HomeMy WebLinkAbout2005-3528 and 1999-122 Civil
IN RE: JOHN HOFFSTETTER
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 05-3528 CIVIL TERM
MENTAL HEALTH APPEAL
IN RE: JOHN HOFFSTETTER
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 99-0122 CIVIL TERM
MENTAL HEALTH APPEAL
IN RE: OPINION PURSUANT TO P A. R.A.P. 1925
OLER, 1., August 29, 2005.
In this unfortunate mental health commitment matter, an inmate at the Cumberland
County Prison has appealed to the Pennsylvania Superior Court from an order finding
him severely mentally disabled and in need of treatment, and subjecting him to
involuntary treatment. The basis for the appeal has been expressed in a statement of
matters complained of on appeal as follows:
1. According to the Mental Health Procedures Act, "[ a] person is
severely mentally disabled when, as a result of mental illness, his
capacity to exercise self-control, judgment and discretion in the
conduct of his affairs and social relations or to care for his own
personal needs is so lessened that he poses a clear and present danger
of harm to others or to himself." 50 P.S. 9 7301(a).
2. In order to establish that a person is a "clear and present
danger" to himself, it must be shown that, within the past thirty days,
the person has attempted or threatened suicide, 50 P.S.
9 7301 (b )( 2)( ii); the person has mutilated or threatened
to mutilate himself, SOP. s. 9 7301 (b )( 2)( iii); or the
person has acted in such manner as to evidence that he
would be unable, without care, supervision and the
continued assistance of others, to satisfy his need for
nourishment, personal or medical care, shelter, or self-
protection and safety, and that there is a reasonable
probability that death, serious bodily injury or serious
physical debilitation would ensue within 30 days unless
adequate treatment were afforded under this act. 50 P.S.
97301(b)(2)(i).
3. Appellant John Hoffstetter was illegally committed under 50
P.S. 9 7304 of the Mental Health Procedures Act because insufficient
evidence was offered to establish a reasonable probability of death,
serious bodily injury or serious physical debilitation within the next
thirty days, as required under section 301(b)(2)(i) of the Mental
Health Procedures Act. 50 P.S. 9 7301(b )(2)(i).1
This opinion in support of the order finding John Hoffstetter severely mentally
disabled and in need of treatment, and subjecting him to involuntary treatment, is written
pursuant to Pennsylvania Rule of Appellate Procedure 1925.
STATEMENT OF FACTS
Following his arrest on charges of disorderly conduct, defiant trespass and open
lewdness,2 John Hoffstetter was placed in the Cumberland County Prison on June 9,
2005.3 As a result of various incidents suggestive of mental illness, a Cumberland
County mental health caseworker petitioned for his subjection to involuntary treatment
under the Mental Health Procedures Act. 4
The petition recited a finding by a psychiatrist, based upon an examination on July
5, 2005, that Mr. Hoffstetter was "extremely agitated and delusional. He is aggressive,
attempts to hit staff and people. He is talking in a grandiose, disorganized fashion. He
refuses medicine-he is verbally insulting the staff. Denies metal illness-is extremely
paranoid and irritable and threatening."s According to the petition, the psychiatrist was
of the opinion that Mr. Hoffstetter required inpatient treatment and believed that "being
in jail actually is intensifying his psychosis. . . .,,6
1 Statement of Matters Complained of on Appeal, para. 3 (filed August 18,2005).
2 NT. 8, Hearing, July 14,2005 (hereinafter NT. ~.
3 NT. 11.
4 Petition for Involuntary Treatment via the Criminal Justice System (docketed July 13, 2005, No. 1999-
122 Civil Term).
5 Petition for Involuntary Treatment via the Criminal Justice System, at 4 (docketed July 13, 2005, No.
1999-122 Civil Term).
6 Petition for Involuntary Treatment via the Criminal Justice System, at 4 (docketed July 13, 2005, No.
1999-122 Civil Term).
