In the Interest of D.L.D.

Summary

The Pennsylvania Superior Court reviewed the extension of D.L.D.'s involuntary outpatient mental health treatment under the Mental Health Procedures Act. The court held that Centre County failed to present clear and convincing evidence that D.L.D. continued to constitute a clear and present danger of harm to himself or others, and it reversed the order extending treatment.

Holdings

1. An extension under 50 P.S. §§ 7304(a)(2) and 7305(a) requires clear and convincing evidence that the conduct supporting the original commitment occurred and that the patient's condition continues to evidence a clear and present danger to himself or others. For a danger-to-self finding under § 7301(b)(2)(i), the County must prove both that the patient cannot provide for his own nourishment, housing, personal or medical care, or safety without continued assistance and that a reasonable probability exists that death, serious bodily injury, or serious physical debilitation will occur within thirty days without treatment.
2. The MHPA's requirement of a reasonable probability of death, serious bodily injury, or serious physical debilitation requires clear and convincing evidence of a substantial likelihood of the statutory harm; mere speculation or conjecture that harm could conceivably occur is insufficient.
3. The trial court incorrectly relied in part on the criteria for assisted outpatient treatment under 50 P.S. § 7301(c), because Centre County had not implemented assisted outpatient treatment and the proceeding was based on the clear-and-present-danger standard. Remand was unnecessary because the trial court also made the factual findings relevant to § 7301(b), and the sufficiency question was one of law.
4. The expiration of D.L.D.'s 180-day commitment period did not moot the appeal because the issues were capable of repetition yet likely to evade review.

Questions Presented

1. Whether the County presented clear and convincing evidence that D.L.D.'s condition continued to demonstrate that he was a clear and present danger to himself under 50 P.S. § 7301(b)(2)(i), as required to extend involuntary outpatient treatment under §§ 7304(a)(2) and 7305(a).
2. Whether the evidence established a reasonable probability that D.L.D. would suffer death, serious bodily injury, or serious physical debilitation within thirty days if involuntary outpatient treatment were discontinued.
3. Whether the appeal was moot because the challenged 180-day commitment period had expired.

Disposition

reversed