Winnebago County v. B. R. C.

COURT OF APPEALS
DECISION NOTICE
DATED AND FILED This opinion is subject to further editing. If
published, the official version will appear in
the bound volume of the Official Reports.
February 14, 2024
A party may file with the Supreme Court a
Samuel A. Christensen petition to review an adverse decision by the
Clerk of Court of Appeals Court of Appeals. See WIS. STAT. § 808.10
and RULE 809.62.

Appeal No. 2023AP1842 Cir. Ct. No. 2023ME129

STATE OF WISCONSIN IN COURT OF APPEALS
DISTRICT II

IN THE MATTER OF THE MENTAL COMMITMENT OF B.R.C.

WINNEBAGO COUNTY,

PETITIONER-RESPONDENT,

V.

B.R.C.,

RESPONDENT-APPELLANT.

APPEAL from orders of the circuit court for Winnebago County:
MICHAEL S. GIBBS, Judge. Affirmed.
No. 2023AP1842

¶1 LAZAR, J.1 Brooke2 appeals from orders for her involuntary
commitment under WIS. STAT. § 51.20(1)(a)2. and for the involuntary
administration of medication and treatment under WIS. STAT. § 51.61(1)(g).
Brooke asserts that, contrary to Langlade County v. D.J.W., 2020 WI 41, ¶59, 391
Wis. 2d 231, 942 N.W.2d 277, the trial court failed to make specific factual
findings of dangerousness with reference to a particular paragraph of
§ 51.20(1)(a)2. She also asserts that Winnebago County did not satisfy its burden
to prove that Brooke was dangerous under either § 51.20(1)(a)2.a. or 2.b. by
admissible clear and convincing evidence. Finally, Brooke asserts that the County
did not provide clear and convincing evidence that she is either incapable of
expressing an understanding, or substantially incapable of applying an
understanding, of the advantages and disadvantages of the prescribed medication
to her mental illness. Thus, she contends, both orders must be reversed.

¶2 This court concludes that the trial court in this case made sufficient
specific factual findings to support a commitment decision. There was sufficient
admissible evidence of dangerousness under both subdivision paragraphs
presented to the trial court. And the trial court’s finding that Brooke was
substantially incapable of applying an understanding of the advantages,
disadvantages, and alternatives to her condition in order to make an informed
choice as to whether to accept or refuse psychotropic medication and treatment

1
This appeal is decided by one judge pursuant to WIS. STAT. § 752.31(2)(d) (2021-22).
All references to the Wisconsin Statutes are to the 2021-22 version unless otherwise noted.
2
In order to protect her confidentiality, pursuant to WIS. STAT. RULE 809.19(1)(g), this
court refers to the subject individual by the pseudonym she selected.

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No. 2023AP1842

was not clearly erroneous based upon the testimony and evidence. Both orders are
affirmed.

BACKGROUND

¶3 The County filed a Statement of Emergency Detention for Brooke
seeking her commitment under WIS. STAT. ch. 51 on April 17, 2023. Brooke had
been taken into custody several days earlier after her parents reported to law
enforcement that she had “attacked her dad,” made “suicidal statements,” and
exhibited other threatening or dangerous behavior due to her declining mental
health. At a final hearing on the County’s request, the County relied on testimony
from Brooke’s parents and Dr. Marshall Bales, a psychiatrist who had examined
Brooke, to show that she met the statutory requirements for involuntary
commitment and medication.

¶4 Bales opined that Brooke suffers from bipolar disorder and that she
is manic and psychotic. He confirmed that bipolar disorder is a substantial
disorder of thought, mood, and perception that grossly impairs her judgment.
When questioned about his opinion as to whether Brooke is a danger to herself or
others, he stated:

Primarily the dangerousness is the assaultive behavior
but also this almost a confusion where in the middle of the
night she’s in the road, it was dark out, and the neighbor
felt her to be at risk and brought her home and that’s one
example where she’s simply at risk. And she confirmed
that, by the way. There’s some details how much traffic,
how far in the road and some things but it was alarming,
especially considering that she’s not fully reality based, but
separately she’s been getting assaultive and threatening to
her family ….

