijuana again, she would have permanent psychosis. Id. at 9.

[5] Dr. Cornett said that M.A. was taking a mood stabilizer (Depakote) and an anti-psychotic medication (Abilify). She said that although M.A. had improved since July 25, she had “periods of time where she's very clear and then throughout the day, there's not a pattern per s[e], but then there'll be periods throughout the day where she continues to really struggle with keeping her thoughts organized, keeping the past and present separate, being able to make any kind of basic life decisions ․” Id. at 15. Dr. Cornett believed that M.A. needed further treatment and that a regular commitment was “necessary” and “appropriate.” Id. at 29.

[6] M.A. testified about her plans if she were discharged, including possibly returning to her old job where there was drug use, renting a room in her former attorney's house, using essential oils, and attending AA meetings. Although M.A. claimed at one point that she would continue taking her medication if she were discharged, she said at another point that she was “unsure.” Id. at 48. At the end of the hearing, the trial court told M.A.:

[I]n your testimony I've observed you to be disorganized, to lose your way sometimes in answering questions, even more than most people going to court who get nervous judges and lawyers get nervous going to court too but sometimes ma'am in getting confused in answering the question and losing your way, you've been almost dreamlike or detached at other times you've been very clear and very lucid. What I do know is the plan that you've discussed is not just unrealistic it's potentially dangerous․ The plan you've talked about doesn't describe going back to great strategies but maybe trying them like going to AA or to a church for help or returning to your treatment provider, but we're confronted by more than occasional but seriously impairing substance use disorder involving Delta Nine, Delta Eight, marijuana, marijuana with formaldehyde or other unknown adjuncts and moon rock ․ To return to an employer where there is drug use or where you think your boss is going to help you direct what's best for you will be a catastrophic misjudgment. The idea of going to your former lawyer's house and renting a room is a disaster waiting to happen․ The strategies you've outlined today demonstrate that you're not in your right mind when it comes to planning and judgment, you're just not.

Id. at 57-58. The court said that it relied on Dr. Cornett's opinion given that she had treated M.A. three times. The court found that M.A. was mentally ill in that she suffered from “severe” marijuana-use disorder and bi-polar disorder unspecified. Appellant's App. Vol. II p. 10. The court also found that M.A. was “gravely disabled in her judgment and reasoning, as she remains disorganized and unable to make safe decisions.” Id. at 11. The court highlighted Dr. Cornett's warning that continued marijuana use “risks permanent psychosis after prior crisis hospitalizations.” Id. M.A. was sent to Richmond State Hospital, and the trial court set a review hearing for today (February 25, 2025).

[7] M.A. now appeals.¹

Discussion and Decision

[8] M.A. appeals her involuntary regular commitment. In Indiana, an individual may be civilly committed either voluntarily or involuntarily. Involuntary civil commitment may occur under three circumstances: (1) “Emergency Detention” for up to 72 hours under Indiana Code chapter 12-26-5; (2) “Temporary Commitment” for up to 90 days under Indiana Code chapter 12-26-6; and (3) “Regular Commitment” for more than 90 days under Indiana Code chapter 12-26-7. Here, St. Vincent sought M.A.’s regular commitment.

[9] M.A. contends the evidence is insufficient to support her civil commitment. To obtain an involuntary regular commitment, a “petitioner is required to prove by clear and convincing evidence that: (1) the individual is mentally ill and either dangerous or gravely disabled; and (2) detention or commitment of that individual is appropriate.” Ind. Code § 12-26-2-5(e). When reviewing the sufficiency of the evidence supporting a civil commitment, we consider only the probative evidence and reasonable inferences supporting it, without weighing evidence or assessing witness credibility. Civ. Commitment of T.K. v. Dep't of Veterans Affairs, 27 N.E.3d 271, 273 (Ind. 2015). We will affirm if clear and convincing evidence supports the trial court's judgment. Id.

[10] On appeal, M.A. only challenges one of the requirements, that is, she argues St. Vincent failed to prove by clear and convincing evidence that she was “gravely disabled” at the time of the hearing. “Gravely disabled” “means 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.” I.C. § 12-7-2-96. Here, the trial court found that M.A. was gravely disabled because she had a substantial impairment in her “judgment and reasoning, as she remains disorganized and unable to make safe decisions” and that she was in danger of coming to harm because she was at risk of “permanent psychosis” if she used marijuana again.

[11] The evidence is sufficient to establish that M.A. was “gravely disabled.” Dr. Cornett testified that at the time of the hearing, M.A. was still (1) struggling with basic decision making, (2) having disorganized thoughts, and (3) unable to differentiate past versus present. Dr. Cornett believed these things would impact M.A.’s ability to function independently outside a hospital setting and that she wouldn't comply with outpatient orders if she started using drugs again. Moreover, Dr. Cornett had “grave” concerns that based on M.A.’s prior hospitalizations for cannabis-induced psychosis, her psychosis would become permanent if she used marijuana again.

[12] M.A. points out that she voluntarily sought treatment on July 25 and had a plan to take care of herself upon discharge. The trial court commended M.A. for voluntarily seeking treatment but found that her plan was dangerous. Accordingly, M.A.’s arguments are merely requests for us to reweigh the evidence, which we don't do. M.A. also cites T.D. v. Eskenazi Health Midtown Community Mental Health Center, 40 N.E.3d 507 (Ind. Ct. App. 2015). There, T.K. was found to be gravely disabled based in part on an incident at a hotel. This Court found that one incident was not enough:

As for T.D.’s incident at the hotel, we find that, while this behavior might have indicated a need for treatment, it was not a sufficient basis for an ongoing, regular commitment. In Addington [v. Texas, 441 U.S. 418 (1979)], [the United States] Supreme Court warned against the danger of committing individuals based on “a few isolated instances of unusual conduct.” [Id. at 427]. The hotel incident was one isolated incident, and, while T.D.'s actions at the hotel were unusual, she did not harm herself or anyone else.

T.D., 40 N.E.3d at 512. This case is easily distinguishable from T.D., as this is M.A.’s third hospitalization for cannabis-induced psychosis, with each hospitalization taking longer for M.A. to recover from the psychosis. Because of that, Dr. Cornett had “grave” concerns that M.A. would have permanent psychosis if she used marijuana again. We therefore affirm the trial court.

[13] Affirmed.

FOOTNOTES

1.   After briefing in this case was completed, Richmond State Hospital filed a periodic report on February 12. According to the report, M.A. is doing well and on the discharge list; the hospital is searching for a group home for M.A. upon discharge because she still needs structure and supervision; and the hospital anticipates M.A. being released in 1-3 months.

Vaidik, Judge.

Judges Bailey and DeBoer concur. Bailey, J., and DeBoer, J., concur.