IN THE MATTER OF: MICHAEL CHARLES HAYES, Respondent.
Attorney General Roy Cooper, by Assistant Attorney General
Diane Martin Pomper, for the State.
Karl E. Knudsen, for respondent-appellant.
HUDSON, Judge.
Michael Charles Hayes (“respondent”) appeals from an order of
recommitment. For the reasons given below, we affirm.
In 1988, respondent was indicted on four counts of first
degree murder, five counts of felonious assault with a deadly
weapon, and two counts of assault on a law officer. In 1989, a
jury found him not guilty on all counts by reason of insanity, and
respondent was committed to a state mental health facility.
Since the time of his original commitment, respondent has been
recommitted at each hearing on the matter. Respondent has appealed
several of the recommitment orders, resulting in two published
opinions from this Court. See In re Hayes, 139 N.C. App. 114, 532
S.E.2d 553 (2000); In re Hayes, 111 N.C. App. 384, 432 S.E.2d 862,
appeal dismissed, 335 N.C. 173, 436 S.E.2d 376 (1993). The most
recent hearing occurred on 8 January through 10 January 2001. The
relevant testimony is reviewed below. Following the hearing, thesuperior court ordered that respondent's commitment be extended by
an additional 365 days. Respondent appeals.
By statute, when a defendant has been involuntarily committed
to a mental institution pursuant to N.C. Gen. Stat. § 15A-1321(b)
following an acquittal by reason of insanity, the court is required
to hold a hearing fifteen days before the end of any commitment
period. See N.C. Gen. Stat. § 122C-276.1(a) (1999). At this
hearing,
[t]he respondent shall bear the burden to
prove by a preponderance of the evidence that
he (i) no longer has a mental illness as
defined in G.S. 122C-3(21), or (ii) is no
longer dangerous to others as defined in G.S.
122C-3(11)b. If the court is so satisfied,
then the court shall order the respondent
discharged and released. If the court finds
that the respondent has not met his burden of
proof, then the court shall order inpatient
commitment be continued . . . . The court
shall make a written record of the facts that
support its findings.
N.C. Gen. Stat. § 122C-276.1(c) (1999). “Mental illness” is
defined as “an illness which so lessens the capacity of the
individual to use self-control, judgment, and discretion in the
conduct of his affairs and social relations as to make it necessary
or advisable for him to be under treatment, care, supervision,
guidance, or control.” N.C. Gen. Stat. § 122C-3(21)(i) (1999).
“Dangerous to others”
means that within the relevant past, the
individual has inflicted or attempted to
inflict or threatened to inflict serious
bodily harm on another, or has acted in such a
way as to create a substantial risk of serious
bodily harm to another, or has engaged in
extreme destruction of property; and that
there is a reasonable probability that thisconduct will be repeated. Previous episodes
of dangerousness to others, when applicable,
may be considered when determining reasonable
probability of future dangerous conduct.
Clear, cogent, and convincing evidence that an
individual has committed a homicide in the
relevant past is prima facie evidence of
dangerousness to others.
N.C. Gen. Stat. § 122C-3(11)(b) (1999).
We see no reason to distinguish the standard of review of a
recommitment order from that of a commitment order, and hence, we
review this order as we would a commitment order. Thus, we must
determine whether there is competent evidence to support the trial
court's factual findings and whether these findings support the
court's ultimate conclusion that respondent still has a mental
illness and is dangerous to others. Cf. In re Lowery, 110 N.C.
App. 67, 71, 428 S.E.2d 861, 863 (1993) (standard of review for
commitment order pursuant to N.C.G.S. § 122C-268).
Respondent argues that the following facts found by the trial
court are not supported by “the greater weight of the evidence.”
3. At the time of the killings and felonious
assaults committed by the respondent on
July 17, 1988, the respondent suffered
from an acute psychotic episode which
lasted approximately 3 to 4 months in
duration from the week before the
killings on July 17, 1988, up to and
including the time period in which he was
being treated and observed at Dorothea
Dix Hospital in October 1988. This
psychotic episode evidences either a
schizophreniform disorder, or a psychotic
disorder, NOS (not otherwise specified).
