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In re K.M.

Court of Appeals of Columbia District

September 12, 2013

In re K.M.; L.M., Appellant.

Argued Sept. 6, 2012.

Page 225

Laurie P. McManus for appellant.

Stacy L. Anderson, Assistant Attorney General for the District of Columbia, with whom Irvin B. Nathan, Attorney General for the District of Columbia, Todd S. Kim, Solicitor General, and Donna M. Murasky, Deputy Solicitor General, were on the brief, for appellee District of Columbia.

Mindy Leon, Guardian ad Litem for appellee K.M., filed a statement joining the brief of appellee District of Columbia.

Jack S. Gilmore, counsel for C.H., father of K.M., filed a statement that a brief would not be filed on behalf of appellee C.H.

Page 226

Before WASHINGTON, Chief Judge, McLEESE, Associate Judge, and BELSON, Senior Judge.

McLEESE, Associate Judge:

After an evidentiary hearing, a magistrate judge found that K.M., who was twelve years old at the time, was a neglected child. More specifically, the magistrate judge found that K.M.'s mother, appellant L.M., suffers from a delusional disorder of persecutory type, and that this mental illness has harmed K.M.'s mental and emotional health. The finding of neglect was affirmed by the reviewing judge. On appeal to this court, L.M. argues that the evidence does not support the determination that K.M. is a neglected child. We agree with L.M. and therefore reverse.



The following evidence was adduced at the evidentiary hearing. In September 2010, the D.C. Child and Family Services Agency (" CFSA" ) received a hotline report raising concerns about L.M.'s mental health. CFSA investigator Guillermo Cintron and CFSA social worker Meghan Snyder met with L.M. and K.M. in their home. Mr. Cintron explained D.C. law regarding child abuse and neglect to L.M., and reviewed the allegations against her. Mr. Cintron found L.M. to be " very calm" and " very organized." L.M. showed Mr. Cintron around the apartment, and he determined that the home was clean, neat, and adequately stocked with food. L.M. denied the allegations against her, but Mr. Cintron remained concerned about her mental health in light of L.M.'s expressed concerns that a group of people were " following her and doing different things to her." While Mr. Cintron spoke with L.M., Ms. Snyder interviewed K.M. in a separate room. After completing a home assessment and determining that the situation was safe for K.M., Mr. Cintron and Ms. Snyder left the home.

Approximately one week later, CFSA received another hotline report concerning K.M. Mr. Cintron immediately went to K.M.'s school. After discussing the allegations with K.M., Mr. Cintron decided to remove K.M. from L.M.'s custody immediately and to place him in foster care.[1]

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During the interview, K.M. appeared fearful to Mr. Cintron. Unable to reach L.M. at home, Mr. Cintron left a letter at the front desk of L.M.'s building to inform her of K.M.'s removal. Later that evening, Mr. Cintron received a very angry call from L.M., during which L.M. expressed deep suspicion of Mr. Cintron. According to Mr. Cintron, L.M. called him a liar, accused him of being part of the group of people who were " out to get her," and said that he was " part of the conspiracy" against her.

Ms. Esther Song was K.M.'s social worker after he was placed in foster care. Ms. Song testified that, starting a month or so after K.M. was placed in foster care, she observed K.M. occasionally misbehaving at school and in the car when Ms. Song drove him places. On one occasion, when Ms. Song refused K.M.'s request for a meal while they were driving to his foster home, he started throwing trash at her. During this same car trip, K.M. tried unsuccessfully to open the car door at a stop light and get out of the car. When he was unable to do so, he punched Ms. Song's arm while she was driving and said he was planning to punch her in the face. Ms. Song spoke with L.M. about K.M.'s behavior in the car, but K.M. and L.M. both accused her of lying. On another day when Ms. Song was driving K.M. to a supervised visit with L.M., K.M. began banging on the window after Ms. Song refused to put the window down. Ms. Song warned K.M. that if he tried to damage the car or made her feel unsafe or uncomfortable, she would not be able to drive him places. K.M. said that she was not allowed to stop his visits, but Ms. Song explained that another social worker would have to transport him. When they arrived at their destination, K.M. told L.M. that Ms. Song was trying to prevent their visits, that Ms. Song was evil, and that Ms. Song was part of a North Korean invasion of America.