2
This petition resulted in a hearing before the Cumberland County Mental Health
Review Officer on July 7, 2005, and a recommended order for involuntary treatment.7
Through his court-appointed counsel, Mr. Hoffstetter petitioned for a de novo hearing
before the court on this issue,8 which was held on July 14, 2005.
The evidence at the hearing consisted of testimony of ( a) the mental health
caseworker, Thomas Haley, (b) a psychiatrist, Dr. Soroush N oori, and (c) Mr. Hoffstetter.
The testimony of the caseworker was to the effect that Mr. Hoffstetter had been observed
speaking to people in his cell when he was alone in the cell,9 that on June 26, 2005, he
had assaulted another prisoner,lO that he had spit from his cell on another prisoner on
June 28, 2005,11 that he had been clucking like a chicken and disturbing the sleep of other
prisoners during the night of June 13, 2005,12 and that he had cut his wrist with stolen
kitchen utensils on July 5, 2005.13
The caseworker testified further that Mr. Hoffstetter was refusing to take his
medication, that the prison had been forced to remove him from the general population
and segregate him with other inmates who were permitted out of their cells only one hour
per day.14 The caseworker also noted that on at least two previous occasions when Mr.
Hoffstetter had been imprisoned mental health commitments had been necessary, and that
they had resulted in improvement of his condition. IS
7 Petition for Involuntary Treatment via the Criminal Justice System, at 5 (docketed July 13, 2005, No.
1999-122 Civil Term).
8 Petition for Appeal from Involuntary Commitment, filed July 12, 2005. This petition was filed, for
some reason, at No. 05-3528 Civil Term rather than at No. 1999-122 Civil Term, where the petition for
involuntary commitment was filed. By order of court dated August 24, 2005, these cases have been
consolidated for purposes of coordinating the record.
9 NT. 6.
10 NT. 7, 10.
11 NT. 7, 10.
12 NT. 7, 10.
13 NT. 7,10.
14 NT. 9.
15 NT. 7, 9.
3
Dr. Soroush N oori, a medical doctor specializing in psychiatry and licensed to
practice in Pennsylvania,16 testified that he had examined Mr. Hoffstetter following his
recent admission into the prison 17 and diagnosed him as suffering from paranoid
schizophrenia. 18 He expressed the opinion that Mr. Hoffstetter was at risk from other
prisoners, that he was likely to assault other prisoners, and that without treatment his
condition was likely to deterioriate.19
Dr. Noori was provided with the statutory concepts of severe mental disability,
including its component of clear and present danger,20 and asked to express an opinion to
a reasonable degree of psychiatric certainty as to whether Mr. Hoffstetter was severely
mentally disabled21 and in need of treatment.22 His response as to each issue was in the
affirmative.23
Mr. Hoffstetter's testimony was to the effect that he had in fact committed the acts
referred to in the caseworker's testimony. 24 He noted that he had actually spit on three
other inmates, rather than one?5 The tenor of his testimony may be appreciated by the
following excerpts on the subject of self-mutiliation:
Q Mr. Hoffstetter, how did you injure your wrist?
A May I start from the beginning or would you like me to
take it from the middle and forget the extraneous circumstances-
Q Be clear and concise.
A Okay. To begin with, I walked into my house on an LSD
trip, and I walked in my basement and my mother said-I heard my
16 NT. 15.
17 NT. 14.
18 NT. 15.
19 NT. 17.
20 NT. 19-20.
21 NT. 21.
22 NT. 21.
23 NT. 21-22.
24 NT. 25-29.
25 NT. 25.
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mother's voice saying I have this, and I heard a whisper coming from
the chimney and the wind blew very cool.
THE COURT: You heard what?