These illnesses are recognized as Axis I
mental disorders by DSM-IV (Diagnostic
and Statistical Manual of the American
Psychiatric Association). Although the
psychotic phase of this illness has
apparently not recurred since hisadmission to Dorothea Dix Hospital in
1989, it is unclear whether this
particular mental disorder will recur in
the future should the respondent be
released from his current controlled
environment at Dorothea Dix Hospital.
The respondent is currently given a
diagnosis of and meets criteria in the
DSM-IV of:
a. Axis I, History of
schizophreniform disorder; or
history of psychotic disorder,
NOS (not otherwise specified),
and Rule out History of
Substance-induced Psychotic
Disorder with delusions and
hallucinations, with onset
during withdrawal;
b. Axis I, Alcohol Dependence, in
remission, in a controlled
environment; Axis I, Cannabis
dependence, in remission, in a
controlled environment; and,
c. Axis II, Personality Disorder
NOS, with antisocial and
narcissistic traits;
4. The diagnoses set out in items b. and c.
above are mental illnesses which are
currently being treated, have not been
cured, and are likely to continue in the
future;
5. The Axis I and Axis II mental disorders
described in items b. and c. above,
either existed or are related to the
mental conditions that existed at the
time of the commitment of the homicides
by the respondent in 1988, and were
probably causative factors in or related
to the psychotic disorder evident during
those homicides, described in item a.
above; and, taken together and separately
these mental disorders so lessen the
capacity of Michael Hayes to use self-
control, judgment and discretion in the
conduct of his affairs and social
relations as to make it necessary or
advisable for him to be under treatment,care supervision, guidance, or control,
and, thus, they constitute mental
illnesses as defined by G.S. 122C-3(21).
. . . .
7. The four homicides and seven felonious
assaults committed by the respondent on
July 17, 1988, are episodes of
dangerousness to others in the relevant
past which in combination with his past
and present mental condition, his
multiple mental illnesses, and his
conduct since admission to Dorothea Dix
Hospital since 1989, and up to and
including his conduct in the hospital
during the previous year indicates there
is a reasonable probability that the
respondent's seriously violent conduct
will be repeated and that he will be
dangerous to others in the future if
unconditionally released with no
supervision at this time. That there is
a reasonable probability that if the
respondent were released today it is
likely that he may relapse into his
previous pattern of multi-substance
abuse/dependence, and relapse into a
situation repeating his exposure to the
same ordinary life stressors at least as
serious as those which were present in
1988 at the time of the killings. It is
likely that, should these kinds of
relapses occur, the respondent will run
the risk of future violent behavior;
8. The respondent is dangerous to others as
defined by G.S. 122C-3(11)b; he suffers
from multiple mental illnesses as
previously described by the Court; and
that continued hospitalization is
advisable to ensure the safety of others
and to alleviate, treat, or cure his
mental illnesses.
Contrary to the standard articulated by respondent--that we should
review “the greater weight of the evidence”--we are bound to uphold
these findings if there is any competent evidence to support them.
It is for the trial court, not this Court, to determine the weightthat should be given to evidence and, ultimately, “whether the
competent evidence offered in a particular case met the burden of
proof.” In re Collins, 49 N.C. App. 243, 246, 271 S.E.2d 72, 74
(1980); see In re Underwood, 38 N.C. App. 344, 347-48, 247 S.E.2d
778, 780-81 (1978).
Respondent particularly objects to the findings quoted above
insofar as the court determined that respondent currently suffers
from mental illness and presents a danger to others. Having
carefully reviewed the record, we hold that these findings are
supported by competent evidence.
With regard to the question of mental illness, Dr. Jonathan
Weiner, who was qualified as an expert in the field of forensic
psychiatry and was appointed as an expert to assist the court in
determining whether respondent met the criteria for release,
diagnosed respondent as follows:
I gave [respondent] a primary psychiatric
diagnosis on Axis I of alcohol dependence,
sustained full remission in a controlled
environment, and cannabis dependence, which is
marijuana, sustained full remission in a
controlled environment. I gave him the
additional diagnosis of Axis II, history of a
personality disorder not otherwise specified
with antisocial and narcissistic traits, and
on Axis I, history of a schizophrenic form
disorder and also on Axis I, rule out a
history of substance-induced psychotic
disorder with delusions and hallucinations
with onset during withdrawal.
