In the Matter of the Civil Commitment of: Steven P. Lindquist.

This opinion will be unpublished and
may not be cited except as provided by
Minn. Stat. § 480A.08, subd. 3 (2016).

STATE OF MINNESOTA
IN COURT OF APPEALS
A17-0676

In the Matter of the Civil Commitment of:
Steven P. Lindquist.

Filed August 28, 2017
Affirmed in part and remanded
Cleary, Chief Judge

Kandiyohi County District Court
File No. 34-PR-17-24

Shane D. Baker, Kandiyohi County Attorney , Stephen J. Wentzell, First Assistant
Kandiyohi County A ttorney, Willmar, Minnesota (for respondent Kandiyohi County
Health and Human Services)

John E. Mack, Mack & Daby, P.A., New London, Minnesota (for appellant Lindquist)

Considered and decided by Cleary, Chief Judge; Peterson, Judge; and Smith, Tracy
M., Judge.
U N P U B L I S H E D O P I N I O N
CLEARY, Chief Judge
In this challenge to the district court’ s order committing him as mentally ill and
approving the forced administration of neurol eptic medication, appellant argues that the
district court erred by (1) cons idering his refusal to speak as evidence of mental illness,
(2) permitting him to waive his appearance at the commitment hearing despite his
2
incompetence, and (3) failing to appoint a substitute decision-maker. Appellant also
contends that the district court’s findings are insufficient to sup port his commitment and
the forced administration of neuroleptic medi cation. We affirm in part and remand for
findings.
FACTS
Appellant Steven P. Lindquist was fo und unresponsive behind a dumpster in
Willmar on March 6, 2017. In the emergenc y room, his blood alcohol concentration was
.224 and he had elevated car bon monoxide levels. He wa s combative durin g treatment,
and he was eventually transferred to a ment al-health unit on a 72-hour hold. Kandiyohi
County Health and Human Services (the county) filed a petition to civilly commit appellant
and requested an order to permit administration of neuroleptic medication to him. During
this process, appellant refused to speak to hospital or county personnel and instead
communicated through notes or writings.
A commitment/ Jarvis1 hearing was held on March 28, 2017. In hand-written notes
given to hospital staff, appellant refused to attend the hearing. After a short discussion, the
district court concluded th at appellant’s absence was permitted under Minn. Stat.
§ 253B.08, subd. 5 (2016), and that appellant might be “seriously disruptive.” The district
court allowed the hearing to continue in appellant’s absence.

