In re A.R.F., 2022AP1262

CourtCourt of Appeals of Wisconsin
Writing for the CourtGRAHAM, J.
PartiesIn the matter of the mental commitment of A.R.F.: Portage County, Petitioner-Respondent, v. A.R.F., Respondent-Appellant.
Docket Number2022AP1262
Decision Date17 November 2022

In the matter of the mental commitment of A.R.F.: Portage County, Petitioner-Respondent,

A.R.F., Respondent-Appellant.

No. 2022AP1262

Court of Appeals of Wisconsin, District IV

November 17, 2022

This opinion will not be published. See Wis. Stat. Rule 809.23(1)(b)4.

APPEAL from orders of the circuit court for Portage County: No. 2018ME148 THOMAS T. FLUGAUR, Judge.

GRAHAM, J. [1]


¶1 Ashley[2] appeals a Wis.Stat. ch. 51 order for involuntary commitment, as well as an order for involuntary medication and treatment. She argues that the orders must be reversed because the circuit court did not make "specific factual findings with reference to the [dangerousness] subdivision paragraph of § 51.20(1)(a)2. on which [Ashley's] recommitment is based," as required by Langlade Cnty. v. D.J.W., 2020 WI 41, 391 Wis.2d 231, 942 N.W.2d 277. I conclude that the circuit court made all the findings that are required by § 51.20 and D.J.W., and therefore, I affirm.

¶2 In March 2022, Ashley was subject to an existing mental health commitment order and an existing involuntary medication order, both of which were set to expire in April 2022. Portage County timely petitioned the circuit court to extend Ashley's commitment for 12 months.

¶3 Under Wis.Stat. § 51.20, a person may be involuntarily committed for treatment if the county submitting the petition proves that the person is mentally ill, a proper subject of treatment, and currently dangerous to themselves or others under one of the statutory dangerousness standards set forth in § 51.20(1)(a)2. Each of the dangerousness standards requires evidence of recent acts or omissions. See § 51.20(1)(a)2.a.-e.

¶4 Additionally, a person who is subject to an existing commitment may be recommitted for up to 12 months if the same three criteria are met. D.J.W., 391 Wis.2d 231, ¶31. However, in a recommitment proceeding, proof of current


dangerousness under any of the dangerousness standards may take a somewhat different form than it would take in an initial commitment proceeding. See Wis. Stat. § 51.20(1)(am). Under § 51.20(1)(am), in lieu of proving recent acts or omissions evidencing dangerousness, proof of dangerousness can be made through a different "evidentiary pathway"-by showing "'a substantial likelihood, based on the subject individual's treatment record, that the individual would be a proper subject for commitment if treatment were withdrawn.'" D.J.W., 391 Wis.2d 231, ¶32 (quoting § 51.20(1)(am)). Two years ago in D.J.W., our supreme court clarified that when a circuit court recommits a person based on the language of § 51.20(1)(am), the court must "make specific factual findings with reference to the [dangerousness] subdivision paragraph of … § 51.20(1)(a)2., on which the recommitment is based." D.J.W., 391 Wis.2d 231, ¶3; see also id., ¶¶40-44.

¶5 In this case, the County's recommitment petition alleged that there was a substantial likelihood that Ashley would be a proper subject for commitment if treatment were withdrawn. According to the County, she was dangerous because she would "discontinue treatment against medical advice" and has a "history of becoming dangerous [when she is not taking prescribed medications] due to impaired judgment." The County also submitted the written report of Ashley's treating physician, Dr. Wagdy Khalil. In his report, Dr. Khalil stated that Ashley had been under his care "for approximately 2+ years." He opined that she has severe schizoaffective disorder, bipolar type and other specified anxiety disorder, that she experiences auditory hallucinations and paranoid delusions, and that she "is known to be not compliant with her medications that lead[s] to quick deterioration and require[s] immediate admission to inpatient psychiatric hospitals." Dr. Khalil


opined that Ashley was dangerous under Wis.Stat. § 51.20(1)(a)2.c.[3] and § 51.20(1)(a)2.d.,[4] (sometimes referred to as the third and fourth standards), and that, consistent with § 51.20(1)(am), "there is a substantial likelihood that [Ashley] would become a proper subject for commitment under [those] standard[s] if treatment were withdrawn."

¶6 The circuit court held a recommitment hearing, at which the County presented Dr. Khalil as its sole witness. Dr. Khalil gave testimony that was consistent with his written report. He testified that, among other things, Ashley lived in a group home where she received outpatient treatment. He further testified that Ashley told him she would quit taking all of her medication if the commitment were to end, and that refusal to take prescribed medication was consistent with her history. As Dr. Khalil explained, when, in the past, her commitment "was canceled or left to expire, … she immediately stopped taking the medication and relapsed and she required hospitalization with a longer stay to re-stabilize her." Dr. Khalil described an incident that occurred a year prior to the recommitment hearing, in which she attacked her father as a result of a paranoid delusion. He also described more recent incidents in which Ashley's hallucinations and delusions led her to


falsely believe that she was being abused by her caregivers. According to Dr. Khalil, Ashley "still suffers from paranoid delusions" which impair her judgment, but they are "better because of the medication."

¶7 The circuit court determined that the County had satisfied its burden of proof, and it recommitted Ashley for a period of 12 months. In issuing its oral ruling, the court made the following findings based on Dr. Khalil's testimony and report, which had been received into evidence. The court found that Ashley is mentally ill and experiences paranoid delusions. Further, Ashley has a "history of noncompliance" when "not under a court order regarding taking medication," and that, "[w]hen she doesn't take medication, she decompensates, quickly relapses, and gets into acute psychosis and paranoid behavior." Based on Dr. Khalil's testimony and Ashely's "own words to [Dr. Khalil] which … haven't been refuted," the court found that, "if she's not under a commitment, she's going to stop taking her medication." Additionally, the court found that, "[i]f treatment were withdrawn, there's a substantial probability of physical impairment or injury to herself or others due to that impairment." The court then clarified that it was "referring back to" the third dangerousness standard, Wis.Stat. § 51.20(1)(a)2.c.,[5] "in terms of if treatment were withdrawn and that prong of the statutes becoming effective."

¶8 After determining that the County satisfied its burden of proof, the circuit court further ordered that Ashley be treated in "the least restrictive [setting]," which was "continued outpatient treatment at [the] facility she's currently in." However, continued treatment at the outpatient facility would be...

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