Dr. Jim Bellard, who was qualified as an expert in forensic
psychiatry, testified that he gave respondent a diagnosis under
Axis I of history of psychotic disorder, not otherwise specified.
Dr. Robert S. Brown, Jr., who was qualified as an expert in thefield of forensic psychiatry and was appointed to assist the State
as an expert in reviewing the case, testified that he gave
respondent a diagnosis of personality disorder NOS, Not Otherwise
Specified, with “aspects of antisocial traits and aspects of
narcissistic traits that relate directly to the personality
disorder NOS.” Dr. Brown testified that “without a doubt
[respondent] has ongoing--he has an ongoing mental illness
diagnosis of a personality disorder.” This evidence supports the
trial court's Finding of Fact No. 3, regarding respondent's
diagnoses.
Dr. Weiner testified that “alcohol dependence, sustained full
remission is a mental illness. It meets the statutory requirements
. . . .” Both Dr. Weiner and Dr. Brown testified to the opinion
that respondent is not cured or recovered from alcohol dependence
or cannabis dependence. Dr. Brown testified that “without a doubt
[respondent] has ongoing--he has an ongoing mental illness
diagnosis of a personality disorder.” Dr. Mark Hazelrigg, who is
the program director for the forensic treatment program at Dorothea
Dix Hospital and was qualified as an expert in the field of
forensic psychology, acknowledged that “it's unusual for a person
to be cured of a personality disorder completely.” Dr. Brown
explained the difference between his opinion and that expressed by
those who testified that respondent is no longer mentally ill as
follows:
I think that some of my colleagues may have
forgotten something; and that is, it's
axiomatic, that if a patient has a personality
disorder, that ten years from now, whetherthey're terribly misbehaving or not, as an
axiom, they still have a personality disorder.
It's just less evident. They're just
expressing it less for whatever reason. Maybe
the stress is minimized, maybe they're in a
controlled environment, maybe the--the
external goal of getting out of the mental
hospital is so strong, they're careful what
they say to whom.
Dr. Hazelrigg acknowledged under cross-examination that, in
the year prior to the hearing, respondent had been involved in
several incidents that evinced behavior consistent with a
personality disorder. Edwin Munt, a psychologist who provided
individual therapy to respondent, agreed on cross-examination that
these “behaviors could be personality characteristics that are
reflective of some problems that he had in the past with--in terms
of personality disorders.”
For example, respondent's medical records indicated that he
had been involved in “several instances of power struggles with
Dorothea Dix Hospital police.” Additionally, respondent became
angry when the door to the Alcoholics Anonymous (“AA”) meeting room
was not opened; Dr. Hazelrigg acknowledged that respondent
“indicate[d] anger, hostility” during the incident. On another
occasion, respondent hit a vending machine with his shoulder,
shattering the glass, after his snack got caught in the machine.
On 30 September 2000, there was an entry from a nurse reading:
“Although [respondent] continues to be somewhat manipulative and/or
exploitive of staff, he has this month been generally pleasant and
nonproblematic.” An entry on 12 October indicated that staff had
reported that respondent had been “arrogant,” which is consistentwith a narcissistic trait.
Respondent had conflicts with his girlfriend and with other
patients.[Tr.I, 120-24] His medical records indicated an “ongoing
conflict with another patient,” which, according to Dr. Hazelrigg,
involved a disagreement over how to run the AA and Narcotics
Anonymous meetings. This conflict lasted “for a couple of weeks.”
One patient who worked with respondent wanted to quit his job
because respondent repeatedly kicked him. An inmate from the
women's prison who worked with respondent complained that
respondent used inappropriate language with her. Dr. Brown, who
later interviewed her, testified that “she reported essentially a
three-week period of time where [respondent] remained angry with
her, hostile toward her, and was verbally abusive to her.”
Dr. Brown testified that he asked respondent about the
incidents between respondent and his co-workers, and respondent
“basically said that he didn't do any of those things.” Respondent
acted “shocked” when Dr. Brown discussed the accusations of
respondent's co-workers with him, and Dr. Brown testified that
respondent “thought that perhaps there was something going on
regarding a conspiracy to damage his attempts at--to being
released.”
