HEALTH LAW

Involuntary Commitment

In re J.H., PICS Case No.14-0510 (C.P. Lycoming March 27, 2014) Lovecchio, J. (5 pages).

J.H., involuntarily committed by his mother, petitioned for a mental health review. Denied and his involuntary commitment was extended for 20 days.

J. H.’s mother made an involuntary examination and treatment application on March 12, 2014 because J.H. told her that he was fighting the evil forces in his mind telling him to destroy his family and to commit suicide and he was losing the strength to fight. The physician who examined J.H. found that he suffered from paranoid delusions and that J.H. believed that another person could control his mind and he could not stop a violent command. The hearing examiner concluded that J.H. was unable to care for him-self without assistance, that he had refused medication for treatment of his delusions and that inpatient care was the least restrictive alternative to prevent him from harming himself or others.

A few days prior to his commitment, J. H. indicated that he was hearing two voices in his head that were telling him to commit suicide, murder, rape and other horrible deeds and he was too tired to fight them off. However, he was not willing to take medication because it was “poison.” His treating physician diagnosed him as suffering from schizophrenia of the paranoid type and expressed concerns about J.H.’s dangerous behavior due to his refusal to take medication and his proclivity to drink alcohol.

The procedures required by the act were followed. Applications for involuntary treatment and for extended treatment were made and a hearing was held before a mental health review officer, where J.H. was represented by counsel. The court found clear and convincing evidence that J.H. was severally mentally disabled, in need of treatment, and presented a danger to himself and others. While J.H. was doing well in a supportive environment, the court could not ignore anecdotal evidence of J.H.’s deteriorating behavior, escalating threats to himself and others, his refusal to take medication and his conduct. In the past 30 days, J.H. acted in manner that suggested he cannot satisfy his needs for medical care, self-protection and safety without the assistance of others.

The court found credible and substantial evidence from J.H.’s physician, nurses and family members that his symptoms included hallucinations, delusional thoughts, paranoia, agitation, suicidal ideation, and homicidal ideation and that he was a real and present danger to himself and others given that he could not maintain his medication directive even while institutionalized.

J.H.’s petition for mental health review was denied and he was ordered to remain involuntarily committed for a period not to exceed 20 days.