Matter of B.O.T., 342 P.3d 981

On Dec. 23–24, 2013, B.O.T. was found lying at a Missoula bus station in cold, sleeting weather and was taken to the emergency room; tests showed chronic conditions (diabetes, hypertension, hyperkalemia).
Hospital staff reported disorganized behavior: pulling out and breaking an IV and refusing prescribed medications; referred for mental health evaluation.
Evaluators and treatment providers reported schizo-related illness, long-standing noncompliance with injectable antipsychotic medication, eviction/unstable housing, and inability/unwillingness to activate a food-stamp card (no immediate access to food).
The State filed a petition for involuntary commitment; the District Court detained B.O.T. at Montana State Hospital (MSH) and held a commitment hearing on Dec. 27, 2013.
The court found B.O.T. suffered from a mental disorder causing substantial inability to provide for basic needs (food, shelter, health/safety), ordered 90-day commitment to MSH, and authorized involuntary medication.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether substantial evidence supports that, because of a mental disorder, B.O.T. is substantially unable to provide for basic needs (food, clothing, shelter, health, safety)	State: Evaluator testimony and records show schizoaffective/schizo-related disorder, medication noncompliance, homelessness, inability to access food — meets §53-21-126(1)(a) commitment standard	B.O.T.: Temporary lack of housing does not prove inability to care for basic needs; no evidence of malnourishment; hearsay predominates; he testified to plans for food and travel and medication compliance	Court: Affirmed — substantial admissible evidence supports finding under §53-21-126(1)(a); hearsay objections not preserved on appeal

In re Mental Health of L.K.-S., 359 Mont. 191 (2011) (standard of review for commitment orders; findings of fact tested for clear error)
In re Mental Health of T.J.F., 359 Mont. 213 (2011) (view evidence in light most favorable to prevailing party when assessing substantial evidence)
In re R.F., 369 Mont. 236 (2013) (overt acts not required to prove respondent substantially unable to provide for basic needs except when imminent threat of self-harm/others is alleged)
In re G.P., 246 Mont. 195 (1990) (same legal principle regarding proof of mental disorder and basic-needs incapacity)
Schmidt v. Cook, 326 Mont. 202 (2005) (appellate role is to determine whether evidence supports the lower court’s conclusion)
In re Mental Health of J.D.L., 348 Mont. 1 (2008) (court will apply plain error review in commitment cases when substantial liberty interests are implicated)