February 10, 2011
IN THE MATTER OF THE CIVIL COMMITMENT OF P.W.
On appeal from the Superior Court of New Jersey, Law Division, Burlington County, Docket No. BUSC-1213-09.
NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION
Telephonically argued: January 20, 2011
Before Judges Sapp-Peterson and Fasciale.
P.W. appeals from a July 28, 2010 civil commitment order entered pursuant to Rule 4:74-7 and the Comprehensive Civil Commitment Statute, N.J.S.A. 30:4-27.1 to -27.23.*fn1 We affirm.
P.W. was found not guilty of arson and murder by reason of insanity in 1981 and the court placed P.W. on Krol*fn2 status. His confinement to a mental hospital was interrupted in 2000 and 2007 because he was sentenced to state prison for convictions for two separate aggravated assaults. Defendant's Krol status was reinstated after his state prison confinements.
After his Krol status expired, the court conducted civil commitment hearings on May 5, June 30, and July 28, 2010. The record reveals that P.W. has a long history of dangerous behavior including, but not limited to, setting fire to his mattress, throwing chairs at hospital staff, punching a psychiatrist, refusing medication, threatening escape, and destroying his bedroom. After each hearing, Judge Hawkins committed P.W. to the Ann Klein Forensic Center (AKFC), where he resides currently. Judge Hawkins continued the civil commitment status because P.W. suffered from a mental illness that caused him to be a danger to himself and others.
On appeal, P.W. argues that the judge erred by finding that his violence was caused by his mental illness. He also contends that he received ineffective assistance of counsel at the May 5 hearing.
Our review of a commitment determination "is extremely narrow and should be modified only if the record reveals a clear mistake." In re D.C., 146 N.J. 31, 58 (1996) (citing State v. Fields, 77 N.J. 282, 311 (1978); In re Commitment of J.L.J., 196 N.J. Super. 34, 49 (App. Div. 1984), certif. denied, 101 N.J. 210 (1985)). We must "determine whether the lower courts' findings were clearly erroneous." Id. at 59 (citing Fields, supra, 77 N.J. at 311).
Rule 4:74-7(f) governs civil commitments and provides that an involuntary commitment shall be ordered if four factors are met by clear and convincing evidence:
(1) the patient is mentally ill,
(2) mental illness causes the patient to be dangerous to self or dangerous to others or property as defined in N.J.S.A. 30:4-27.2(h) and -.2(i),
(3) the patient is unwilling to be admitted to a facility for voluntary care, and
(4) the patient needs care at a short-term care or psychiatric facility or special psychiatric hospital because other services are not appropriate or available to meet the patient's mental health care needs.
Rule 4:74-7(a) adopts the definitions contained in the civil commitment statute:
"Dangerous to self" means that by reason of mental illness the person has threatened or attempted suicide or serious bodily harm, or has behaved in such a manner as to indicate that the person is unable to satisfy his need for nourishment, essential medical care or shelter, so that it is probable that substantial bodily injury, serious physical debilitation or death will result within the reasonably foreseeable future; however, no person shall be deemed to be unable to satisfy his need for nourishment, essential medical care or shelter if he is able to satisfy such needs with the supervision and assistance of others who are willing and available. [N.J.S.A. 30:4-27.2(h).]
"Dangerous to others or property" means that by reason of mental illness there is a substantial likelihood that the person will inflict serious bodily harm upon another person or cause serious property damage within the reasonably foreseeable future. This determination shall take into account a person's history, recent behavior and any recent act or threat. [N.J.S.A. 30:4-27.2(i).]
"Mental illness" means a current, substantial disturbance of thought, mood, perception or orientation which significantly impairs judgment, capacity to control behavior or capacity to recognize reality, but does not include simple alcohol intoxication, transitory reaction to drug ingestion, organic brain syndrome or developmental disability unless it results in the severity of impairment described herein. The term mental illness is not limited to "psychosis" or "active psychosis," but shall include all conditions that result in the severity of impairment described herein.
The ultimate determination of dangerousness "lies with the courts, not the expertise of psychiatrists and psychologists." In re D.C., supra, 146 N.J. at 59. We are required to balance the individual's interest in personal liberty and autonomy against society's interest in protection from harmful conduct. Ibid. "The ultimate decision on dangerousness is, therefore, a legal one, not a medical one, even though it is guided by medical expert testimony." Ibid. (citing In re Newsome, 176 N.J. Super. 511, 516 (App. Div. 1980); Krol, supra, 68 N.J. at 261).
We reject P.W.'s argument that his violence was not the result of his mental illness. Our review of the record does not reveal a clear mistake or any abuse of discretion by continuing the civil commitment.
Three of defendant's treating psychiatrists testified at each of the hearings that P.W. has had a long history of psychiatric problems. At the May 5 hearing, Dr. Gharmani, testified that P.W. has had a long history of psychiatric problems and violent behavior. The doctor explained that P.W. suffers from a mental illness, is a high risk, and is a danger to others if he were not in the supervised environment of a psychiatric hospital. P.W. admitted at the hearing that he had a "mental abnormality."
Dr. Douglas Smith testified at the June 30 hearing. Dr. Smith diagnosed P.W. with "schizoaffective disorder, and antisocial personality traits." The doctor opined that P.W. was a danger to others and cited, as an example, that P.W. assaulted an officer in the hospital two weeks before the hearing. Dr. Smith stated that P.W. has no insight into his need for medication, and that P.W. cannot be treated anywhere other than AKFC. Dr. Smith testified that P.W.'s mental condition would decompensate in jail.
Dr. Elizabeth Hogan testified at the July 28 hearing that P.W. suffered from "schizoaffective disorder, bipolar type," continued to display symptoms of mental illness, and remained "psychotic." She explained that P.W. "continues to engage in threatening behavior," and that "if [P.W.] refuses medication, he is very dangerous to others." Dr. Hogan stated that "[i]t is very unlikely that [P.W.] would comply with medication." She testified that P.W. demonstrated "paranoid delusional thinking" and "threatening behavior," created a high risk for assaulting others due to his mental illness, and "that symptoms of his mental illness certainly contribute to his violent behavior and make him a very high risk for violence." Dr. Hogan opined in her July 27, 2010 report that "[P.W.] remains dangerous to others due to his mental illness."
Finally, P.W.'s argument that his counsel was ineffective is without sufficient merit to warrant discussion in a written opinion. R. 2:11-3(e)(1)(E).