California Court of Appeal Oct 21, 2020 No. E073834Unpublished
Filed 10/21/20 P. v. J.T. CA4/2
NOT TO BE PUBLISHED IN OFFICIAL REPORTS California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.
IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
FOURTH APPELLATE DISTRICT
DIVISION TWO
THE PEOPLE,
Plaintiff and Respondent, E073834
v. (Super.Ct.No. RIF1203670)
J.T., OPINION
Defendant and Appellant.
APPEAL from the Superior Court of Riverside County. Jeffrey Prevost, Judge.
Affirmed.
Barbara A. Smith, under appointment by the Court of Appeal, for Defendant and
Appellant.
Xavier Becerra, Attorney General, Lance E. Winters, Chief Assistant Attorney
General, Julie L. Garland, Assistant Attorney General, Michael Pulos, Seth M. Friedman
and Britton B. Lacy, Deputy Attorneys General, for Plaintiff and Respondent.
Defendant and appellant J.T. appeals from the August 1, 2019 order extending his
commitment as a mentally disordered offender (MDO) pursuant to Penal Code section 1
2970. He contends the evidence was insufficient as a matter of law to sustain the
B. Trial Testimony Related to Defendant’s Mental Health Condition
Alejandro Perez
Psychiatrist Alejandro Perez treated defendant at Atascadero from November 2018
through January 2019. He diagnosed defendant with schizophrenia, antisocial personality
disorder, and substance abuse disorders. His primary diagnosis was schizophrenia, which
is a brain disease that cannot be cured, but can be managed by medication. Its symptoms
include delusional thoughts, hallucinations, paranoid ideation, and disorganized speaking
and behaviors.
4
When defendant arrived at Atascadero in November 2018, he was taking the
antipsychotic medication Geodon to treat his schizophrenia. Perez increased the dose
defendant was taking from 40 milligrams a day to 80 milligrams a day. Then in January
2019, he increased the dose to 120 milligrams a day. Despite the increases, defendant
continued to have a persistent systematized delusional belief system that signified that he
was not in remission.
Perez spoke with defendant about his prior convictions. With regard to the 2012
assault of L.J., defendant told Perez he was protecting himself from witches who were
after him. He said the witches were trying to have sex with him and cut up his body so
they could extract his inner light, which was a special power that allowed defendant to
control fire and create explosions. Defendant also told Perez that while he was housed in
the California Department of Corrections and Rehabilitation (CDCR) inmates tried to kill
him to remove his inner light. He responded violently to protect himself. In both
situations, defendant felt he was in genuine danger and that he had responded
appropriately.
Defendant also told Perez about a program in Riverside that was trying to locate
him to liquify his limbs, and that there have been many women throughout his life who
have tried to have sex with him to remove parts of his body. Defendant also said he had
seen demons. He described hearing voices and seeing cat eyes stare at him, although he
said the last time he experienced the hallucinations was several years earlier when he had
5
used methamphetamine. Defendant did not believe he had a mental illness. He attributed
the hallucinations to his prior methamphetamine use.
Defendant did not engage in any violent behavior while under Perez’s care. The
only incident that occurred was in December 2018 when hospital staff found a modified
pen in defendant’s room. Staff was concerned about the possibility that defendant could
use the pen as a stabbing device. Defendant was counseled about it, and no further issues
were noted.
Perez assessed defendant at a low-to-moderate risk for violence when he was in a
controlled setting like Atascadero and taking his medication, although he believed
defendant’s risk for violence would be elevated in the community, particularly if he were
not taking his medication. Perez did not believe defendant would continue taking his
medication if released because defendant did not believe he had a mental illness. Perez
explained that if defendant were to stop taking his medication, it would increase his
psychotic symptoms, which in turn would increase defendant’s risk of physical harm to
others. Perez believed it was possible that defendant would react violently if he felt
unsafe because he had a history of doing so, and a pattern of past violence is the greatest
predictor of future violence.
Valerie Davis
Psychiatrist Valerie Davis treated defendant at Atascadero for roughly six weeks
in January and February 2019. She also diagnosed defendant with schizophrenia.
6
Davis described defendant’s progress as having plateaued. Defendant was taking
a 120-milligram dose of Geodon while under Davis’s care, but even at that medication
level, he continued to maintain a delusional belief system and experience mild
hallucinations. As examples of this, Davis reported that in February 2019, defendant told
a nurse practitioner that he sees demons. He also told Davis that witches exist, and he
told Perez that it was witches in the CDCR who tried to take away his inner light in the
2014 incident. Davis explained that defendant did not understand the delusions and
hallucinations he experienced were symptoms of his illness. He did not believe he had
schizophrenia and did not understand the warning signs or triggers of his illness, nor did
he understand that he needed medication. He took his medication voluntarily, but
reluctantly. He asked Davis multiple times to reduce the dose because he did not believe
he needed such a high dose.
