There were specific facts in the court record from which the New York Supreme Court, Appellate Division, could conclude that the patient’s continued involuntary psychiatric commitment was justified. That is, based upon the facts elicited through his caregivers’ testimony, the court concluded that the patient not only suffered from a mental illness, but presented a substantial threat of harm to himself and to others and was in need of continued treatment and structured care.

   The patient often screamed at the top of his lungs that he was going to kill anyone trying to keep him at the hospital, and that, after getting his release, he was going to come back and "get his revenge." There were other aggressive outbursts in which the patient hurled verbal expletives at the staff.

   The patient once masturbated in front of a female staff member.

   There were problems with patient non-compliance with his medication regimen. The patient was known to try to avoid taking the medications intended to control his anxiety and impulsiveness, while he would take other medications without incident.

   In trying to devise a proposed aftercare plan for the patient, an appropriate caretaker could not be lined up. A family member to whose household the patient wanted to be released had significant health problems and had no ability to exert any manner of control upon the patient.