IN RE: Commitment of L.S. (2026)

MEMORANDUM DECISION

Statement of the Case

[1] L.S., who has a history of mental health hospitalizations, appeals her involuntary temporary commitment to Indiana University Health Methodist (“Hospital”). L.S. presents one issue for our review: Whether Hospital presented sufficient evidence to support her commitment.

[2] We affirm.

Facts and Procedural History

[3] L.S. has a lengthy history of mental health hospitalizations and is formally diagnosed with bipolar disorder ¹ and delirium ² . In June 2024, L.S. was admitted to Hospital for psychiatric care. In August 2024, L.S. suddenly lost her vision. In November 2025, L.S. was involuntarily temporarily committed to Hospital. In December 2025, L.S. was again admitted to the psychiatric unit. In March 2026, L.S. was admitted to the psychiatric unit after attempting suicide. On April 1, she was released after Hospital's involuntary commitment petition was denied.

[4] After her release on April 1, L.S. arrived at the home she shared with her daughter (“Daughter”). In the approximately 17 hours L.S. was there, she refused food and drinks from Daughter because she “believed [Daughter] was trying to poison her,” Tr. Vol. II at 19; selectively took her medication after accusing Daughter of giving her the wrong dosage; and caused Daughter to call 911 three times. The first call occurred when L.S. refused Daughter's help after L.S. pulled a bookshelf down on herself as she fell. The second call occurred when L.S. refused Daughter's help to get herself off the floor and to bed. The third call occurred when L.S. woke up in the middle of the night “screaming at the top of her lungs, ‘help me, help me, call 9-1-1.’ ” Id. at 20. Later in the morning on April 2, L.S. “started yelling and saying she was ․ going to die, ‘just let me die here at home.’ ” Id. at 24. Daughter drove L.S. to a local hospital, and L.S. was transferred to Hospital. On April 7, Hospital sought a regular commitment order.³

[5] Doctor Jonathan Withers, a board-certified psychiatrist with Hospital, has treated L.S. for her mental health conditions throughout the aforementioned admissions, an emergency detention, and at least one other temporary commitment. At the evidentiary hearing on Hospital's commitment petition, Dr. Withers testified that since L.S. became blind, previously “latent,” Tr. Vol. II at 36, “cluster B personality pathology traits,” id. at 33—consistent with borderline personality disorder and narcissistic personality disorder—have emerged as a “maladaptive defense mechanism,” providing a “very significant barrier to her meeting her basic needs,” id. at 36. In other words, L.S.’s “behaviors [are] a result of her mental health condition [and] have prevented her from adequately practicing and solidifying the skills needed to adapt to her” blindness. Id. at 52. Dr. Withers testified that L.S.’s behavior in the short time she stayed with Daughter was consistent with the cluster B personality traits, which include increased paranoia, distrust, and impulsive behaviors. Dr. Withers opined that a regular commitment was needed to treat L.S.’s cluster B personality traits in a stable environment.

[6] L.S. testified that Daughter would not help her walk to the bathroom, administered her medication too early, and did not offer her anything to eat or drink until “about two a.m.” Tr. Vol. II at 60. L.S. also denied falling. If released, L.S. intended to move into an apartment and rely on Senior Helpers for help with housework and Meals on Wheels for her food needs. When asked whether she “believe[d her] daughter was trying to harm” her, L.S. declined to answer. Id. at 70.

[7] The trial court determined that L.S. was dangerous to herself and gravely disabled and granted a temporary commitment. This appeal ensued.

Discussion and Decision

Hospital Presented Sufficient Evidence to Support L.S.’s Temporary Commitment

[8] L.S. challenges the sufficiency of the evidence to support her involuntary civil commitment. Specifically, L.S. argues that (a) our review is limited by the trial court's express determination that L.S. was suffering from bipolar disorder and delirium, and (b) Hospital did not prove that L.S. is gravely disabled. We address each in turn.

a. Express Determination

[9] In its commitment order, the trial court determined that L.S. was “suffering from bipolar disorder and delirium, which is a mental illness as defined in I.C. 12-7-2-130.” Appellant's App. Vol. II at 31. The trial court did not mention the emerging cluster B personality traits. Thus, L.S. contends that we cannot consider Dr. Withers's testimony about the emerging cluster B personality traits. Hospital argues that we can look to the entire record regardless of the trial court's determination.

[10] A trial court is not required to make special findings supporting a temporary commitment order; rather, “[i]f, upon the completion of the hearing and consideration of the record, the court finds that the individual is mentally ill and either dangerous or gravely disabled, the court may” enter a commitment order. Ind. Code § 12-26-6-8(a) (effective July 1, 2020, to June 30, 2026). A person is “mentally ill” or has a “mental illness” if she has “a psychiatric disorder” that “substantially disturbs” her “thinking, feeling, or behavior” and that “impairs” her “ability to function.” Id. § 12-7-2-130 (effective July 1, 2023, to June 30, 2026). A formal diagnosis is not required. See id. “Psychiatric disorder” means “a mental disorder or disease.” Id. § 12-7-2-150 (effective July 1, 2015, to June 30, 2026).

