In Re the Necessity for the Hospitalization of Stephen O., 2013 Alas. LEXIS 168

Stephen O. experienced a religious conversion in late 2009 and shortly thereafter his family reported hearing voices and behavior they considered similar to a 2004 psychotic episode that culminated in self‑harm.
A petition for involuntary commitment was filed; police took Stephen into emergency custody and he was held in the Haines jail for six days because weather delayed transport to Bartlett Regional Hospital in Juneau.
Dr. John Pappenheim evaluated Stephen, diagnosed bipolar disorder, current manic with psychotic features, and recommended hospitalization; a court‑appointed visitor reported Stephen presented well but opposed psychotropic medication (willing to accept it if court‑ordered).
At a contested hearing the superior court found by clear and convincing evidence that Stephen was "gravely disabled" under AS 47.30.915(7)(B) and ordered an 80‑day involuntary commitment (30‑day statutory commitment extended in practice); later the court denied involuntary medication but continued commitment; Stephen was discharged early and appealed.
The Alaska Supreme Court considered mootness (applying the collateral‑consequences exception) and reviewed whether the evidence met the heightened clear‑and‑convincing standard for involuntary commitment under the statutory definition and Wetherhorn.

Issue	Plaintiff's Argument (Stephen)	Defendant's Argument (State)	Held
Mootness / ability to appeal expired commitment	Appeal is moot because commitment expired	Collateral‑consequences exception applies to first involuntary commitment	Court applied collateral‑consequences exception and reached merits
Sufficiency of evidence to show "gravely disabled" under AS 47.30.915(7)(B)	Evidence (prior episode, diagnosis, family concerns, hearing voices) still did not meet clear & convincing proof that he cannot live safely outside a controlled environment	Court may rely on diagnosis, history, family reports, and expert testimony predicting deterioration	Reversed: evidence did not meet clear & convincing standard; commitment vacated
Reliance on prior 2004 episode and hearsay reports	Prior episode and secondhand family reports are speculative and insufficient to prove current incapacity	Prior serious episode is predictive and relevant to future risk	Court held 2004 episode and hearsay were insufficiently probative to satisfy the heightened burden
Role of religious belief vs delusion	Stephen’s beliefs (sudden religiosity, hearing Jesus) can be part of religious expression and not evidence of dangerous incapacity	Expert testified the beliefs were delusional and not culturally grounded; relevant to incapacity	Court emphasized protection of religious freedom and found beliefs alone did not establish grave disability

Wetherhorn v. Alaska Psychiatric Inst., 156 P.3d 371 (Alaska 2007) (clarifies constitutional construction of "gravely disabled" and requires ability to live safely outside controlled environment)
In re Tracy C., 249 P.3d 1085 (Alaska 2011) (reaffirms high clear‑and‑convincing standard in commitment cases)
In re Jeffrey E., 281 P.3d 84 (Alaska 2012) (upholds commitment where respondent was acutely catatonic and would quickly relapse without medication)
O'Connor v. Donaldson, 422 U.S. 563 (U.S. 1975) (mental illness alone insufficient to justify involuntary confinement of nondangerous person able to survive safely)
Addington v. Texas, 441 U.S. 418 (U.S. 1979) (establishes clear‑and‑convincing standard for civil commitment)
Joan K. v. State, 273 P.3d 594 (Alaska 2012) (applies collateral‑consequences exception to mootness in first involuntary commitment appeals)