People ex rel. Cal. Dep't of State Hosps. v. S.M.
People ex rel. Cal. Dep't of State Hosps. v. S.M.
Opinion of the Court
*456In 2014 S.M was adjudicated a Mentally Disordered Offender (MDO) and committed for treatment to the Department of State Hospitals (the Department). (See Pen. Code, § 2960 et seq. )
The involuntary medication order is due to expire on July 20, 2019. It is a renewal of a prior order that expired in 2018. In an unpublished opinion, we affirmed the prior order. ( People v. S.M.,
Appellant contends that (1) the Department lacked standing to petition to renew the involuntary medication order; (2) he was denied his statutory right to represent himself; (3) because of a discovery violation, the expert testimony of appellant's current treating psychiatrist should have been excluded; and (4) the trial court abused its discretion in admitting the opinion of a non-testifying psychiatrist. We affirm.
Facts
Two psychiatrists testified for the Department: Drs. Joshua Deane and Jonathan Funk. Dr. Deane is appellant's current treating psychiatrist. He concluded that appellant suffers from schizophrenia characterized by paranoia, delusions, and disorganization. Dr. Deane opined that appellant "cannot even appreciate the fact that he is a very impaired individual.... And he certainly does not see the impact of his mental illness o[n] his life ... [and] he is not able to appreciate the ... benefit of medication." When asked if appellant had "the capacity to make decisions regarding administration of antipsychotic medication," Dr. Deane replied: "No, he does not. He is too disorganized, illogical and cannot have a ... basic understanding of the fact that he has a mental illness .... Given the fact that he does not even think that he has [a] mental illness, he certainly does not see a need for medication treatment ...." Dr. Deane continued: "[H]e suffers from schizophrenia. And the very nature of this illness dictates that he needs medication treatment, and in addition ... he has been a violent individual. So for that reason he needs to be medicated."
Dr. Funk was appellant's treating psychiatrist for about nine months in 2017-2018. Dr. Funk testified: Appellant has schizophrenia, characterized by "delusions and thought disorder." He has "a history *457of refusing medications." "[H]e does not believe that he has a mental illness." He is not "able to understand and rationally evaluate and participate in the treatment decision." "[H]is appreciation of facts is impaired by his mental illness." There are "numerous episodes where [appellant] asserts things that reality testing demonstrates are a product of his mental illness." Examples of his delusional thinking are that "he had achieved ... advanced degrees from Pepperdine University at age four, and that he had been kidnapped and rescued at age 13." He lacks "the capacity to make decisions regarding administration of antipsychotic medication." He will not take his medication "without an involuntary medication order."
Appellant testified that he was not mentally ill and did not have delusions. He was being involuntarily medicated "as a punishment to make you sluggish and want to sleep all the time."
Daniel Summersdrager, a registered nurse at Atascadero State Hospital, was called as a witness on appellant's behalf. He provided no relevant evidence as to appellant's capacity to refuse treatment with antipsychotic drugs.
Standing
Appellant contends that the Department lacked "standing to file and prosecute the petition" to renew the prior order authorizing it to involuntarily administer antipsychotic medication. (Capitalization and bold omitted.) Appellant claims that the petition should have been filed by the District Attorney: "The MDO law does not permit [the Department] to circumvent the process of referring a recommendation for treatment issues to the district attorney, and to jump in the saddle and file a petition with its own team of lawyers ...."
Appellant argues that the District Attorney is the proper person to file and litigate the petition because "[t]he District Attorney is specified as the attorney who litigates MDO commitments and recommitments ( Pen. Code, §§ 2966, subd. (b) ; 2970, subd. (b)[; 2972, subd. (b) ] ) ...." But the order appealed from does not involve appellant's commitment or recommitment as an MDO. It involves his medical treatment during his commitment or recommitment. The Legislature intended that the Department be responsible for such treatment. Section 2972, subdivision (f) provides: "Any commitment under this article places an affirmative obligation on the treatment facility to provide treatment for the underlying causes of the person's mental disorder."
Since the Department is vested with responsibility for appellant's treatment, it has standing to petition for an order authorizing it to involuntarily medicate appellant as part of his treatment. "The purpose of a standing requirement is to ensure that the courts will decide only actual controversies between parties with a sufficient interest in the subject matter of the dispute to press their case with vigor. [Citations.]" ( Common Cause v. Board of Supervisors (1989)
Right to Self-representation
Appellant argues that the trial court erroneously denied his motion for self-representation. Appellant said: "I
*458would like to represent myself. I imagine I will have the same problem with new counsel. They would be unwilling to call witnesses I require." His appointed counsel declared, "He mentioned one witness at the hospital.... I didn't think it was worth subpoenaing him. I didn't think he was helpful."