[11] Our standard of review is record-oriented, directing us to look beyond the trial court's commitment order to the evidence supporting it. 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.” A.D. v. Cmty. Fairbanks Behav. Health, 274 N.E.3d 463, 464 (Ind. 2026) (per curiam) (alteration and internal quotation marks omitted) (quoting J.W. v. Cmty. Fairbanks Behav. Health, 260 N.E.3d 946, 951 (Ind. 2025)). “Probative evidence is that which ‘tends to prove or disprove a point in issue.’ ” Id. (quoting J.W., 260 N.E.3d at 951). “[T]o be clear and convincing, the existence of a fact must be highly probable.” Id. (quoting J.W., 260 N.E.3d at 951). When, however, a trial court enters findings and conclusions sua sponte, we review the “issues covered by the findings with a two-tiered standard of review that asks whether the evidence supports the findings, and whether the findings support the judgment.” Steele-Giri v. Steele, 51 N.E.3d 119, 123 (Ind. 2016) (citing In re S.D., 2 N.E.3d 1283, 1287 (Ind. 2014)). We review any issue not covered by the findings “under the general judgment standard,” which means we will affirm “on any legal theory supported by the evidence.” Id. at 123–24 (citing S.D., 2 N.E.3d at 1287). We will not reweigh the evidence or judge witness credibility, and we consider only the evidence and reasonable inferences that support the court's decision. In re Ma.H., 134 N.E.3d 41, 45 (Ind. 2019) (citing In re K.E., 39 N.E.3d 641, 646 (Ind. 2015)).

[12] L.S. claims that for us to consider Dr. Withers's testimony regarding the cluster B personality traits, we would have to “set aside the trial court's [mental illness] finding” as clearly erroneous. Appellant's Reply Br. at 9. L.S. construes the trial court's finding too broadly. Here, the trial court sua sponte made a finding that L.S. is “suffering from bipolar disorder and delirium”; it did not make a specific finding as to the cluster B personality traits. Appellant's App. Vol. II at 31. The trial court's findings did not cover (1) whether L.S. is suffering from the cluster B personality traits; (2) whether those traits qualify as a mental illness; and (3) whether L.S. is gravely disabled as a result of those traits. Thus, applying the general judgment standard, our review is not limited to only the mental illnesses listed in the commitment order. That is, we may consider L.S.’s emerging cluster B personality traits without “set[ting] aside the trial court's finding.” Appellant's Reply Br. at 9.

[13] Here, Dr. Withers testified extensively about the emerging cluster B personality traits that were consistent with borderline personality disorder and narcissistic personality disorder. Dr. Withers opined that a regular commitment was needed to treat L.S.’s cluster B personality traits in a stable environment because they provide a “very significant barrier to her meeting her basic needs.” Tr. Vol. II at 36. For these reasons and given the definition of mental illness, this working diagnosis is sufficient to prove by clear and convincing evidence that L.S. is also suffering from a mental illness as a result of the emerging cluster B personality traits.

b. Gravely Disabled

[14] A petitioner seeking an involuntary commitment must prove by “clear and convincing evidence” both that (1) the individual “is mentally ill and either dangerous or gravely disabled” and (2) commitment “is appropriate.” I.C. § 12-26-2-5(e). L.S. asserts there was not clear and convincing evidence that she was gravely disabled. “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.

Id. § 12-7-2-96 (effective Jan. 1, 1992, to June 28, 2026).

[15] L.S. maintains that she is not gravely disabled because she can function independently. This argument amounts to a request to reweigh the evidence and reassess witness credibility, which we cannot do, see A.D., 274 N.E.3d at 464 (quoting J.W., 260 N.E.3d at 951). The probative evidence and the reasonable inferences supporting the commitment show that shortly after her discharge on April 1, L.S. fell twice; refused to eat or drink anything Daughter provided because she believed Daughter was “trying to poison her,” Tr. Vol. II at 19; woke up screaming for Daughter to call 911; and yelled about her belief that she was going to die. These behaviors “put [L.S.] at significant risk and demonstrated impulsive decision making and ․ stress induced paranoia, that were not present when in a more stable environment.” Id. at 35. L.S.’s prognosis is “[p]oor” if she is not properly treated, id. at 42, and her “recent suicide attempt places her at elevated risk for subsequent attempts,” id. at 38. Furthermore, L.S. intended to live independently upon her release, despite Dr. Withers's advice that she have “twenty-four seven assistance” due in part to her mental illnesses. Id. at 38. This evidence shows that, as a result of her mental illness, L.S. cannot function independently. Accordingly, Hospital presented sufficient evidence to show that L.S. is gravely disabled, and the trial court did not err when it ordered L.S. temporarily committed. See, e.g., G.H. v. Richard L. Roudebush Veterans Affs. Med. Ctr., 216 N.E.3d 485 (Ind. Ct. App. 2023) (affirming a commitment where patient showed deterioration of judgment and physician testified that patient's mental illness impaired his ability to function independently). We therefore affirm the trial court's commitment decision.

[16] Affirmed.

FOOTNOTES

1.   Bipolar disorder is a mental health condition “characterized by mood episodes consisting of both depression and mania.” Tr. Vol. II at 31.

2.   Delirium impairs cognition and is “typically” episodic and “tends to resolve when the underlying cause is treated or mitigated.” Tr. Vol. II at 32.

3.   A regular commitment is for a period expected to be more than 90 days, Ind. Code § 12-26-7-3(a)(2)(B), whereas a temporary commitment is for a period of not more than 90 days, id. § 12-26-6-1.

Felix, Judge.

Tavitas, C.J., and Bradford, J., concur.