In Re The Detention Of: M.y.

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON
In the Matter of the Detention of
M.Y.
No. 85921-8-I
DIVISION ONE
UNPUBLISHED OPINION
SMITH, C.J. — M.Y. was admitted to Western State Hospital in August
2022, following the dismissal of a non-violent criminal offense. Upon his
admission, Dr. Vanessa Kieu and Dr. Carola Rong petitioned for further
involuntary treatment. As a basis for the petition, Dr. Kieu testified that she
diagnosed M.Y. with unspecified schizophrenia spectrum and other psychotic
disorders. Dr. Kieu also stated that M.Y. lacked insight and judgment, which put
him at risk of serious physical harm. M.Y. testified that he had temporary
housing accessible, would live with his parents if the shelter was unavailable and
agreed to seek mental health treatment in the community. The court nonetheless
found M.Y. was gravely disabled and ordered him detained for 90 days of less
restrictive involuntary treatment. Because of delays in permanent housing
options, M.Y. stayed at Western State Hospital. On appeal, M.Y. contends that
the evidence was insufficient to find him gravely disabled. We agree and vacate
the trial court’s 90-day involuntary commitment order.

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FACTS
In August 2022, M.Y. was admitted to Western State Hospital following the
dismissal of a non-violent criminal charge. The underlying incident arose when a
citizen called law enforcement after seeing a man leave the Bothell Home Depot
store, shouting and talking to himself about carrying a bomb. The citizen
provided a description of the man and law enforcement eventually arrested M.Y.
Although it had been over an hour since the original 911 call and he was four
miles away from the Home Depot, M.Y. roughly matched the citizen’s description
and seemed disheveled and incoherent. The State charged M.Y. with the non-
violent felony of threat to bomb or injure property.
The court found M.Y. incompetent to stand trial. The court later found
that, because of the delay in competency restoration, M.Y. was unlikely to regain
competency in a reasonable period of time. The State conceded the delay, and
several months after M.Y.’s arrest, the court dismissed the charge without
prejudice. The court then referred M.Y. for a civil commitment evaluation. The
court committed M.Y. to Western State for 120 hours to perform that evaluation.
After the five day involuntary detention, Dr. Vanessa Kieu and Dr. Carola
Rong petitioned to detain M.Y. for up to 180 days of further involuntary treatment
under chapter 71.05 RCW. The doctors provided two separate grounds for the
petition. First, they alleged that M.Y. had committed a felony and that he
presented a substantial likelihood of repeating the act because of a behavioral
health disorder. And second, the doctors alleged that M.Y. was gravely disabled
because of a behavioral health disorder.

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In September 2022, at a hearing before a court commissioner, M.Y.
sought to represent himself pro se but was denied on the basis that his request
was not voluntary, knowing, and intelligent.
The commitment hearing centered on the doctors’ testimony. As to the
first ground in the petition, the commissioner found that the facility failed to meet
its burden of proof by clear, cogent, and convincing evidence that M.Y. had
committed acts which amounted to a felony and presented a substantial
likelihood of repeating the act. The citizen witness could not identify M.Y. as the
man from the Home Depot and no other evidence supports the felony charge.
Without a felony charge, no basis exists for commitment on that ground in the
petition.
Concerning the second ground, whether M.Y. was gravely disabled,
Dr. Kieu testified that she was familiar with M.Y. and had evaluated him for
potential commitment. She had made multiple attempts to speak with M.Y., but
as he was often agitated and guarded, he only spoke with her once. Dr. Kieu’s
evaluation primarily involved reviewing records and consulting with M.Y.’s regular
treatment team. That information allowed her to diagnose M.Y. with “unspecified
schizophrenia spectrum and other psychotic disorder.” Dr. Kieu’s evaluation
detailed that M.Y. was argumentative, confrontational, and paranoid. He often
circled back to beliefs that he was being held illegally, was being persecuted by
the hospital, and kept for monetary gain. He did not believe he had any mental
illness and was consistently non-compliant with medication. While in the
hospital, M.Y. informed his providers that, if discharged, he would not take any of

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the medication prescribed. Dr. Kieu indicated that taken together, this behavior
showed that M.Y. did not have the tools to maintain himself safely in the
community and should not be discharged.
M.Y.’s mother testified that she and her husband would help M.Y. settle
once released. She also testified to M.Y.’s history of mental illness. Although
she sought M.Y.’s discharge, M.Y.’s mother noted that he had a history of
delusions and being verbally combative. She detailed his consistent refusal of
any medication at all.
M.Y. also testified on his own behalf. He pointed to a shelter in Bellevue
he had used in the past as a temporary housing option. He stated that he would
accept his parents’ help in getting treatment. And he identified mental health
services that he trusted and was willing to attend. In contrast to his earlier
statements, M.Y. asserted that he would continue treatment outside of the
hospital, to “clear [his] name.”
The commissioner found that M.Y. met the definition of gravely disabled
by clear, cogent, and convincing evidence and granted the petition for involuntary
treatment. M.Y. appeals.
ANALYSIS
M.Y. contends that substantial evidence does not support the trial court’s
finding that he is gravely disabled. We agree.
Where the trial court has weighed evidence, our review is “limited to
determining whether substantial evidence supports the findings and, if so,
whether the findings in turn support the trial court’s conclusions of law and