¶5 Bales also testified that Brooke, a normally “pretty high functioning”
teacher and mother, is “definitely treatable.” Given her “lack of insight into

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No. 2023AP1842

getting help voluntarily,” he said that she needs medication and treatment and
went on to identify the particular medication he recommended. Bales went on to
summarize his discussions with Brooke about the purpose of the medication as
well as its advantages and disadvantages. Bales’s report was received into
evidence.

¶6 Brooke’s parents had reported to law enforcement that Brooke had
been staying with them due to her mental health. At the hearing, Brooke’s mother
testified that among other increasingly strange behavior, on the night before her
detention, Brooke told her, “[D]on’t be surprised if your body is not here
tomorrow…. I’ll be here, but you won’t be.” This caused her mother to question
whether Brooke might suffocate her and also prompted her to have her other
daughter stay elsewhere out of safety concerns. Brooke also told her mother that
she would need the suicide hotline number “really soon,” which her mother
understood meant that either Brooke would become suicidal or Brooke would kill
her and “stage it that [she] committed suicide.”

¶7 Brooke’s father testified that when he had been in the house with her
trying to calm her down shortly before her detention, Brooke “just went crazy and
scratched [his] arm,” which started bleeding. Immediately after that incident,
Brooke told him “that the weatherman was going to get [him] and he was going to
be carrying a lime green gun.”

¶8 Finally, Brooke testified on her own behalf. She stated that she was
taking the medication Abilify, which helped her sleep and mood. She refuted her
father’s account of the events preceding her detention, saying, “At no point did I
touch him.” On cross-examination, Brooke stated that she did not believe she was
mentally ill, but that she was taking her medication because she “was court-

4
No. 2023AP1842

ordered to take the Abilify” which she also said she was taking “by choice.” She
said she was “trying to follow the advice of medical health professionals and …
the Court.”

¶9 The trial court found that the County met its burden to prove the
requisite dangerousness for commitment, stating that

the Court having heard the testimony of Doctor Bales, as
well as both parents of [Brooke], and having heard from
[Brooke] herself, does make the following findings:
Relying heavily upon the opinion of the medical
professional here -- that being Doctor Bales -- the County
has met the burden showing by clear and convincing
evidence that [Brooke] is currently suffering from a major
mental illness, that being bipolar disorder with manic and
psychotic tendencies, which is a treatable condition.
Though it is a substantial disorder of her thought, her
mood, and her perception, it is grossly impairing her
judgment as well as her behavior and her capacity to
recognize reality.

She has had recent episodes of spiritually grandiose
thinking, paranoid delusions. The testimony today is clear
that she is a danger to herself and others, so the County has
met the burden under both the A and the B standards.

¶10 The court also concluded that Brooke was incompetent to refuse
medication, citing her “lack of insight into her condition.” The court’s six-month
involuntary commitment and medication orders expired on October 27, 2023, the
day Brooke filed her opening brief in this appeal.

DISCUSSION

¶11 To issue a civil commitment order, a trial court must find by clear
and convincing evidence that a subject individual is mentally ill, a proper subject
for treatment, and dangerous to herself or others under at least one of the five
statutory standards. D.J.W., 391 Wis. 2d 231, ¶29; WIS. STAT. § 51.20(1)(a)1.-2.,

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No. 2023AP1842

(13)(e). These findings are critical; “[i]t may be true that an erroneous
commitment is sometimes as undesirable as an erroneous conviction.” Addington
v. Texas, 441 U.S. 418, 428 (1979).

¶12 The review of a civil commitment order—determining whether the
petitioner has met its burden of proof—“presents a mixed question of law and
fact.” Waukesha County v. J.W.J., 2017 WI 57, ¶15, 375 Wis. 2d 542, 895
N.W.2d 783. A trial court’s findings of fact are upheld “unless they are clearly
erroneous,” id., and appellate courts will “accept reasonable inferences from the
facts.” Winnebago County v. Christopher S., 2016 WI 1, ¶50, 366 Wis. 2d 1, 878
N.W.2d 109 (citation omitted). Whether those facts satisfy the statutory standards,
however, is a question of law that is reviewed de novo. Marathon County v.
D.K., 2020 WI 8, ¶18, 390 Wis. 2d 50, 937 N.W.2d 901.

