commitment hearing in Alaska

2020The court did not clearly 7 We have explained that although “a commitment order must be based on the patient’s condition at the time of the commitment hearing,” the “court may consider the patient’s recent behavior and condition as well as the patient’s symptoms on the day of the hearing.” In re Hospitalization of Tracy C., 249 P.3d 1085, 1092-93 (Alaska 2011). 8 Id. -5- 1756 err in concluding on the basis of this evidence that Judy was likely to cause harm to herself as a result of her mental illness.

2020The court did not clearly 7 We have explained that although “a commitment order must be based on the patient’s condition at the time of the commitment hearing,” the “court may consider the patient’s recent behavior and condition as well as the patient’s symptoms on the day of the hearing.” In re Hospitalization of Tracy C., 249 P.3d 1085, 1092-93 (Alaska 2011). 8 Id. -5- 1756 err in concluding on the basis of this evidence that Judy was likely to cause harm to herself as a result of her mental illness.

2020In Wetherhorn v. Alaska Psychiatric Institute, 156 P.3d 371 (Alaska 2007), overruled on other grounds by In re Hospitalization of Naomi B., 435 P.3d 918 (Alaska 2019), we concluded that it was not plain error to allow a facility psychiatrist, who was not a petition signer and not otherwise listed in the petition as a likely hearing witness, to testify at a commitment hearing.

2011Id. [22] Id. [23] AS 47.30.735(c) (emphasis added). [24] Wetherhorn v. Alaska Psychiatric Inst., 156 P.3d 371, 378 (Alaska 2007). [25] AS 47.30.735(c) (emphasis added). [26] Wetherhorn, 156 P.3d at 378 (quoting In re LaBelle, 107 Wash.2d 196 , 728 P.2d 138, 146 (1986)). [27] Id. at 379. [28] Id. at 378. [29] Id. at 379 (emphasis added) (internal footnotes omitted); see also In re LaBelle, 728 P.2d at 145-46 (interpreting a similar statute to allow a finding that a patient was gravely disabled even if the patient had improved slightly by the time of the commitment hearing so long as there was "

2025We defer to the master’s credibility findings as to whether Lawrence’s statements were threatening. 9 And although some of the evidence of Lawrence’s behavior may have been hearsay, it was not objected to at the commitment hearing.10 9 See Bigley v. Alaska Psychiatric Inst., 208 P.3d 168, 178 (Alaska 2009) (“We will grant especially great deference when the trial court’s factual findings require weighing the credibility of witnesses and conflicting oral testimony.” (citing Vezey v. Green, 171 P.3d 1125, 1128-29 (Alaska 2007))). 10 See Hayes v. State, 581 P.2d 221 , 222 & n.2 (Alaska 1978) (rej

2023Specifically, Aiden argues the court failed to adequately consider the fourth and fifth Myers factors.21 With regard to the fourth Myers factor: Aiden argues the court failed to consider the possible interactions that the proposed psychotropic medications might have with other medication and substances, including recreational drugs like marijuana.22 Aiden contends that the court’s failure to consider possible interactions was error for two reasons: (1) his interruptions during the commitment hearing, a few of which included mention of marijuana use, should have alerted the court to the need to

2025When 6 In re Hospitalization of Carter K., 557 P.3d 755 , 761-762 (Alaska 2024). 7 In re Hospitalization of Gabriel C., 324 P.3d 835, 838 (Alaska 2014) (first quoting State, Dep’t of Revenue, Child Support Enf’t Div. ex rel.

2022Carl did not object to this error during the proceedings below, so he failed to preserve the issue for appeal.15 We review issues raised for the first time on appeal for plain error, which is an “ ‘obvious mistake’ that is ‘obviously prejudicial.’ ”16 Carl concedes he cannot show prejudice from the signature deficiency and points out that a 12 In re Gabriel C., 324 P.3d 835, 837 (Alaska 2014) (applying independent judgment to interpret Alaska Constitution and mental health commitment statute); Shea v. State, Dep’t of Admin., Div. of Ret. & Benefits, 204 P.3d 1023, 1026 (Alaska 2009) (applying

2020In involuntary commitment proceedings, “[w]e review the superior court’s factual findings . . . for clear error,” only reversing “if we have a ‘definite and firm conviction that a mistake has been made.’ ”9 The superior court may commit an individual to a treatment facility after conducting a commitment hearing only “if it finds, 7 See AS 47.30.735(c) (allowing court to commit respondent to treatment facility for 30 days upon grave disability finding by clear and convincing evidence). 8 Although the underlying issue is technically moot, we recently held that “appeals from involuntary commitmen

