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In re A.D.

Court of Appeals of Texas, Second District, Fort Worth

January 7, 2020

In the Matter of A.D.

          On Appeal from County Court at Law No. 1 Wichita County, Texas Trial Court Nos. CCL1-MH2019-0359; CCL1-MH2019-0423

          Before Gabriel, Womack, and Wallach, JJ.

          MEMORANDUM OPINION

          LEE GABRIEL JUSTICE.

         In these preferential and accelerated appeals, appellant A.D. seeks relief from the trial court's (1) order to authorize psychoactive medication and (2) order granting temporary inpatient mental-health services and committing her to the North Texas State Hospital (NTSH). See Tex. Health & Safety Code Ann. §§ 574.070, 574.108; Tex.R.App.P. 28.1(a). In two issues, she argues that the evidence is legally and factually insufficient to support the commitment order, which also mandates reversal of the psychoactive-medication order. We conclude that the evidence, although conflicting, was sufficient to support the order for temporary mental-health services and that the psychoactive-medication order, therefore, may also stand.

         I. BACKGROUND

         A.D. was committed to NTSH in March 2019 after she stopped eating for five days, drinking only water and coffee, and would not come inside her house because she believed she had been infected with lice. By April 8, A.D.'s symptoms "remitted," and she was discharged. But her symptoms "recurred several times."

         On September 16, 2019, A.D.'s husband Mike filed an application for A.D.'s emergency detention. See Tex. Health & Safety Code Ann. § 573.011. In his affidavit, Mike stated A.D. showed a substantial risk of harming herself or others: "Stays up for days at a time, drinks out of the [non-potable] water. Thinks she has super lice, will not see the doctor or take her medication. H[ears] her old boyfriends talking to her through the radio. God has told her to kill the neighborhood cats, which gave her lice." Mike also affirmed that the risk of harm was imminent unless A.D. was immediately restrained: "Threatened her parents and sister. Killed frogs and gave them to our neighbor at night. Bath[e]s, but doesn't use soap because it is poison. Sometimes will not eat for days (fasting). Our 10 year old daughter is scared of her mother!!" The district attorney filed a motion for protective custody and an application for court-ordered mental-health services, attaching a certificate of medical examination for mental illness by Dr. C.E. Llauger Mier. See id. §§ 574.001, 574.009, 574.011.

         Mier certified that his "brief diagnosis" of A.D. after assessing her condition on September 16 was that she suffered from nonspecific psychosis; was likely to cause serious harm to herself or others; and was suffering severe and abnormal mental, emotional, or physical distress. Mier detailed the bases of his opinion:

Client is not eating, drinking brown water, sleeping outside. Killing animals and throwing them in neighbor[']s yard. She thinks she is covered in lice. Has a paranoia with husband. 'He is petting cats with lice and then touches me.' Also God gave her the mission to kill cats in neighborhood.

         In his supporting affidavit, Mier delineated A.D.'s statements and actions that led to his recommendation to admit A.D. to NTSH, including her belief that the sheriff and firefighters were conspiring to hurt her and that she was aggressive toward her 25-year-old daughter. Mier concluded that A.D. was delusional, aggressive, paranoid, moody, labile, and hallucinatory.

         A magistrate ordered A.D. into protective custody, finding that A.D. presented a substantial risk of serious harm to herself or others if not immediately restrained. See id. § 574.022. The magistrate also ordered the preparation of an alternative treatment recommendation (ATR). See id. § 574.012.

         On September 24, Dr. Peter Fadow filed a certificate of medical examination for mental illness based on his September 20 examination of A.D. See id. §§ 574.009, 574.011. Fadow diagnosed AD. with bipolar I disorder with psychotic features and a severe manic phase. Fadow opined that A.D. was likely to cause serious harm to herself; was suffering severe and abnormal mental, emotional, or physical distress; and was unable to function independently based on the following facts:

Patient has symptoms of mania and psychosis. She has acted on delusional thought and has severely restricted her food intake endangering her health. She [weighed] 116lbs in April 2019 [during] her last admission. She now weigh[s] 96lbs and has a body ma[ss] index of 14.69. Normal BMI is 18 to 25. Patient noted by husband to drink from a fish pond on the property where she lives. Patient admits shooting a BB gun towards feral cats on her property because she believes they have given her an infection with "super lice[.]"

         In his supporting affidavit, Fadow included A.D.'s statements about the cats and her reticence to eat: "I shoot the BB gun at the cats and any dogs. I will try to hit metal around them. I try to make a popping sound[]. I've been killing frogs. They are slimy and they damage my herbal garden with slime. I can't eat soy. It's in all bread I won't eat it." Fadow noted that A.D. was alert but that she was irritable and that her speech ...


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