I. Mootness of the appeal

¶13 Our supreme court has determined that mental commitment appeals
are not moot based upon two (or possibly three) collateral consequences. See
Sauk County v. S.A.M., 2022 WI 46, 402 Wis. 2d 379, 975 N.W.2d 162. For one,
the subject individual is subject to a firearm prohibition. Id., ¶23. This appears to
be Brooke’s first commitment and there are no allegations in the Record to
indicate that she was subject to a prior firearm prohibition (e.g., from a felony
charge).3

3
In her Reply, Brooke asserts that “she has no prior convictions, no restraining orders,
and no prior commitments,” and, obviously, because no one can provide evidence of a negative,
this court takes her counsel’s statements at face value.

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No. 2023AP1842

¶14 The second collateral consequence mentioned in S.A.M. is that a
county may seek to recoup payments for care and medication from the subject
individual. Id., ¶24; see also WIS. STAT. § 46.10(2). In this case, as in many (if
not most), the County has made no indication that it would seek such
reimbursement, nor has Brooke’s counsel indicated that a financial reimbursement
demand was made by the County.

¶15 The County asserts that one or both of these collateral consequences
may not apply to Brooke, but it provides nothing in support of that statement.
Regardless of the possible lack of a viable, non-moot appeal here, this court will
address the merits.

II. The trial court made specific factual findings.

¶16 The key to the first issue in this appeal is an analysis of whether the
trial court made “specific factual findings with reference to the subdivision
paragraph of [WIS. STAT.] § 51.20(1)(a)2. on which the []commitment is based.”
See D.J.W., 391 Wis. 2d 231, ¶40.4 The D.J.W. court set out the rationale
underlying this requirement. “First, it provides clarity and extra protection to
patients regarding the underlying basis for a []commitment.” Id., ¶42. Civil
commitments are significant curtailments of an individual’s personal liberty and

4
The requirement for specific factual findings set forth in Langlade County v. D.J.W.,
2020 WI 41, 391 Wis. 2d 231, 942 N.W.2d 277, applies to both recommitments (at issue in that
case) as well as initial commitments. See Winnebago County v. A.A.L., No. 2020AP1511,
unpublished slip op. ¶17, n.8 (Mar. 24, 2021) (“We recognize that [D.J.W.] specifically dealt
with recommitment proceedings, but we see no reason why the court’s mandate would not
apply for initial commitments as well. The ‘purpose of making specific factual findings’ is
equally applicable to initial commitments.” (citation omitted)). Pursuant to WIS. STAT.
RULE 809.23(3)(b), this court cites to this unpublished opinion for “persuasive value” only.

7
No. 2023AP1842

they can carry an additional deprivation of personal autonomy when accompanied
with an involuntary medication and treatment order.

¶17 Second, as the D.J.W. court elaborated:

a requirement of specific factual findings ... will clarify
issues raised on appeal of []commitment orders and ensure
the soundness of judicial decision making, specifically with
regard to challenges based on the sufficiency of the
evidence. See Klinger v. Oneida [County], 149 Wis. 2d
838, 846-47, 440 N.W.2d 348 (1989) (“[A]s this court has
stated many times, the [trial] court must make a record of
its reasoning to ensure the soundness of its own decision
making and to facilitate judicial review.”). A more
substantial record will better equip appellate courts to do
their job, further ensuring meaningful appellate review of
the evidence presented in []commitment proceedings.

D.J.W., 391 Wis. 2d 231, ¶44 (third alteration in original).

¶18 Appeals to this court based upon an arguable lack of specific factual
findings by the trial court are multiplying and it is clear that all sides could benefit
from clarity on the point. As this court and our supreme court is wont to state,
there are no magic words required by the law. State v. Brown, 2020 WI 63, ¶27,
392 Wis. 2d 454, 945 N.W.2d 584 (“The law generally rejects imposing
‘magic words’ requirements.”); see also Patchak v. Zinke, 583 U.S. 244, 251
(2018) (noting that the Supreme Court refrains from reading statutes to “incant
magic words” (citation omitted)). That being said, there are certain steps that each
trial court in a mental commitment rotation should take when issuing findings and
conclusions. First, the court should set out what it looked at and what it heard to
form the basis for its opinion (e.g., the court has heard from expert X, witnesses Y
and Z, and the subject individual, and has reviewed the following documents).
Next, the court should summarize the testimony that supports (or does not support)
a finding of mental illness, dangerousness, and treatability and state which