Dr. Hazelrigg testified to respondent's current treatment
program as follows:
[T]he treatment has been focused on issues of
substance abuse and recover [sic] from
addiction. To that extent, most of the
treatment modalities are substance abuse
related. He attends AA groups, both in the
hospital and in the community, with staffsupervision. He participates in daily work
assignments and he has individual sessions
with a psychotherapist, and at one point he
had family therapy sessions with another
therapist.
When asked about the prominent traits of respondent's personality
disorder, Dr. Hazelrigg answered:
In the past, the specific types of personality
disorder features that he showed were
antisocial features, which would be
manipulating other people, aggression, and the
other set of features were narcissistic
features which involved having a self-centered
view of things, feeling he's entitled to
special treatment and special privileges and
favors.
Dr. Hazelrigg testified that respondent's psychotherapy sessions
involved issues of anger control, and agreed that anger control is
“an issue that has arisen from [respondent's] personality disorder
diagnoses.” Dr. Hazelrigg acknowledged that “follow[ing] [a]
structured schedule and abid[ing] by rules without being
manipulative or exploitative” was a short-term goal identified in
an entry on respondent's hospital chart dated 3 October 2000. Dr.
Brown testified to his opinion that the treatment respondent is
receiving at Dorothea Dix “is appropriate for the mental health
problems” from which Dr. Brown believes respondent suffers.
This evidence supports Finding of Fact No. 4, that the
diagnoses in parts b. and c. of Finding of Fact No. 3 are “mental
illnesses which are currently being treated, have not been cured,
and are likely to continue in the future.”
Dr. Brown testified that, in his opinion, respondent has
suffered since adolescence from, and continues to suffer from, apersonality disorder, which means he “had a history, an enduring
pattern of inner experience . . . and behaviors that deviate
markedly from the expectations of [his] culture.” This enduring
pattern “leads to clinically significant distress or impairment
socially, occupationally, or other areas, important areas of
function.” And respondent's substance abuse problems “were, in
part, the result of the personality disorder.” Dr. Weiner
testified to his opinion that “the alcohol dependence and the
cannabis dependence were related to events that perhaps led to
[respondent's] psychotic break.” He agreed that respondent's abuse
of alcohol and his abuse of cannabis were “probably causative
factors in the events that led to [the] homicides.” This evidence
supports the trial court's factual finding that respondent's mental
disorders “either existed or are related to the mental conditions
that existed at the time of the commitment of the homicides . . .
in 1988, and were probably causative factors in or related to the
psychotic disorder evident during those homicides.”
Dr. Brown testified that it was his opinion, based on his
diagnoses, that respondent continues to be mentally ill as defined
in N.C.G.S. § 122C-3(21). This, together with the evidence
reviewed above, constitutes evidence in support of the trial
court's finding to that effect in Finding of Fact No. 5.
There is competent evidence in the record to support the
findings of fact relating to mental illness made by the trial
court. Accordingly, the court did not err in its findings numbered
three through five. With regard to whether respondent is dangerous to others, Dr.
Weiner agreed that respondent's “violent history . . . is behavior
that has occurred in the relevant past that is appropriate for the
Court to consider in assessing future dangerousness.” Dr. Brown
also opined that the homicides and other violent felonies committed
by respondent are relevant in assessing future dangerousness; he
responded to questioning in this regard as follows:
Q. Do you consider the four--evidence of four
homicides and five or more felony assaults
which occurred in July of 1988 to be relevant
in your clinical determination of the
probability of [respondent's] future violent
behavior?
A. Yes, I believe they're relevant. They're
relevant because history of violence in the
past is the best predictor of violence in the
future.
Of relevance to respondent's mental condition is Dr. Brown's
testimony regarding psychological testing performed by Dr. John F.
Warren. In particular, Dr. Warren had administered the Minnesota
Multiphasic Personality Inventory II test (the “MMPI-II”) to
respondent on 18 September 2000. Dr. Brown quoted from Dr.
Warren's results as follows:
“He is characterized as angry, belligerent,
rebellious, resentful of rules and
regulations, and hostile toward authority
figures. He is likely to be impulsive,
unreliable, egocentric, and irresponsible. He
often has little regard for social standards.