Defendant was not in remission when Davis treated him because he was mildly
symptomatic on the dose of medication he was taking, and he was not willing to increase
the dose enough to make his symptoms go away. Davis did not believe defendant would
continue taking medication on his own if released. She also believed that if he stopped
taking his medication his symptoms would return; he would become more paranoid and
would begin hallucinating more frequently and more vividly.
Even though defendant did not engage in any violent behavior while under her
care, Davis believed defendant presented a danger to the community because he
7
continued to believe that there were people in the community who were out to get him
and witches who wanted to harm him.
Prakash Kamalnath
Psychiatrist Prakash Kamalnath treated defendant while he was housed in the
Riverside County Jail pending the instant trial. He met with defendant twice, once in
March and once in April 2019. He scheduled four additional appointments with
defendant in June and July 2019, but defendant did not attend them.
Kamalnath diagnosed defendant with schizophrenia. He described defendant as
symptomatic but stable. Defendant was not experiencing any overt psychotic symptoms
while under Kamalnath’s care, but he continued to maintain an internal paranoid
delusional thought process. For example, he continued to believe that he acted
appropriately when he hit L.J. with the pipe because he believed she was a witch and he
needed to protect himself. As for the incident in the CDCR, defendant told Kamalnath
that other inmates had challenged him to bite F.G.’s nose off.
Kamalnath reduced the dosage of defendant’s medication from 120 milligrams per
day to 80 milligrams per day. He did this at defendant’s request and in an effort to get
defendant to continue taking his medication. Kamalnath believed defendant had a
superficial understanding of his mental illness and the need for medication, but he was
not sure if defendant would continue taking his medication if released. Kamalnath was
not willing to predict what would happen if defendant stopped taking his medication, but
he explained that a person’s functioning level decreases if they are not on the correct
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medication, and the danger is that a person who has been violent in the past could be
violent again.
B.F.
Inmate B.F. was housed near defendant in the Riverside County Jail for four
months in 2019. During that time, B.F. saw defendant pacing back and forth and talking
to himself. On one occasion defendant told B.F. he wanted to bite a deputy’s face off.
B.F. was concerned by the comment and told a sergeant about it. This was not the first
time B.F. had seen defendant talking to himself. On another occasion, defendant told
B.F. that evil demons spoke to him. He referred to the demons as “the jug.” Defendant
would look at the wall or ceiling and say things like, “the jug is here” or “the jug is with
me right now.”
Angie Shenouda
MDO evaluator and forensic psychologist Angie Shenouda reviewed defendant’s
medical and legal records and interviewed him in November 2018. She agreed with the
other doctors that defendant had schizophrenia.
She concluded defendant’s schizophrenia was not in remission because he was
currently symptomatic. Jail records as recent as March and May 2019 described
defendant talking to himself and expressing delusional beliefs. Defendant also expressed
delusional beliefs in his interview with Shenouda. He told Shenouda about witches and
people who were out to get him. He said he was afraid of being paroled into Riverside
County because he believed the parole office would send people to eat him. He also
9
believed the justice system was programming him, which meant they were going to kill
him. Some of defendant’s thoughts were hard for Shenouda to follow. He talked about
the FBI and a database that creates people by inserting something into their stomach and
linking them to a computer. He also talked about someone putting a bar code on his
chest, people chanting over his body, and about steaks having been made from his body
that were valued at one million dollars. Defendant also discussed his 2006 conviction
with Shenouda. He said he was carrying a loaded gun in public because voices had told
him to get a gun and protect himself from people who were out to harm him.
Shenouda believed defendant was at a higher risk of engaging in physical violence
while he was symptomatic because he had a well-founded history of doing so. All three
of his prior convictions—the 2006 possession of a firearm, the 2012 assault of L.J. and
the 2014 assault of F.G.—were committed while defendant was symptomatic. Defendant
had also engaged in threatening behavior while apparently symptomatic. In 2017,
defendant threatened a deputy at the Madera County Jail, and after he calmed down, he
was seen pretending to eat an imaginary food item. Then in 2019, while apparently
experiencing psychiatric instability, defendant expressed the desire to bite a deputy’s
face. Shenouda acknowledged on cross-examination that she had not reviewed
defendant’s prison records but had assumed defendant was not taking medication in 2014
when he assaulted F.G. based on her review of other data.