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No. 2023AP1842

witnesses it found to be credible. With respect to dangerousness, the court should
clearly state which paragraph(s) the County is seeking to establish dangerousness
under as well as which paragraph(s) the court finds to be applicable; these may not
necessarily be the same. The court should also tie the evidence to the standard
(e.g., witness Y indicated that he was in fear of his safety, witness Z heard the
individual make suicidal statements, or the subject individual told the expert that a
particular event took place). The more detailed the better (as well as the less likely
to be overturned on appeal). Finally, the trial court should read out loud the
factual findings and conclusions contained in the standard order form for
commitment orders and involuntary administration of medication and treatment
orders.

¶19 In outlining these specific factual findings, the trial court is not
required to issue a complete compendium of all of the prior testimony. As with all
exercises of discretion, however, trial courts must make sure that the record
indicates what they considered and how their decisions were made. Our state
supreme court nicely summarizes how appellate courts discern whether an
exercise of discretion was made:

[W]e first look to “the record to see whether that discretion
was in fact exercised.” [J.A.L. v. State, 162 Wis. 2d 940,
961, 471 N.W.2d 493 (1991).] The exercise of discretion
incorporates a process of reasoning and proper explanation.
State v. Salas Gayton, 2016 WI 58, ¶19, 370 Wis. 2d 264,
882 N.W.2d 459 (“An exercise of discretion contemplates a
process of reasoning. This process must depend on facts
that are of record or that are reasonably derived by
inference from the record and a conclusion based on a
logical rationale founded upon proper legal standards.”
(quotations and citations omitted)); McCleary v. State, 49
Wis. 2d [263], 277, 282, 182 N.W.2d 512 [1971] (holding
that a circuit court that did not provide adequate reasoning
or explanation for a discretionary decision “fail[ed] to
exercise discretion,” and explaining that “[d]iscretion is not
synonymous with decision-making”); State v. Hall, 2002

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WI App 108, ¶¶16-17, 255 Wis. 2d 662, 648 N.W.2d
41 (reasoning that a discretionary decision that was
supported by minimal and inadequate explanation by a
circuit court “reflect[ed] decision making” but not “a
process of reasoning based on a logical rationale,” as is
required for a proper exercise of discretion (citations and
quotations omitted)).

State v. X.S., 2022 WI 49, ¶33, 402 Wis. 2d 481, 976 N.W.2d 425.

¶20 That brings us to the instant matter and the findings actually placed
on the Record regarding Brooke. The trial court listed the witnesses who testified
and indicated it was “[r]elying heavily upon the opinion of the medical
professional.” The court explained that Brooke’s disorder “is grossly impairing
her judgment as well as her behavior and her capacity to recognize reality.” Then,
it itemized the concerning behavior: “She has had recent episodes of spiritually
grandiose thinking, paranoid delusions.” This spiritually grandiose reference,
albeit not a recitation of the exact testimony, obviously relates to a large portion of
Brooke’s mother’s testimony, including the following:

[Brooke] was telling me that she was reincarnated and she
was a witch and was burned at the stake .... She was a bad
person that died in a concentration camp. She was
speaking to dead people.... All of these dead people were
channeling through her ....

[Brooke] said that she had to do a deep cleansing
because there was an Indian -- a native American Indian
outside her bathroom door and he was scalped and she said
that was one of the most scariest of the evil spirits that’s
been with her ....

[Brooke indicated] she was Eve and [was] going to [the]
Garden of Eden, she said she was really, really tired and
she needed to go lay down. And she went down -- she
went to lay down like ten minutes and came up and said,
no, it’s the 7th day when you need the day of rest, which
would have been Sunday, so I didn’t know if all of this was
leading up to Sunday when she was going to end it all.

