In Re The Detention Of J.s.

1 printed pages contain little extracted OCR body text; searchable legal-body completeness has not been established for those pages.

OCR transcription for search; preserved printed pages are authoritative

FILED
9/22/2025
Court of Appeals
Division |
State of Washington

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

In the Matter of the Detention of J.S.
No. 86906-0-1

DIVISION ONE

UNPUBLISHED OPINION

Diaz, J. — J.S. challenges a superior court commissioner's order
committing her to 14 days of involuntary detention pursuant to the involuntary
treatment act (ITA), ch. 71.05 RCW. She raises two main issues. First, J.S. claims
that the commissioner erred by failing to grant a motion to dismiss (Motion), which
argued that the designated crisis responder (DCR) who petitioned for her initial
detention had “totally disregarded” certain requirements of the ITA. She also
argues that there was not substantial evidence in the record to support the
commissioner's finding that she was “gravely disabled.” Disagreeing, we affirm.

I. BACKGROUND

On June 21, 2024, J.S. arrived at the emergency department of a hospital

with chest pain. A hospital social worker examined J.S., who disclosed that she

No. 86906-0-I/2
2
had intentionally overdosed one day prior. 	During this examination, J.S. also
stated that she believed she was being stalked, that she had experienced auditory
hallucinations which told “her terrible things,” and that she had recently slept poorly
due to hearing people “talking to her.” J.S. refused voluntary treatment. Hospital
personnel then referred her, pursuant to the ITA, to a DCR to be examined.
The DCR noted inter alia that J.S. suffered from auditory hallucinations and
“paranoid, persecutory delusions.” The DCR also reviewed J.S.’s medical records,
which indicated that she had “presented to three local emergency departments
within [the preceding] 48-hour period”—the last of which was her visit to the
present hospital. Pursuant to the DCR’s initial petition, J.S. was held, under RCW
71.05.150, for several days and transferred to Telecare North Sound for psychiatric
treatment.
On June 25, 2024, two medical professionals at Telecare North Sound
timely petitioned the superior court for J.S. to be held for up to 14 days of further
involuntary treatment. They asserted J.S. “continue[d] to present with hyperverbal
speech, persecutory, paranoid and illogical thinking, [and] impaired insight and
judgment.”
The next day, the commissioner held a hearing on the petition and on J.S.’s
subsequent Motion, which argued that the DCR had totally disregarded portions of
RCW 71.05.154. 	The commissioner denied the Motion and heard testimony on
the merits of three witnesses: J.S.’s mother, Joann Clemo, who was a social
worker who treated J.S. at Telecare North Sound, and J.S.
At the end of the hearing, the commissioner found that J.S. was gravely

No. 86906-0-I/3
3
disabled under RCW 71.05.020. The commissioner incorporated their oral findings
into their ultimate written order, memorializing the same findings.
J.S. timely appeals.
II. 	ANALYSIS1
A. 	“Total Disregard” of the ITA
J.S. claims the commissioner erred when, in denying her Motion, they
concluded that the DCR sufficiently complied with RCW 71.05.154.
RCW 71.05.154 sets out requirements for a DCR to follow when assessing
a person located in an emergency room at the time of an ITA evaluation. It states
the DCR “shall take serious consideration of observations and opinions by an
examining emergency room physician, advanced registered nurse practitioner, or
physician 	assistant 	in 	determining 	whether 	detention 	under 	this 	chapter 	is
appropriate.” 	RCW 71.05.154. 	It continues, “The designated crisis responder
must document his or her consultation with this professional, if the professional is
available, or his or her review of the professional’s written observations or opinions
regarding whether detention of the person is appropriate.” Id. (emphasis added).
Separately, 	RCW 	71.05.010 	provides 	that, 	“[w]hen 	construing 	the
requirements of this chapter the court must focus on the merits of the petition,
except where requirements have been totally disregarded.” 	The ITA does not
further define “total disregard.” See RCW 71.050.020 (definitions); see also In re
Det. of A.C., 1 Wn.3d 731, 744, 533 P.3d 81 (2023).
1 The parties agree that this appeal is not moot because a record of a prior
involuntary 	detention 	“carries 	collateral 	consequences.” 	We 	accept 	that
agreement and address the entirety of her appeal.

