Conditions for Extension of Court Ordered Commitment Due to Insanity
In Texas, a person subject to court-ordered mental health services due to insanity is "entitled to treatment, to periodic and recurrent review of his mental condition, and to release at such time as he no longer presents a danger to himself or others." State v. Turner, 556 S.W.2d 563, 566 (Tex. 1977), cert. denied, 435 U.S. 929, 55 L. Ed. 2d 525, 98 S. Ct. 1499 (1978).
A proceeding for extended commitment to a mental hospital is a civil matter and, as such, is governed by the "clear and convincing evidence" standard of proof. See In re G.B.R., 953 S.W.2d 391, 395 (Tex. App.--El Paso 1997, no writ).
Clear and convincing proof is defined as "the measure or degree of proof which will produce in the mind of the trier of fact a firm belief or conviction as to the truth of the allegations sought to be established." Id. at 396 (citing State v. Addington, 588 S.W.2d 569, 570 (Tex. 1979)).
While such proof "must weigh heavier than merely the greater weight of the credible evidence, there is no requirement that the evidence be unequivocal or undisputed." G.B.R., 953 S.W.2d at 396 (citing Addington, 588 S.W.2d at 570).
A judge or jury may determine that a patient requires an extension of court-ordered mental health services on an inpatient basis only if the trier of fact finds, from clear and convincing evidence, that the following circumstances are present:
(1) the proposed patient is mentally ill; and
(2) as a result of that mental illness the proposed patient:
(A) is likely to cause serious harm to himself;
(B) is likely to cause serious harm to others; or
(i) suffering severe and abnormal mental, emotional, or physical distress;
(ii) experiencing substantial mental or physical deterioration of the proposed patient's ability to function independently, which is exhibited by the proposed patient's inability, except for reasons of indigence, to provide for the proposed patient's basic needs, including food, clothing, health, or safety; and
(iii) unable to make a rational and informed decision as to whether or not to submit to treatment;
(3) the proposed patient's condition is expected to continue for more than 90 days; and
(4) the proposed patient has received court-ordered inpatient mental health services under this subtitle or under Section 5, Article 46.02, Code of Criminal Procedure, for at least 60 consecutive days during the preceding 12 months. TEX. HEALTH & SAFETY CODE ANN. 574.035(a) (Vernon Supp. 2000).
A court may not renew an order under this section unless it finds that the patient meets the criteria for extended mental health services prescribed by 574.035(a) (1), (2), and (3). See TEX. HEALTH & SAFETY CODE ANN. 574.066(f) (Vernon 1992).
To constitute clear and convincing in this context, the evidence must include expert testimony and, unless waived, evidence of a recent overt act or a continuing pattern of behavior that tends to confirm the following: (1) the likelihood of serious harm to the proposed patient or others;
(2) the proposed patient's distress and the deterioration of the proposed patient's ability to function. See TEX. HEALTH & SAFETY CODE ANN. 574.035(e).