Defendant had poor insight into his mental illness because he did not believe he
suffered from any psychiatric symptoms unless he was abusing methamphetamine.
10
Shenouda explained that a patient’s insight into their mental illness is important because
a person will not take medication for an illness they do not believe they have, and
medication is the primary mode of treatment for schizophrenia. Shenouda did not believe
defendant would take his medication if unconditionally released because he told her he
would not take medication unless he was released into the conditional release program.
He had also refused to take his medication once in April 2019, and an incident report
from January 2017 indicated Madera County jail staff found several unused medications
in defendant’s cell. On cross examination Shenouda acknowledged the incident report
did not indicate whether the unused medication found in defendant’s cell was
psychotropic medication.
Shenouda concluded that defendant represented a substantial risk of physical harm
to others due to his schizophrenia because he had a history of engaging in violence when
symptomatic, and he was currently symptomatic, which elevated his risk for future
violence. He also lacked insight into his mental illness and the need for treatment, and
without treatment his symptoms would be exacerbated that would elevate his risk for
becoming violent in the community. II.
DISCUSSION
“The Mentally Disordered Offender Act (MDO Act), enacted in 1985, requires
that offenders who have been convicted of violent crimes related to their mental
disorders, and who continue to pose a danger to society, receive mental health treatment
during and after the termination of their parole until their mental disorder can be kept in 11
remission. (Pen. Code, § 2960, et seq.)” (In re Qawi (2004) 32 Cal.4th 1, 9.)
“Commitment as an MDO is not indefinite; instead, ‘[a]n MDO is committed for . . . one-
year period[s] and thereafter has the right to be released unless the People prove beyond a
reasonable doubt that he or she should be recommitted for another year.’ [Citation.]”
(Lopez v. Superior Court (2010) 50 Cal.4th 1055, 1063, disapproved on other grounds in
People v. Harrison (2013) 57 Cal.4th 1211, 1230, fn. 2.)
A. The Appeal is Not Moot
Respondent contends the present appeal is moot because while the appeal was
pending the parties entered into a stipulation to continue defendant’s commitment as an
MDO for another year, and as a result, there can be no practical effect from this court
reviewing the August 1, 2019 commitment order.
“A case becomes moot when a court ruling can have no practical effect or cannot
provide the parties with effective relief.” (People v. Dunely (2016) 247 Cal.App.4th
1438, 1445.) Generally, an appeal from an MDO commitment order becomes moot if it
has not been decided by the time the commitment period expires. (People v. Merfield
(2007) 147 Cal.App.4th 1071, 1074.) However, if the defendant raises an issue that
could affect the trial court’s jurisdiction over subsequent recommitment proceedings, the
appeal cannot be considered moot. For example, in People v. J.S. (2014) 229
Cal.App.4th 163, 171, we held that “at least where the People seek to continue an
offender’s involuntary treatment beyond the initial one-year term, an offender’s challenge
to the validity of the initial determination that he or she qualifies as an MDO could have
significant practical effects, and cannot be considered moot.” Our rationale was based on
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the premise that, “if an offender’s initial commitment is improper, any extended
commitment would also be improper.” (Ibid.)
People v. Fernandez (1999) 70 Cal.App.4th 117, came to a similar conclusion in
an appeal from a recommitment order. In Fernandez, the defendant challenged the
court’s recommitment order because the prosecution failed to comply with statutory time
limits in filing the petition and bringing the case to trial. (Id. at pp. 126-127.) While the
appeal was pending, the defendant’s commitment term expired, and the trial court
extended the commitment for another year. (Id. at p. 134.) The Fernandez court
concluded the appeal was not moot because their decision had the potential to “affect the
lower court’s right to continue jurisdiction under the original commitment as well as the
recommitment.” (Id. at pp. 134-135; accord People v. Mord (1988) 197 Cal.App.3d
1090, 1115.)
In the present appeal, defendant challenges the sufficiency of the evidence. The
remedy for a successful insufficiency of the evidence claim in an MDO proceeding is
reversal of the commitment order. (See, e.g., People v. Bendovid (2018) 30 Cal.App.5th
585, 594-595.) Accordingly, defendant’s appeal is not moot because his claim, if
successful, could affect the trial court’s jurisdiction over subsequent recommitment
proceedings. (See also People v. Hernandez (2011) 201 Cal.App.4th 483, 487, fn. 3
[MDO appeal is not moot when parties stipulate to a recommitment while the appeal is
pending because the stipulation may have been predicated on the pendency of the
appeal].) We therefore proceed to the merits of defendant’s contention.
