DC Circuit Rejects Special Circumstances Argument of Potential Lengthy Civil Commitment in Upholding Involuntary Medication Order

United States v. Dillon, 738 F.3d 284 (D.C.Cir. 2013)

The District of Columbia Circuit Court of Appeals upheld on December 24, 2013, the district court’s order authorizing involuntary treatment with antipsychotic medication to restore the defendant’s competency to stand trial. The Court found no merit in the defendant’s argument under the first prong of United States v. Sell, 539 U.S. 166 (2003), that his potential civil commitment undermined the government’s interest in prosecuting him for threatening the President of the United States.

The defendant Simon Dillon was indicted for threatening the President of the United States. Dillon, who had been repeatedly hospitalized for mental illness, sent an email to a Secret Service agent from a location three blocks from the White House, stating that he would not harm the President if the agent met with him and agreed to “meet the demands of God.” If the agent did not, the President would get the worst Christmas present ever, would suffer for 30 days, and would wish for death that would not come to him. The Secret Service arrested Dillon the next day, and the D.C. Department of Mental Health sought his civil commitment. Following an administrative hearing in January 2012, the Mental Health Commission recommended his outpatient civil commitment. Dillon was then re-arrested and shortly thereafter, the district court ordered him committed for a competency evaluation.

Two government doctors first evaluated Dillon at the Metropolitan Correctional Center, and in a March 2012 report, diagnosed him with schizophrenia, paranoid type, but concluded he was competent to stand trial. Their opinion came with less than the usual degree of psychological certainty because they found Dillon was unable to rationally consider an insanity defense. As a result, both Dillon and the government requested a further psychiatric evaluation, and the court committed him to Butner Federal Medical Center. At Butner, he was diagnosed with delusional disorder, grandiose type, and the evaluator concluded he was incompetent to stand trial. Following a hearing, the district court found him incompetent to stand trial and committed him for a determination as to whether he could be restored to competency. Following a competency restoration study submitted to the court in February 2013, two evaluators diagnosed Dillon with schizoaffective disorder, bipolar type and concluded he could be restored to competency with antipsychotic medication. They based their conclusion on studies estimating the rate at which defendants are successfully restored to competency and on Dillon’s medical history indicating he had responded favorably to psychotropic medication during prior hospitalizations. They also reported that Dillon was not a danger to himself or others while in custody.

As a result of this report, the court held a Sell hearing at which both the evaluating psychologist and psychiatrist testified. The district court found that the government had an important interest in bringing the defendant to trial that was not undermined by special circumstances, and that involuntary medication would significantly further that interest. On appeal, the D.C. Circuit first reviewed the Supreme Court decisions on involuntary medication, including the Sell decision. It then concluded that it should conduct a de novo review of the district court’s holding under the first prong of Sell as to the importance of the governmental interest in prosecuting the case, and that it should review the remaining findings on the other three prongs for clear error, following the approach of the majority of other circuits, except the Tenth Circuit.

Dillon first challenged the district court’s finding under the first prong of Sell that important governmental interests were at stake. Dillon conceded that the crime with which he was charged was serious, but argued that special circumstances existed that lessened the importance of the government’s interest, namely the prospect of lengthy civil commitment and his own purported non-dangerousness. Dillon, however, failed to argue the potential for his civil commitment before the district court, even though the government mentioned it in its brief and argument. The Court of Appeals therefore found he had waived his ability to raise this argument on appeal. The Court further found that the argument would not have succeeded in any event even though Sell raised the potential for lengthy civil commitment as a special circumstance that could undermine the government’s interest in prosecution. The Court noted that Dillon was only civilly committed to outpatient treatment following his arrest on these charges, and given his second argument that he was not dangerous, it was unlikely he would have been committed to civil “confinement,” the term used in Sell instead of civil “commitment.”

Dillon also argued that he was not dangerous and this factor undermined the government’s interest in prosecuting him. The Court found, however, that although the government has an interest in incapacitating someone who is a danger to the public, it is not the government’s sole interest. The governmental interest also includes protecting the public by incapacitating the defendant, promoting respect for the law, and providing just punishment for an offense.

Dillon next argued under the second prong of the Sell test that the medication was not substantially likely to restore his competency. He stated that the schizoaffective diagnosis was inaccurate and he instead suffered from a delusional disorder. He argued the success rate for treating delusional disorders with antipsychotic medication was too low to warrant his forced medication. The Court pointed out, however, that the last two doctors who diagnosed Dillon with schizoaffective disorder had a much longer time to observe him and arrive at the correct diagnosis, plus his medical history reflected he had previously responded favorably to treatment with antipsychotic medication. The Court therefore found that the district court’s determinations were not clearly erroneous and upheld its order to treat Dillon with medication over his objection to restore his competency to stand trial.

Found in DMHL Volume 33 Issue 1