2020Our review for clear error in such situations “ ‘grant[s] especially great deference’ to the trial court,” and “we will not reweigh evidence if the record supports the court’s finding.” In re Jacob S., 384 P.3d at 766 , 769 (quoting In re Hospitalization of Tracy C., 249 P.3d 1085, 1089 (Alaska 2011)). -6- 1768 by clear and convincing evidence, that the [individual] is mentally ill and as a result is . . . gravely disabled.”10 The term “gravely disabled” is defined as: [A] condition in which a person as a result of mental illness (A) is in danger of physical harm arising from such complete neg

2019These cases emphasize that the superior court must find likelihood of harm to self or others based on the patient’s condition at the time of the commitment hearing: “The superior court may not involuntarily commit a patient based only on the patient’s symptoms at the time of admission to a treatment facility if by the time of the hearing the patient is no longer mentally ill . . . or likely to harm [self] or others.”14 But in making the finding the superior court “may consider the patient’s recent behavior and condition as well as the patient’s symptoms on the day of the hearing” and the patie

2019These cases emphasize that the superior court must find likelihood of harm to self or others based on the patient’s condition at the time of the commitment hearing: “The superior court may not involuntarily commit a patient based only on the patient’s symptoms at the time of admission to a treatment facility if by the time of the hearing the patient is no longer mentally ill . . . or likely to harm [self] or others.”14 But in making the finding the superior court “may consider the patient’s recent behavior and condition as well as the patient’s symptoms on the day of the hearing” and the patie

2022The State certainly has an interest, as it claims, “in having psychiatrists do their jobs treating patients instead of requiring them to focus [on] 37 See In re Mark V., 375 P.3d 51, 57 (Alaska 2016) (“The definition [of distress and deterioration] establishes ‘the person’s previous ability to function independently’ as the baseline from which ‘a substantial deterioration’ is measured.” (quoting AS 47.30.915(9)(B))). abrogated on other grounds by Naomi B., 435 P.3d at 918 . -15- 7596 legal nuances.” But requiring a mental health professional who is already present at the commitment hearing to

2020In Wetherhorn v. Alaska Psychiatric Institute, 156 P.3d 371 (Alaska 2007), overruled on other grounds by In re Hospitalization of Naomi B., 435 P.3d 918 (Alaska 2019), we concluded that it was not plain error to allow a facility psychiatrist, who was not a petition signer and not otherwise listed in the petition as a likely hearing witness, to testify at a commitment hearing.

2020Joan K. was experiencing a manic episode at the time of the commitment hearing, and if she were released and continued using illicit drugs, her thought processes would become “so completely disorganized” that she would have no idea “what she was doing.” Id. at 599, 601 . 11 In re Joan K., 273 P.3d at 600 (quoting E.P., 205 P.3d at 1111 ). -6- 1756 cause of her suicide attempt, self-harming behavior, and ongoing suicidality.

2011Id. [22] Id. [23] AS 47.30.735(c) (emphasis added). [24] Wetherhorn v. Alaska Psychiatric Inst., 156 P.3d 371, 378 (Alaska 2007). [25] AS 47.30.735(c) (emphasis added). [26] Wetherhorn, 156 P.3d at 378 (quoting In re LaBelle, 107 Wash.2d 196 , 728 P.2d 138, 146 (1986)). [27] Id. at 379. [28] Id. at 378. [29] Id. at 379 (emphasis added) (internal footnotes omitted); see also In re LaBelle, 728 P.2d at 145-46 (interpreting a similar statute to allow a finding that a patient was gravely disabled even if the patient had improved slightly by the time of the commitment hearing so long as there was "

2025We defer to the master’s credibility findings as to whether Lawrence’s statements were threatening. 9 And although some of the evidence of Lawrence’s behavior may have been hearsay, it was not objected to at the commitment hearing.10 9 See Bigley v. Alaska Psychiatric Inst., 208 P.3d 168, 178 (Alaska 2009) (“We will grant especially great deference when the trial court’s factual findings require weighing the credibility of witnesses and conflicting oral testimony.” (citing Vezey v. Green, 171 P.3d 1125, 1128-29 (Alaska 2007))). 10 See Hayes v. State, 581 P.2d 221 , 222 & n.2 (Alaska 1978) (rej

