Minn. Stat. § 480A.08, subd. 3 (1996).
STATE OF MINNESOTA
IN COURT OF APPEALS
Filed May 26, 1998
File No. P9-97-2101
John P. Dimich, 16 Northeast Third St., Grand Rapids, MN 55744 (for appellant)
John J. Muhar, Itasca County Attorney, W. James Mason, Assistant Itasca County Attorney, 123 Northeast Fourth St., Grand Rapids, MN 55744 (for respondent)
Considered and decided by Crippen, Presiding Judge, Harten, Judge, and Foley, Judge.*
U N P U B L I S H E D O P I N I O N
Appellant challenges the district court's order finding her to be mentally ill and committing her jointly to the University Medical Center-Mesabi, the State Operated Community Services (SOCS) at Eveleth, and the Brainerd Regional Treatment Center. We affirm.
* Retired judge of the Minnesota Court of Appeals, serving by appointment pursuant to Minn. Const. art. VI, § 10.
In November 1997, the Itasca County Human Services Department petitioned for the judicial commitment of appellant Deanna Olson. Following a commitment hearing,
the district court found that appellant is mentally ill with schizophrenia and that her failure to obtain shelter and medical care indicates a substantial likelihood that she may harm herself. The district court ordered triple joint commitment to the University of Minnesota Hospital-Mesabi, the SOCS at Eveleth, and the Brainerd Regional Treatment Center. The district court also authorized administration of neuroleptic drugs. Appellant challenges her commitment asserting insufficient evidence and failure to place her in the least restrictive setting.
D E C I S I O N
On appeal from a judicial commitment, our review is limited to whether the district court complied with the law and whether the commitment was justified by the findings based on the evidence submitted at the hearing. In re Knops, 536 N.W.2d 616, 620 (Minn. 1995). The district court's factual findings must be affirmed unless clearly erroneous. In re Schauer, 450 N.W.2d 194, 196 (Minn. App. 1990).
1. Sufficiency of the Evidence. To commit a person as mentally ill, the district court must find by clear and convincing evidence that the person is mentally ill. Minn. Stat. § 253B.09, subd. 1 (Supp. 1997). A mentally ill person is
any person who has an organic disorder of the brain or a substantial psychiatric disorder of thought, mood, perception, orientation, or memory which grossly impairs judgment, behavior, capacity to recognize reality, or to reason or understand, which is manifested by instances of grossly disturbed behavior or faulty perceptions.
Minn. Stat. § 253B.02, subd. 13(a) (Supp. 1997).
The court-appointed psychiatrist interviewed appellant and found her "delusional, paranoid, labile, angry, refusing to cooperate." He diagnosed appellant as mentally ill and suffering from schizophrenia. At the Jarvis hearing, he testified that appellant needed neuroleptic medication to treat her disorder. The court-appointed psychologist confirmed the diagnosis and testified that appellant was in need of inpatient commitment. A therapist from the mental health unit where appellant was being held testified that appellant had faulty perceptions of reality and that she refused to take the prescribed medications. Appellant's delusional thinking and faulty perceptions were evident from her own testimony.
It is not enough, however, to show that the person's perceptions of reality are impaired; the person must also "pose a substantial likelihood of physical harm to self or others." Minn. Stat. § 253B.02, subd. 13(a). The substantial likelihood of harm can be shown by "a failure to obtain necessary food, clothing, shelter, or medical care." Id.
Here, appellant's brother testified that appellant was living in a camper in the back of a pickup (in November) and that she was heating the camper with a cooking stove. He testified that the family offered to bring her to a halfway house, to rent an apartment for her, or to find someone to stay with her, but that she refused each offer. Appellant confirmed that she had been living in a camper and testified that it was adequate for her needs. Based on the evidence of inadequate shelter and medical care presented at the hearing, the district court's finding that appellant is mentally ill is not clearly erroneous.
2. Commitment to Least Restrictive Alternative. A mentally ill person found to be in need of commitment must be committed to the least restrictive treatment program that can meet the person's treatment needs. Minn. Stat. § 253B.09, subd. 1. The treatment decision is to be made only after the district court has considered reasonable alternative dispositions, including voluntary treatment. Id.; In re Butler, 379 N.W.2d 233, 235 (Minn. App. 1985).
Here the district court considered alternatives to commitment, including voluntary outpatient and inpatient care. It rejected voluntary treatment because appellant "does not have sufficient insight into her problems to assure any likelihood of cooperation." The district court also considered a number of alternative treatment programs from community-based nonresidential treatment to involuntary hospitalization before choosing triple joint commitment, first to the University Medical Center-Mesabi in Hibbing, and then, if necessary, to either the Eveleth SOCS or the Regional Treatment Center at Brainerd.
The court-appointed psychologist opined that commitment was necessary for treatment and recommended inpatient treatment at the named facilities. The mental health therapist confirmed that appellant would not take her prescribed medication. Appellant herself testified that she was not mentally ill and not in need of drugs. Accordingly, the evidence supports the district court's finding that voluntary treatment was inappropriate.
Appellant argues that the district court's reliance on administrative agencies to decide whether appellant should be transferred to the Brainerd Regional Treatment Center defeats the least restrictive setting requirement. Although appellant's transfer, if needed, may be decided by administrative action, appellant can challenge the administrative decision by means of the procedures provided in Minn. Stat. § 253B.17 (Supp. 1997) (patient or interested person may petition court for order that patient is no longer in need of care or is no longer mentally ill). In addition, "[t]he placement choice between state institutions is a prerogative of the commissioner." In re King, 476 N.W.2d 190, 193 n.7 (Minn. App. 1991); see also Minn. Stat. § 253B.14 (Supp. 1997) (commissioner of human services has authority to transfer committed person from regional treatment center to any treatment facility within commissioner's jurisdiction). The commissioner's authority commences at the time of judicial commitment and is subject to review procedures that involve not only the courts but also institutional review boards. King, 476 N.W.2d at 193 n.7. The record supports the district court's determination that triple joint commitment to University Medical
Center-Mesabi, the SOCS at Eveleth, and the Brainerd Regional Treatment Center is the least restrictive alternative.