In Re The Detention Of: K.b. - Affirms 14-Day Mental Health Commitment

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April 13, 2026 Get Citation Alerts Download PDF Add Note

In Re The Detention Of: K.b.

Court of Appeals of Washington

• Citations: None known
• Docket Number: 87433-1

• Precedential Status: Non-Precedential

• Opinion

• Authorities (6)

• Cited By (0)

• Summaries (0)

• Similar Cases (5.4K)

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Lead Opinion

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

In the Matter of the Detention of
No. 87433-1-I
K.B.
DIVISION ONE

UNPUBLISHED OPINION

HAZELRIGG, C.J. — K.B. appeals from the order that committed her to 14

days of involuntary mental health treatment and avers that the State did not

present sufficient evidence to support the court’s finding that she was gravely

disabled. We disagree and affirm.

FACTS

On October 30, 2024, K.B. arrived at the University of Washington Medical

Center Montlake emergency room “via ambulance after refusing to get off a city

bus.” Upon assessment at the hospital, K.B. indicated she was seeking “hot water

for instant noodles and assessment of toe fungus,” but did not describe the incident

on the bus or explain why she refused to leave it. K.B. was evaluated by a licensed

independent clinical social worker and by a designated crisis responder (DCR).

The DCR filed a petition for initial detention under the involuntary treatment

act 1 (ITA) later that day, which included a declaration from the social worker. The

petition stated that K.B. had two previous involuntary commitments, most recently

1 Ch. 71.05 RCW.
No. 87433-1-I/2

in August 2024. It alleged that K.B. “suffer[ed] from a behavioral health disorder

characterized by impaired insight, impaired judgement [sic], impaired impulse

control, increased aggression, disorganized speech[,] and threatening to kill a

nurse.” The petition further described observations by staff, specifically that K.B.

was “responding to internal stimuli; yelling at the wall as if there was another

person there.” The petition also stated that K.B. “was not cooperative with medical

staff and attempted to spit [on] and kick a nurse.” During the DCR’s evaluation,

K.B. displayed “disorganized and nonsensical thought.” K.B. “denied having made

threats to harm a nurse,” but when asked about it, K.B. “became emotionally

escalated.” The social worker’s supporting declaration stated that K.B. “exhibit[ed]

evidence of a mental disorder including with diagnosis of Bipolar Disorder with

symptoms of mania including delusions, hallucinations, responding to internal

stimuli, and hypersexual behavior.” K.B. also repeatedly “exposed herself” to the

social worker and other staff. The petition concluded that as “a result of a

behavioral health disorder,” K.B. was “at imminent risk of physical harm due to

being gravely disabled and is a danger to others” which necessitated “involuntary

hospitalization for further evaluation, treatment[,] and stabilization.” K.B. was

transported to Fairfax Hospital, pursuant to the custody authorization that followed

the initial petition.

Laura Yen, a licensed independent clinical social worker and court evaluator

at Fairfax, filed a petition for 14 days of involuntary treatment under the ITA a few

days later. The 14-day petition also contended that K.B. presented a “likelihood of

serious harm to others” and was “gravely disabled” because, as a result of her

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No. 87433-1-I/3

“mental disorder,” she was “in danger of serious physical harm resulting from a

failure or inability to provide for [her] essential human needs of health or safety

and/or manifests severe deterioration in routine functioning.” The 14-day petition

reiterated allegations from the initial petition and added that at Fairfax, K.B. was

“agitated, disorganized, dysphoric, irritable[,] and restless[,] with poor hygiene and

untreated headlice.” It further noted that at the time the petition was filed, K.B. was

“showing increased loss of cognitive and volitional functioning” and “poor insight

regarding symptoms” such that continued hospitalization was “essential.”

On November 20, the trial court held a probable cause hearing on the 14-

day petition. The State called Joseph Cisneros, a court evaluator for the University

of Washington, and Yen as witnesses. Cisneros read from a “discharge mental

status exam” that described K.B.’s affect and behavior at the end of a previous

period of treatment in August 2024. Her behavior was “noted as being cooperative

with good eye contact, mood as good, thought content with no auditory or visual

hallucinations.” K.B. was “alert and oriented,” her memory was “grossly intact,”

and her “insight [wa]s good.” However, while she acknowledged “having mental

health issues,” she still exhibited a “rambling speech pattern” at the time of that

discharge from care. Cisneros also reiterated and expanded on allegations from

the initial petition. On cross-examination, he also noted that K.B. had tested

positive for “amphetamines and methamphetamines” while in the emergency

room.