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No. 2023AP1842

¶21 Brooke’s mother testified that after telling her that her body
wouldn’t be there the next day, Brooke threw her passport, driver’s license, and
things from her children into a bag that she tossed into a fire pit. It is reasonable
to infer, from this testimony as well as from Bales’s Report (which was admitted
into evidence)5 that the trial court found Brooke’s conduct to be a sound basis
upon which to conclude that she was dangerous under the relevant statutory
provisions. While the trial court’s findings were not more fully bolstered6 with
those examples of her spiritual grandiosity, they surely are sufficient, when taken
with the reasonable inferences from the record, to conclude that there were
specific factual findings. These findings are sufficient to allow appellate courts to

5
In Dr. Bales’ Report of Examination, dated April 22, 2023, marked at trial as
Petitioner’s Exhibit 2, he explains:

On April 14, 2023 the detention document notes that [Brooke]
attacked her father leaving marks. She also was noted when
detained to state “you’re not going to be here tomorrow. Your
spirit will be, but your body won’t”. Around this time she was
speaking of demonic spirits as well.

[Brooke] admitted these threats, but then when I interviewed
her she started talking about spiritual baths and other delusional
sounding subjects.... The crisis department noted as well that she
spoke of her parents being dead the next day. She was found to
be delusional and putting her parents in fear. She was declining
voluntary mental health care. Crisis noted scratches nearly the
entire length of [Brooke’s] father’s forearm. He later reported
that he feared for his safety.

When interviewed [Brooke] seemed euphoric and elevated in
mood. She talked about spiritual awakenings. She was
delusional. She confirmed the concerns leading to being in
seclusion. She denied any mental illness and particularly saw no
need for psychotropic medications. She appears fairly
intelligent, but does lack insight into her condition.
6
This court, again, encourages trial courts to more fully detail the bases upon which they
make their findings of dangerousness.

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No. 2023AP1842

conduct a meaningful review of the trial court’s exercise of discretion and the
evidence presented at the hearing.7

¶22 Finally, the County asserts that Brooke forfeited her right to bring
this appeal based on a lack of specific factual findings by not raising that argument
during the trial or to the trial court in a postdisposition motion. While the court
agrees with Brooke that there is no basis for the forfeiture argument, it also
believes that civil litigation, in particular in cases of mental commitment, is not a
game; litigants should not be holding back on asking trial courts to make complete
and proper records and findings. The extraordinarily large influx of appeals in
mental commitment cases is starting to overwhelm the appellate court system. All
parties, and the trial courts, should be taking great pains to ensure that rulings are
supported by admissible evidence and the appropriate factual findings are stated in
full on the record.

III. There was sufficient admissible evidence of dangerousness.

¶23 Brooke next argues that the County offered insufficient admissible
evidence to support a finding that she was dangerous under either relevant
statutory paragraph. She further contends that evidence that was admitted into the
Record, as well as Bales’s reports, were inadmissible hearsay upon which the trial
court should not have relied. The County contends that there was no error and no

7
The County also contends that a failure to make specific factual findings per D.J.W. is
harmless error and that “Brooke’s substantial rights were not affected by the [trial] court’s failure
to recite how specific facts applied to each element of the two standards when [the trial court] had
just listened to the testimony of all the witnesses, including Brooke’s.” If this were correct,
D.J.W. would be gutted because a trial court could summarily say “ditto” and commit the
individual for up to one year. It takes less than five minutes to summarize and pull out those
specific facts upon which such an important ruling is based.

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No. 2023AP1842

admission of hearsay through Bales’s testimony or reports, but that even if there
were, there was still sufficient evidence in other witnesses’ and Brooke’s own
testimony to support the court’s finding of dangerousness.

¶24 Hearsay is defined as “a statement, other than one made by the
declarant while testifying at the trial or hearing, offered in evidence to prove the
truth of the matter asserted.” WIS. STAT. § 908.01(3). It is generally inadmissible.
WIS. STAT. § 908.02. But Bales testified as an expert. Under WIS. STAT.
§ 907.03, an expert may rely on otherwise inadmissible evidence, such as hearsay,
if the evidence is of the type experts typically rely upon to form their opinions. In
the context of WIS. STAT. ch. 51 commitments, testifying expert physicians are
expressly permitted to rely upon an individual’s treatment records, WIS. STAT.
§ 51.20(1)(am), and they may use that review as a basis to formulate their opinions
as to the three key issues. See § 51.20(9)(a)5.

