MEMORANDUM DECISION
Pyle, Judge.
Statement of the Case
[1] M.M. (“M.M.”) appeals the trial courts order continuing his involuntary regular commitment
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in Logansport State Hospital (“the Hospital”). M.M. argues that there is insufficient evidence to support the trial courts commitment order. Specifically, M.M. contends that the Hospital failed to present clear and convincing evidence that he was a danger to himself and others and that he was gravely disabled. Concluding that M.M.’s sufficiency argument is nothing more than a request to reweigh the evidence, we affirm the trial courts involuntary regular commitment order.
[2] We affirm.
Issue
Whether the trial courts order for an involuntary commitment is supported by sufficient evidence.
Facts
[3] M.M., who is currently thirty-nine years old, first engaged in mental health treatment when he was thirteen years old. When M.M. was seventeen years old, he committed “sex offenses” and was placed in a juvenile sex offender program at the Pendleton Juvenile Correctional Facility (“the juvenile facility”). (Tr. Vol. 2 at 8). Once M.M. turned eighteen, M.M. was “found to remain inappropriate for community release[,]” and the juvenile facility filed an involuntary commitment petition. (Tr. Vol. 2 at 8-9). In April 2003, the trial court granted the petition, and M.M. was transferred to the Hospital in May 2003. M.M. has remained in the Hospital to receive treatment since that time.
[4] In June 2022, the trial court held an annual commitment review hearing. During that hearing, the State presented testimony from Douglas Morris (“Dr. Morris”), who is a staff psychiatrist at the Hospital and has worked there since 2008. Dr. Morris testified that he had been M.M.’s attending psychiatrist at various times over the years, including, most recently, since January 2022. Dr. Morris testified that he has worked with some of the “higher risk patients” on a unit in the Isaac Ray Treatment Center (“Isaac Ray Unit”) of the Hospital and that M.M. had been transferred to that unit in January 2022. (Tr. Vol. 2 at 7). Dr. Morris also testified that he examined M.M. on a monthly basis and that he had diagnosed M.M. with borderline personality disorder, anti-social personality disorder, bipolar II disorder, paraphilia unspecified, and mild intellectual disability.
[5] During the hearing, Dr. Morris testified that, based on his current treatment of M.M. and his knowledge of M.M.’s historical background, he believed that M.M. was dangerous to himself and to others and that he was gravely disabled. Dr. Morris explained that M.M. was dangerous to himself because he had a “history of repeated self-injurious behaviors ․ such as swallowing foreign objects and inserting objects into orifices such as his urethra.” (Tr. Vol. 2 at 9). For example, M.M. had swallowed “the arm of a pair of glasses” in September 2021. (Tr. Vol. 2 at 15). Dr. Morris explained that M.M. had “made some progress” in limiting these overt self-harm behaviors but that he continued to struggle with these self-harm thoughts, which then required “heightened safety monitoring” of M.M. to keep him safe. (Tr. Vol. 2 at 9).
[6] Additionally, Dr. Morris explained that M.M. was dangerous to others because he continued to have “physically assaultive” behavior and had a “risk of sexual predatory behavior[.]” (Tr. Vol. 2 at 10). For example, in the months just before the review hearing, M.M. had “required restraint after becoming angry and aggressively approach[ing] a peer to fight that peer[,]” and he had been “in an altercation with a peer and [had] sp[a]t in a peer[‘]s face.” (Tr. Vol. 2 at 10-11). Dr. Morris acknowledged that M.M. had made “improvements through the years in assault[ive] behaviors,” but he stated that “these behaviors remain concerning.” (Tr. Vol. 2 at 11).
[7] In regard to M.M. being dangerous to others due to “sexual predatory behavior[,]” Dr. Morris testified that M.M. had “struggled with these difficulties since adolescence” and that he had “an unwillingness to refrain from inappropriate sexual behavior on his current unit.” (Tr. Vol. 2 at 11). Dr. Morris provided recent examples of how M.M. had been “caught [at]tempting to perform oral sex on a peer in the ․ phone area” and had been “observed to have grabbed a peers groin.” (Tr. Vol. 2 at 11).
