Appeals Court Upholds Order For Mental-Health Treatment

The Washtenaw County Probate Court properly granted a petition for the respondent to receive mental-health treatment, the Michigan Court of Appeals has ruled.

The respondent in In re MEL (Docket No. 365552 ) denied that she suffered from a mental illness, namely schizophrenia, or that she was at risk of harm to herself or others. After a hearing, the probate court granted the petition for the respondent to receive mental-health treatment, finding the respondent required treatment because of a reasonable expectation of intentional or unintentional harm to herself or others, and the respondent’s judgment was so impaired that she lacked an understanding of her need for treatment. The respondent appealed the decision.

The Court of Appeals affirmed.

“[T]he petition used for the probate court’s determination that respondent required mental-health treatment and the clinical certificates complied with the statutory requirements set by the Mental Health Code,” the Court of Appeals said.

Judge James Robert Redford, Judge Douglas B. Shapiro and Judge Christopher P. Yates were on the panel that issued the unpublished opinion.

Background

On March 2, 2023, a psychologist filed the initial petition in the Washtenaw County Probate Court seeking order for the respondent to receive mental-health treatment. The petition requested the respondent be transported to and examined at the University of Michigan Psychiatric Emergency Services (PES). The petition was not signed and was not accompanied by clinical certificates. The same day, the probate court ordered the respondent’s transport and examination by PES, noting there were no clinical certificates with the initial petition. The order indicated the respondent required immediate assessment and should be transported and hospitalized at PES by March 12, 2023, unless law enforcement provided the probate court an explanation why the order was not timely executed. The probate court further ordered the examination and clinical certificates be completed within 24 hours after the respondent’s hospitalization and that, if this did not occur, the respondent was to be released from the hospital.

The record did not indicate whether the respondent was transported to PES for treatment before March 12, 2023. However, a social worker completed a separate petition for mental-health treatment on March 17, 2023, and marked section 3.a of the form, which states: “[A]s a result of that mental illness, the individual can reasonably be expected within the near future to intentionally or unintentionally seriously physically injure self or others, and has engaged in an act or acts or made significant threats that are substantially supportive of this explanation.” A second petition stated: “[The respondent] reports a foreign entity has taken over her body and is causing her sensations that are torturing her. She feels her home is bugged and is putting holes in the wall in search of bugs. She is sending out explicit and graphic emails to neighbors.” The petition indicated the hospital received it on March 18, 2023, at 2:19 p.m. Once filed with the probate court, the second petition was accompanied by two, timely completed clinical certificates dated March 18, 2023 and March 19, 2023. 

A hearing was held on March 22, 2023. The respondent’s in-patient psychiatrist testified the respondent was diagnosed with schizophrenia. The psychiatrist indicated the respondent was at risk of harm to herself and others, the respondent refused to take medications and the respondent had no insight regarding her mental illness. The psychiatrist recommended treatment and antipsychotic medication, and affirmed this was the least restrictive means of treatment.

The respondent testified that she had a good support system and could care for herself.
She denied that she suffered from any mental illness, and affirmed that she had an outpatient therapist whom she saw weekly and to whom she had phone access.  The respondent denied that she was at risk of harm to herself or others and explained that she did not believe that she needed to be hospitalized. The respondent stated that she was of sound mind, sane, intelligent and clear thinking.

After closing arguments, the probate court granted the petition for mental-health treatment and ordered the respondent be hospitalized for 60 days and undergo outpatient treatment not exceeding 180 days.

The respondent appealed.

Statutory Requirements Satisfied

On appeal, the respondent argued the petition for mental-health treatment violated the Mental Health Code - specifically MCL 330.1435 and MCL 330.1436 - because 1) she was not timely transported to the hospital as ordered by the probate court and 2) law enforcement failed to provide an explanation regarding the lack of compliance with her transport.

Relevant to this appeal, MCL 330.1435 says:

“(2)  If the petition is not accompanied by a clinical certificate, and if the court is satisfied a reasonable effort was made to secure an examination, the court shall order the individual to be examined by a psychiatrist and either a physician or a licensed psychologist. 

(3)  The individual may be received and detained at the place of examination as long as necessary to complete the examination or examinations, but not more than 24 hours.”

Meanwhile, MCL 330.1436 provides, in relevant part:

“(1) If it appears to the court that the individual will not comply with an order of examination under section 435, the court may order a peace officer to take the individual into protective custody.  After the individual is taken into protective custody, a peace officer or security transport officer must transport the individual to a preadmission screening unit or hospital designated by the community mental health services program or to another suitable place for the ordered examination or examinations.

(2) A court order for a peace officer to take an individual into protective custody and transport the individual as described in subsection (1) must be executed within 10 days after the court enters the order. If the order is not executed within 10 days after the court enters the order, the law enforcement agency must report to the court the reason the order was not executed within the prescribed time period.”

The Court of Appeals pointed out that, based on the first petition, the probate court ordered the respondent be transported to PES no later than March 12, 2023. “Respondent argues that the probate court violated the Mental Health Code because an examination was not completed until March 18, 2023. Respondent, however, fails to refer to the probate court’s final order which indicated that the probate court relied upon the second petition and not the first to determine that respondent required mental-health treatment.”

According to the Court of Appeals, the record indicated  the respondent presented to the emergency room on March 18, 2023 at 2:19 p.m. with “delusions, paranoia, and inappropriate behavior” and a second petition was issued on March 17, 2023 and received by the hospital on March 18, 2023, at 4:15 p.m., the day the respondent presented to the emergency room.

Looking at MCL 330.1423, the Court of Appeals noted the statute says: “A hospital designated by the department or by a community mental health services program shall hospitalize an individual presented to the hospital, pending receipt of a clinical certificate by a psychiatrist stating that the individual is a person requiring treatment, if a petition, a physician’s or a licensed psychologist’s clinical certificate, and an authorization by a preadmission screening unit have been executed. For an individual hospitalized under this section, a petition shall have been executed not more than 10 days before the presentation of the individual to the hospital, and the petition must meet the conditions set forth in section 434(1) and (2).”

A person who is hospitalized under MCL 330.1423 “shall be examined by a psychiatrist as soon after hospitalization as is practicable, but not later than 24 hours, excluding legal holidays, after hospitalization,” the Court of Appeals observed. “The individual ‘may be received and detained at the place of examination as long as necessary to complete the examination or examinations, but not more than 24 hours.’”

In this case, after the respondent was admitted, “two clinical certificates were completed on March 18, 2023, at 3:18 a.m., and March 19, 2023, at 11:13 a.m.,” the Court of Appeals said. “Accordingly, the clinical certificates were completed within 24 hours of respondent’s hospitalization and the time that the hospital received the second petition. The probate court, therefore, relied on the valid second petition and accompanying clinical certificates that complied with the Mental Health Code.”

As a result, “the petition used for the probate court’s determination that respondent required mental-health treatment and the clinical certificates complied with the statutory requirements set by the Mental Health Code,” the Court of Appeals concluded, affirming the probate court’s decision.