No. 86906-0-I/4
4
Our Supreme Court has accorded meaning to that term from dictionary
definitions, holding that the word “[t]otally is defined . . . as in a total manner: to a
total or complete degree.” 	A.C., 1 Wn.3d at 744 (quoting MERRIAM-W EBSTER
O NLINE 	DICTIONARY, 	https://www.merriam-webster.com/dictionary/totally 	(last
visited June 16, 2023)). 	And the Court held that the word “[d]isregard is defined
as to pay no attention to: to treat as unworthy of regard or notice[.]” Id. at 744-45
(quoting 	MERRIAM-W EBSTER 	O NLINE 	DICTIONARY, 	https://www.merriam-
webster.com/dictionary/disregard (last visited June 16, 2023)).
Our Supreme Court further instructed that reviewing courts “must consider
the totality of the circumstances in determining whether the requirements of the
[involuntary treatment] act have been totally disregarded.” 	Id. at 747. 	The mere
fact that “some aspect of the act has been violated” is not, in every case, sufficient
to show that that the “requirements of the ITA [have been] totally disregarded.” Id.
at 745.
The question of “when and whether dismissal is required when the ITA has
been violated” is a question of law which we review de novo. Id. at 739. But we
review whether a trial court properly applied the law to given facts for abuse of
discretion. 	Id. 	More specifically, “[w]e review the superior court’s total disregard
determination for abuse of discretion.” In re Det. of E.S., 22 Wn. App. 2d 161, 185,
509 P.3d 871 (2022).
We find an abuse of discretion when the trial court decision is manifestly
unreasonable or exercised on untenable ground or for untenable reasons. 	In re
Det. of D.H., 1 Wn.3d 764, 774, 533 P.3d 97 (2023). This includes a decision that

No. 86906-0-I/5
5
is reached by applying the wrong legal standard, id., or discretion that is exercised
on a misunderstanding of the law, A.C., 1 Wn.3d at 740.
Here, the DCR’s petition attests that she conducted a review of J.S.’s recent
treatment history, including notes of the professionals who had examined her in
the preceding days. 	In addition to notes from two examining social workers, her
medical file included notes from a physician assistant (PA)—one of the medical
professionals enumerated in RCW 71.05.154—which indicated J.S. had refused
treatment and “grew hostile when asked about her medical history.”
J.S. contends the DCR’s review of the PA’s notes was insufficient to satisfy
RCW 71.05.154 because the PA did not include further observations or opinions
specifically regarding whether J.S.’s detention was appropriate. 	For its part, the
State concedes that the DCR did not “perfectly” follow RCW 71.05.154, but argues
that it was not an abuse of discretion for the commissioner to conclude that the
DCR did not “totally disregard” its requirements. We agree.
The plain text of RCW 71.05.154 sets out two alternative documentation
requirements. Only the latter is relevant here and it contains four component parts.
Namely, the DCR must (i) document that (ii) they reviewed a medical professional’s
(iii) examination notes regarding (iv) the appropriateness of detention. 	RCW
71.05.154. We hold that it was not an abuse of discretion to reject the claim that
the DCR “pa[id] no attention” to those requirements and not “to a total or complete
degree.” A.C., 1 Wn.3d at 744-45.
The DCR here (i) documented that she (ii) considered the opinions of a
relevant professional (iii) memorialized in the available medical records, before

No. 86906-0-I/6
6
making her detention recommendation concerning J.S. 	And it would not be an
abuse of discretion to interpret those notes—taken by an emergency room
professional less than 48 hours prior about her initial detention—pertained to J.S.’s
amenability to treatment. 	That is, it was not manifestly unreasonable for the
commissioner to conclude that J.S.’s “hostility” meant she was not amenable to
treatment in an outpatient setting.
Moreover, the totality of the circumstances present at the time of the DCR’s
petition supports this conclusion. The PA’s notes described J.S.’s condition during
what was the first of three ensuing emergency hospital visits in a short duration
immediately preceding her evaluation. Thus, it was not “manifestly unreasonable”
for the commissioner to determine the DCR did not totally disregard RCW
71.05.154 when she reviewed J.S.’s chart and consulted notes from a physician
assistant who had examined J.S., all of which regarded “whether detention [was]
appropriate.” RCW 71.05.154.2
2 This court similarly held that a DCR had not totally disregarded the ITA in In re
Det. of A.V., No. 85686-3-I, slip op. at 15 (Wash. Ct. App. Jul. 15, 2024)
(unpublished), https://www.courts.wa.gov/opinions/pdf/856863.pdf, which we cite
to pursuant to GR 14.1 as necessary to a reasoned decision. 	It is true that A.V.
contained certain facts not present in this record; namely, that the DCR had tried
to find a doctor and had testified to her usual protocol. Id. at 15 n.8. But we also
considered it “significan[t]” that the DCR had reviewed all available hospital records
associated with the patient, and that those records included notes from an
emergency room professional, as occurred here. 	Id. at 11. 	We also note our
conclusion in In re Det. Of W.C. is consistent with this holding. No. 82420-1-I, slip
op. 	at 	2 	(Wash. 	Ct. 	App. 	Nov. 	22, 	2021) 	(unpublished)
https://www.courts.wa.gov/opinions/pdf/824201.pdf. 	There, on distinguishable
facts, we accepted the respondent’s concession that appellant’s counsel had
rendered ineffective assistance of counsel by failing to seek dismissal of a petition
for lack of compliance with RCW 71.05.154, where the crisis responder had
“neither consulted with the examining medical professional nor documented her
review of the medical professional’s written observations[.]” Id. (emphasis added).