Two expert witnesses testified. First, psychiatrist Dr. Susan Theut testified as an expert in child, adolescent, and adult psychiatry. After interviewing L.M. as part of a court-ordered psychiatric evaluation, Dr. Theut provisionally diagnosed L.M. as suffering from " delusional disorder persecutory type." Dr. Theut described this disorder as involving irrational and firmly fixed beliefs that one " is being harmed by others or other people mean to hurt [ ] or persecute [one]." During Dr. Theut's interview with L.M., Dr. Theut observed that L.M. was " preoccupied with the fact that some people called the Smalls and the Tuckers have been following her ... [and] that they mean to hurt her, that they have gone through her belongings, stolen things from her." L.M. told Dr. Theut that the Smalls and the Tuckers had pursued her in Georgia, Maryland, and now in Washington D.C., and had been out to get her since at least 1998. L.M. also told Dr. Theut that K.M. was taken away from her by CFSA because she had sued the United States government. Dr. Theut explained that her diagnosis was provisional because she had no " collateral information" to support her diagnosis. In particular, Dr. Theut lacked L.M.'s prior medical or psychiatric records, other information about L.M.'s medical history, and information from persons close to L.M. in the last ten years. Nevertheless, based on Dr. Theut's interview with L.M., Dr. Theut " felt [L.M.] really does have delusional disorder persecutory type."

Dr. Theut opined that a person with delusional disorder who did not obtain treatment would have an " extremely poor" ability to independently parent children. Dr. Theut explained that: (1) " there's always a concern about ... the behavior that can be driven by the delusions; " (2)

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persons with delusional disorder are " always questioning other people's motives; " and (3) " children raised around people who have a delusional disorder become very scared and frightened ... [and] often don't know who[m] to trust." When asked what effect a parent's persecutory-type delusions would or could have on a child, Dr. Theut stated that the child " could" become fearful of other people, and that the child " could end up with ... a shared delusional disorder," where the child shares the parent's delusional beliefs and starts exhibiting the same kind of paranoid behavior. Dr. Theut further testified that there would be concerns about the child's ability to trust others, such as teachers, and whether the child could differentiate between delusions and reality. Dr. Theut stated that she thought reunification of K.M. with L.M. would be " very problematic" if L.M. did not seek treatment for her disorder. Dr. Theut noted that she had discussed treatment options with L.M., but that L.M. did not believe she needed treatment.

Dr. Theut acknowledged that it is possible for a person to suffer from a mental illness and adequately parent a child, and explained that the person's parenting ability would depend on the nature, extent, and severity of the mental illness. Dr. Theut also acknowledged that persons with delusional disorder can be " very functional except when the delusions intrude," and that such persons " can present sometimes in a normal way." Finally, Dr. Theut acknowledged that L.M. was cooperative during their interview and that Dr. Theut personally did not observe any impulsive behavior by L.M.

Psychologist Dr. Seth King testified as an expert in adult and child psychology and psychological assessments. Dr. King also conducted a court-ordered clinical interview with L.M., which resulted in a provisional diagnosis of delusional disorder of persecutory type. Dr. King testified that although L.M. was " well-groomed," " well-spoken," and " intelligent," she also spoke in a " tangential manner" and provided a great deal of extraneous information during their interview, which required Dr. King to frequently redirect her to the topics he asked her about. L.M. described in great detail how the Smalls and Tuckers had conspired against her for decades. L.M. told Dr. King that these individuals " were always working against her, trying to get her and her children." Dr. King explained that his diagnosis was provisional because he lacked corroborating information. Specifically, Dr. King said that it would have been helpful to have information from individuals who had known L.M. throughout her life, and Dr. King recommended that L.M. meet regularly with someone who could assess her over a length of time. Dr. King concluded that L.M. was in denial about her mental-health condition, and that L.M. whole-heartedly believed in her conspiracy theories, which made it unlikely that she would seek treatment for her disorder.

Dr. King opined, to a reasonable degree of clinical certainty, that if L.M. does not seek treatment, her disorder " will have a negative impact on her ability to appropriately and effectively parent K.[M.]" Dr. King stated that parents with delusional disorder " would be ... impair[ed] in ability to parent a child in that the lack of insight [and] poor judgment could affect decision-making." Dr. King further explained that preoccupation with delusions " could interfere with [L.M.'s] ability to focus on the needs of the child .... [and] could interfere with [L.M.'s] ability to work collaboratively with others such as school personnel." Dr. King also testified that a parent suffering from delusional disorder could be " modeling" this behavior for a child, meaning that the child " could

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adopt that way of thinking, that way of being distrustful." Dr. King further testified that having a delusional parent " could be frightening" or " confusing" for the child, and that the child " could ... start believing that there are other people to talk to that are actually not there ... [or] could eventually believe that the parent does have problems with reality ... which could impact that child's ability to respect that parent or ... that parent's authority." When asked whether there are " any potential long-lasting effects" on a child parented by an individual with delusional disorder, Dr. King responded that " [t]here could be various outcomes based on a parent exercising poor judgment, poor decision-making, not providing effective parenting, [and] not being able to focus on the needs of the child." Dr. King further indicated that these parental deficiencies " could lead to a host of problems such as the child being neglected in some way educationally ...[,] adopting some of these thought processes ...[,] not following directions, having a lack of structure [or] a lack of supervision.... [, or having] difficulty forming appropriate relationships ... or understanding the societal expectations of relationships."

