IN THE MATTER OF: R.H., Respondent and Appellant.
Submitted on Briefs: October 26, 2016
FROM: District Court of the Thirteenth Judicial District, In
and For the County of Yellowstone, Cause No. DI 15-0098
Honorable Rod Souza, Presiding Judge
Appellant: Chad Wright, Chief Appellate Defender, Moses
Okeyo, Assistant Appellate Defender, Helena, Montana
Appellee: Timothy C. Fox, Montana Attorney General, Katie F.
Schulz, Assistant Attorney General, Helena, Montana Scott
Twito, Yellowstone County Attorney, Billings, Montana
R.H. appeals from an involuntary commitment order entered by
the Thirteenth Judicial District Court, Yellowstone County,
on October 14, 2015. The order committed R.H. to the Montana
State Hospital for a period not to exceed three months and
ordered the use of involuntary medication, if needed. We
affirm the order for commitment and reverse the
administration of involuntary medication.
R.H. presents the following issues for review:
Whether there was sufficient evidence to support the
commitment of R.H.
Whether the District Court erred in authorizing involuntary
AND PROCEDURAL BACKGROUND
R.H., age 72, suffers from bipolar disorder and general
anxiety disorder. She takes medication for her mental
illnesses. R.H. also has physical infirmities, including
chronic obstructive pulmonary disease, congestive heart
failure, hypertension, hyperlipidemia, diabetes and gout. She
is being treated with oxygen, insulin, and other medications.
In September of 2015, R.H. was evicted from her senior-living
apartment at Pleasantview after having multiple altercations
with her neighbors. Following her eviction, R.H.'s adult
son paid for one week's lodging at a motel. However, as
of October 6, 2015, R.H. had nowhere to go and her son was
unsuccessful in securing other living arrangements. R.H.
lives on a limited fixed income controlled by a conservator,
Joyce Wuertz (Wuertz). ¶4 On October 6, 2015, R.H.'s
son and Wuertz contacted R.H.'s treating physician, Dr.
Amstutz, because they were concerned about where R.H. was
going to live and that R.H. was exhibiting mood swings and
other symptoms of her bipolar disorder. Further, R.H. had
made a suicidal comment and did not appear to understand that
her finances prevented her from continuing to stay in a
hotel. Dr. Amstutz requested that R.H. be picked up by law
enforcement and transported to the Billings Clinic
Psychiatric Center for evaluation.
Upon admission to the Billings Clinic, R.H. was evaluated by
Dr. Schuett. Dr. Schuett determined R.H. suffered from a
mental disorder and needed treatment. Thereafter, the
Yellowstone County Attorney's Office filed a petition on
October 8, 2015, to involuntarily commit R.H. At the initial
hearing held October 9, 2015, the court found probable cause
to believe R.H. was suffering from a mental disorder which
might need commitment, and set trial on the State's
petition for October 14, 2015. The court appointed R.H.
counsel and subsequently appointed, on October 13, 2015,
Bonnie Karinen (Karinen) to evaluate R.H. Karinen is a nurse
practitioner with an emphasis in psychiatry.
On October 13, 2015, Karinen filed a report with the court
describing R.H.'s moods as labile; that R.H. exhibited
grandiose thoughts and irrational decision-making; and that
R.H. easily became irritable or cried. Karinen concluded R.H.
suffered from a mental disorder requiring commitment because
R.H. was unable to care for herself. During the hearing on
October 14, 2015, Karinen testified consistent with her
report and added that she believed the court should order
involuntary medication for R.H. Karinen explained, "[i]n
most cases for the safety of the patient and possibly others,
you know, we usually do recommend [involuntary medication],
and I would in this case, too." Karinen testified,
however, that R.H. had no history of refusing her medication
and that, at the time, R.H. was compliant and had been taking
her medication as directed.
The evidence produced at trial established that R.H. either
applied for or otherwise considered multiple types of
housing, including Section 8 or HUD housing, hotels, nursing
homes, assisted living, a crisis center, and a friend's
home. In each instance, R.H. was unsuccessful in securing
housing, either because her request was denied or not
responded to, or because R.H., herself, was uncooperative.
Karinen testified that, "once a patient is a patient in
the psychiatric center when we ...