THE WITNESS: A wind blow from the chimney, very cool,
and I noticed a plastic bag over the flue, and I walked to it, and I
heard a whispering wind, set them free, so I pulled the rubber band off
the bag, and there was a series of wasps. There were many wasps in
the flue. And so I decided I would set them free because it seemed
like the thing to do. So I took the paper bag, I opened it, and I started
to brush the little wasps out of the chimney because I was afraid that
this coming winter they would be burned or they would die and they
wouldn't be able to make it up the chimney.
So I took them into the rear-and beg your pardon, Your Honor.
Before I took my hand and touched one of them, and the wasp stung
me. So I took them out and set them free, all of them, actually. I
didn't kill the one that stung me, but then I was-I held him in
contempt in my heart and found the wasp drilling into the wood beam
above the patio, and I caught it by its wings and I pinched the wings
and maliciously I pulled its stinger out and threw it away and tortured
the insect and threw it away. I recently confessed that to the Lord, but
after the fact I had a big lump on my wrist.
Now, my mother told me, you're going to have to lance it. So
what I did was I took my Swiss army knife and lanced it and kind of
X'd it. Then it scarred very obscurely, and there was a big lump
there. While I was a resident in the Harrisburg State Hospital, the
doctor informed me that a lump like that is from a herniated
muscularity in any tender form, and within a joint they used to just
slap it against the wall. So I took a book-he said-he actually told
me, you take a book and slam it. He used to slam a book. So I just hit
the mother fucker against the wall, and it herniated and it pulsed and
then it ran up my arm and out my ears and then it was gone.
Then later, while I was running-while I was retreating to the
woods naked, which was another thing held in contempt, that they had
bitten me, which the priest had told me, warning me of the heralds of
Christ. I ran into the woods naked, and I actually started to pierce my
wrist here, this scar, and which was caught in a shaft that went into
my wrist in a car accident, and I pierced-I broke the blood of the
piercing, which I feel was an abomination to the cross I carry for
Christ.
5
THE COURT: So are you saying that you already had these
scars before you went into prison?
[THE WITNESS]: No, not the scars.
THE COURT: Did anything happen In the pnson that
caused scars on your wrist?
[THE WITNESS]: Yes.
THE COURT: What happened?
[THE WITNESS]: I came to the rationalization that disobeying
my mother to begin with was the cause of-was the cause of the
mutated scarring on my wrist, and holding me in contemptuousness of
my cross, which is-which was breaking the blood of my piercing,
which has a profound definition by itself, but if the Court will honor
my word, I thought this was held in contempt, and I threw the spoon
up against the wall out of anger, and it shattered, and then I was
compelled to take the sharp edge of the spoon and break the blood of
the actual lancing, as to put to moot the contemptuousness which was
precluded by the actual disobedience of my mother, which was a
dishonor to her, which is a violation of the Lord. I don't know which
commandment exactly it is . . . ?6
At the conclusion of the hearing, the court expressed its sympathy for Defendant's
condition,27 but felt that it "ha[d] no choice but to enter [the following] order:"
AND NOW, this 14th day of July, 2005, upon consideration of
the Petition for Appeal from Involuntary Commitment in the matter of
John Hoffstetter at No. 05-3528 Civil Term, and following a de novo
hearing held on this date at which the Petitioner, John Hoffstetter, was
represented by his court-appointed counsel, Michael M. Jerominski,
Esquire, and the Court finding that the Petitioner is severely mentally
disabled, by reason of paranoid schizophrenia, and in need of
treatment, John Hoffstetter is hereby subjected to involuntary at a
secure state mental health institution such as Mayview State Hospital
for a period not to exceed 90 days. . . ?8
26 NT. 27-29.
27 NT. 31.
28 Order of Court, July 14,2005.
6
In entering the order, the court found itself in agreement with the testimony of Dr.
N oori that "being in prison is not the best place for [Mr. Hofstetter]. He needs
h. . ,,29
psyc IatrIc treatment.