At the hearing on the motion for self-representation, appellant denied that he was suffering from a mental illness. However, he appeared to be delusional. He told the court that in October 1979 he "and the LAPD SWAT team" killed "three kidnappers," the event "was reported to the country by Walter Cronkite on the Saturday Evening News," and "President Carter called [him] the next day and talked about the kidnapping." At the time of the alleged kidnapping, appellant was 13 years old.
In denying appellant's motion for self-representation, the trial court explained, "I do believe that you suffer from delusions, and I believe those and your mental illness will impair you from representing yourself." On the other hand, the court found appellant to be "a very intelligent person" with "some understanding of the law." The court further found that appellant understood "what's being charged, what this petition means and what the effects of that petition would be."
After denying the motion for self-representation, the trial court granted appellant's Marsden motion and appointed new counsel (Jean Matulis) to represent him. ( People v. Marsden (1970)
"[B]ecause MDO proceedings are not punitive in nature they are considered civil proceedings, and therefore there is no constitutional right to self-representation. However, as the MDO commitment statutes give defendants the right to appointed counsel, a defendant also could refuse counsel and represent him- or herself. The right only being statutory, any denial of a request to represent oneself is governed by due process principles and the decision is reviewed for an abuse of discretion." ( People v. Williams (2003)
The Department concedes that "appellant has a statutory right to counsel, and thus a statutory right to self-representation." The Department asserts, "This Court should review the trial court's denial of appellant's self-representation motion for abuse of discretion and apply the Watson harmless error standard of review." ( People v. Watson (1956)
In People v. Johnson (2012)
We need not decide whether the trial court abused its discretion in denying appellant's motion to represent himself. If the court had abused its discretion, it is not reasonably probable that appellant would have received a better result had he been allowed to represent himself. Appellant told the court that he wanted to represent himself because his appointed counsel was "unwilling to call witnesses I require." During the Marsden hearing after the trial court had denied his motion for self-representation, appellant said that he wanted to call two witnesses - Dr. Funk and Daniel Summersdrager. Both witnesses testified at the hearing on the Department's petition. Appellant does not claim that counsel's performance was deficient. Nor does he claim that he would have provided different or additional evidence or advanced a new theory had he been permitted to represent himself. No mental health professional disputed the opinions of Drs. Deane and Funk that, because of his mental illness, appellant lacked the capacity to refuse medical treatment with antipsychotic drugs. Appellant "presented no evidence, other than his own self-serving denial that he suffered from a mental illness, to counter these opinions." ( Williams , supra , 110 Cal.App.4th at p. 1593,
Appellant asserts that "the erroneous denial of [his] request to represent himself is a structural error, requiring reversal." He relies on People v. Blackburn (2015)
Blackburn is distinguishable. Appellant was not deprived of his statutory right to a jury trial in an MDO commitment proceeding. He had already been lawfully committed. He allegedly was deprived of his statutory right to represent himself in a proceeding to determine whether, during his commitment, the Department could involuntarily medicate him with antipsychotic drugs. The deprivation of this right does not necessarily defy " 'analysis by "harmless-error" standards.' " ( Blackburn , supra , 61 Cal.4th at p. 1135,
Alleged Discovery Violation
Dr. Deane is appellant's current treating psychiatrist. Appellant maintains that he was denied his due process right to cross-examine Dr. Deane regarding his testimony as an expert (not as a treating psychiatrist) because the Department had failed to provide discovery of Dr. Deane's notes. Appellant asserts, "Deane's testimony *460as an 'expert' should have been excluded."
" 'Broadly speaking, an appellate court applies the abuse of discretion standard of review to any ruling by a trial court on the admissibility of evidence. [Citations.]' [Citation.] A party challenging a trial court's evidentiary rulings must demonstrate both an abuse of discretion and a consequent miscarriage of justice. [Citation.]" ( Kim v. The True Church Members of Holy Hill Community Church (2015)
Appellant's counsel told the court, "I haven't been given anything in terms of [Dr. Deane's] notes, which I specifically requested.... [I]f [Dr. Deane testifies, his testimony] should be limited to [his] role as percipient witness[ ], because I have not received any discovery that would justify [him] being called as [an] expert[ ]." The Department's counsel responded: "Dr. Deane actually has been a treating psychiatrist for the past two weeks approximately.... He said he has a personal knowledge and he doesn't have to bring anything because he actually sat down with [appellant], and he's going to just testify on those matters." The Department's counsel did not "think" that Dr. Deane had prepared a report "[b]ecause he's recently been assigned as [appellant's treating] psychiatrist."