13
B. There Was Sufficient Evidence to Sustain the Petition
Defendant contends the August 1, 2019 recommitment order must be set aside
because the evidence was insufficient to establish that he poses a substantial risk of
physical harm to others. We disagree.
“In considering the sufficiency of the evidence to support MDO findings, an
appellate court must determine whether, on the whole record, a rational trier of fact could
have found that defendant is an MDO beyond a reasonable doubt, considering all the
evidence in the light which is most favorable to the People, and drawing all inferences the
trier could reasonably have made to support the finding. [Citation.] ‘ “ ‘Although we
must ensure the evidence is reasonable, credible, and of solid value, nonetheless it is the
exclusive province of the trial judge or jury to determine the credibility of a witness and
the truth or falsity of the facts on which that determination depends. [Citation.] Thus, if
the [finding] is supported by substantial evidence, we must accord due deference to the
trier of fact and not substitute our evaluation of a witness's credibility for that of the fact
finder. . . .’ [Citation]” ’ ” (People v. Clark (2000) 82 Cal.App.4th 1072, 1082-1083.)
To obtain an order extending the defendant’s commitment as an MDO, the People
must prove that: (1) the defendant continues to have a severe mental health disorder;
(2) the defendant’s severe mental health disorder is not in remission or cannot be kept in
remission without treatment; and (3) because of his or her severe mental health disorder,
the defendant continues to represent a substantial danger of physical harm to others.
(§ 2972, subd. (c); People v. Beeson (2002) 99 Cal.App.4th 1393, 1398-1399.) The
People may present evidence of the defendant’s prior violent offenses and mental health
14
history to satisfy these elements (People v. Pace (1994) 27 Cal.App.4th 795, 799), but the
focus of a recommitment proceeding is on the defendant’s current condition and whether
his or her current condition justifies an extension of the commitment (People v. Cobb
(2010) 48 Cal.4th 243, 252).
The first element is not in dispute. All four of the doctors diagnosed defendant
with schizophrenia, which qualifies as a severe mental health disorder. (Pen. Code,
§ 2962, subd. (a)(2).)
The second element—lack of remission—can be proven in one of two ways, either
by proof that the defendant’s severe mental health disorder is not in remission, or that it
cannot be kept in remission without treatment. (Pen. Code, § 2972, subd. (c).)
Remission, for purposes of an MDO proceeding, is defined as “a finding that the overt
signs and symptoms of the severe mental health disorder are controlled either by
psychotropic medication or psychosocial support.” (Pen. Code, 2962, subd. (a)(3).)
Doctors Perez, Davis and Shenouda all testified that defendant was not in remission.
Kamalnath did not directly give an opinion on whether defendant was in remission, but
like the others, he testified that defendant was still experiencing a delusional thought
process despite the medication. This was sufficient evidence for the jury to conclude
defendant was not in remission. We therefore need not address defendant’s argument
that the evidence did not show any recent instances of violence, threats, property damage,
or noncompliance with treatment plans, as those are factors for assessing whether a
defendant’s mental health disorder can be kept in remission without treatment. (Pen.
Code, § 2962, subd. (a)(3).)
15
As for the third element—substantial danger of physical harm—the evidence
showed that defendant had a history of engaging in violent and threatening behavior
while symptomatic and of responding violently when he feels threatened by people who
he perceives to be witches. In 2006, defendant openly carried a .357 rifle on a public
street because voices told him to get a gun and protect himself from people who were out
to harm him. In 2012, he hit L.J. with a pipe because he believed she was a witch and he
needed to protect himself. In 2014, he bit the tip off of F.G.’s nose because he believed
inmates in the prison, who he had described as witches, were trying to take away his
inner light and he needed to protect himself. In 2017, he threatened custodial staff at the
Madera County Jail and after he calmed down, was observed to be eating an imaginary
food item. And in 2019, he told an inmate at the Riverside County Jail that demons, who
he referred to as “the jug,” spoke to him and that he wanted to bite a deputy’s face off.
The evidence also showed that despite the increases in medication and treatment
defendant received over the past year, he continues to maintain delusional beliefs,
including that witches exist, and he has not gained the insight to understand that his
delusional beliefs are a symptom of an illness that needs to be treated with medication.