Yen testified to her own evaluation of K.B. and read from medical records

generated during K.B.’s hospitalization at Fairfax. Yen opined that K.B. suffered

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No. 87433-1-I/4

from “bipolar disorder, manic with psychotic features” as evinced by symptoms

including “delusional content” with “some auditory hallucinations.” Yen said K.B.

was “hyperverbal with loud, pressured speech” and both displayed “difficulty with

impulse control” and instigated “some aggressive behavior.” Yen stated it was her

opinion that K.B.’s mental disorder put her in danger of serious physical harm and

K.B. also showed severe deterioration which suggested she would not receive

essential care outside the hospital.

K.B. also testified on her own behalf. She explained that she believed she

had a mental health disorder that required treatment and medication. She also

stated that she knew of several different shelters available to her upon discharge

and friends that she could stay with. K.B. admitted that she was unable to refill her

prescriptions when she ran out of her medications. She explained that because

her phone had been stolen, she was unable to navigate to reach appointments,

and it was difficult to follow up with doctors and refill her prescriptions, so she

stopped taking them. She stated that she was on a waitlist for subsidized housing

and had plans to get new identification and a phone.

After testimony and closing argument, the trial court issued its oral ruling

and, later, entered findings of fact, conclusions of law, and an order committing

K.B. for 14 days of involuntary treatment. It concluded that the State had proven

by a preponderance of the evidence that K.B. suffered from a mental disorder such

that she was gravely disabled and there was “sufficient evidence [t]here of a

decline in baseline function since” K.B.’s discharge from a previous round of

treatment. It did not find she was a risk to others. It also found that K.B.’s

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No. 87433-1-I/5

“testimony regarding her ability to function in the community” was “not persuasive”

because, even if she had knowledge of the shelters available to her, she previously

had difficulty in securing and maintaining access to those resources. The trial court

further found that less restrictive alternative treatment was not in K.B.’s best

interest.

K.B. timely appealed.

ANALYSIS

As a threshold matter, K.B. avers that even though the 14-day commitment

has concluded, the issue she presents on appeal is not moot because “she still

faces collateral consequences from the commitment order.” The State

appropriately concedes that point in its response brief. We agree and reach the

merits.

I. Sufficiency of the Evidence

K.B.’s briefing on appeal contends that although she does suffer from

bipolar disorder, “she is also unhoused, has struggled with substance use, and

had difficulty utilizing services in the past because her phone and ID were stolen.”

She avers that “the evidence does not prove that [K.B.]’s alleged loss of cognitive

control and alleged inability to continue receiving treatment was ‘a result of her

behavior health disorder’ and not a result of external factors.” (Emphasis omitted).

The State’s response brief counters that substantial evidence supported the trial

court’s determination regarding the need for involuntary treatment because it had

established K.B.’s baseline and “deterioration from that baseline,” her inability to

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No. 87433-1-I/6

make rational decisions about her treatment needs, and that her bipolar disorder

prevented her from accessing resources and “avoiding additional

decompensation.”

Where, as here, “the trial court has weighed the evidence, appellate review

is limited to determining whether substantial evidence supports the findings, and,

if so, whether the findings in turn support the trial court’s conclusions of law and

judgment.” In re Det. of LaBelle, 107 Wn.2d 196, 209, 728 P.2d 138 (1986).

“‘Substantial evidence is evidence that is in sufficient quantum to persuade a fair-

minded person of the truth of the declared premise.’” In re Det. of T.C., 11 Wn.

App. 2d 51, 56, 450 P.3d 1230 (2019) (internal quotation marks omitted) (quoting

In re Det. of A.S., 91 Wn. App. 146, 162, 955 P.2d 836 (1998), aff’d, 138 Wn.2d

898, 982 P.2d 1156 (1999)). The party challenging the findings has the burden of

demonstrating that they are not supported by substantial evidence. Id. We will not

disturb the trial court’s assessment of witness credibility or consider the strength

of the evidence. In re Det. of A.F., 20 Wn. App. 2d 115, 125, 498 P.3d 1006 (2021).