DISCUSSION
"Under the Mental Health Procedures Act, '[i]nvoluntary treatment [for mental
illness] . . . funded in whole or in part by public moneys shall be available at [certain
specified types of treatment facilities]. ",30
Any person, including a criminal defendant, who is mentally ill to
a degree describable as severely mentally disabled and who is in need
of treatment may be subjected to involuntary examination and
treatment at such a facility.31
Involuntary commitment for a period generally not more than ninety days
is available upon petition to the court for a person severely mentally
disabled and in need of treatment. Such a commitment is subject to
the following conditions precedent: (a) a determination that the
petition sets forth reasonable cause to believe that the person is
severely mentally disabled and in need of treatment, (b) appointment
of an attorney for the subject in the case of indigency, (c) three-day
notice to the subject of a hearing on the petition, (d) availability of
expert assistance to the subject, (e) availability of psychiatric
examination to the subject, (f) a hearing conducted by a judge or
mental health review officer, at which the subject may remain silent,
may cross-examine witnesses, and may present evidence and at which
the rules of evidence applicable to other proceedings which may result
in extended deprivation of liberty apply, (g) a finding, upon clear and
convincing evidence, within forty-eight hours of the close of
evidence, that the subject is severely mentally disabled and in need of
treatment, and (h) an order by the judge directing treatment. 32
A person is severely mentally disabled when, "as a result of mental illness, his
capacity to exercise self-control, judgment and discretion in the conduct of his affairs and
29 NT. 15.
30 Oler, Pennsylvania Criminal Law: Defendant's Mental State ~4.4, at 57 (1986) (footnote omitted).
31 Id., at 58-60 (footnotes omitted).
32 Id., at 62-65 (footnotes omitted).
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social relations or to care for his own personal needs is so lessened that he poses a clear
and present danger of harm to others or to himself." Act of July 9, 1976, P.L. 817,
s301(a), 50 P.S. s7301(a).
With respect to the requirement of a clear and present danger:
The existence of a clear and present danger of harm to others or
oneself is generally dependent upon the occurrence within the
immediately previous 30 days of certain acts by the subject: the
infliction or attempted infliction of serious bodily harm upon another,
conduct evidencing self-neglect reasonably likely to have serious
consequences within 30 days, attempted suicide and the reasonable
likelihood of repetition, or attempted or actual self-mutilation of a
substantial nature and the reasonable likelihood of repetition. Act of
July 9,1976, P.L. 817, S301(b), as amended, 50 P.S. S7301(b); see 55
Pa. Admin. Code S5100.85 (regulations specifying factors to be
considered in applying statutory standards regarding severe mental
disability). 33
In the present case, the following factors militated in favor of a finding, on the
basis of clear and convincing evidence, that Mr. Hoffstetter was mentally ill to the extent
that he was severely mentally disabled and in need of treatment: (1) Mr. Hoffstetter's
behavior within the thirty-day period prior to the filing of the mental health commitment
petition and hearing by the court, which included acts of self-mutilation, assault upon
another inmate, spitting upon other inmates, auditory hallucinations, and imitation of a
chicken during the night; (2) Mr. Hoffstetter's diagnosis by an examining psychiatrist of
mental illness in the form of paranoid schizophrenia, (3) the psychiatrist's opinion,
premised upon the statutory definition of severe mental disability, including the element
of clear and present danger, that Mr. Hoffstetter was severely mentally disabled and in
need of treatment, and (4) the disordered thought processes indicated by Mr. Hoffstetter's
testimony. As a result of this evidence, the court entered the order subjecting Mr.
Hoffstetter to involuntary treatment, from which he has appealed.
33 Id., at 59 n.33.
8
Robert L. O'Brien, Esq.
19 West South Street
Carlisle, P A 17013
Attorney for County Mental
Health/Mental Retardation Agency
Michael M. Jerominski, Esq.
28 South Pitt Street
Carlisle, P A 17013
Attorney for John Hoffstetter
BY THE COURT,
1. Wesley Oler, Jr., 1.
9