1 In Jarvis v. Levine, 418 N.W.2d 139, 14 8 (Minn. 1988), the Minnesota Supreme Court
held that forced administration of neuroleptic medication must be preauthorized by a court
order. Minn. Stat. § 253B.092, subd. 8(e) (2016) now provides the procedure and authority
for forced administration of neuroleptic medication.
3
At the hearing, court-appoin ted examining psychologist Dr. Tinius stated that he
attempted to interview appella nt, who would not speak with him. Dr. Tinius concluded
that appellant suffered from a psychosis, not ot herwise specified. Dr. Tinius also opined
that appellant was schizophrenic, but he was unable to be more specific because appellant
refused to speak. Dr. Tinius believed that appellant’s refusal to speak was “secondary,” or
attributable, to his mental illness. Dr. Tini us testified that there was no less-restrictive
alternative to hospitalizing appellant and that medical treatment would reduce his
symptoms. Dr. Tinius had considered “d ismissal, voluntary outpatient, voluntary
admission, appointment of a guardian or cons ervator, or release before commitment” and
concluded that none of these alternatives would meet appellant’s needs.
Dr. Scott, the hospital psychiatrist, tes tified that he interacted with appellant
frequently between his admission and the heari ng. Appellant also refused to speak to
Dr. Scott, but appellant gave him “copious” notes containing “c ontent of significant
psychotic-type thinking, very paranoid thinking.” The content of the notes frightened staff
members, some of whom refused to work w ith appellant. Dr. Scott reviewed previous
hospitalization records, spoke with appellant’s family, and concluded that appellant “has a
form of bipolar disorder, and . . . more likely schizoaffective disorder, due to the
continuance of . . . psychotic and paranoid symptoms, even when he’s been sober now for
three weeks.”
Dr. Scott testified that appellant needed an “injectable form of anti-psychotic
medication that also can be used as a mood st abilizing agent.” He attempted to persuade
4
appellant to voluntarily take medication, but appellant refused. Dr. Scott concluded that
injectable Haldol would be the most approp riate medication because appellant’s medical
records indicated that he had been on Haldol before and had done well. Dr. Scott preferred
another medication, Invega Sustenna, but protocol requi red oral administration to
determine if a patient would have side effects, and appellant would not cooperate. He also
mentioned Abilify Maintenna, but he opined that the medication might not be as effective
as the other two. Dr. Scott testified that despite the potential for side effects, Haldol would
probably permit appellant to be more quickly discharged to a less -restrictive setting.
Dr. Scott described the protocols for preventing serious side effects. He concluded that
there were no appropriate alternatives to administering neuroleptic medication to appellant.
Finally, he stated that the benefits of us ing neuroleptic medicati on outweighed the risks
involved.
The district court concluded that “commi tment is appropriate for a period not to
exceed six months” and that the benefits of neuroleptic medi cation outweighed its risk.
The district court issued an amended order on April 14, 2017. This appeal followed.
D E C I S I O N
A court may commit a person if it finds by clear and convincing evidence that the
person is mentally ill and there is no suitable alternative to judicial commitment. Minn.
Stat. § 253B.09, subd. 1 (2016). This court is limited to examini ng whether the district
court complied with the commitment act’s requirements. In re Civil Commitment of
Janckila, 657 N.W.2d 899, 902 (Minn. App. 2003). We review the district court’s findings
5
of fact for clear error and th e question of whether the eviden ce is sufficient to support a
commitment de novo. Id. This court reviews the record in the light most favorable to the
district court’s decision. In re Civil Commitment of Carroll, 706 N.W.2d 527, 539 (Minn.
App. 2005).
A district court may order the forced ad ministration of neuroleptic medication if it
finds that the patient lacks ca pacity to decide whether to take medication. Minn. Stat.
§ 253B.092, subd. 8(e). Before issuing such an order, the di strict court must
consider: (1) whether the use of neuroleptic medication would offend the patient’s family
and community, or the patient’s moral, relig ious, and social values; (2) the risks and
benefits of treatment and a ny alternatives to treatment; (3) whether past use of the
medications has been effective; and (4) any other relevant factors. Minn. Stat. § 253B.092,
subd. 7(b) (2016). We review the district court’s findings for clear error. In re Thulin, 660
N.W.2d 140, 145 (Minn. App. 2003).
I.
Appellant argues that the district cour t erred by relying on medical testimony that
his refusal to speak supported a finding of mental illness. Appellant asserts a constitutional
right to remain silent and contends that (1) medical personnel should not have commented
on his silence, and (2) without inferences drawn from his refusal to speak, the evidence is
insufficient to support the court’s finding that he is mentally ill.
Both the United States Constitution and the Minnesota Constitution state that a
person cannot be compelled to be a witness ag ainst himself in any criminal case. U.S.
6
Const. amend. V; Minn. Const., art. I, § 7. “The object of the [Fifth Amendment] was to
insure that a person should not be compelled, when acting as a witness in any investigation,
to give testimony which might tend to s how that he had committed a crime.” In re
Contempt of Ecklund, 636 N.W.2d 585, 588 (Minn. App. 2001) (quotation omitted). Civil
commitment, while a significant restraint on liberty, is not c onsidered to be a criminal
proceeding because the restraint is for treatment and not for punitive purposes. See Call v.
Gomez, 535 N.W.2d 312, 319-20 (Minn. 1995) (discussing commitment as a psychopathic
personality as remedial rather than puniti ve). Appellant’s claim of a constitutionally
protected right to remain silent during medical examinations preceding a civil commitment
is without merit. Furthermore, this record does not support his claim that his commitment
was based solely on his silence.
II.
Appellant argues that the district court e rred by failing to inquire whether he had the
capacity to waive his appe arance at the commitment/ Jarvis hearing. A hearing on a
commitment petition must be held within fourteen days afte r the filing of the petition.
Minn. Stat. § 253B.08, subd. 1 (2016). The proposed patient has the right to attend and to
testify at the hearing. Id., subd. 3 (2016). Bu t the proposed patient may also waive
attendance at the hearing or th e court “may exclude or excuse a proposed patient who is
seriously disruptive or who is incapable of comprehending and participating in the
proceedings.” Id., subd. 4(a), (b) (2016). When the court excludes or excuses a proposed
patient, the court must state with “specificity” its reasons for doing so. Id., subd. 4(b).
7
At the hearing, appellant’s attorney indi cated that appellant refused to attend the
hearing, and the district court stated that the mental-health unit administrator notified the
court that appellant refused to attend and took a “strong position.” The district court
accepted the county’s position that appellant could be excluded from the proceedings if he
would be “seriously disruptiv e,” and “agree[d] it would be inappropriate to make any
further efforts [to compel attendance].” See Minn. Stat. § 253B.08, subd. 5(b) (2016). The
district court’s decision to excuse appellant from attendan ce, based on appellant’s own
strongly held position, was not error.
In the alternative, appellant argues that the district court erred by not appointing a
substitute decision-maker. “Upon the request of any person, and upon a showing that
administration of neuroleptic medications may be recommended and that the person may
lack capacity to make decisi ons regarding the administrati on of neuroleptic medications,
the court shall appoint a substitute decision- maker with authority to consent to the
administration of neuroleptic medication.” Minn. Stat. § 253B.092, subd. 6 (2016).
Although a court must appoint a substitute decision-maker in this situation, no request was
made during this proceeding and the appellant was repres ented by counsel. This
distinguishes the matter from In re Civil Commitment of Raboin, 704 N.W.2d 767, 772-73
(Minn. App. 2005), in which this court held that the district court erred by failing to appoint
a substitute decision-maker despite a request ma de by the patient. The district court did
not err by failing to sua sponte appoint a substitute decision-maker.

