In Re Hospitalization of Naomi B.
435 P.3d 918
| Alaska | 2019Background
- Two consolidated appeals from expired involuntary commitment orders (Naomi B. and Linda M.); Naomi also appealed an involuntary medication order. Both orders expired while appeals were pending.
- Naomi: admitted to Alaska Psychiatric Institute (API), diagnosed with schizoaffective disorder; refused medication and treatment; API sought 30-day involuntary commitment and court-ordered psychotropic medication (olanzapine; lorazepam PRN). Magistrate found her gravely disabled and ordered commitment and medication.
- Linda: history of psychosis, violent incidents against others, arrested; jury found her mentally ill and likely to cause harm to others; superior court held evidentiary hearings and found no feasible less-restrictive alternative to 90-day API commitment.
- Procedural posture: prior Alaska decisions often dismissed expired commitment appeals as moot (Wetherhorn) or applied narrow exceptions (collateral consequences). Parties briefed whether the court should revisit mootness rules for involuntary commitment and medication appeals.
- The court overruled prior mootness approach and held that appeals from involuntary admission for treatment and involuntary medication are categorically exempt from mootness under the public interest exception; it then reviewed and affirmed both commitment orders and Naomi’s medication order on the merits.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether appeals of expired involuntary commitment orders are moot | Naomi/Linda: exceptions (public interest or collateral consequences) apply; merits should be reviewed | State: prior precedent (Wetherhorn) renders such appeals moot unless narrow exceptions shown | Court: public interest exception applies categorically to all involuntary commitment appeals; will hear merits despite expiration |
| Whether involuntary medication appeals are moot | Naomi: medication appeal falls under public interest and should be heard | State: same mootness concerns; but agreed exception may apply | Court: public interest exception categorically applies to involuntary medication appeals as well |
| Sufficiency of evidence that Naomi was "gravely disabled" under AS 47.30.915(9) | Naomi: evidence was weak/speculative; voluntary hospital stay indicates amenability; medication order improper | State/API: uncontroverted expert testimony showed severe delusions, lack of housing, inability to plan discharge, risk without controlled environment | Held: court’s finding not clearly erroneous; uncontradicted testimony supports grave disability (affirmed) |
| Whether any feasible less-restrictive alternative existed for Linda | Linda: court wrongly rejected Soteria-Alaska as a less-restrictive alternative and should not defer because it was defunded | State/API: less-restrictive option must be actually available and feasible now; closed Soteria not available | Held: closed Soteria was not "actually available" or feasible; superior court did not clearly err in finding no feasible less-restrictive alternative (affirmed) |
| Whether forced medication for Naomi was in her best interests and no less-intrusive alternative existed | Naomi: court failed to weigh liberty interests and alternatives; Bigley/Minnesota factors require broader analysis | State/API: court applied mandatory Myers factors; no viable alternatives; expert testimony supported need for medication | Held: trial court properly applied Myers factors; not required to expressly apply Minnesota factors; evidence supports no less-intrusive alternative and medication order upheld |
Key Cases Cited
- Wetherhorn v. Alaska Psychiatric Inst., 156 P.3d 371 (Alaska 2007) (held expired 30‑day commitment appeal moot; limited public‑interest application)
- In re Joan K., 273 P.3d 594 (Alaska 2012) (applied collateral‑consequences exception to first commitment appeal)
- E.P. v. Alaska Psychiatric Inst., 205 P.3d 1101 (Alaska 2009) (recognized repetition and public‑interest factors in commitment appeals)
- Myers v. Alaska Psychiatric Inst., 138 P.3d 238 (Alaska 2006) (set mandatory best‑interests factors for involuntary medication)
- Bigley v. Alaska Psychiatric Inst., 208 P.3d 168 (Alaska 2009) (addressed less‑intrusive/feasibility inquiry and application of Myers factors)
- In re Mark V., 324 P.3d 840 (Alaska 2014) (addressed statutory appeal right and mootness; skepticism that statute overrides mootness)
- In re Jacob S., 384 P.3d 758 (Alaska 2016) (examples of repeated fact patterns and application of commitment standards)