In Re the Necessity for the Hospitalization of Jacob S.
2016 Alas. LEXIS 126
| Alaska | 2016Background
- Jacob S. was hospitalized after behavior (paranoid delusions about a neighbor, alleged involvement in property-damaging incidents) prompted an involuntary petition; API clinicians sought commitment and court authorization to give psychotropic medication.
- A magistrate judge ordered a 30-day commitment and approved involuntary medication after finding Jacob lacked capacity to give informed consent; those findings were adopted by the superior court.
- The State filed a 90-day commitment petition; Jacob requested a jury trial. The jury found Jacob mentally ill, likely to harm others, and that he had refused voluntary treatment; the court then held a separate hearing to decide less-restrictive-alternative and medication issues.
- The superior court rejected release to a less restrictive alternative (e.g., living with his brother) because Jacob’s delusions remained active and he was unlikely to adhere to medication, and it ordered a 90-day commitment and continuation of involuntary medication.
- Jacob appealed, raising due process (telephonic witness testimony), sufficiency of the 30- and 90-day commitment findings, who decides the less-restrictive-alternative question at a jury trial, and the standard and findings for competency/medication.
Issues
| Issue | Plaintiff's Argument (Jacob) | Defendant's Argument (State) | Held |
|---|---|---|---|
| Whether allowing telephonic testimony at the 30-day hearing violated due process | Telephonic testimony prevented in-person confrontation and credibility assessment and prejudiced him | Mathews balancing and exigent 72-hour timetable justified telephonic testimony; no actual prejudice shown | No due process violation; telephonic testimony allowed for good cause and no substantial prejudice |
| Whether evidence supported 30-day commitment (mentally ill and likely to harm others) | Commitment rested on speculation and insufficient facts to meet clear-and-convincing standard | Record contained partner, neighbor, and clinician testimony showing delusions produced dangerous conduct or risk | Affirmed — factual findings not clearly erroneous; clear-and-convincing standard met |
| Who decides existence of less-restrictive alternative when respondent requests a jury trial on a 90-day petition | Jury should decide underlying factual questions about less-restrictive alternatives when jury trial is requested | Statutory structure assigns the less-restrictive-alternative decision to the court; jury decides mental-illness-and-danger findings | Court (not jury) decides less-restrictive-alternative and related factual findings; upheld court’s decision |
| Whether a single AS 47.30.837(d)(1) factor can render a patient incompetent for treatment decisions and whether court’s competence/ best-interests findings were supported | Court improperly based incompetence solely on (B) denial of illness; competency requires weighing all factors; medication best-interests findings were insufficiently detailed | Statute is conjunctive; failure of any one element (including denial of illness under (B)) can establish incompetence; record supports incompetence and best-interests findings | Held that lack of any single statutory element can justify finding incompetence; court’s findings on incompetence and that medication was in Jacob’s best interests were not clearly erroneous |
Key Cases Cited
- Mathews v. Eldridge, 424 U.S. 319 (U.S. 1976) (three-factor balancing test for required process)
- Wetherhorn v. Alaska Psychiatric Inst., 156 P.3d 371 (Alaska 2007) (standards and review for involuntary commitment)
- Myers v. Alaska Psychiatric Inst., 138 P.3d 238 (Alaska 2006) (requirements and best-interests balancing for involuntary psychotropic medication)
- Bigley v. Alaska Psychiatric Inst., 208 P.3d 168 (Alaska 2009) (due process and less-restrictive-alternative considerations in commitment proceedings)
- In re Tracy C., 249 P.3d 1085 (Alaska 2011) (mootness/public-interest exception and standards for reviewing commitment findings)