[8] Dr. Morris also testified that he believed that M.M. was gravely disabled as a result of his mental illness. The doctor explained, in part, that M.M. had “poor judgment and impulse control [that] impair[ed] his ability to safely function in a community setting.” (Tr. Vol. 2 at 11). Dr. Morris recommended that M.M. continue his civil commitment and treatment in his “current, more restrictive environment” with a goal to return to a less restrictive unit within the Hospital. (Tr. Vol. 2 at 17). At the end of the hearing, the trial court ordered M.M. to continue his involuntary regular commitment at the Hospital. M.M. did not appeal the trial courts order.
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[9] The following year, on June 16, 2023, the trial court held another commitment review hearing. Dr. Morris again testified on behalf of the Hospital. Dr. Morris testified that M.M. had been diagnosed with borderline personality disorder, anti-social personality disorder, bipolar II disorder, paraphilia unspecified, and mild intellectual disability. At the time of the hearing, M.M.’s “psychiatric medications” included Clozapine “to aid [M.M.] with emotional stability[;]” Fluoxetine and Wellbutrin “for depressive symptoms[;]” Buspirone “for anxiety[;]” and Depo-Provera “to help [M.M.] modify his inappropriate sexual behavior.” (Tr. Vol. 2 at 43).
[10] Additionally, Dr. Morris again testified that M.M. was dangerous to himself and others and that he was gravely disabled. Dr. Morris explained that M.M. had a “history of repeated episodes of self-injurious behavior involving ․ swallowing objects and inserting objects into orifices such as his penis.” (Tr. Vol. 2 at 40). Dr. Morris testified that during the past year, M.M. had been able to “decrease[ ] this behavior” and “ha[d] been better able to manage the chronic thoughts he has of self-harm without acting ․ on these thoughts.” (Tr. Vol. 2 at 40). Dr. Morris testified that “while [M.M.] had made significant improvements in these areas during the past year, he d[id] remain at risk of ․ self-harm.” (Tr. Vol. 2 at 41). The doctor explained that M.M. “less often required heightened monitoring for safety due to self-harm” and “less often required restraint due to his stated inability to refrain from self-harm outside of restraint.” (Tr. Vol. 2 at 40-41).
[11] When discussing M.M. being dangerous to others, Dr. Morris also acknowledged that M.M. had “made improvements” with his “long[-]standing history of ․ assaultive behavior[,]” but he cautioned that M.M.’s “difficulties with ․ threatening and aggressive behavior ․ continue[d] to occur at times.” (Tr. Vol. 2 at 41). Dr. Morris testified that M.M.’s “dangerousness to others involv[ing] sexual inappropriate behavior ․ remain[ed] an ongoing difficulty for [M.M.]” (Tr. Vol. 2 at 41). Dr. Morris provided recent examples of M.M.’s inappropriate behavior, including performing oral sex on a peer and allowing a peer to touch his genitals. Dr. Morris also testified that when M.M. had been cited for “inappropriately touching a peer[,]” M.M. had become angry, had “vowed to swallow an object or insert a foreign object into his body[,]” and had “required restraint[.]” (Tr. Vol. 2 at 41).
[12] Additionally, Dr. Morris testified that M.M. was gravely disabled, explaining that M.M.’s “[i]intellectual limitations, poor judgment, and lack of life experience d[id] not allow him to independently meet his basic needs for food, clothing, and shelter.” (Tr. Vol. 2 at 42). Moreover, Dr. Morris testified that M.M.’s “poor judgment and impulse control difficulties impair[ed] his ability to safely function in a community setting.” (Tr. Vol. 2 at 42). The doctor also testified that “even in a highly structured institutional setting, [M.M.] ․ still ha[d] difficulties with an unwillingness to conform his behavior, especially sexually inappropriate behavior[.]” (Tr. Vol. 2 at 42).
