Substantial Evidence Required In California LPS Conservatorships

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In Conservatorship Of the Person Of S.A., the California Appeals Court, Second Appellate District, considered an appeal of an order reappointing a conservator under the Lanterman-Petris-Short Act (LPS Act), and whether or not substantial evidence was presented that the conservatee was gravely disabled beyond a reasonable doubt.

The Facts of Conservatorship Of the Person Of S.A.

In September 2019, Y.A. filed for reappointment as LPS conservator for her adult daughter, S.A.  Y.A. asked that the court continue Y.A.’s authority over S.A. in the conservatorship, including her authority to force S.A. to take psychotropic medications.  Y.A. also asked the court to override S.A.’s right to refuse medication.

Two witnesses presented evidence at the trial in the LPS conservatorship: Dr. Arom and S.A.

Dr. Arom is a licensed psychologist.  Dr. Arom testified that S.A.:

  • Had symptoms of schizophrenia
  • Believed her name was something other than S.A.
  • Denied having mental illness
  • Believed her parents were movie stars Michelle Pfeiffer and Michael Keaton
  • Denied her Indian heritage
  • Denied the need to take medication
  • Did not know what month it was

 

Dr. Arom opined that if S.A. was not under a conservatorship, S.A. would have no viable plan to provide for her shelter and maintenance, and that S.A. did not have enough mental capacity to make an informed refusal of medication.

S.A. also testified, and much of S.A.’s testimony confirmed Dr. Arom’s views.  S.A. testified that if not under a conservatorship, she could finish her degree, get a job, and look for her real family (Michelle Pfeiffer and Michael Keaton).

The California court found, based on the evidence presented, beyond a reasonable doubt that S.A. remained gravely disabled and reappointed Y.A. as S.A.’s conservator in the LPS conservatorship.  The court authorized Y.A. to require S.A. to accept psychotropic medications.

What Is an LPS Conservatorship In California?

An LPS conservatorship, also known as a mental health conservatorship, makes one adult (the conservator) responsible for a mentally ill adult (the conservatee).  Under California law, an LPS conservatorship is for adults with mental illnesses, including schizophrenia, bi-polar disorder, clinical depression, and obsessive compulsive disorder.

We have written about LPS Conservatorships before here.

When Can a Court Establish an LPS Conservatorship?

A court may establish or renew a conservatorship under the LPA Act if a person is gravely disabled.  A person is gravely disabled if the person, as a result of a mental health disorder, is unable to provide for her or his basic personal needs for food, clothing, or shelter. See §§ 5350 and 5008.

The petitioner must prove the conservatee is gravely disabled beyond a reasonable doubt, providing substantial evidence to support the LPS Conservatorship under California law.

What Evidence Supports a Finding Of Grave Mental Illness?

Evidence conservatees (1) lack insight about their mental illness, (2) would not take medication without the support of a conservator, and (3) could not provide for themselves without medication is enough to support a court’s finding of grave mental illness to continue or institute an LPS conservatorship under California law. (Walker, supra, 206 Cal.App.3d at p. 1577.)

In determining that there was substantial evidence S.A. was gravely disabled beyond a reasonable doubt, the Court stated:

Arom’s and S.A.’s testimony demonstrated S.A. lacked insight about her mental illness. S.A. did not believe she had schizophrenia and instead thought she had an unrelated medical issue.

S.A. would not take medication without the support of a conservator. S.A. denied needing medication. She did not want it. Everyone agrees she would not take medication without a conservatorship.

S.A. could not provide for herself without a conservatorship and without medication. Substantial evidence supported this finding. Arom testified S.A., if unmedicated, would not be able to make and carry out a viable plan for food, clothing, or shelter.

Evidence showed, for example, S.A. could not provide for shelter without a conservatorship. Based on her meeting with S.A., Arom believed S.A.’s plans for housing were not viable. S.A. had some views about how she might find housing. But, after a bench trial, we review the court’s determinations about witness credibility with extreme deference. (Schmidt v. Superior Court (2020) 44 Cal.App.5th 570, 582.) Here we indeed do defer to the court’s implied finding that Arom was more reliable and more credible than S.A.

S.A. incorrectly claims Arom’s testimony was speculation. Arom’s opinions were based on her observations of S.A., not on speculation. S.A. argues she expressed unwillingness to go to board and care facilities only because Arom falsely told her such facilities always require residents to take medication. This argument slights our duty to make inferences in favor of the judgment. (Walker, supra, 206 Cal.App.3d at p. 1577.) Arom testified S.A. disapproved of living in a board and care facility because those facilities are for people with mental illnesses and S.A. denied having a mental illness. An inference in favor of the judgment is S.A. would not agree to live in such a facility. This evidence supported a finding that S.A. could not provide for her own shelter.

When Can a Court Order Involuntary Medication?

A court may order involuntary medication if clear and convincing evidence shows the conservatee is incompetent to give or withhold informed consent.  A court’s determination that a conservatee is gravely disabled does not, by itself, justify imposing an order allowing involuntary medication.

To determine whether the conservatee is incompetent to give or withhold informed consent, the court may look at whether the conservatee lacks mental capacity rationally to understand the nature of the medical problem, the proposed treatment, and its attendant risks.

Can a Psychologist Testify About Competency?

Yes, a psychologist can testify about competency in an LPS conservatorship.  Here, S.A. argued that Dr. Arom was unqualified to testify about competency, because Dr. Arom was a psychologist and could not prescribe medication.

Dr. Arom’s inability to prescribe medications did not preclude her from rendering an opinion on whether S.A. could understand her mental illness and medication.  Dr. Arom had observed S.A. personally, and therefore her opinions were not mere speculation.

The Court affirmed the decision, finding that substantial evidence existed to support the continuation of the LPS conservatorship.

 

 

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