Matter of S.H., 2016 MT 137

Background

S.H., with a diagnosed bipolar disorder, was brought to Billings Clinic after reporting auditory hallucinations, parasitic infestations, and persecutory delusions; clinic staff petitioned for involuntary commitment.
Nurse practitioner Diane Goedde evaluated S.H., reporting mania, delusions, refusal of medication, unstable judgment, loud/abusive behavior, and a recent physical altercation with another patient.
At the commitment hearing S.H. testified inconsistently, refused psychotic medication (believing she was healed), and said she planned to live in her van despite cold weather; she also had limited shelter options and an unclear discharge plan.
The District Court found S.H. suffered from bipolar disorder in a manic, delusional, agitated, paranoid state and ordered commitment under Mont. Code Ann. § 53-21-126(1)(a) and (c) (not able to care for basic needs; imminent threat to others).
S.H. appealed, arguing insufficient evidence supported commitment and that her counsel provided ineffective assistance for not objecting to Goedde (a non-appointed professional person) and not requesting a continuance after staff involuntarily medicated her within 24 hours of the hearing.
The Montana Supreme Court affirmed; S.H. was later unconditionally discharged by the professional person.

Issues

Issue	Plaintiff's Argument (S.H.)	Defendant's Argument (State)	Held
Whether evidence supported commitment under § 53-21-126(1)(a) (substantial inability to provide basic needs)	S.H. argued she was meeting basic needs and evidence was insufficient to show inability to provide for food, shelter, health, or safety	State argued S.H.’s refusal of treatment, delusions, and intent to remain living in her van in cold weather showed inability to care for health and safety	Court held evidence was sufficient: refusal of treatment plus lack of winter shelter supported commitment under (a)
Whether evidence supported commitment under § 53-21-126(1)(c) (imminent threat to others)	S.H. argued the single altercation and lack of injury did not prove an imminent threat	State relied on the recent physical altercation, agitation, delusions, and paranoia as an overt, recent act showing risk to others	Court held evidence was sufficient: the prior-night physical altercation and current mental state supported an imminent-threat finding under (c)
Whether counsel rendered ineffective assistance	S.H. argued counsel should have objected to Goedde’s testimony (not the appointed evaluator) and moved for a continuance after involuntary medication within 24 hours	State argued counsel actively represented S.H. (timely appearance, effective cross-examination); counsel did not learn of the injection until testimony and thus omission did not defeat overall effective advocacy	Court held counsel was not ineffective: record showed vigorous representation and no reversible lapse in advocacy

Key Cases Cited

In re Mental Health of L.K.-S., 359 Mont. 191, 247 P.3d 1100 (2011) (standard of review for civil commitment findings)
In re R.F., 369 Mont. 236, 296 P.3d 1189 (2013) (appeal of involuntary commitment not moot where issues capable of repetition)
In re S.M., 377 Mont. 133, 339 P.3d 23 (2014) (refusal of medication and dangerous behavior can support commitment under inability-to-care-for-basic-needs)
In re Mental Health of A.S.B., 342 Mont. 169, 180 P.3d 625 (2008) (imminent threat requires recent overt acts relevant to present condition)
Matter of F.B., 189 Mont. 229, 615 P.2d 867 (1980) (threat must be fairly immediate; certainty not required)
In re Mental Health of C.R.C., 350 Mont. 211, 207 P.3d 289 (2009) (right to effective assistance of counsel in commitment proceedings)
In re Mental Health of T.J.F., 359 Mont. 213, 248 P.3d 804 (2011) (evaluate counsel effectiveness by considering record as a whole)
In re C.R.C., 325 Mont. 133, 104 P.3d 1065 (2004) (limitations on relying on testimony from improperly appointed evaluators)