In Re the Necessity for the Hospitalization of Mark V., 375 P.3d 51

Mark V. was taken into emergency custody after public nudity and delusional behavior and admitted to Alaska Psychiatric Institute (API).
Providence petitioned for an initial 72-hour hold; the State later sought a 30-day involuntary commitment alleging Mark was gravely disabled by mental illness and that no less restrictive alternative existed.
Dr. LeeAnn Gee, Mark’s treating psychiatrist, testified Mark had manic/psychotic symptoms, intermittently refused oral meds, required emergency injections at API, and would not reliably maintain medication or self-care if released.
Mark testified he could obtain outpatient medication and receive family help for daily tasks, but made inconsistent statements about his need for and willingness to take medication.
The magistrate and superior courts found by clear and convincing evidence that Mark was gravely disabled and that there was no less restrictive alternative; the 30-day commitment was affirmed.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether evidence accounted for family/community support when finding “unable to function independently”	Mark: court failed to consider that family support could enable independent functioning	State: burden was on Mark to prove existence of adequate outside support	Court: burden to disprove less restrictive alternatives (including support) rests on petitioner; but here State met its burden
Who bears burden to prove absence of less restrictive alternatives	Mark: respondent should prove outside support exists	State: respondent must prove support exists	Court: petitioner must prove by clear and convincing evidence that no less restrictive alternative exists
Applicable standard for proving no less restrictive alternative	Mark: unclear application; argued court misapplied standard	State: relied on evidence of instability and past failures to take meds	Court: finding that no less restrictive alternative exists must be proved by clear and convincing evidence
Whether 30-day commitment was appropriate given the record	Mark: family support and outpatient care made commitment unnecessary	State: unrebutted medical testimony showed medication noncompliance and need for stabilization	Court: affirmed commitment; medical evidence supported lack of viable less restrictive alternative

Wetherhorn v. Alaska Psychiatric Inst., 156 P.3d 371 (Alaska 2007) (discusses constitutional limits on commitment and consideration of family support)
O’Connor v. Donaldson, 422 U.S. 563 (1975) (persons capable of surviving safely in freedom cannot be confined absent more)
Addington v. Texas, 441 U.S. 418 (1979) (clear and convincing evidence is required for involuntary commitment)
In re Joan K., 273 P.3d 594 (Alaska 2012) (upheld finding of no less restrictive alternative based on treating physicians’ testimony)
Meyers v. Alaska Psychiatric Inst., 138 P.3d 238 (Alaska 2006) (discusses gravely disabled standard and risk without help)
In re Stephen O., 314 P.3d 1185 (Alaska 2013) (explains the meaning of clear and convincing evidence)