Dangerous to Self

Under ORS 426.005(1)(e), the state may consider a person mentally ill for the purposes of commitment if, due to a mental disorder, she is a danger to herself.

The General Standard

• In order to establish that a person is a danger to herself, the state must show that the mental disorder has “resulted in harm…or created situations likely to result in harm.” State v. Christofferson, 47 Or App 1087 (1980).

• A determination as to whether or not the state’s evidence was sufficient to support commitment on the ground that the appellant was a danger to herself, turns on whether or not her mental disorder would cause her to engage in behavior that is “likely to result in physical harm to herself in the near future.” State v. N.A.P., 216 Or App 432 (2007).

• The likelihood of harm need not be immediate, but “must exist in the near future.” State v. Jacobson, 142 Or App 371, 377 (1996).

• “Apprehensions, speculations and conjecture are not sufficient” to prove a need of involuntary commitment.” State v. Ayala, 164 Or App 399 (1996).

• In determining danger to self, the court should consider factors such as whether or not the AMIP is actually harming herself, engaging in genuinely dangerous behavior, or demonstrating an inclination or propensity for dangerous behavior. State v. Sea, 137 Or App 333 (1995).

The Danger Must Exist in the Near Future and Not Be Simply a Speculative Danger

• With no witness and no investigator’s report on the record, the state conceded that there was insufficient evidence to demonstrate a pressing danger to self when the AMIP presented at the hearing with markedly disorganized thinking. State v. Allen, 209 Or App 647 (2006).

• When determining whether or not an AMIP presents a danger to himself, there must be some immediacy of danger. In order to meet this standard, there need not be an immediately dangerous situation but the threat of danger must exist in the near future. Where drinking had caused the AMIP serious physical problems such as liver dysfunction and seizures, continued drinking put Mr. Jacobson at serious risk in the near future, and where the AMIP would continue to drink because he was compelled to do so, there was an imminent threat of danger.  State v. Jacobson, 142 Or App 371 (1996).

Severity of Danger Needed to Commit

• AMIP was dangerous to himself where, due to increasing bipolar mania, he narrowly avoided crashing his car because voices were telling him to take his hands off the wheel.  It was also relevant that during his previous manic period he had jumped off a two story building and seriously hurt himself.  At the time of the hearing, defendant had little insight, refused to take medications and was hostile and threatening. State v JDS

• By walking onto the roof of her house without shoes, the AMIP demonstrated that she couldn’t help but put herself in inherently dangerous situations. State v. Bolander, 178 Or App 514 (2001).

• Where the AMIP frequently drove too fast, drank too much, slept irregularly, refused to take prescribed antidepressant medications, and was ill tempered and often unable to make decisions but had not demonstrated any genuinely self-destructive tendencies, evidence was not sufficient to rise to the level of severity of dangerousness needed to commit. State v. Fletcher, 60 Or App 623 (1982).

Confidence Needed that Past Dangerous Activities Will Occur Again in the Future

• Where the state has established that the AMIP had been assaulted in the past and had difficultly interacting with people, the evidence was insufficient to establish that Mr. North was likely to be assaulted again, and much less likely that he was in any sort of life-threatening danger in the near future. State v. North, 189 Or App 518 (2003).

• Where the AMIP had crashed his car because he was distracted by voices in his head but no evidence indicated the incident was anything but isolated, there was insufficient evidence that the AMIP would crash his car in the near future. State v. Siebold, 100 Or App 561 (1994).

The Danger Must be at the Time of the Hearing

• Where the AMIP had attempted suicide in the past, a good faith apprehension of the examiners that the appellant was not emotionally stable enough to ensure that she would not repeat her suicide attempt did not meet the legal standard they were required to show by demonstrating clear and convincing evidence that her depression at the time of the hearing was so severe that she was a danger to herself. State v. C.R., 216 Or App 395 (2007).

• Whether a person is mentally ill for the purposes of involuntary commitment is determined by his condition at the time of the commitment hearing as understood in the context of his past. State v. King, 177 Or App 373 (2001).