The trial court offered to grant a continuance of the hearing so that appellant could discover Dr. Deane's notes: "[I]f you want a continuance, I would grant a continuance. I'm not going to limit or prevent [his] testimony today." "I would like to hear his opinion as a psychiatrist and as the treating psychiatrist."
Appellant did not ask for a continuance. Instead, his counsel said, "Okay.... [I]f it appears that [Dr. Deane is] testifying from notes, I'm going to want to see those during the proceeding, ... I'm taking [his] word[ ] if [he is] not going to be using notes ...." The Department's attorney responded, "I have no objection to that, your honor." The court stated: "Okay. If there are relevant notes, we'll take a look at that."
The Department claims that appellant waived his discovery objection because, "[d]espite knowing that [the Department's] expert[ ] would be permitted to offer expert opinion testimony, appellant still elected to proceed rather than to continue the hearing." We agree. A similar situation occurred in Kim , supra ,
Moreover, because appellant did not accept the trial court's offer to grant a continuance, he cannot establish prejudice. In People v. Pinholster (1992)
Admission of Opinion of Non-testifying Psychiatrist
Appellant argues that, during the direct examination of Dr. Deane, the trial court abused its discretion in admitting the opinion of a non-testifying psychiatrist. While answering a question asking him to "elaborate" on appellant's "history of refusing medications," Dr. Deane testified, "I noticed that on January 6th, 2016, ... his treating psychiatrist changed his diagnosis from delusional disorder to schizophrenia. Because she at that time witnessed the disorganization, odd behaviors, which merit[ ] the change of diagnosis." Appellant's counsel objected on the ground that "testifying doctors are not allowed to testify to the opinions of other doctors that are not present." Dr. Deane said that the rationale for the change of diagnosis is in appellant's medical records and is "relevant [to] my daily work with him." The trial court overruled the objection. It reasoned: "This is the kind of information that is relied upon regularly by doctors to assess patients, make their own diagnosis."
In claiming that the trial court erred, appellant relies on the following excerpt from this court's opinion in People v. Campos (1995)
"While the italicized language [in the above excerpt from Campos ] would suggest that no expert could ever refer during direct examination to the contents of another expert's report, ... Campos cannot be read for such a broad prohibition. Campos ... [was] concerned with preventing the introduction of multiple opinions, insulated from cross-examination, into evidence. Since this concern does not arise unless the expert is relying on other expert opinions, the reasoning of [ Campos ] is confined to that situation." ( People v. Bordelon (2008)
The Department contends that Campos is inapplicable because Dr. Deane did not *462indicate that he was relying on the opinion of the prior treating psychiatrist: "Dr. Deane testified as to appellant's behaviors and change in diagnosis in 2016 in the context of appellant's history of refusing medication ...." But Dr. Deane said, "[T]he rationale for [the] ... change of diagnosis is complete[ly] germane, relevant with my daily work with [appellant]." It therefore appears that he was relying on the prior treating psychiatrist's opinion. The trial court understood this to be the case because it said, "This is the kind of information that is relied upon regularly by doctors to assess patients, make their own diagnosis."
Even if the trial court erred in overruling appellant's objection, the reference to the January 6, 2016 change of diagnosis and rationale for the change was "not prejudicial. The[ ] reference[ ] consumed only a small portion of [his] ... testimony. The remainder of [his] ... expert testimony [together with Dr. Funk's testimony] easily supports the [trial court's] determination that appellant [lacked the capacity to refuse medication with antipsychotic drugs]. There was no miscarriage of justice. It is not reasonably probable that a result more favorable to appellant would have been reached in the absence of this evidence. [Citations.]" ( Campos , supra , 32 Cal.App.4th at pp. 308-309,
Disposition
The order that appellant be involuntarily administered antipsychotic medication is affirmed.
We concur:
GILBERT, P. J.
PERREN, J.
Unless otherwise stated, all statutory references are to the Penal Code.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.