On appeal from the Superior Court of New Jersey, Law Division, Monmouth County, Indictment No. 10-04-0538, Case No. 10-754.
NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION
Submitted July 24, 2012 -
Before Judges Lihotz and Baxter.
In July 2010, F.S. was ordered involuntarily confined to Trenton Psychiatric Hospital (TPH), following her acquittal by reason of insanity on several criminal charges. She appeals from a July 22, 2011 Law Division order that continued her involuntary civil commitment. We affirm.
F.S. was charged in a Monmouth County indictment with third-degree terroristic threats, N.J.S.A. 2C:12-3; third-degree possession of a weapon, namely a box cutter, for an unlawful purpose, N.J.S.A. 2C:39-4(d); and fourth-degree unlawful possession of a weapon, N.J.S.A. 2C:39-5(d). The charges stemmed from an incident that occurred on February 12, 2010, when F.S. was waving a box cutter in the air while walking closely behind a mother and a daughter on a Freehold sidewalk. The women stated that while brandishing the box cutter, F.S. cursed at them and threatened to "kill [them] right now." The daughter reported that F.S. grabbed her hair and pushed the point of a sharp object into her back.
At the conclusion of a July 2010 bench trial, F.S. was found not guilty by reason of insanity (NGRI), and, pursuant to State v. Krol, 68 N.J. 236 (1975), was committed to TPH. Judge Perri ordered that F.S.'s involuntary commitment status would be reviewed at a periodic review hearing on January 6, 2011. At the January 2011 hearing, after considering the testimony of F.S.'s treating psychiatrist, Dr. Yves DuBois, Judge Perri determined that F.S. remained a danger to herself and others. The judge continued F.S.'s Krol status and confinement to TPH pending a review hearing in July 2011.
At the July 14, 2011 Krol hearing that is the subject of this appeal, the State presented the testimony of F.S.'s treating physician, Carolina Diao, M.D., a board-certified psychiatrist. Dr. Diao described F.S.'s prior psychiatric history, noting that F.S. had been involuntarily committed to TPH in January 2009, for an incident that bore considerable similarity to the incident that underlies her current involuntary psychiatric commitment. In particular, in January 2009, after becoming noncompliant with her anti-psychotic medication, F.S. began hallucinating and became aggressive. She spit in the face of a man on the street whom she did not know, but thought was harassing her. F.S. reportedly threatened others on the street as well. The 2009 incident resulted in a two-week involuntary psychiatric hospitalization at TPH.
Dr. Diao explained that F.S. was currently assigned to privilege level 2, which prohibited her from leaving her locked hospital ward unless accompanied by a staff member. Dr. Diao noted that as recently as two weeks earlier, F.S. was at the lowest privilege level, and not allowed to leave the ward even with a staff member, because she had swallowed a battery on May 3, 2011. As a result, of that incident, F.S.'s treatment team "dropped" her privilege level to level 1. The doctor explained that this incident of "self-injurious behavior" resulted from F.S.'s anger at her involuntary confinement.
When asked whether F.S. continues to suffer from a mental illness, Dr. Diao answered in the affirmative, stating that F.S. presently suffers from "schizophrenia, paranoid type, chronic." The psychiatrist observed that in the "past couple of months," F.S. had been "calm [and] cooperative," and was not experiencing any hallucinations or delusions. Dr. Diao expressed concern, however, about F.S.'s very limited understanding of the dynamics of her "mental illness." The doctor opined:
[I]f she has limited [insight] or lack[s] insight [into] her mental illness, th[e]n there's a probability when she will be released from the hospital that . . . she will not take the medication[,] [and] she will decompensate and then she can be psychotic[.] [T]he symptoms that she had before will, again, appear, like the hallucinations, the aggressive behavior.
Dr. Diao also observed that F.S.'s history of abusing drugs and alcohol created an increased risk that F.S. would, if discharged, become non-compliant with the taking of her anti-psychotic ...