No. 86906-0-I/7
7
Our Supreme Court’s decision in A.C. is also instructive. There, the Court
consolidated 	three 	unrelated 	matters 	and 	held 	that 	the 	State 	had 	totally
disregarded the ITA when it held two appellants for more than a month after orders
authorizing their detention had expired. A.C., 1 Wn.3d at 747. By contrast, it held
that the State had not totally disregarded the ITA as to the third appellant (AC) who
had never been held without lawful authority, even though it acknowledged her
rights under the ITA had been “plainly violated.” 	Id. 	In explaining its reasoning,
the Court noted, “[w]e stress that on the record before us, AC was never held
without authority of law. She was at all times detained either under the emergency
provisions of the ITA or by court order.” Id. at 748 n. 9.
Similarly, J.S. was never held beyond the lawful duration set out in the ITA’s
provisions or in a commitment order. 	She was, as A.C. herself was, “brought
before 	[the 	superior 	court] 	on 	the 	appointed 	day,” 	who 	then—following 	an
independent review of the facts—“extended her detention” finding a “clear need
for additional treatment.” Id. at 748. As the Court did there, we “hold that the trial
court did not abuse its discretion in denying the motion to dismiss.” Id.
Thus, J.S.’s first assignment of error fails.
B. 	Substantial Evidence for Finding Grave Disability
J.S. 	next 	claims 	that 	there 	was 	not 	substantial 	evidence 	before 	the
commissioner to support its finding she was “gravely disabled” as defined in RCW
71.05.020.3
3 As a threshold matter, J.S. asserts the court’s findings were not sufficient for
appellate review. 	We disagree, first, because she cites no authority for the

No. 86906-0-I/8
8
Pursuant to RCW 71.05.240, a court must hold a probable cause hearing
on a petition requesting an order for up to 14 days of involuntary treatment, and it
may only enter such an order if, at the conclusion of the hearing:
the court finds by a preponderance of the evidence that a person
detained for behavioral health treatment, as the result of a behavioral
health disorder, presents a likelihood of serious harm, or is gravely
disabled, 	and, 	after 	considering 	less 	restrictive 	alternatives 	to
involuntary detention and treatment, finds that no such alternatives
are in the best interests of such person or others.
RCW 71.05.240(4)(a) (emphasis added).
The ITA further provides two independently sufficient definitions of “gravely
disabled.” According to the statute, the term means:
a condition in which a person, as a 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 or 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.
RCW 71.05.020(25).
We hold that there was substantial evidence to support the finding of grave
proposition that the court was required to specify in detail which facts supported
which portion of the statute’s alternate definitions of grave disability. 	Cowiche
Canyon Conservancy v. Bosley, 118 Wn.2d 801, 809, 828 P.2d 549 (1992)
(holding that arguments unsupported by inter alia citation to pertinent authority
need not be considered). 	As our Supreme Court has explained, the standard is
that a court’s findings in grave disability determinations must “at least be sufficient
to indicate the factual bases for the ultimate conclusions.” 	In re Det. of LaBelle,
107 Wn.2d 196, 218, 728 P.2d 138 (1986) (emphasis added). 	Moreover, to the
extent J.S.’s challenge focuses on the sufficiency of the court’s written findings, we
note that “written findings may be supplemented by the trial court’s oral decision
or statements in the record,” id. at 219, as occurred here, rendering the record
sufficiently complete.

