In re R.H., 385 Mont. 530

R.H., a 72-year-old with bipolar disorder and other physical ailments, was evicted after repeated altercations with neighbors and became homeless despite attempts to secure housing.
Conservator and son contacted treating physician; R.H. was transported to Billings Clinic Psychiatric Center for evaluation.
Nurse practitioner Karinen evaluated R.H., concluded she had a mental disorder, was unable to care for herself, and recommended commitment and involuntary medication (although R.H. had been compliant with meds).
The State filed a petition for involuntary commitment; the District Court found probable cause, held a trial, and ordered commitment to Montana State Hospital for up to three months and authorized involuntary medication “may be necessary to facilitate treatment.”
R.H. appealed, challenging sufficiency of evidence for commitment and the authorization of involuntary medication.

Issue	Plaintiff's Argument (R.H.)	Defendant's Argument (State)	Held
1. Was there sufficient evidence to commit R.H. under §53-21-126(1)(a) (unable to meet basic needs because of mental disorder)?	Her homelessness/housing crisis resulted from lack of resources and family support, not her mental disorder.	Bipolar symptoms (mania/depression, poor insight, irrational decisions, conflicts with neighbors) caused eviction and inability to secure housing.	Affirmed. Substantial evidence showed R.H.’s mental disorder prevented her from obtaining shelter, satisfying statute.
2. Did the court properly authorize involuntary medication under §53-21-127(6)?	No—there was no present necessity; R.H. was compliant and had not refused medication. The court’s “may be necessary” finding is insufficient.	Authorization is one tier of review; subsequent medical officer and review committee also consider necessity, so court’s broader language suffices.	Reversed. Court erred: statute requires a finding that involuntary medication "is necessary," not that it "may be" necessary; evidence did not show present necessity.

In re Mental Health of L.K.-S., 247 P.3d 1100 (Mont. 2011) (standard of review for civil commitment; review of findings and conclusions)
In re C.R., 289 P.3d 125 (Mont. 2012) (strict adherence to statutory scheme for involuntary commitment)
In re S.M., 339 P.3d 23 (Mont. 2014) (legal questions about statutory findings reviewed de novo)
In re B.D., 362 P.3d 636 (Mont. 2015) (emphasis on strict adherence to involuntary commitment statutes given liberty interests)
In re R.W.K., 297 P.3d 318 (Mont. 2013) (statutory requirements for commitment and rights protection)
In re Mental Health of D.V., 174 P.3d 503 (Mont. 2007) (appeals from civil commitment not rendered moot by expiration of commitment)