IN RE: the Civil Commitment of D.B. (2025)

MEMORANDUM DECISION

Case Summary

[1] D.B. brings this expedited appeal and challenges her involuntary temporary commitment to Community Fairbanks Behavioral Health (“Community”).¹ D.B. claims the evidence is insufficient to show that she is a danger to herself or others or that she is gravely disabled. Concluding that clear and convincing evidence supports D.B.’s involuntary temporary commitment, we affirm.

Issue

[2] D.B. raises one issue, which we restate as whether the evidence is sufficient to support D.B.’s involuntary temporary commitment.

Facts

[3] D.B. is sixty-three years old and retired from General Motors. D.B. has income from a rental house, Social Security, and a pension. D.B. was diagnosed with bipolar disorder approximately twenty years ago. D.B. has been living with her son, K.B. (“Son”), his wife, and their two young children for four to five years. Son takes care of D.B.’s financial matters; D.B. does not drive, does not shop for groceries, and rarely cooks.

[4] Son took D.B. to see her psychiatrist regularly. D.B. claimed that her psychiatrist allowed D.B. to stop taking her medication. In May or June 2025, Son noticed that D.B.’s behavior was changing. D.B. was: (1) “cleaning for 23 hours a day”; (2) was not eating, taking her medication, nor maintaining her hygiene because she was cleaning so much; (3) sleeping under Son's office desk; and (4) leaving the refrigerator open all night; and (5) leaving sharp items in locations that her young grandchildren could reach. Tr. Vol. I p. 5. D.B. told Son that she needed to keep cleaning to get ready for a garage sale that Son indicated was not planned. D.B. would dump the contents of cabinets and drawers onto the middle of the floor as part of her cleaning and decluttering.

[5] On July 10, 2025, law enforcement brought D.B. to Community after D.B. had a physical altercation with her daughter-in-law. Dr. Syed Hasan examined D.B., who was “jumping from one topic to another topic, very, very loud, hyperverbal, intrusive, and ․ making comments to hurt her daughter-in-law.” Id. at 20. D.B. told Dr. Hasan that she had not been sleeping well and that she was trying to make Son's residence “perfect” because she wanted to start a business staging houses. Id. D.B. believed that “people who work for General Motors usually get relocated every two years ․ [s]o she wanted to make sure the house [was] clean and ready for sale.” Id.

[6] D.B. was transferred to a medical unit because she “was in acute renal failure because of volume depletion.”² Id. at 23. Patients in a manic phase have a “high level of energy, not caring about themselves, not eating regularly, not taking medications prescribed by the doctors” and “can have metabolic abnormalities and kidney problems” as D.B. had. Id. According to Dr. Hasan, D.B.’s acute renal failure was connected to her bipolar disorder. After treatment for her renal failure, D.B. was returned to the psychiatric unit of the hospital. On July 17, 2025, D.B. requested that she be discharged from the hospital.

[7] On the same day, Community filed a request for D.B.’s temporary commitment. Community alleged that D.B. had a psychiatric disorder; that D.B. is dangerous; and that D.B. is gravely disabled. An evidentiary hearing was held on July 21, 2025.

[8] Son testified that D.B. had not been acting normally for approximately thirty days before her hospitalization. D.B. became “very combative, very aggressive” and cursed at Son. Id. at 8. Son testified that D.B. could not return to his residence in “a manic state and be in the same house as my kids and wife right now, it's just not safe for anybody.” Id. at 16. While hospitalized, D.B. repeatedly insisted to Son that she wanted to take Wellbutrin, which is an antidepressant.

[9] Dr. Hasan testified that he had examined D.B. four times since her admission, including on the morning of the hearing, and that D.B.’s condition was unchanged. Dr. Hasan diagnosed D.B. with “bipolar [a]ffective disorder, current episode manic,” which is a chronic mental illness. Id. at 21. Dr. Hasan observed that D.B. “presented with high level of energy, very active, very animated, less need for sleep, very talkative, talking fast, having racing thoughts, jumping from one topic to another topic, easily distracted, argumentative, and needs a lot of redirections, disinhibited, touching people and not able to make rational decisions.” Id. Even on the morning of the hearing, D.B. continued “to be pretty hyperverbal, talkative, still have some racing thoughts, [and] gets irritable easily ․” Id. at 31.