No. 86906-0-I/9
9
disability under the standard set out by RCW 71.05.020(25)(b), with regard to both
of its subparts.4
As to the first part of the standard under RCW 71.05.020(25)(b), J.S. claims
the record did not support the commissioner’s findings that she “manifest[ed]
severe deterioration in routine functioning evidenced by repeated and escalating
loss of cognitive or volitional control over his or her actions.” 	Notably, however,
she herself acknowledges that the evidence before the commissioner included:
“suicidal statements, her belief that people are trying to get and hurt her, her talking
to people who are not there, her delusions about injuries to her body, her trespass
from businesses, [and] the loss of her job[.]” 	Br. of Appellant at 60. 	Indeed, her
mother and a social worker testified to each of these facts, and also that J.S. had
disrupted sleep patterns and occasionally “wouldn’t eat for two or three days.”
From this evidence, the commissioner inferred that J.S. had suffered a
deterioration in routine functioning, including specifically, poor sleep and eating
patterns, 	the 	loss 	of 	her 	livelihood 	and 	social 	circle, 	and 	the 	debilitating
preoccupation of “see[ing] and talk[ing] to people that weren’t there[.]”
In response, J.S. appears to argue that the evidence did not show a loss of
control that was sufficiently recent or significant. 	However, J.S. cites no case in
support of the proposition that a rational person could not conclude newfound
symptoms 	within 	an 	eight-month 	period—which 	again 	included 	suicidal
ideations—does not represent a loss of control that is “recent” or “significant.”
4 Because 71.05.020(25) sets out two equally valid bases for finding a person
gravely disabled, we need not additionally assess the extent of the evidence in the
record of grave disability according to 71.05.020(25)(a).

No. 86906-0-I/10
10
DeHeer v. Seattle Post-Intelligencer, 60 Wn.2d 122, 126, 372 P.2d 193 (1962)
(“Where no authorities are cited in support of a proposition, the court is not required
to search out authorities, but may assume that counsel, after diligent search, has
found none.”).
We hold that there was a sufficient basis for a rational person to conclude it
was more likely than not that J.S. manifested severe deterioration in routine
functioning 	evidenced 	by 	sufficiently 	significant 	and 	recent 	repeated 	and
escalating loss of cognitive or volitional control over her actions, so as to support
the commissioner’s grave disability finding.
As to the second portion of RCW 71.05.020(25)(b), which requires evidence
she “[was] not receiving such care as is essential for his or her health or safety,”
J.S. claims the commissioner found only that detention would be beneficial, rather
than essential. 	She is correct that a court may not order involuntarily detention
simply because an individual might benefit from treatment. 	In re Det. of Labelle,
107 Wn.2d 196, 207, 728 P.2d 138 (1986). 	Rather, as our Supreme Court has
explained, there must be a “factual basis for concluding that [J.S.] [was] not
receiving or would not receive, if released, such care as is essential for [her] health
or safety.” Id. at 208.
However, J.S. fails to establish that the record lacked evidence she would
not 	have 	received 	care 	essential for 	her health 	and 	safety without 	further
involuntary treatment. There is ample evidence in the record that she was not yet
stabilized, was actively experiencing psychosis, and did not acknowledge any of
these facts, including her diagnosis. 	Further, J.S. had outbursts in which she

No. 86906-0-I/11
11
caused herself physical injury and she herself testified that she had multiple recent
interactions with law enforcement, which she could only recall as “a blur.” 	She
cites no case supporting the claim that continued treatment for someone in that
situation is not “essential.” DeHeer, 60 Wn.2d at 126.
Moreover, contrary to J.S.’s contention, our review of the record for
substantial evidence is not limited to the bare assertions made in testimony
because triers of fact, as the commissioner here, may draw reasonable inferences
from the direct evidence. See State v. Epefanio, 156 Wn. App. 378, 384, 234 P.3d
253 (2010). We hold that the evidence in the record provided a basis from which
a rational person could reasonably infer that it was more likely than not that J.S.
would go without essential treatment outside the inpatient setting. 	The social
worker testified that J.S. could not “provide for her essential health and safety
needs” outside of the “structured setting” of inpatient treatment. And J.S.’s mother
testified that she could not provide a place for her to stay upon release because
she did not know whether she and her partner could care for J.S.
In short, as the commissioner summarized, there was evidence in the
record demonstrating J.S.’s “lack of insight and illogical thinking,” “guarded,
agitat[ed]” 	behavior, 	and 	an 	“inability 	or 	unwillingness 	to 	participate 	in
conversations about her treatment[.]” 	In turn, we hold that it was a reasonable
inference to conclude that J.S.’s capacity to comply with ongoing outpatient
psychiatric treatment was dubious.
Thus, J.S.’s second assignment of error fails.

No. 86906-0-1/12

III. CONCLUSION

We affirm.

Diaz, D.

WE CONCUR:

4. ~—, KET MG, 0
(PJ

12