Doctors Perez, Davis and Shenouda all testified that they did not believe defendant would
continue taking his medication if released and that his psychotic symptoms would
increase if he were to discontinue his medication. Perez and Shenouda further testified
that given defendant’s history of engaging in violence while symptomatic, this would
increase the risk of physical harm he presented to others. Davis believed defendant
presented a danger to the community by virtue of his continued delusional belief that
16
there were witches and people in the community who want to harm him. Finally, Perez
testified that a pattern of past violence is the greatest predictor of future violence, and
Kamalnath testified that there was a danger that a person who had been violent in the past
could be violent again. This was sufficient evidence for the jury to conclude defendant
presented a substantial danger of physical harm to others due to his severe mental
disorder.
Defendant contends the evidence did not show that he presented a substantial
danger of physical harm to others because he has not engaged in any violence related to
his mental illness in the past year. However, the law does not require a recent overt act of
violence to satisfy this element. “ ‘The dangerous[ness] finding requires only an
assessment of future dangerousness. It does not require proof of a recent overt act.”
(People v. McKee (2010) 47 Cal.4th 1172, 1203; accord, In re Qawi, supra, 32 Cal.4th at
p. 24; see Pen. Code, § 2962, subd. (g) [“As used in this chapter, ‘substantial danger of
physical harm’ does not require proof of a recent overt act.”].) Defendant’s argument
that under In re Qawi, supra, 32 Cal.4th at p. 24, the substantial danger element requires
a finding of recent dangerousness is based on a misreading of the case. In Qawi, the
court addressed both the MDO Act and the Lanterman-Petris-Short (LPS) Act. The court
was referring to the LPS Act (specifically Welfare and Institutions Code section 5300)
when it discussed the requirement of a finding of recent dangerousness, not the MDO
Act. (In re Qawi, supra, 32 Cal. 4th at p. 24.)
Finally, we reject defendant’s arguments that the medical experts speculated about
defendant’s dangerousness based on remote past events rather than making a reasonable
17
inference as to his current potential for violence, and that Shenouda’s opinion was based
on misrepresentations of fact and a great deal of conjecture. In MDO proceedings,
mental health professionals are entitled to give their opinion on the defendant’s future
dangerousness. (In re Qawi, supra, 32 Cal.4th at p. 24.) In doing so, they may take into
account the defendant’s prior violent offenses and his mental health history. (People v.
Pace, supra, 27 Cal.App.4th at p. 799.) The trier of fact then gets to decide what weight
to give the opinion. (People v. Ward (1999) 71 Cal.App.4th 368, 374.) Here, the
doctors’ opinions were not based on speculation. They were based on an assessment of
defendant’s prior violent offenses and mental health history. The jury was free to accept
or reject the opinions given. We do not reassess the credibility of experts or reweigh the
relative strength of their conclusions. (People v. Poe (1999) 74 Cal.App.4th 826, 830.)
As for Shenouda’s testimony, the jury was well aware that the defense contested
her opinion and disputed the facts on which she relied. On cross examination and in
closing argument, defense counsel challenged many of the misrepresentations that were
identified in defendant’s briefing. But Shenouda was only one of four mental health
professionals to testify and even if the jury disregarded her opinion there was still
sufficient evidence in the record to sustain the petition. Doctors Perez, Davis and
Kamalnath all testified that defendant had schizophrenia, that he was still actively
delusional despite taking medication, and that given his assaults on L.J. and F.G, he had a
history of engaging in violent behavior while symptomatic. Additionally, Perez and
Davis did not believe defendant would take his medication if released. Perez believed
this would increase the risk of physical harm defendant presented to others and Davis
18
believed defendant presented a danger to the community by virtue of his continued belief
that there were witches and people in the community who want to harm him.
In sum, substantial evidence supports the jury’s conclusion that defendant’s
schizophrenia, which is not in remission, renders defendant a substantial danger to others.
We therefore affirm the judgment.
III.
DISPOSITION
The trial court’s order filed August 1, 2019, extending defendant’s commitment to
March 14, 2020, is affirmed.
NOT TO BE PUBLISHED IN OFFICIAL REPORTS
RAMIREZ P. J.
We concur:
McKINSTER J.
SLOUGH J.
19
AI Brief
AI-generated · verify before citing
Holding. The court held that there was sufficient evidence to support the extension of the defendant's commitment as a mentally disordered offender (MDO) because he continued to suffer from a severe mental disorder that was not in remission and posed a substantial danger of physical harm to others.
Issues
Whether the appeal of the MDO commitment order is moot due to a subsequent stipulated extension.
Whether there was sufficient evidence to support the finding that the defendant poses a substantial danger of physical harm to others.
Disposition. Affirmed.
Quotations verified verbatim against the opinion
“The dangerous[ness] finding requires only an assessment of future dangerousness. It does not require proof of a recent overt act.”
“a pattern of past violence is the greatest predictor of future violence”