2023Specifically, the psychiatrist testified that Aiden’s hostile and irritable behavior had substantially improved after his October hospitalization and medication, indicating that the severity of these behaviors was not his baseline level of functioning. 11 In re Hospitalization of Carl S., 510 P.3d 486, 494 (Alaska 2022) (quoting AS 47.30.915(9)(B) (2021)). 12 In re Hospitalization of Rabi R., 468 P.3d 721, 734 (Alaska 2020). -8- 1996 Aiden also argues his conduct at the commitment hearing, other reported behaviors, and recent series of hospitalizations over a relatively short period of time di

2023Specifically, the psychiatrist testified that Aiden’s hostile and irritable behavior had substantially improved after his October hospitalization and medication, indicating that the severity of these behaviors was not his baseline level of functioning. 11 In re Hospitalization of Carl S., 510 P.3d 486, 494 (Alaska 2022) (quoting AS 47.30.915(9)(B) (2021)). 12 In re Hospitalization of Rabi R., 468 P.3d 721, 734 (Alaska 2020). -8- 1996 Aiden also argues his conduct at the commitment hearing, other reported behaviors, and recent series of hospitalizations over a relatively short period of time di

2022Carl did not object to this error during the proceedings below, so he failed to preserve the issue for appeal.15 We review issues raised for the first time on appeal for plain error, which is an “ ‘obvious mistake’ that is ‘obviously prejudicial.’ ”16 Carl concedes he cannot show prejudice from the signature deficiency and points out that a 12 In re Gabriel C., 324 P.3d 835, 837 (Alaska 2014) (applying independent judgment to interpret Alaska Constitution and mental health commitment statute); Shea v. State, Dep’t of Admin., Div. of Ret. & Benefits, 204 P.3d 1023, 1026 (Alaska 2009) (applying

2022Carl did not object to this error during the proceedings below, so he failed to preserve the issue for appeal.15 We review issues raised for the first time on appeal for plain error, which is an “ ‘obvious mistake’ that is ‘obviously prejudicial.’ ”16 Carl concedes he cannot show prejudice from the signature deficiency and points out that a 12 In re Gabriel C., 324 P.3d 835, 837 (Alaska 2014) (applying independent judgment to interpret Alaska Constitution and mental health commitment statute); Shea v. State, Dep’t of Admin., Div. of Ret. & Benefits, 204 P.3d 1023, 1026 (Alaska 2009) (applying

2022Carl did not object to this error during the proceedings below, so he failed to preserve the issue for appeal.15 We review issues raised for the first time on appeal for plain error, which is an “ ‘obvious mistake’ that is ‘obviously prejudicial.’ ”16 Carl concedes he cannot show prejudice from the signature deficiency and points out that a 12 In re Gabriel C., 324 P.3d 835, 837 (Alaska 2014) (applying independent judgment to interpret Alaska Constitution and mental health commitment statute); Shea v. State, Dep’t of Admin., Div. of Ret. & Benefits, 204 P.3d 1023, 1026 (Alaska 2009) (applying

2022The State certainly has an interest, as it claims, “in having psychiatrists do their jobs treating patients instead of requiring them to focus [on] 37 See In re Mark V., 375 P.3d 51, 57 (Alaska 2016) (“The definition [of distress and deterioration] establishes ‘the person’s previous ability to function independently’ as the baseline from which ‘a substantial deterioration’ is measured.” (quoting AS 47.30.915(9)(B))). abrogated on other grounds by Naomi B., 435 P.3d at 918 . -15- 7596 legal nuances.” But requiring a mental health professional who is already present at the commitment hearing to

2022In In re Arthur A. a hospital initiated a 30-day involuntary commitment petition against a respondent alleged to be actively psychotic and experiencing delusions.23 At the commitment hearing, the respondent’s attorney informed the court that the respondent wished to represent himself.24 The court was prepared to find that the respondent was not mentally fit to represent himself based on the petition alone, but 21 518 P.2d 85 (Alaska 1974). 22 457 P.3d 540, 543 (Alaska 2020). 23 Id. at 544 . 24 Id. -11- 7577 the respondent asked to be evaluated by a psychiatrist first.25 After the psychiatrist’

