Court of Appeals of Texas, Second District, Fort Worth
Appeal from County Court at Law No. 1 Wichita County, Texas
Trial Court Nos. CCL1-MH2019-0359; CCL1-MH2019-0423
Gabriel, Womack, and Wallach, JJ.
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.
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."
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.
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
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
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.
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[.]"
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 ...