may not be cited except as provided by
Minn. Stat. § 480A.08, subd. 3 (1996).
STATE OF MINNESOTA
IN COURT OF APPEALS
In the Matter of :
Cori Lee Larson.
Filed March 25, 1997
Hennepin County District Court
File No. P4-95-60567
Michael O. Freeman, Hennepin County Attorney, John P. St. Marie, Assistant County Attorney, A-2000 Government Center, 300 S. Sixth St., Minneapolis, MN 55487 (for Respondent)
Douglas F. McGuire, Smith
* Fisher, MSB Center, Ste. 400, 1401 West 76th St., Richfield, MN 55423 (for Appellant)
Considered and decided by Randall, Presiding Judge, Harten, Judge, and Willis, Judge.
Appellant Cori Lee Larson was committed as mentally ill. She contends (1) that as required under Minn. Stat. § 253B.02, subd. 13(b)(i) (1996), the evidence was not clear and convincing that she posed a danger to herself by a failure to obtain necessities, (2) that the district court erred in rejecting less restrictive placement alternatives, and (3) that the district court's order authorizing the administration of neuroleptic medication violates the Freedom of Conscience Clause of the Minnesota Constitution. We affirm.
Appellant's sister testified that when appellant was later found she was dirty, manifested poor hygiene, smelled horrible, and had burn marks on her face from lighting fires under a bridge. Appellant said that she had spent two nights in a shelter and three nights under the bridge and that her only nourishment during the preceding two days was some pop and chips. Appellant told her sister, and admitted during the commitment hearing, that while she was living under the bridge a man approached her and attempted to rape her three nights in a row but appellant "prayed to God that this man would go away" and he did.
Two psychiatric social workers testified at the commitment hearing. The senior psychiatric social worker recommended commitment because appellant was endangered due to her inability to care for her basic needs; also, appellant was at risk of attack by other people because she placed herself in vulnerable positions. The other psychiatric social worker who interviewed appellant and reviewed her medical records recommended inpatient commitment because of her refusal to accept necessary psychiatric medications. The court-appointed physician-examiner diagnosed appellant as suffering from paranoid type schizophrenia, religious delusions, and hallucinations. The examiner testified that appellant's illness had rendered her incapable of providing for her basic needs and that a judicial order for neuroleptic medication was necessary because appellant's religious delusions rendered her incompetent to consent to treatment. The court-appointed psychologist-examiner testified that appellant was suffering from either a delusional disorder or paranoid schizophrenia and recommended dual commitment and a judicial order for neuroleptic medication.
The district court found that appellant suffers from schizophrenia (chronic undifferentiated type) and, because of her overwhelming religious preoccupations and delusions, engages in behavior that poses a substantial likelihood of causing physical harm to herself. The district court ordered dual commitment to Hennepin County Medical Center (HCMC) and Anoka Metro Regional Treatment Center (AMRTC). It also authorized the administration of neuroleptic drugs to appellant. This appeal resulted.
2. A mentally ill person determined to be in need of commitment must be committed to the least restrictive treatment facility that can meet his or her treatment needs. Minn. Stat. § 253B.09, subd. 1. The treatment decision is made only after the district court has considered reasonable alternative dispositions, including voluntary treatment. Id.; In re Rice, 410 N.W.2d 907, 910 (Minn. App. 1987), review denied (Minn. Oct. 28, 1987).
Appellant asserts that the district court's rejection of alternatives to dual commitment to HCMC and AMRTC is unsupported by the evidence. The evidence, however, fully supports the district court's finding that voluntary community-based treatment was not possible. Appellant has been unable to successfully complete voluntary treatment because her religious delusions and refusal to accept neuroleptic medications deprive her of insight into her illness. The examining psychologist and both psychiatric social workers testified that commitment was necessary because less restrictive attempts had failed. We conclude that the district court properly considered less restrictive alternatives and found no reasonable alternative to dual commitment to HCMC and AMRTC. See In re Butler, 379 N.W.2d 233, 235 (Minn. App. 1985) (affirming commitment where record supported district court's finding that no alternative disposition existed).
3. Appellant contends that the district court's order authorizing involuntary administration of neuroleptic medication violates her constitutional right to exercise her religion freely under the Freedom of Conscience Clause of the Minnesota Constitution. See Minn. Const. art. I, § 16 (government may not infringe on right to exercise religion freely). A person must be competent in order to refuse neuroleptic medication. See Jarvis v. Levine, 418 N.W.2d 139, 148 n.7 (Minn. 1988) (finding of legal incompetence prerequisite to involuntary treatment with neuroleptics). Competency to refuse medication has been defined as: (1) an awareness of having a mental disorder; (2) sufficient knowledge about medication and the mental disorder; and (3) a refusal that is not based upon delusional beliefs. In re Peterson, 446 N.W.2d 669, 673 (Minn. App. 1989) (citing James C. Beck, Right to Refuse Anti-Psychotic Medication: Psychiatric Assessment and Legal Decision-Making, 11 Mental & Physical Disability L. Rep. 369 (1987)), review denied (Minn. Dec. 1, 1989).
We have reviewed the evidence and conclude that it supports the district court's finding that appellant is incompetent to refuse neuroleptic medication. Appellant's refusal of neuroleptic medications stems from her religious delusions and hallucinations. We conclude that the order authorizing involuntary administration of neuroleptic medication does not violate appellant's constitutional right to exercise her religion freely.