Under § 51.61(1)(g)4.(intro.) and b., the entity seeking the medication order must show that: 1) the advantages and disadvantages of, and the alternatives to, medication were explained to the patient; and 2) the patient is “substantially incapable of applying an understanding” of the advantages, disadvantages and alternatives to make an informed choice about refusing medication. “Substantially incapable of applying an understanding” means that “to a considerable degree, a person lacks the ability or capacity” “to make a connection between an expressed understanding of the benefits and risks of medication and the person’s own mental illness.” Outagamie County v. Melanie L., 2013 WI 67, ¶¶70-71, 349 Wis. 2d 148, 833 N.W.2d 607.
Contrary to Treadway’s claims, the evidence in this case—which consisted of oral testimony and a written report from Stephen Weiler, Treadway’s treating psychiatrist, and a report from a Sand Ridge social worker (¶¶3-9)—was enough to make both showings.
The first requirement was proved by direct evidence from Weiler: He signed the Physician’s Report for Medication, explicitly acknowledging that he explained the advantages and disadvantages and alternatives to accepting medication or treatment; and he testified that he had been Treadway’s treating psychiatrist for five-and-a-half years and that he “had discussed the advantages of [psychotropic medication] on multiple occasions … nearly every visit.” (¶20).
The second requirement was proven by the report from Sand Ridge describing Treadway’s deteriorating mental state in the days leading up to his refusal to take medication and by Weiler’s testimony. Weiler testified that Treadway has refused to acknowledge that he suffers from schizophrenia and only takes his medication when he is able to understand that it calms him. According to Weiler, as Treadway’s condition deteriorated over a period of months, he had lost the ability to understand the benefits and effects of taking psychotropic medication. (¶24).