In re Interest of J.C., A-16-841

Background

On April 20, 2016, police found J.C. with two deep cuts to his left wrist, covered in blood, a large knife nearby, and he had threatened to set himself on fire; his blood alcohol content was .242. He was taken to the hospital and placed under emergency protective custody.
A psychiatric nurse practitioner (Jessica Sawyer, APRN) diagnosed J.C. with adjustment disorder with depressed mood and alcohol‑induced depressive disorder, concluded he was mentally ill and dangerous at admission, and recommended commitment; she also testified J.C. remained overwhelmed the morning of the Board hearing.
The Platte County Attorney filed a Commitment Act petition alleging J.C. was mentally ill and dangerous and that less‑restrictive alternatives were unavailable or insufficient.
The Mental Health Board ordered J.C. committed to outpatient dual‑diagnoses treatment on April 27, 2016; the district court affirmed on de novo review; J.C. appealed, arguing insufficient clear and convincing evidence that he was mentally ill and dangerous at the time of the hearing.
The central factual dispute was whether J.C.’s recent self‑harm and statements (within seven days and the day of the hearing) were sufficiently probative of his present condition and future dangerousness to justify commitment.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether evidence met Commitment Act standard that J.C. was "mentally ill and dangerous" at time of hearing	J.C.: Past acts (the April 20 attempt) alone are insufficient absent medical testimony predicting present/future dangerousness	Board: Recent suicide attempt, intoxication, diagnoses, and hospital statements (including on the morning of hearing) were probative of present condition and future risk	Affirmed: Court held clear and convincing evidence supported finding of mental illness and dangerousness at time of hearing
Whether medical opinion was required to predict future dangerousness	J.C.: No medical testimony as to status at hearing so prediction improper	Board: Medical diagnosis at admission and contemporaneous statements suffice with other evidence to predict near‑future risk	Court: Medical judgment is involved but sufficiency of evidence is a legal question; facts and clinician’s admissions supported prediction
Whether the April 20 act was too remote to be probative	J.C.: Attempt occurred days earlier and thus may be insufficient	Board: The attempt occurred only 7 days before hearing and, combined with hospital conduct/statements, was recent and probative	Court: Seven‑day interval was sufficiently recent; prior acts may be probative depending on circumstances
Whether less‑restrictive alternatives were available	J.C.: Implied that outpatient or voluntary options could suffice	Board: Testimony indicated outpatient dual‑diagnoses treatment was the least‑restrictive adequate option	Court: Agreed with Board that less‑restrictive alternatives were unavailable or insufficient

Key Cases Cited

Castellano v. Bitkower, 216 Neb. 806, 346 N.W.2d 249 (Neb. 1984) (defines clear and convincing evidence standard)
In re Interest of Kochner, 266 Neb. 114, 662 N.W.2d 195 (Neb. 2003) (district court reviews mental health board de novo on the record)
In re Interests of Blythman, 208 Neb. 51, 302 N.W.2d 666 (Neb. 1981) (past dangerous acts may be probative of present/future dangerousness; remoteness assessed by circumstances)
Lynch v. Baxley, 386 F. Supp. 378 (M.D. Ala. 1974) (quoted for proposition that confinement requires recent overt dangerous acts)
In re Interest of Rasmussen, 236 Neb. 572, 462 N.W.2d 621 (Neb. 1990) (actions and statements prior to hearing are probative of present mental condition)
In re Interest of Headrick, 3 Neb. App. 807, 532 N.W.2d 643 (Neb. Ct. App. 1995) (past acts alone insufficient absent foundation showing prediction of future dangerousness)