[13] Dr. Morris further testified that his recommended treatment plan for M.M. was to continue his commitment and treatment at the Hospital. Dr. Morris testified that M.M. was still housed on the Isaac Ray Unit, which provided a “very highly structured setting” within the Hospital. (Tr. Vol. 2 at 43). Dr. Morris also testified that M.M.’s current placement in that unit involved “coping skills” groups that “focused on emotional and behavioral stability and maintaining safe and appropriate behavior.” (Tr. Vol. 2 at 43). The doctor explained that if M.M. were to do well in that current setting, then he would be able to “step down to a less restrictive ․ hospital setting” and then participate in “treatment that w[ould] be more focused on community re-entry.” (Tr. Vol. 2 at 44).
[14] Following Dr. Morris’ testimony, M.M. testified and agreed that he “still [had] some issues [that] [he] need[ed] to work on” and that he was not yet ready to step down to a less restrictive environment. (Tr. Vol. 2 at 50). M.M. testified that he had “reported that [he] ha[d] been having a lot more difficulty with [his] sexual[ly] inappropriate urges” and that Dr. Morris had increased M.M.’s medication for that issue. (Tr. Vol. 2 at 48). Additionally, M.M. acknowledged that he “ha[d] times where [he] still ha[d] the thoughts of self-harm.” (Tr. Vol. 2 at 49).
[15] At the end of the review hearing, the trial court ordered M.M. to continue his involuntary regular commitment in the Hospital. In relevant part, the trial court concluded that M.M. was dangerous to himself, dangerous to others, and was gravely disabled.
[16] M.M. now appeals.
Decision
[17] M.M. contends that there is insufficient evidence to support the trial courts commitment order. We disagree.
[18] The purpose of civil commitment proceedings is to protect the public and to ensure the rights of the person whose liberty is at stake. Civil Commitment of T.K. v. Dept of Veterans Affairs, 27 N.E.3d 271, 273 (Ind. 2015). Given the liberty interest at stake, the serious stigma involved, and the adverse social consequences that accompany such physical confinement, a proceeding for an involuntary civil commitment is subject to due process requirements. Id. In order to protect the due process rights of a person subject to commitment, the facts justifying an involuntary commitment must be shown by clear and convincing evidence. Id. This standard of proof “communicates the relative importance our legal system attaches to a decision ordering an involuntary commitment,” and it has the function of reducing the likelihood of inappropriate commitments. Id. (cleaned up). When we review the sufficiency of the evidence supporting an involuntary civil commitment, we will affirm if, after considering the probative evidence and reasonable inferences supporting the decision, a reasonable trier of fact could have found the necessary elements proven by clear and convincing evidence. Id. We do not reweigh the evidence, nor do we judge witness credibility. Id.
[19] To obtain an involuntary commitment, a petitioner is “required to prove by clear and convincing evidence that: (1) the individual is mentally ill and either dangerous or gravely disabled; and (2) detention or commitment of that individual is appropriate.” IND. CODE § 12-26-2-5(e) (format altered). Thus, here, the Hospital had the burden of proving subsections (1) and (2) by clear and convincing evidence.
[20] M.M. does not dispute the sufficiency of the evidence supporting the elements that he is mentally ill and that the commitment is appropriate. Instead, he challenges the dangerous and gravely disabled elements. Specifically, M.M. contends that the Hospital failed to present clear and convincing evidence that he was dangerous to himself and others and that he was gravely disabled.
[21] However, “[i]t is important to note that in order to carry its burden of proof, [the Hospital] only had to prove that [M.M.] was either gravely disabled or dangerous. It did not have to prove both of these elements.” M.Z. v. Clarian Health Partners, 829 N.E.2d 634, 637 (Ind. Ct. App. 2005) (emphasis in original), trans. denied. Accordingly, we will address only the dangerous element. “Dangerous” is statutorily defined as “a condition in which an individual as a result of mental illness, presents a substantial risk that the individual will harm the individual or others.” I.C. § 12-7-2-53 (emphasis added).