“[W]e review the evidence in a light most favorable to the petitioner.” In re Det. of

K.P., 32 Wn. App. 2d 214, 221, 555 P.3d 480 (2024), review denied, No. 103607-8

(Wash. Mar. 4, 2025).

RCW 71.05.240(1) directs the trial court to hold a probable cause hearing

after a petition for 14 days of involuntary treatment is filed. RCW 71.05.240(4)(a)

further provides that

at the conclusion of the probable cause hearing, if the court finds by
a preponderance of the evidence that a person detained for
behavioral health treatment, as the result of a behavioral health
disorder . . . is gravely disabled, and, after considering less restrictive

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No. 87433-1-I/7

alternatives to involuntary detention and treatment, finds that no such
alternatives are in the best interests of such person or others, the
court shall order that such person be detained for involuntary
treatment not to exceed 14 days in a facility licensed or certified to
provide treatment by the department or under RCW 71.05.745.

Pertinent here, “gravely disabled” is defined as

a condition in which a person, as a result of a behavioral health
disorder: (a) Is in danger of serious physical harm resulting from a
failure to provide for [their] essential human needs of health or safety;
or (b) manifests severe deterioration in routine functioning evidenced
by repeated and escalating loss of cognitive or volitional control over
[their] actions and is not receiving such care as is essential for [their]
health or safety.

RCW 71.05.020(25). Although the State pursued a theory based on harm to others

and grave disability, as defined by both subsections (a) and (b), the trial court

concluded only that K.B.’s mental health disorder resulted in her grave disability,

specifically a “severe deterioration in routine functioning” as set out in subsection

(b).

The trial judge’s findings relied on the testimony of Cisneros, who

established K.B.’s baseline and presentation at the emergency room, and Yen,

who relayed K.B.’s course of treatment and behavior at Fairfax. Crucially,

Cisneros provided a contrast between K.B.’s baseline at discharge following a prior

course of treatment and her presentation during her admission at the emergency

room. When K.B. was discharged in August 2024, her behavior was described as

“cooperative,” her mood was good, she was not experiencing any hallucinations,

and she had proper insight into her disorder and her need to continue treatment.

Cisneros’ testimony detailed K.B’s deterioration just a few months later as

exhibited during her emergency room visit where she was combative, aggressive

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No. 87433-1-I/8

with staff, and responded to internal stimuli. Yen then provided further contrast

between K.B.’s baseline and how she presented during her time at Fairfax;

although there was improvement, K.B.’s functioning was still below the level

present in August. This is “recent, tangible evidence” of grave disability, which is

sufficient to justify involuntary treatment under the ITA. See LaBelle, 107 Wn.2d

at 204.

K.B. contends that the State did not present sufficient evidence to establish

her baseline, but again, even if the evidence was limited, the contrast between

K.B.’s condition in August and in October was significant. The trial court conceded

that the evidence regarding her baseline was “not extensive” but also noted that

the description of K.B. at the time of her August discharge “was of someone who

could engage, in discharge planning, who could hold a conversation[,] who was

not hostile, was showing essentially normal speech and interactions,” was not

delusional, “and had some plans on being able to obtain further treatment in the

community.” Additionally, even if K.B’s deterioration may have been exacerbated

by a variety of external factors, as she contends in briefing, she was unable to

navigate the process safely on her own to utilize available resources for support

and, thus, was returned to the emergency room in the condition described, supra.

At the time of the hearing on the 14-day petition, K.B. did express a desire and

knowledge of how to obtain help after discharge, but the trial judge did not find her

testimony credible. We do not revisit the trial court’s credibility determinations or

reweigh the evidence. A.F., 20 Wn. App. 2d at 125. The testimony that established

K.B.’s deterioration from August to October, the evidence relied on by the trial court

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No. 87433-1-I/9

for its commitment order, was sufficient to support its findings of fact and ultimate

conclusion that she was gravely disabled and required continued involuntary

treatment.

Affirmed.

WE CONCUR:

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