The evidence was sufficient to justify an extension of Laura B.’s commitment and an order for involuntary medication and treatment.
Under Laura’s initial six-month commitment there was no order for involuntary medication and treatment, and she did not comply with various aspects of her treatment plan. (¶¶2-3). Predictably enough, her refusal to comply predictably played a role at the extension hearing, as the county’s examiner relied on it to conclude that Laura had a continuing need for treatment and that she couldn’t express or apply an understanding of the advantages, disadvantages, and alternatives to treatment, given her “abject denial that any of that applies to her ….” (¶9).
The extension order is supported by the examiner’s conclusion that without continued commitment she “could” get worse and attempt suicide again, even though there was no evidence Laura engaged in dangerous behavior during her commitment:
¶14 …. As noted in [State v.] W.R.B., [140 Wis. 2d 347, 411 N.W.2d 142 (Ct. App. 1987),] the whole point of [§ 51.20(1)](am) is to remove the need to show recent, overt acts in order to extend a commitment. The County did not have to show that Laura had exhibited any dangerous behavior during her commitment. Rather, the County had to show that, given her treatment record, if treatment were withdrawn there is a substantial likelihood that she would become dangerous. The circuit court found that Rawski’s testimony was credible and noted Rawski’s description of Laura’s delusional thoughts and behaviors and that she had not complied with treatment recommendations. Laura herself testified that she would only take psychotropic medications if ordered to do so. Laura’s noncompliance with her psychiatrist’s recommendation evidences the uncontested finding that she was incapable of expressing or applying an understanding of the advantages and disadvantages of medication and the alternatives. Rawski opined in his report that, based on her treatment record and presentation, Laura “would become the proper subject for commitment if treatment were withdrawn.” Rawski opined that Laura’s condition would not improve without treatment; indeed, he stated that it might get “as bad as it was when she was above a bridge considering suicide.” ….
In addition, the involuntary medication and treatment order is supported on the examiner’s unrebutted opinion that she can’t express or apply an understanding of the advantages and disadvantages of treatment. (¶¶9-11).