Opinion
No. C1-97-257.
Filed June 17, 1997.
Appeal from the District Court, Hennepin County, File No. P482300104.
James S. Dahlquist, (for appellant Nancy Reinhold).
Hubert H. Humphrey, III, Attorney General, Terri D. Yellowhammer, Assistant Attorney General, (for respondent).
Michael O. Freeman, Hennepin County Attorney, Coleen M. Brady, Assistant County Attorney, (for respondent).
Considered and decided by Toussaint, Chief Judge, Crippen, Judge, and Willis, Judge.
This opinion will be unpublished and may not be cited except as provided by Minn. Stat. § 480A.08, subd. 3 (1996).
UNPUBLISHED OPINION
Nancy Reinhold appeals her continued commitment as mentally ill, arguing that the evidence does not meet the statutory standard as to likelihood of harm to herself or others. She also challenges the Jarvis order authorizing involuntary treatment with neuroleptic medication, claiming that she is competent to decide whether to take medication because her continued commitment was in error. Because we find there is clear and convincing evidence to support the district court's finding that Reinhold is likely to cause physical harm to herself or others if her commitment is not continued, we affirm. We also affirm the Jarvis order.
DECISION I.
District court findings will not be reversed unless clearly erroneous. Minn.R.Civ.P. 52.01, see In re Melcher , 404 N.W.2d 309, 312 (Minn.App. 1987) (concluding trial court did not clearly err in finding continued commitment necessary). Whether the evidence is sufficient to meet the standard for commitment is a question of law, which we review de novo. In re Knops , 536 N.W.2d 616, 620 (Minn. 1995).
Reinhold was previously committed as mentally ill. See Minn. Stat. § 253B.09, subd. 1 (1996) (court may commit mentally ill person to treatment program); Minn. Stat. § 253B.02, subd. 13(b) (1996) (definition of mentally ill person including one who has made recent attempt or threat to physically harm self or others). Before the commitment may be continued, the court must hold another hearing. Minn. Stat. § 253B.13, subd. 1 (1996). The standard for continued commitment is as follows:
In determining whether a person continues to be mentally ill * * *, the court need not find that there has been a recent attempt or threat to physically harm self or others, or a recent failure to provide necessary personal food, clothing, shelter, or medical care. Instead, the court must find that the patient is likely to attempt to physically harm self or others, or to fail to provide necessary personal food, clothing, shelter, or medical care unless involuntary commitment is continued.
Minn. Stat. § 253B.12, subd. 4 (1996); see Minn. Stat. § 253B.13, subd. 1 (1996) (providing that standard in section 253B.12, subdivision 4, applies to continued commitment). The court must determine the need for continued commitment by clear and convincing evidence. Minn. Stat. § 253B.12, subd. 4.
The district court found that if Reinhold were not involuntarily committed, she would likely attempt to harm herself or others physically and to fail to provide necessities. The district court's decision is supported by the following: (1) despite many years of psychiatric treatment, Reinhold did not have insight into her condition, (2) she did not comply with treatment and medication, (3) she was verbally abusive, provocative, assaultive, and exhibited sexually inappropriate behavior, (4) when Reinhold did not take her medication, she decompensated rapidly and became extremely vulgar and intrusive, and (5) when she was extremely vulnerable, and outside of a hospital setting, she would likely suffer a retaliatory physical or sexual assault.
Reinhold acknowledges that during the proceeding she was disruptive and appeared disorganized. However, she contends that her treating physician's testimony was speculative and was not based on her actual actions. Because more than mere speculation is needed for commitment, she contends the standard was not met. See In re McGaughey , 536 N.W.2d 621, 623 (Minn. 1995) (addressing initial commitment and holding likelihood of harm may not be based on speculation). Reinhold does not appear to challenge the findings, but instead disagrees with the weight of the evidence. We do not agree that the testimony or evidence was speculative. See id. (noting person need not come to harm or harm others before commitment is justified, but requiring that statutory factors revealing likelihood of harm must be present).
The district court made findings that are supported by the record and are not clearly erroneous. See Melcher, 404 N.W.2d at 312. The findings demonstrate Reinhold is likely to attempt to harm herself or others physically or to fail to provide necessities unless her involuntary commitment is continued. See In re Adams , 352 N.W.2d 117, 119 (Minn.App. 1984) (holding evidence that patient was unlikely to provide necessities, would likely harm others due to his hostile and angry outbursts, had threatened to kill others or to commit suicide, and needed medication to prevent such outbursts supported continued commitment).
II.
Reinhold challenges the Jarvis order authorizing involuntary treatment with neuroleptic medication. Reinhold contends that if her behavior does not meet the standard for continued commitment, she must be deemed competent to consent or to refuse to take neuroleptic medication. Because this court is upholds the commitment, Reinhold's argument fails. Additionally, the record supports the district court's conclusion that Reinhold has little, if any, insight into her mental illness. There is clear and convincing evidence of her incompetency. See In re Peterson , 446 N.W.2d 669, 672 (Minn.App. 1989) (for purpose of Jarvis hearing, competency requires an awareness of having a mental disorder, sufficient knowledge about medication and mental disorder, and refusal not based on delusional-beliefs) (citing Beck, Right to Refuse Anti-Psychotic Medication: Psychiatric Assessment and Legal Decision-Making: II Mental and Physical Disability Law Rptr. 368 (1987))., review denied (Minn. Dec. 1, 1989). We conclude the Jarvis order was correctly issued.