• The determination as to whether a person is dangerous must focus on his or her condition at the time of the hearing. Although prior actions and statements of the AMIP may help hint at his present mental condition, they are not sufficient of a finding of mental illness unless they clearly form the foundation for a prediction of future dangerousness. State v. Lucas, 31 Or App 947 (1997).

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Alcoholism

• Chronic Alcoholism, liver disorder, seizures and no insight at hearing were not enough to establish that the AMIP was a danger to himself. State v Jacobson, 142 Or App 371 (1996)

Assaults Against the AMIP

• The court reversed a commitment where the state established that the AMIP had been assaulted in the past and had difficulty interacting with people, holding that such evidence did not establish that Mr. North was likely to be assaulted again, much less that he was in any sort of life-threatening danger in the near future. State v North, 189 Or App 518 (2003)

Dangerous Acts with no threat of Harm/Ill Advised Behavior

• “A person can be deemed dangerous to self if he or she has established a pattern in the past of taking certain actions that lead to self-destructive conduct, and then he or she begins to follow the pattern again…However, the state must present clear and convincing evidence that a person’s mental disorder has resulted in harm or created situations likely to result in harm.” State v. Judd, 206 Or App 146 (2006).

• The state failed to prevent clear and convincing evidence that the AMIP was a danger to herself when she had gone swimming in the nude in 40 degree weather because there was no evidence that she was harmed as a result of that conduct. State v. Hambleton, 202 Or App 526 (2005).

• Where the record showed no more than a possibility of harm arising from riding one’s bike in the nude, evidence was not sufficient to demonstrate the risk of harm needed for involuntary commitment. State v. Webb, 186 Or App 404 (2003).

• Evidence of having or picking at open wounds, without evidence regarding the nature or magnitude of any risk or infection to others from appellant’s loss of body fluid, was not enough evidence of dangerousness for involuntary commitment.State v. Turel, 182 Or App 235 (2002).

• Hitting one’s head hard against a Plexiglas window for minutes was not evidence of dangerousness because there was no evidence that harm occurred as a result. State v. Powell, 178 Or App 89 (2001).

Speculative Fear of the AMIP Ending up in “Harm’s Way” is Insufficient

• Unpredictable and impulsive behavior is not sufficient for commitment even if the behavior is inherently risky and the result of a mental disorder.  Here, AMIP had a tendency to get paranoid, run away and find herself in a confused state away from her home.  The trial court feared that these actions would put the AMIP in harms way, thus making her a danger to herself. However, the appellate court has repeatedly said that such evidence is speculative and not clear and convincing, even in the best light for the state. State v. B.B., 240 Or. App 75 (2010)
• AMIP was committed on the grounds that if she was released she would (1) be unable to find shelter and, therefore, (2) suffer hypothermia or other harm from the freezing weather at that time and, therefore, (3) suffer a risk of serious harm or death be cause she’d be unable or unwilling to seek help for such harm.  All three of these grounds are too speculative to justify commitment. AMIP had a mental disorder that caused her to be hospitalized multiple times in the E.D. and the psych ward.  However, she had previously been staying in a hotel and she was in the hospital for the current commitment hearing because she had sought help for apparent hypothermia. State v. F.C., 239 Or. App 83 (2010)
• “The abstract possibility that a person’s bizarre and agitated behavior might theoretically draw a violent response from someone cannot satisfy the requirement that the threat of harm be real, rather than speculative, and ‘exist in the near future.’” State v. J.G., 218 Or App 398 (2008).

• A trial court’s conclusion that the AMIP would find himself in harm’s way if his conduct continued was merely conjecture and was insufficient to demonstrate the level of danger to self required for involuntary commitment.State v. Woolridge, 101 Or App 390 (1990)

Failure to Take Medications

• Failure to take medication, standing alone, is not sufficient to demonstrate the risk of danger to self if it only causes a speculative threat. However, in this case, where the AMIP’s failure to take his medication almost caused his death, failure to take medication was sufficient to demonstrate danger to self. State v. DeSassive, 118 Or App 383 (1993).

• Where there was no evidence that the AMIP’s likely failure to take his medication would cause harm in the near future, there was not enough evidence to demonstrate the required level of danger to one’s self in order to justify involuntary commitment. State v. Brungard, 101 Or App 67 (1990).