He often shows poor judgment and seems to have
difficulty planning ahead and benefiting [sic]
from his previous experiences. He makes a
good first impression, but long-term
relationships tend to be rather superficial
and unsatisfied.
. . . .
He may be described as exhibiting excessive
control as hostile impulses, but also is
exhibiting periodic, angry outbursts. He is
socially alienated and is reluctant to admit
any form of a psychological symptom. He is
seen as rigid and not displaying anxiety
overtly.”
Dr. Brown testified that
the overall significance of the issue of
overcontrolled hostility is that in life
we--we come upon frustrating and irritating
things; and if we don't address them because
of the use of denial and repression and things
like that, the amount of the inner tension can
build up and it will erupt into a significant
angry outburst.
Dr. Brown confirmed that such an “angry outburst” could be violent.
Dr. Weiner explained his diagnosis of alcohol and cannabis
dependence, sustained full remission in a controlled environment,
as it relates to the possibility that respondent could relapse into
substance abuse, as follows:
[W]hat happens in life is you get out into the
world and you have all kinds of different
stressors impact upon you. So, do you have
the strengths and the coping skills to deal
with that without relapsing again or lapsing
into alcohol use? So, it has to do with
motivation, it has to do with stressful
events, it has to do with his cognitive
behavioral changes that have gone on. So,
it's a difficult clinical question. There's
always a possibility that he would relapse.
Is it probable? It's less probable now than
it was two years ago, but it's possible. Of
course, it's possible.
While, according to Dr. Weiner, respondent would have a small
chance of relapsing into substance abuse if he stayed in AA, there
is a ninety percent chance of relapse for those who drop out of
treatment; this might occur as a result of “some unforeseen thingsthat happen in people's [sic] lives, stressful things that happen
in people's [sic] lives: Loss, deaths.”
Dr. Hazelrigg testified that if respondent “started abusing
drugs and he developed the personal [sic] disorders again, then
there would be a high probability of violent behaviors.” Mr. Munt
confirmed that if respondent “were exposed to severe social,
family, economic stressors upon release, that he may have some
susceptibility to redevelop a psychosis,” and that a person who has
demonstrated extreme violence while psychotic is at a greater risk
for violence if he becomes psychotic again.
Dr. Brown testified that, in his opinion, respondent is at an
“unacceptably high risk” for relapse into substance abuse if he was
released because of his “personality and his low frustration
tolerance for certain forms of stress.” Dr. Brown further
testified that he viewed respondent “as an individual, because he's
had one episode of drug-induced psychosis, as being vulnerable to
having another episode of psychosis with substance abuse.”
Regarding the risk of future dangerousness, Dr. Brown testified as
follows:
Q. And have you considered various types of
factors in assessing his risk for future
violent behavior?
A. Yes. You know, forensic psychiatrists
deal with not the prediction of risk, but the
assessment of risk, the assessment of risk.
And by and large we do this in two categories.
As the category of--of dynamic factors, things
which can be addressed through treatment, for
instance, if someone is psychotic, one of the
dynamic--that may be a dynamic factor relating
to future violence and you can treat that with
medication. But there are other factorshaving to do with static things, things that
are primarily historical in nature and refer
back to the past.
Now, some of those things carry with them
a risk of future violence, and everything from
some--some history of juvenile delinquency, a
history of being suspended from school, a
history of witnessing or being abused in your
childhood. If your mother was abused and you
saw it or if you were abused as a child. A
history of substance abuse, a history of
engaging in illegal occupations, a history of
cruelty to animals, and all of those things
which we really can't change today but are
still important today with regard to the
future prediction of others.
Q. And have you seen some of those risk
factors present in [respondent's] history?
A. All of them.
Q. And do you consider those to be
significant in predicting future probability
of dangerousness or violence?
A. They're significant today--even today
concerning the assessment of the risk of
future violence.
Dr. Brown testified that, in his opinion, respondent continues to
pose a risk of danger to others, as defined in N.C.G.S. § 122C-
3(11).
The evidence reviewed above, together with the evidence
supporting the trial court's findings regarding respondent's mental
illness, supports the court's Findings of Fact No. 7 and No. 8.
