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In re B.T.

Supreme Court of New Hampshire

May 19, 2008

In re B.T.

UNPUBLISHED OPINION

The respondent, B.T., appeals an order of the Merrimack County Probate Court involuntarily admitting her to New Hampshire Hospital for a period not to exceed five years, with a conditional discharge as soon as appropriate. See RSA 135-C:34, :50 (2005). She challenges the sufficiency of the record to support the probate court's findings and ruling. We affirm.

To involuntarily admit the respondent, the probate court was required to find, by clear and convincing proof, that she was "in such mental condition as a result of mental illness as to create a potentially serious likelihood of danger to h[er]self or others." RSA 135-C:34; see In the Matter of B.T., 153 N.H. 255, 260 (2006). Danger to self or others means ". . . a lack of capacity to care for one's own welfare such that there is a likelihood of serious debilitation if admission is not ordered." B.T., 153 N.H. at 260. "We review sufficiency of the evidence claims as a matter of law and uphold the findings and rulings of the trial court unless they are lacking in evidential support or tainted by error of law." Id. at 259 (quotation omitted). We will affirm the probate court unless no rational fact finder could have made the findings by clear and convincing evidence. Id. at 260.

The respondent has a history of mental illness. See generally id. at 256-57. On April 2, 2007, the respondent's guardian visited her apartment, found her lying on the sofa with the kitchen faucet "running full blast, " and observed that she appeared to have lost weight. The guardian returned on April 5, 2007, and again found the water running. A maintenance staff member for the building shut the water off, and the guardian explained to her that her water was being turned off because she was depleting the water supply for the building. The guardian additionally discussed the respondent's nonpayment of rent, and that an eviction was forthcoming. The respondent replied that she "would pay a penny a day." The guardian noted, at this point, that the respondent "had lost a pretty decent amount of weight."

On April 17, 2007, the respondent was involuntarily admitted on an emergency basis to New Hampshire Hospital. See RSA 135-C:27 (2005). A psychiatrist who had treated her for many years testified that he was "shocked" by her appearance, that she "was extremely thin and haggard, " and that she "had clearly lost a lot of weight." The court-appointed psychiatrist described her as being "emaciated." While he admitted that, according to one table, the weight range for a woman of the respondent's height between the ages of 25 and 59 was between 104 and 115 pounds, he also testified that the table simply presented a statistical analysis, and was not a recommended weight range. At the time of her admission, the respondent was 62 years old, and weighed 102 pounds. By the time of the hearing on the involuntary admission petition, she had gained at least fifteen pounds.

The probate court found that the respondent was in such a condition as a result of her mental illness as to create a potentially serious likelihood of danger to herself. The court further found that unless required to do so through a conditional discharge, she would not take her medication, and that without her medication, she "decompensates and is unable to adequately care for herself." The court noted that she faced eviction for nonpayment of rent, that her landlord had turned off her water because she ran it constantly, that she was not eating properly, and that she had lost a significant amount of weight and was emaciated.

To support a finding of dangerousness under RSA 135-C:34, the petitioner is required to plead and prove specific acts demonstrating dangerousness. See id. at 260. The respondent contends that the probate court's finding is not supported by proof of specific acts, and that the evidence does not support the court's findings of dangerousness. We disagree.

The record supports the probate court's findings that the respondent would not take her medication on a voluntary basis, that she had not been properly eating and had lost a significant amount of weight, that she had stopped paying rent, and that the constant running of water had led to the shutting off of her water. While weight loss, a lack of tap water, and potential homelessness may not, in isolation and in every instance, constitute a danger, a rational fact finder could weigh the specific actions of the respondent here, and find by clear and convincing proof that she "lack[ed] capacity to care for [her] own welfare such that there [wa]s a likelihood of serious debilitation if admission [wa]s not ordered." Id.

Nor do we agree with the respondent that the probate court could not base the admission upon "a lack of capacity to care for one's own welfare" because the probate court did not expressly find "a likelihood of serious debilitation if admission is not ordered." Id. To the contrary, we generally assume that the probate court made all subsidiary findings necessary to support its order. See In the Matter of Kosek & Kosek, 151 N.H. 722, 725 (2005). In view of its express finding that the respondent, without medication, "decompensates and is unable to adequately care for herself, " a finding of "a likelihood of serious debilitation if admission is not ordered, " in accordance with B.T., is implied in the probate court's order.

To the extent the respondent challenges the probate court's reliance upon her weight loss because there was no evidence regarding how much weight she had lost or over what period of time she had lost the weight, and because her weight was close to a range contained in a height and weight table, we note that the testimony of those who knew the respondent established that her weight loss had been significant. Nothing in RSA 135-C:34 compelled the probate court to wait until she had reached the point of starvation to find "a lack of capacity to care for one's own welfare." B.T., 153 N.H. at 260.

Upon this record, we cannot conclude that the probate court's order was either lacking in evidentiary support or tainted by legal error.

Affirmed.

DALIANIS, DUGGAN and GALWAY, JJ., ...


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