IN THE MATTER OF: D. L. B., Respondent and Appellant.
Submitted on Briefs: November 2, 2016.
FROM: District Court of the Tenth Judicial District, In and
For the County of Fergus, Cause No. DI 2015-11 Honorable Jon
A. Oldenburg, Presiding Judge.
Appellant: Chad Wright, Chief Appellate Defender, Kristen L.
Peterson, Assistant Appellate Defender, Helena, Montana
Appellee: Timothy C. Fox, Montana Attorney General, Katie F.
Schulz, Assistant Attorney General, Helena, Montana
P. Meissner, Fergus County Attorney, Craig R. Buehler,
Special Deputy County Attorney, Lewistown, Montana
D.L.B. appeals the order of the Tenth Judicial District
Court, Fergus County, recommitting him for a period of up to
six months to the Montana Mental Health Nursing Care Center
(Nursing Care Center) in Lewistown. We affirm, and state the
issue as follows:
the District Court err by extending D.L.B.'s commitment
to the Nursing Care Center?
AND PROCEDURAL BACKGROUND
D.L.B. is a 75-year-old male who, unfortunately, has suffered
from mental illness his entire adult life. He was originally
diagnosed with paranoid schizophrenia after his first
psychotic episode, at age 22. Since this initial diagnosis,
D.L.B. has been involuntarily committed to mental hospitals
throughout his life. D.L.B.'s May 2015 Mental Health
Assessment for Recommitment states that he has been
involuntarily committed to mental health hospitals at least
six times and that other "[r]ecords indicate [that] he
[has] likely had other psychiatric hospitalizations through
the years, but [complete] information is not
available." D.L.B.'s last four hospital
commitments, in 2004, 2011, 2012, and 2014, were to the
Montana State Hospital (MSH).
D.L.B.'s psychosis centers around a fear of the Nazis and
of being persecuted by them. He also suffers from delusions
regarding an imaginary wife and children who reside in
Canada. Critically, he has a pervasive history of medication
noncompliance arising from his belief that he does not suffer
from a mental illness.
D.L.B.'s 53-year history of mental illness evidences a
relatively predictable and cyclical pattern, typically
beginning with a psychotic episode. During these episodes, he
acts out and is a physical danger to himself, as well as to
others. The episodes typically result in an involuntary
commitment of D.L.B. to a mental health hospital, where he is
medicated and begins to stabilize. After improving, D.L.B. is
transferred from the hospital to a mental health nursing care
facility, where supervision helps him to stay on his
medication and maintain stability. After he is released from
the mental health nursing care facility to a community based
rehabilitation center or treatment program, he typically
stops taking his medicine, leading to another psychotic
episode and a repeat of the cycle.
At the July 8, 2015, recommitment hearing, the District Court
verbally summarized D.L.B.'s condition as follows:
[D.L.B.] does suffer from a mental disorder that being
paranoid schizophrenia which in his case causes him to have a
lack of insight in to his own mental disorders and how those
affect him and leads to a persistent desire and a pattern of
medication refusal and removing himself from the medication
which then causes his mental disorder to spiral out of
control and causes [D.L.B.] to decompensate and have to start
over again with his treatment. This presents a danger to
[D.L.B.] as each and every time he has to start over it takes
more and more to get him back to normal and during those
psychotic episodes he's a danger to himself and could be
a danger to others just basically due to his lack of insight
and ability to control himself.
In 2014, D.L.B. was living at a rehabilitative center in
Dillon when he again refused to take his medicine. He
decompensated to the point that he "believed staff at
the facility were contracting with the Nazi's [sic] to
torture him and inflict pain on him with infrared
devices." He became verbally aggressive and attempted to
physically strike the staff, leading to his commitment to MSH
on September 23, 2014. On March 24, 2015, after he had
stabilized, D.L.B. was transferred from MSH to the Nursing
Care Center. Based on his behaviors, however, D.L.B. was
considered an elopement risk. At the Nursing Care Center,
D.L.B. received regular medical and psychiatric care. Despite
this care, D.L.B. continued to have visual hallucinations and
paranoid delusions, be verbally and physically aggressive
toward the staff, refuse to take his medication, and isolate
himself. On June 2, 2015, the State filed the subject
petition to extend D.L.B.'s commitment to the Nursing
Care Center for further evaluation and treatment.
In support of the petition, the State submitted a report by
Susan Stevens (Stevens), a Mental Health
Professional. Stevens' report explained that D.L.B.
had a long history of medication noncompliance and,
consequently, a recurring inability to successfully live
independently in ...