2022In In re Arthur A. a hospital initiated a 30-day involuntary commitment petition against a respondent alleged to be actively psychotic and experiencing delusions.23 At the commitment hearing, the respondent’s attorney informed the court that the respondent wished to represent himself.24 The court was prepared to find that the respondent was not mentally fit to represent himself based on the petition alone, but 21 518 P.2d 85 (Alaska 1974). 22 457 P.3d 540, 543 (Alaska 2020). 23 Id. at 544 . 24 Id. -11- 7577 the respondent asked to be evaluated by a psychiatrist first.25 After the psychiatrist’

2021“The ‘clear and convincing’ standard of proof required by the [involuntary commitment] statute demands ‘a firm belief or conviction about the existence of a fact to be proved.’ ” Id. at 1192-93 (quoting In re Johnstone, 2 P.3d 1226, 1234 (Alaska 2000)). -3- 1838 that the State had failed to demonstrate by clear and convincing evidence that he had engaged in “recent behavior causing, attempting, or threatening harm” to others as required by statute for commitment.8 The superior court reviewed the commitment hearing de novo9 and ordered the 30-day commitment for treatment.

2020Joan K. was experiencing a manic episode at the time of the commitment hearing, and if she were released and continued using illicit drugs, her thought processes would become “so completely disorganized” that she would have no idea “what she was doing.” Id. at 599, 601 . 11 In re Joan K., 273 P.3d at 600 (quoting E.P., 205 P.3d at 1111 ). -6- 1756 cause of her suicide attempt, self-harming behavior, and ongoing suicidality.

2020Joan K. was experiencing a manic episode at the time of the commitment hearing, and if she were released and continued using illicit drugs, her thought processes would become “so completely disorganized” that she would have no idea “what she was doing.” Id. at 599, 601 . 11 In re Joan K., 273 P.3d at 600 (quoting E.P., 205 P.3d at 1111 ). -6- 1756 cause of her suicide attempt, self-harming behavior, and ongoing suicidality.

2020Servs., Office of Children’s Servs., 411 P.3d 622, 628 (Alaska 2018). 20 AS 47.30.735(b)(4). 21 Christina J. v. State, Dep’t of Health & Soc.

2020This is 29 Bennett v. Weimar, 975 P.2d 691, 696 (Alaska 1999) (citing Murat v. F/V Shelikof Strait, 793 P.2d 69, 75 (Alaska 1990)) (recognizing a superior court may properly consider evidence that had not been timely objected to). 30 See, e.g., Barbara P. v. State, Dep’t of Health &Soc.

2020This is 29 Bennett v. Weimar, 975 P.2d 691, 696 (Alaska 1999) (citing Murat v. F/V Shelikof Strait, 793 P.2d 69, 75 (Alaska 1990)) (recognizing a superior court may properly consider evidence that had not been timely objected to). 30 See, e.g., Barbara P. v. State, Dep’t of Health &Soc.

2011Id. [22] Id. [23] AS 47.30.735(c) (emphasis added). [24] Wetherhorn v. Alaska Psychiatric Inst., 156 P.3d 371, 378 (Alaska 2007). [25] AS 47.30.735(c) (emphasis added). [26] Wetherhorn, 156 P.3d at 378 (quoting In re LaBelle, 107 Wash.2d 196 , 728 P.2d 138, 146 (1986)). [27] Id. at 379. [28] Id. at 378. [29] Id. at 379 (emphasis added) (internal footnotes omitted); see also In re LaBelle, 728 P.2d at 145-46 (interpreting a similar statute to allow a finding that a patient was gravely disabled even if the patient had improved slightly by the time of the commitment hearing so long as there was "

2011Id. [22] Id. [23] AS 47.30.735(c) (emphasis added). [24] Wetherhorn v. Alaska Psychiatric Inst., 156 P.3d 371, 378 (Alaska 2007). [25] AS 47.30.735(c) (emphasis added). [26] Wetherhorn, 156 P.3d at 378 (quoting In re LaBelle, 107 Wash.2d 196 , 728 P.2d 138, 146 (1986)). [27] Id. at 379. [28] Id. at 378. [29] Id. at 379 (emphasis added) (internal footnotes omitted); see also In re LaBelle, 728 P.2d at 145-46 (interpreting a similar statute to allow a finding that a patient was gravely disabled even if the patient had improved slightly by the time of the commitment hearing so long as there was "