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SCOW: “threat of suicide” ground for involuntary commitment does not require articulation of plan

Outagamie v. Michael H., 2014 WI 127, 12/16/14, affirming an unpublished court of appeals decision, majority opinion by Justice Crooks; case activity

Section 51.20(1)(a)2.a authorizes the involuntary commitment of a person who is “dangerous,” a test that may be met by showing recent threats of, or attempts at, suicide. This unanimous decision holds that in the right circumstances just thinking about suicide–without articulating a plan for committing it–constitutes a sufficient “threat” to satisfy the involuntary commitment statute.

This case focuses on 2 of the 5 grounds that may be used to establish a person’s dangerousness under §51.20: recent threats of suicide or serious bodily harm and impaired judgment manifested by a pattern of recent acts or omissions.

According to mental health professionals, “suicidal ideation” encompasses everything from: (1) wishing to be dead, (2) having suicidal thoughts, (3) thinking about suicide and methods for committing it, but lacking a plan, (4) having a suicidal intent without having a plan for doing it, and (5) having a suicidal intent with a specific plan. Given this continuum, it can be hard to predict which suicidal people are at highest risk for killing themselves. This uncertainty seems to have driven the result in this case.  The court explained that permitting involuntary commitment only when a suicidal person has articulated a plan for committing suicide would create a barrier to treatment of a person who is in a confused mental state. That is inconsistent with the statute’s purpose. Slip op. ¶6.

Next, the court considered the amount of evidence required to satisfy the “threats of suicide” test for dangerousness.  Judging from the decision (the record is confidential) the only concrete reference to suicide in this case occurred when a nurse asked Michael if he was suicidal, and he responded “yes.” But because a jury had found Michael H. to be “dangerous,” the appellate court had to apply a highly deferential standard of review. It had to search the record for any credible evidence that, when viewed in the light most favorable to the verdict, supported it. According to the court, there was plenty of credible evidence available to the jury.

Specifically, Michael had repeatedly told family that “nobody’s safe.” He told a police officer that he wanted to harm himself. He exhibited delusional and paranoid behavior. He carried a knife and had access to guns. He walked 2 miles with a 5-year-old through the snow based on a fear that his sister was in danger. He bought several cell phones to avoid being tracked by an unnamed person and thought one was bugged. He was unable to sleep, told his mom that he could not think straight, and had repeatedly refused medication.  Slip op. ¶18. These facts, combined with his admission that he was suicidal, provided sufficient support for the jury’s verdict.

The court also examined the sufficiency of evidence to support a jury finding that Michael had impaired judgment manifested by a pattern of recent acts or omissions showing that he might harm himself. Wis. Stat. §51.20(1)(a)2.c. The court held that the same evidence that could support a finding of a “threat of suicide” would support a finding of “impaired judgment.” Slip op. ¶39-¶40.

The court reaffirmed Lessard v. Schmidt, 349 F. Supp. 1078 (E.D. 1972)(followed by Lessard II, III, IV and V) which established the substantive and procedural due process rights for a person subject to involuntary commitment proceedings. Though it examined the “threat of suicide” ground for commitment, it also left a lot up in the air. A “threat” does not require an articulated plan. But what if Michael had simply admitted to feeling suicidal minus most of the other facts? There’s room for litigation on the low end of the “suicidal ideation” spectrum.

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