¶25 “It is well settled that it is ‘proper for a physician to make a
diagnosis based in part upon medical evidence of which he has no personal
knowledge but which he gleaned from the reports of others.’” Walworth County
v. Therese B., 2003 WI App 223, ¶8, 267 Wis. 2d 310, 671 N.W.2d 377 (quoting
Karl v. Employers Ins. of Wausau, 78 Wis. 2d 284, 299, 254 N.W.2d 255
(1977)). The court in Therese B. noted “two important qualifications of this rule.”
Id., 267 Wis. 2d 310, ¶8. “First, although WIS. STAT. § 907.03 allows an expert to
base an opinion on hearsay, it does not transform the hearsay into admissible
evidence.” Therese B., 267 Wis. 2d 310, ¶8. Second, it “does not give license to
the proponent of an expert to use the expert solely as a conduit for the hearsay
opinions of others.” Id., ¶9.

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No. 2023AP1842

¶26 Brooke’s mother testified about Brooke’s strange spiritual and
delusional behavior in the days leading up to her commitment. There were
comments about reincarnation, spirits, witches, and more. Of most concern were
Brooke’s comments about her mother’s body not being present the next day and
her mother’s need for the suicide hotline telephone number: either for Brooke or
for herself. One would be a statement of Brooke’s suicide ideation, the other a
threat to the life of Brooke’s mother. Her mother saw Brooke take actions to
attempt to destroy her identification documentation and her children’s toys. Her
mother further testified that she was afraid for her own safety and for that of her
other daughter and that she also believed that Brooke intended to hurt herself.
Brooke’s mother was a witness to all these statements and actions; they are not
inadmissible hearsay.

¶27 Brooke’s father testified about Brooke’s reaction to him and how she
scratched his arm. He also testified about Brooke’s comment that the
“weatherman” with a “green gun” was coming for him. None of these statements
are hearsay (even though Brooke testified that she never scratched or attacked her
father).

¶28 Finally, the trial court admitted Bales’s two expert reports (over
Brooke’s hearsay objections). In those reports, there are additional statements
made by Brooke to Bales in which she admits walking into the road at night in
dark clothing. These statements are not hearsay because Brooke was the source of
the information. Statements made by a party—or, in this case, the subject
individual—are not hearsay and are admissible. See WIS. STAT. § 908.01(4)(b)1.;
State ex rel. Kalt v. Board of Fire and Police Comm’rs for Milwaukee, 145
Wis. 2d 504, 516, 427 N.W.2d 408 (Ct. App. 1988).

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No. 2023AP1842

¶29 Even without Brooke’s statements to Bales, there was sufficient,
admissible evidence that established, by clear and convincing evidence, that
Brooke was making statements about self-harm or suicidal ideation and that
Brooke’s mother and father were in reasonable fear for their safety from violent
behavior and serious bodily harm from Brooke. Her mother clearly was
frightened enough to send their other daughter away and had fears that Brooke
was planning on either suffocating her with a pillow or killing her and staging it to
look like a suicide. Merely because neither parent was certain when and how
Brooke would possibly harm them does not mean that they were not in reasonable
fear of violent behavior or physical harm from their daughter. Accordingly,
Brooke has failed to establish a basis for reversal on this issue.

IV. The involuntary medication and treatment order was properly
issued.

¶30 As a final issue, Brooke asserts that because she was able to express
her understanding of the advantages and disadvantages of the available
medications for her condition, the trial court erred when it ordered her to comply
with involuntary medication and treatment. This court agrees that a person can be
mentally ill “yet nevertheless capable of evaluating the advantages and
disadvantages of taking psychotropic drugs and making an informed decision”
about the same. Outagamie County v. Melanie L., 2013 WI 67, ¶45, 349 Wis. 2d
148, 833 N.W.2d 607 (citation omitted). It further agrees that mere disagreement
with a physician’s medication or treatment recommendations does not establish
that someone is incompetent to make those decisions. See Virgil D. v. Rock
County, 189 Wis. 2d 1, 15-16, 524 N.W.2d 894 (1994). But, that is not
determinative in and of itself—the actual testimony in each trial must be
examined.

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No. 2023AP1842

¶31 Here, Brooke was able to identify the medication she had been
prescribed, how it seemed to assist her, and some of the side effects that could
result from that medication. She stated that believed the medication was helping
her and that “[a]side from improved sleep, [she] fe[lt] pretty healthy.” But, upon
cross-examination she clearly stated that she did not believe she was mentally ill.
Brooke first stated that she was only taking the medication because she was court-
ordered to do so, and that medical health professionals advised her to take it. She
then contradicted herself, stating that even though she doesn’t have a mental
health disorder, she would continue taking it if not under court orders.