[10] D.B. continues to have “conflict with her daughter-in-law” and told Dr. Hasan that, if her daughter-in-law approached her, D.B. “will not stop hitting her ․” Id. at 22. D.B., thus, continues to “have this aggression and mindset towards daughter-in-law about hurting her or having verbal or physical aggression towards [daughter-in-law].” Id. D.B. also exhibited “several episodes of aggression in the hospital.” Id. at 25. D.B. continues to have mistrust toward her family members and treatment providers, and her thinking and decision-making abilities are “pretty impaired.” Id. at 24.

[11] Dr. Hasan also testified that D.B. was unable to provide for herself or her “essential human needs.” Id. at 23. Dr. Hasan opined that D.B. was unable to function independently and unable to perform more complex tasks, such as maintaining housing, managing finances, or securing transportation. D.B. told Dr. Hasan that she was going to load her things into a U-Haul truck and drive toward Mississippi, Illinois, or Evansville and that she will distribute her money to poor people. D.B. does not understand her diagnosis and focuses upon taking only Wellbutrin rather than the recommended medications. In the hospital, D.B. has been focused upon being discharged from the hospital, taking Wellbutrin, leaving Indiana, and staging houses. D.B. started taking the proper medication about three days before the evidentiary hearing, and an additional three or four days were needed to obtain a therapeutic level of the medication to improve D.B.’s symptoms. Without a commitment, Dr. Hasan did not believe that D.B. would take her medication or follow up with treatment. Without treatment, Dr. Hasan opined that D.B.’s prognosis was “poor.” Id. at 28.

[12] D.B. testified at the evidentiary hearing. D.B.’s testimony demonstrated an inability to focus and continued irrational thoughts. She claimed to be taking three or four showers a day, although Son and Dr. Hasan testified that her hygiene was unsatisfactory. D.B. claimed that she was cleaning to prepare for a garage sale, but Son testified that a garage sale had not been planned.

[13] After the hearing, the trial court stated that D.B. “caused herself harm by not eating and drinking sufficiently and had to have a regular hospitalization for renal failure.” Id. at 59. The trial court also stated that D.B. was gravely disabled and Son “has to do just about everything for her right now.” Id. On July 22, 2025, the trial court found by clear and convincing evidence that D.B. is suffering from “Bipolar I disorder, current or most recent episode manic with psychotic features,” that D.B. was dangerous to herself and others, and that D.B. was gravely disabled. Appellant's App. Vol. II p. 24. The trial court ordered that D.B. be committed “until October 19, 2025, unless discharged prior.” Id. D.B. now appeals.

Discussion and Decision

[14] D.B. appeals her involuntary temporary commitment. “ ‘[T]he purpose of civil commitment proceedings is dual: to protect the public and to ensure the rights of the person whose liberty is at stake.’ ” Civ. Commitment of T.K. v. Dep't of Veterans Affs., 27 N.E.3d 271, 273 (Ind. 2015) (quoting In re Commitment of Roberts, 723 N.E.2d 474, 476 (Ind. Ct. App. 2000)). “To satisfy the requirements of due process, the facts justifying an involuntary commitment must be shown ‘by clear and convincing evidence ․ [which] not only communicates the relative importance our legal system attaches to a decision ordering an involuntary commitment, but ․ also has the function of reducing the chance of inappropriate commitments.’ ” Id. (quoting Commitment of J.B. v. Midtown Mental Health Ctr., 581 N.E.2d 448, 450 (Ind. Ct. App. 1991), trans. denied).

[15] We will affirm a civil commitment “if, ‘considering only the probative evidence and the reasonable inferences supporting it, without weighing evidence or assessing witness credibility, a reasonable trier of fact could find [the necessary elements] proven by clear and convincing evidence.’ ” J.W. v. Cmty. Fairbanks Behav. Health, 260 N.E.3d 946, 951 (Ind. 2025) (quoting T.K., 27 N.E.3d at 273). “Probative evidence is that which ‘tends to prove or disprove a point in issue.’ ” Id. (quoting Galloway v. State, 938 N.E.2d 699, 711 (Ind. 2010)). “And ‘[i]n order to be clear and convincing, the existence of a fact must be highly probable.’ ” Id. (quoting Commitment of B.J. v. Eskenazi Hosp./Midtown CMHC, 67 N.E.3d 1034, 1038 (Ind. Ct. App. 2016)).