[22] Here, during the commitment review hearing, the Hospital met its burden of proving the involuntary commitment elements through the testimony of Dr. Morris, who testified, among other things, that M.M. was dangerous both to himself and to others. When discussing how M.M. was dangerous to himself, Dr. Morris explained that M.M. had a “history of repeated episodes of self-injurious behavior involving ․ swallowing objects and inserting objects into orifices such as his penis.” (Tr. Vol. 2 at 40). Dr. Morris acknowledged that M.M. had made some progress in his ability to decrease this behavior but cautioned that M.M. “remain[ed] at risk of ․ self-harm.” (Tr. Vol. 2 at 41). Dr. Morris indicated that there was still a need for “required heightened monitoring for safety due to [M.M.’s] self-harm” and for “required restraint due to his stated inability to refrain from self-harm outside of restraint” but that the need was now “less often[.]” (Tr. Vol. 2 at 40-41). Moreover, when M.M. testified, he acknowledged that he “ha[d] times where [he] still ha[d] the thoughts of self-harm.” (Tr. Vol. 2 at 49).
[23] Additionally, when discussing M.M. being dangerous to others, Dr. Morris discussed M.M.’s issues with aggressive behavior and sexually inappropriate behavior. Dr. Morris acknowledged that M.M. had “made improvements” with his “long[-]standing history of ․ assaultive behavior[,]” but he cautioned that M.M.’s “difficulties with ․ threatening and aggressive behavior ․ continue[d] to occur at times.” (Tr. Vol. 2 at 41). Dr. Morris also testified that M.M.’s “dangerousness to others involv[ing] sexual inappropriate behavior ․ remain[ed] an ongoing difficulty for [M.M.], ” and the doctor provided examples of such behavior. (Tr. Vol. 2 at 41). Dr. Morris also testified that when M.M. had been cited for “inappropriately touching a peer[,]” M.M. had become angry, had “vowed to swallow an object or insert a foreign object into his body[,]” and had “required restraint[.]” (Tr. Vol. 2 at 41). Furthermore, during M.M.’s testimony, he agreed that he “still [had] some issues [that] [he] need[ed] to work on[,]” and he testified that he had “reported that [he] ha[d] been having a lot more difficulty with [his] sexual inappropriate urges[.]” (Tr. Vol. 2 at 48, 50).
[24] In light of the clear and convincing evidence that M.M. was dangerous to either himself or to others, we conclude that the trial court did not err by ordering M.M. to continue his involuntary regular commitment at the Hospital. M.M.’s argument is nothing more than a request to reweigh the evidence, which we will not do. T.K., 27 N.E.3d 273. We affirm the trial courts involuntary regular commitment order.
[25] Affirmed.
FOOTNOTES
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. In Civil Commitment of T.K. v. Dept of Veterans Affairs, 27 N.E.3d 271, 273 n. 1 (Ind. 2015), the Indiana Supreme Court explained:In Indiana, an adult person may be civilly committed either voluntarily or involuntarily. Involuntary civil commitment may occur under four circumstances if certain statutorily regulated conditions are satisfied: (1) “Immediate Detention” by law enforcement for up to 24 hours; (2) “Emergency Detention” for up to 72 hours; (3) “Temporary Commitment” for up to 90 days; and (4) “Regular Commitment” for an indefinite period of time that may exceed 90 days.(internal citations omitted).
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. M.M. had appealed the trial courts 2020 order continuing his involuntary regular commitment. See M.M. v. Logansport State Hosp., No. 21A-MH-1530 (Ind. Ct. App. Jan. 12, 2022) (mem).
Memorandum Decision by Judge Pyle
Judges Tavitas and Foley concur.
Tavitas, J., and Foley, J., concur.