¶32 In its second order, the trial court found that, due to her mental
illness, Brooke was not competent to refuse psychotropic medication or treatment
because she was both (1) “incapable of expressing an understanding of the
advantages and disadvantages of accepting medication or treatment and the
alternatives” and (2) “substantially incapable of applying an understanding of the
advantages, disadvantages and alternatives to … her condition in order to make an
informed choice as to whether to accept or refuse psychotropic medication.”
Appellate courts will not disturb a trial court’s findings of fact unless they are
clearly erroneous. Melanie L., 349 Wis. 2d 148, ¶38. As noted previously,
reasonable inferences can be relied upon and the appellate courts can search the
lower court record for support. Christopher S., 366 Wis. 2d 1, ¶50.

¶33 Bales testified as to Brooke’s lack of insight into her mental
condition8 and wrote in his report that she:

8
For instance, Bales testified that “[t]he problem is her lack of insight into getting help
voluntarily which she gives me the definite impression she would not do.”

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No. 2023AP1842

denied mental illness and, therefore, could not see the need
for psychotropics nor weigh pros and cons of them. She
has also self-medicated with marijuana. In my opinion, she
could not competently refuse psychotropics. An
involuntary medication order is requested.

¶34 The trial court made the following findings after hearing the
testimony of Bales, Brooke’s parents, and Brooke:

Also there was testimony about her lack of insight into
her condition, and though she is currently taking her
medication, she did state herself that she did not believe
that it was due to her medical condition, rather more to
comply with court orders. So she is unable to express or
apply an understanding of the medications as applicable to
her condition.

¶35 This finding by the trial court—after hearing evidence from both
Bales and Brooke as well as argument by counsel—is not clearly erroneous. The
court found Brooke was mentally ill and, because she denied that condition, that
she lacked insight into her mental illness and met both standards for the
involuntary administration of medication and treatment. This court agrees that the
evidence supports a finding that Brooke is substantially incapable of applying any
understanding of the advantages, disadvantages, and alternatives to her condition
precisely because, based on Bales’s testimony and reports, she did not accept that
she had a mental illness. Given Brooke’s clear elaboration about her medication,
how it improves her sleep, and the recitation of the different side effects, however,
this court concludes that the evidence does not support a finding that Brooke was
incapable of expressing an understanding of the disadvantages of treatment, but
rather that she may not have been competent to express an understanding of the
advantages or alternatives to treatment. Having concluded that one 9 of the bases

9
See Sweet v. Berge, 113 Wis. 2d 61, 67, 334 N.W.2d 559 (Ct. App. 1983) (when one
issue is dispositive of an appeal, we need not discuss other issues).

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No. 2023AP1842

for ordering the involuntary medication was met, it is not necessary for this court
to delve further and determine whether the trial court was in error for finding both
bases applied.

CONCLUSION

¶36 Civil commitments are massive curtailments of liberty, and citizens
have the inherent right to be free from unjustified commitments. See Jones v.
United States, 463 U.S. 354, 361 (1983). There is “no constitutional basis for
confining [someone who is mentally ill] if they are dangerous to no one and can
live safely in freedom.” O’Connor v. Donaldson, 422 U.S. 563, 575 (1975).
Courts, however, are required to commit individuals who do meet the three
statutory factors of being mentally ill, treatable, and dangerous. WIS. STAT.
§ 51.20(1)(a)1.-2.

¶37 The trial court in this case made sufficient specific factual findings
to support a commitment decision. There was sufficient admissible evidence of
dangerousness under both statutory bases presented to the trial court. And, the
trial court’s finding that Brooke was substantially incapable of applying an
understanding of the advantages, disadvantages and alternatives to her condition in
order to make an informed choice as to whether to accept or refuse psychotropic
medication and treatment was not clearly erroneous based upon the testimony and
evidence.

¶38 Accordingly, the commitment order and the corresponding order for
involuntary administration of medication and treatment are affirmed.

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No. 2023AP1842

By the Court.—Orders affirmed.

This opinion will not be published. See WIS. STAT.
RULE 809.23(1)(b)4.

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