James was diagnosed with chronic paranoid schizophrenia and hospitalized many times. He appeal an order extending his involuntary commitment and argued, unsuccessfully, that the county failed to present evidence of recent acts of violence against others and insufficient evidence that he would become dangerous if treatment were withdrawn.
The court of appeals held:
¶8 While we agree that the hearing testimony did not establish that James is dangerous due to any “recent overt act,” Wis. Stat. § 51.20(1)(a)2.b., that is not the standard for a commitment extension. Section 51.20(1)(am) eliminates the requirement for evidence of “a recent overt act” under § 51.20(1)(a)2., in recognition that a person who is currently committed and receiving treatment is unlikely to act in the same manner that would subject him or her to an initial commitment. Section 51.20(1)(am)’s alternative standard is intended to “avoid the ‘revolving door’ phenomena whereby there must be proof of a recent overt act to extend the commitment but because the patient was still under treatment, no overt acts occurred and the patient was released from treatment only to commit a dangerous act and be recommitted.” State v. W.R.B., 140 Wis. 2d 347, 351, 411 N.W.2d 142 (Ct. App. 1987). The County need not show that James was recently violent toward others.
¶9 We also disagree with James that the County did not meet its burden that there is a substantial likelihood, based on his treatment record, that he would become dangerous if treatment were withdrawn. See Wis. Stat. § 51.20(1)(am). According to James’s psychiatrist, James has a long history of denying his mental illness and his need for medication. This denial has led James to refuse to take his medication, which in turn has led to deterioration significant enough to require recent hospitalization. During times of such refusal he has threatened the safety of others. There is clear and convincing evidence to support the court’s extension of James’s mental health commitment.