Accordingly, the court did not err in making these findings.
Respondent argues that the statutory definition of “dangerous
to others” makes it impossible for a respondent who has been
acquitted of homicide by reason of insanity to prove that he is no
longer dangerous to others when the trial court finds that thehomicide was committed in the “relevant” past. The statute
provides that “[c]lear, cogent, and convincing evidence that an
individual has committed a homicide in the relevant past is prima
facie evidence of dangerousness to others.” N.C.G.S.
§ 122C-3(11)(b).
Respondent's argument is based on the assertion that “a person
who has been acquitted of a homicide by reason of insanity and is
involuntarily committed due to his or her mental illness, will
always be considered dangerous to others as long as the court finds
that the homicide occurred in the 'relevant past.'” A person who
has been acquitted by reason of insanity of a homicide that the
court has found to have occurred in the relevant past will not
“always be considered” dangerous to others, as respondent asserts;
rather, pursuant to the statute, such a person will be presumed
dangerous to others. The respondent has the burden of rebutting
that presumption. If the respondent successfully carries his
burden, the trial court may find that he is no longer dangerous to
others. While we agree that the General Assembly has set a high
hurdle for the respondent to overcome in these circumstances, a
difficult burden is justified. We find respondent's fear that the
burden can never be met unwarranted and his argument to be without
merit.
We have already rejected respondent's argument that he has
been denied due process because the statute does not define
“relevant past.” See Hayes, 139 N.C. App. at 122, 532 S.E.2d at
559. Respondent contends that he has “proven by a preponderance ofthe evidence that he has not exhibited behavior which would be
indicative of dangerousness since 1988,” and that he has “fully
recovered from the mental illness which rendered him dangerous in
1988.” Thus, he argues, “the prior homicides cannot reasonably be
considered as being within the 'relevant' past so as to justify a
finding of present dangerousness.” As we have noted above,
however, there is competent evidence in the record to support the
trial court's finding that respondent committed the homicides in
the relevant past, a determination that the legislature placed in
the sound discretion of the trial court. We also held that there
is competent evidence to support the finding that respondent
continues to be dangerous to others. Therefore, we can ascribe no
error to the court's conclusion that respondent failed to meet his
burden to rebut the presumption, imposed by statute, that he is
dangerous to others. See Collins, 49 N.C. App. at 246, 271 S.E.2d
at 74 (trial court determines “whether the competent evidence
offered in a particular case met the burden of proof”).
Respondent next argues that the trial court's legal conclusion
that respondent failed to bear his burden of proving that he meets
the criteria for release is error. We disagree. We held above
that the court's findings of fact are supported by competent
evidence. We also hold that these findings support the conclusion
that respondent continues to suffer from a mental illness and is
dangerous to others.
Foucha v. Louisiana, 504 U.S. 71, 118 L. Ed. 2d 437 (1992),
does not help respondent. At issue in Foucha was a Louisianastatute that allowed “the indefinite detention of insanity
acquittees who are not mentally ill but who do not prove they would
not be dangerous to others.” Id. at 83, 118 L. Ed. 2d at 450. In
Foucha, the Supreme Court noted its earlier holding that an
“acquittee may be held as long as he is both mentally ill and
dangerous, but no longer.” Id. at 77, 118 L. Ed. 2d at 446. The
State of Louisiana did not “contend that Foucha was mentally ill at
the time of the trial court's hearing. Thus, the basis for holding
Foucha in a psychiatric facility as an insanity acquittee [had]
disappeared, and the State [was] no longer entitled to hold him on
that basis.” Id. at 78, 118 L. Ed. 2d at 447. Here, the trial
court has found both that respondent is mentally ill and that he
has failed to prove he is not dangerous to others. Thus, Foucha is
distinguishable. See Hayes, 139 N.C. App. at 120-21, 532 S.E.2d at
558.
Because respondent has shown no error in the trial court's
findings of fact and conclusions of law, we hold that the court
properly extended his commitment for another year. See N.C. Gen.
Stat. § 122C-276.1(d) (1999). Accordingly, we affirm the judgment
of the trial court.
Affirmed.
Judges MARTIN and THOMAS concur.
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