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Chapter 51 commitment extended in order to “control” subject’s behavior with medication

Marathon County v. P.X., 2016AP1490, 4/18/17, District 3 (1-judge opinion, ineligible for publication); case activity

P.X., who has longstanding diagnoses of autism, obsessive-compulsive disorder, and intellectual disabilities, was the subject of a Chapter 54 guardianship and a Chapter 55 protective placement, when the County sought to extend his Chapter 51 civil commitment. P.X. argues that he is not a “proper subject for treatment” under Chapter 51 because he is not “capable of rehabilitation” under Fond du Lac County v. Helen E.F., 2012 WI 50, 340 Wis. 2d 500, 814 N.W.2d 179. Instead, the county is using medication to “control” his behavior.

Helen E.F., ¶36, provides:

If treatment will “maximize[e] the[ ] individual functioning and maintenance” of the subject, but not “help[ ] in controlling or improving their disorder[ ],” then the subject individual does not have rehabilitative potential, and is not a proper subject for treatment. However, if treatment will “go beyond controlling … activity” and will “go to controlling [the] disorder and its symptoms,” then the subject individual has rehabilitative potential, and is a proper subject for treatment.

Applying this test the court of appeals held that a Chapter 51 commitment:

¶12 . . . is not improper merely because P.X.’s disorders may be “long-standing.” “An individual with an incurable physical or mental illness or disability may still be considered capable of rehabilitation and able to benefit from treatment in the sense that symptoms can be controlled and the ability to manage the illness ameliorated.” See C.J. v. State, 120 Wis. 2d 355, 360, 354 N.W.2d 219 (Ct. App. 1984). Moreover, P.X. misses the point when he claims that keeping him “safe,” as Starr testified, “does not equate with being capable of rehabilitation.” Here, the circuit court’s findings that P.X.’s disorders were treatable, and his safety was improved as a result, are supported by the evidence. Unlike the subject’s disorder in Helen E.F., both doctors testified P.X.’s disorders and manifested symptoms,  not just the disturbances he caused, could be controlled and improved through medication and a proper living environment. See Helen E.F., 340 Wis. 2d 500, ¶¶7, 38. Indeed, Starr and the social worker testified P.X. had shown progress and his symptoms had recently improved under commitment. Coates may have appeared skeptical about the effectiveness of P.X.’s treatment, but he too testified P.X.’s behavior was “more controlled” by medication. Accordingly, we conclude P.X. was a proper subject for treatment under ch. 51.

We’ll see if SCOW agrees with the court of appeals’ assessment. Waukesha County v. J.W.J., 2016AP46-Ft, now pending in SCOW, asks how courts are to determine whether treatment controls the symptoms of a person’s disorder (thus making him the proper subject of a Chapter 51 commitment) or whether treatment controls just his activity and behavior (thus making him an improper subject of a Chapter 51 commitment).  Medical experts confuse symptoms and behavior, so you can be sure courts do too. Expect SCOW’s opinion in J.W.J. by the end of June.

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