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judgment.” In re Det. of LaBelle, 107 Wn.2d 196, 209, 728 P.2d 138 (1986).
Substantial evidence is evidence sufficient to persuade a rational, fair-minded
person of the asserted premise. State v. Homan, 181 Wn.2d 102, 106, 330
P.3d 182 (2014). We will not disturb a trial court’s finding of grave disability if
that finding is supported by substantial evidence the lower court could have
reasonably found to be clear, cogent, and convincing. LaBelle, 107 Wn.2d
at 209.
“[I]nvoluntary commitment for mental disorders is a significant deprivation
of liberty which the State cannot accomplish without due process of law.”
LaBelle, 107 Wn.2d at 142. In general, an individual may only be involuntarily
committed as the result of a mental disorder if the individual either (1) poses a
substantial risk of harm to themselves, others, or the property of others, or is
gravely disabled. LaBelle 107 Wn.2d at 202.
RCW 71.05.020(25) defines “gravely disabled” as
a condition in which a person, as the result of a behavioral health
disorder: (a) [i]s in danger of serious physical harm resulting from a
failure to provide for his or her essential human needs of health or
safety; or (b) manifests severe deterioration in routine functioning
evidenced by repeated and escalating loss of cognitive or volitional
control over his or her actions and is not receiving such care as is
essential for his or her health or safety.
Under the first definition, the petitioner must offer “recent, tangible
evidence” that the individual’s failure or inability to provide for needs like food,
clothing, shelter, or medical treatment presents a high likelihood of serious
physical harm in the near future. LaBelle, 107 Wn.2d at 204-205. This failure or

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inability to provide must stem directly from the mental disorder. LaBelle, 107
Wn.2d at 204-205.
Under the second definition, the petitioner must provide a factual basis for
the conclusions that the individual “ ‘manifests severe deterioration in routine
functioning.’ ” LaBelle, 107 Wn.2d at 208 (quoting RCW 71.05.025(b)). This
evidence must include recent proof of significant loss of cognitive or volitional
control. RCW 71.05.020(25). “It is not enough to show that care and treatment
of an individual’s mental illness would be preferred or beneficial or even in [their]
best interests. To justify commitment, such care must be shown to be essential
to an individual’s health or safety.” LaBelle, 107 Wn.2d at 208. The fact that an
individual is mentally ill is not enough to demonstrate that the person is incapable
of making a rational choice as to their treatment. LaBelle, 107 Wn. App. at 208.
Here, the court ordered M.Y.’s involuntary commitment based solely on
M.Y.’s “grave disability,” as defined by RCW 71.05.020(25)(b). But the court’s
findings are insufficient to establish that M.Y. is gravely disabled under either
definition.
The State offered no evidence that M.Y.’s mental or physical state while at
Western State was a severe deterioration from a higher level of function. M.Y.’s
mother testified to his long history of behavioral and mental health issues. She
described instances of delusion and paranoia, a history of combative behavior
and a consistent refusal of any medication. This indicates that M.Y.’s level of
functioning while at Western State tracked closely with his level of function

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across the decades before his commitment. A history of similar issues does not
establish a “severe deterioration.”
The State also failed to present evidence that M.Y. had a repeated and
escalating loss of cognitive or volitional control. This was M.Y.’s first admission
to Western State, undermining the idea that this is part of a repeated pattern of
loss of control. And the State provided no evidence of escalating behavior.
Rather, M.Y.’s behavior on admission to the hospital was similar to that before
his admission, and then began to improve.
Despite the improvement, the State did not offer evidence that the care
M.Y. received at Western State was essential to his health or safety. Although
M.Y. appeared disheveled at the time of his arrest and sometimes while in the
hospital, Dr. Kieu testified that he was eating, showering, and maintaining basic
hygiene. The State provided no evidence that M.Y. was malnourished,
dehydrated, or otherwise injured while he was arrested or any time at Western
State. This indicates that M.Y. was capable of meeting his basic needs while in
the community and that his time in the hospital was not essential to his ability to
do so.
Looking to the future, M.Y.’s mother indicated that she was willing to
clothe him, house him for a few days, and help him get treatment in the
community. She had already located resources on bus lines so that M.Y. could
easily reach them. In addition, M.Y. testified about a shelter he knew he could
use, mental health services he trusts, and his willingness to follow any court

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instructions. All of this suggests that M.Y. would continue to be capable of caring
for his essential needs once released.
Again, the fact that an individual has a mental illness is not enough to
prove they are incapable of caring for themselves. LaBelle, 107 Wn. App. at 208.
No evidence exists of any severe deterioration in M.Y.’s routine functioning or
any inability to care for his essential needs. Accordingly, the evidence is
insufficient to find that, as a result of a behavioral health disorder, M.Y. manifests
severe deterioration in routine functioning evidenced by repeated and escalating
loss of cognitive or volitional control over actions, and he is not receiving such
care as is essential for health and safety.
We hold that the trial court’s findings do not support its conclusion that
M.Y. is gravely disabled. We therefore vacate the court’s 90-day involuntary
commitment order.
WE CONCUR: