Summary
The North Dakota Supreme Court reversed orders involuntarily committing W.K. to the North Dakota State Hospital and authorizing involuntary medication. The Court held that the evidence did not clearly and convincingly establish that W.K. was a person requiring treatment because untreated mental illness posed a reasonable expectation of a serious risk of harm. Because that prerequisite was not met, the medication order was also reversed.
Topics
Practice areas
Questions Presented
- Whether clear and convincing evidence established that W.K. was a person requiring treatment and presented a reasonable expectation of a serious risk of harm sufficient to support involuntary hospitalization and treatment.
- Whether the district court could order involuntary treatment with medication when the evidence did not establish that W.K. was a person requiring treatment.
- Whether the Court needed to address the propriety of less restrictive treatment after reversing the commitment and medication orders.
Holdings
- The district court clearly erred in finding that clear and convincing evidence established W.K. was a person requiring treatment under N.D.C.C. § 25-03.1-02(12). The evidence did not establish a reasonable expectation that, if untreated, W.K. presented a serious risk of harm to herself.
- The district court also erred by ordering involuntary treatment with medication because the evidence did not establish that W.K. was a person requiring treatment.
Key quotations
“Therefore, to establish a person presents a serious risk of harm to themself, the State must demonstrate that, without treatment, there is a great likelihood that the person will suffer a significant decline in physical or mental health.” (776 N.W.2d at 576)
“However, a generalized natural tendency does not establish a substantial likelihood for a particular individual.” (776 N.W.2d at 577)
Factual background
W.K.'s brother sought her involuntary commitment based on alleged prior hospitalizations, unusual behavior, failure to perform activities of daily living, hallucinations and delusions, and potential danger to herself. A social-services representative observed W.K. sleeping on a couch in pajamas during the afternoon and reported that she lacked insight into her condition, while W.K. disputed the allegations and testified that she could care for herself. A psychiatrist diagnosed schizophrenia and testified that W.K. would likely suffer substantial physical and mental deterioration without treatment, but acknowledged that he had not reviewed her Maryland medical records, that she was not suicidal or violent, and that she performed her activities of daily living at the State Hospital.
Procedural history
W.K.'s brother petitioned for her involuntary commitment. After a treatment hearing, the district court found by clear and convincing evidence that W.K. was a person requiring treatment, ordered her committed to the North Dakota State Hospital for up to ninety days, and authorized involuntary medication. W.K. appealed, and the North Dakota Supreme Court reversed both orders.