[16] For involuntary temporary commitments of not more than ninety days, the petitioner must prove that the individual is “mentally ill and either dangerous or gravely disabled.” Ind. Code § 12-26-6-1, -8(a). The trial court can only order an involuntary temporary commitment if it finds by clear and convincing evidence that the person is mentally ill and either dangerous or gravely disabled and that committing them is appropriate. Ind. Code § 12-26-2-5(e), -6-8(a). D.B. does not challenge the trial court's determination that she is mentally ill or that commitment was appropriate. Rather, D.B. challenges the trial court's determination that D.B. was dangerous and gravely disabled.

A. The trial court's finding that D.B. is dangerous is supported by clear and convincing evidence.

[17] D.B. argues that Community failed to present evidence that she is a danger to herself or others. “Dangerous” is defined as “a condition in which an individual as a result of mental illness, presents a substantial risk that the individual will harm the individual or others.” Ind. Code § 12-7-2-53(a).

[18] Community presented evidence that D.B., during a manic episode, failed to eat, drink, and take her medications, leading to acute renal failure. Although D.B. has now been eating and drinking while hospitalized in a structured environment, D.B. is still in the midst of a manic episode. At the time of the hearing, D.B.’s mental condition remained unchanged from when she was admitted to the hospital. D.B. exhibited a continued irrational focus on taking Wellbutrin to address her mental health despite the fact that Wellbutrin is contraindicated for patients in a manic episode. Under these circumstances, the trial court's finding that D.B. was still a danger to herself was supported by clear and convincing evidence.

[19] Further, Community presented evidence that D.B. was a danger to others. D.B. was hospitalized after a physical altercation with her daughter-in-law. Even on the morning of the evidentiary hearing, D.B. continued to make threatening comments regarding her daughter-in-law. D.B. told Dr. Hasan that, if her daughter-in-law approached her, D.B. “will not stop hitting her ․” Tr. Vol. I p. 22. During her hospitalization, D.B. also exhibited “several episodes of aggression[.]” Id. at 25. Under these circumstances, the trial court's finding that D.B. was a danger to others was also supported by clear and convincing evidence.

B. The trial court's finding that D.B. is gravely disabled is supported by clear and convincing evidence.

[20] D.B. also challenges the trial court's finding that she is gravely disabled. The statute, however, is written in the disjunctive. Accordingly, Community was only required to prove that D.B. was dangerous or that she was gravely disabled. See M.Z. v. Clarian Health Partners, 829 N.E.2d 634, 637 (Ind. Ct. App. 2005) (“[I]n order to carry its burden of proof, Clarian only had to prove that M.Z. was either gravely disabled or dangerous. It did not have to prove both of these elements.”), trans. denied.

[21] We have concluded that Community proved that D.B. was dangerous by clear and convincing evidence. Additionally, we conclude that the trial court's finding that D.B. is gravely disabled is supported by clear and convincing evidence. Gravely disabled is defined 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.

Ind. Code § 12-7-2-96.

[22] Dr. Hasan testified that D.B. was unable to provide for her essential needs and unable to function independently. D.B.’s manic episode resulted in her cleaning twenty-three hours a day, neglecting her hygiene and physical well-being to the point that she suffered from renal failure, and making irrational decisions. In her current condition, D.B. was unable to maintain housing, manage her finances, or secure transportation. D.B. told Dr. Hasan that she was going to load her things into a U-Haul truck and drive toward Mississippi, Illinois, or Evansville and that she will distribute her money to poor people. D.B. does not understand her diagnosis and focuses upon taking only Wellbutrin rather than the recommended medications. D.B.’s testimony demonstrates that she has continued with her irrational focus on staging houses, preparing for a garage sale, and taking Wellbutrin. Under these circumstances, the trial court's finding that D.B. is gravely disabled is supported by clear and convincing evidence.

Conclusion

[23] Clear and convincing evidence supports D.B.’s involuntary temporary commitment, and we affirm the trial court's involuntary temporary commitment order.

[24] Affirmed.

FOOTNOTES

1.   This expedited appeal is part of the two-year Marion County Expedited Mental Health Appeals Pilot Project established by the Indiana Supreme Court. In re Marion Cnty. Expedited Mental Health Appeals Pilot Project, No. 24S-MS-190, slip op. at 1 (Ind. July 16, 2024).

2.   Volume depletion “is characterized by a reduction in extracellular fluid volume that occurs when salt and fluid losses exceed intake on a sustained basis.” Volume depletion in adults, BMJ Best Practice, https://bestpractice.bmj.com/topics/en-us/937 [https://perma.cc/6UVH-ZSMU] (last visited Aug. 26, 2025).

Tavitas, Judge.

Judge Foley and Senior Judge Robb concur. Foley, J., and Robb, Sr. J., concur.