Dr. King acknowledged that individuals with delusional disorder are able to function in various areas of their lives that are not related to the object of the delusion. L.M. was cooperative during her interview with Dr. King, and Dr. King did not observe any impulsive behavior on her part. Dr. King also acknowledged that there are studies showing a low rate of violence among individuals with delusional disorder. Dr. King's primary concern about L.M. was not that she would engage in violence, but rather was with her " decision-making, judgment, [and] things that could lead to neglect." Dr. King believed K.M. was at an age where his mother's delusional disorder " would have an impact on him."

Three witnesses testified on behalf of L.M. at the evidentiary hearing: her father E.M., her adult son D.G., and family friend Ms. Warlene Smith. E.M. spoke with and saw K.M. and L.M. regularly after they moved to the area and before K.M.'s removal. E.M. described the relationship between K.M. and L.M. as " normal," noting that K.M. and L.M. " got along pretty well." L.M. corrected K.M. verbally and did not do anything " out of the ordinary" to discipline K.M. L.M. had told E.M. about her belief that people were harassing her. E.M. did not know any of the people that L.M. had told him about, and he had advised her to get some kind of help to deal with the problem. L.M.'s son D.G. frequently spoke with K.M. on the phone. D.G. observed that K.M. seemed well cared for and appeared to be attending school regularly. K.M. never expressed a fear of L.M. to D.G. and never complained about physical discipline by L.M. Finally, Ms. Smith spoke frequently with L.M. on the phone, and K.M. visited her home once with L.M. During that visit, K.M. looked " good," " clean," and " healthy," and L.M. was " very protective" of K.M. and corrected him verbally when needed. [2]

The magistrate judge generally credited the testimony of all the witnesses, but determined that L.M.'s witnesses offered little information regarding the allegations of neglect. The magistrate judge also noted that L.M.'s love for K.M. and desire to provide proper care for him were evident.

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The magistrate judge found by a preponderance of the evidence that K.M. was a neglected child. She based her findings on the mental-health experts' testimony that L.M. suffered from a delusional disorder and on the social workers' testimony regarding L.M.'s behavior, which the magistrate judge viewed as consistent with the experts' opinions. The magistrate judge also relied on the experts' opinions regarding L.M.'s parenting abilities and the effects that L.M.'s delusions could have on K.M. In particular, the magistrate judge identified K.M.'s aggressive and disruptive behavior with his social worker and at school as confirming the experts' prediction that exposure to L.M.'s delusional disorder would cause K.M. to adopt L.M.'s " maladaptive and paranoid beliefs and behaviors."

L.M. filed a motion seeking judicial review of the magistrate judge's order. The reviewing judge affirmed.[3]


The District bore the burden of proving by a preponderance of the evidence that K.M. was a neglected child within the meaning of D.C.Code § 16-2301 (2001-2012). See, e.g., In re E.H., 718 A.2d 162, 168 (D.C.1998). The scope of our review is circumscribed by D.C.Code § 17-305(a) (2001), which provides that a judgment " may not be set aside except for errors of law unless it appears that the judgment is plainly wrong or without evidence to support it." In re E.H., 718 A.2d at 168 (quoting D.C.Code § 17-305(a)). In assessing the sufficiency of the evidence, we must " consider the evidence in the light most favorable to the government, giving full play to the right of the judge, as trier of fact, to determine credibility, weigh the evidence, and draw reasonable inferences." In re A.H., 842 A.2d 674, 684 (D.C.2004) (internal quotation marks omitted).

This is a very unusual neglect case. There was no evidence of parental abuse or mistreatment, nor was there any evidence that L.M. had ever acted violently or threatened to do so. The District's witnesses testified that the family home was clean, neat, and well supplied with food. The magistrate judge credited testimony from family members that K.M. was well cared for, that K.M. was clean and healthy, and that L.M. was protective of K.M. and corrected K.M. appropriately. The evidence thus indicated that L.M. sufficiently met K.M.'s physical and material needs, and the magistrate judge specifically found that L.M. had not physically endangered K.M. Further, no expert testified that K.M. had in fact suffered any emotional or psychological injury as a result of his mother's illness. In nevertheless finding neglect, the magistrate judge concluded (1) K.M. was already suffering ...

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