8
III.
Appellant challenges the sufficiency of the evidence to support both his
commitment and the forced administration of neuroleptic medication. The county has the
burden of proving by clear and convincing evidence that a patient is mentally ill and subject
to civil commitment. See In re Colbert, 454 N.W.2d 614, 615 (Minn. 1990). In this matter,
the county was required to demonstrate by cl ear and convincing evidence that appellant
had an “organic disorder of the brain or a substantial psychiatric disorder” that: (1) grossly
impaired his judgment, behavior, capacity to recognize reality, or to reason or understand;
(2) manifested itself “by instances of grossly disturbed behavior or faulty perceptions”; and
(3) created a substantial likelihood that he would physically harm himself or others. Minn.
Stat. § 253B.02, subd. 13(a) (2016). A “substan tial likelihood of physical harm to self or
others” is demonstrated in various ways, in cluding “an inability for reasons other than
indigence to obtain necessary . . . medical care as a result of the impairment and it is more
probable than not that the person will suffer substantial harm, psychiatric deterioration or
debilitation or serious illness, unless appropriate treatment or services are provided.” Id.
Civil commitment and forced administratio n of neuroleptic medication, although
intended to protect and assist those suffering from serious mental illness, represent serious
constraints on an individual’s liberty interests. Because of this, a reviewing court must
carefully consider whether the district court has made “a good faith attempt to isolate the
most important factors” supporting civil commitment. In re Civil Commitment of Ince, 847
N.W.2d 13, 23 (Minn. 2014) (quotation omitted). “As the trier of fact, the district court
9
will be in the best position to determine the weight to be attributed to each factor
[supporting civil commitment], as well as to evaluate the credibility of witnesses—a critical
function in these cases that rely so he avily on the opinions of experts.” Id. at 23-24. To
conduct a thorough review and to determine if clear and convincing evidence supports a
civil commitment, this court relies on the district court’s findings.
We cannot conduct a thorough review when the district court’s findings are
conclusory and fail to address the statutory bases for commitment. See In re Civil
Commitment of Spicer, 853 N.W.2d 803, 809 (Minn. App. 2014). Minn. Stat. § 253B.09,
subd. 2 (2016), requires “the findings of fact and conclusions of law [to] specifically state
the proposed patient’s conduct which is a basis for determining that each of the requisites
for commitment is met.” Here, in addition to the boilerplate la nguage of the form 2, the
district court found that appe llant “poses a threat to hi mself and staff, and is very
combative. He is bipolar and suffers from a sc hizoaffective disorder.” The district court
made some additional findings on the record at the commitment hearing:
The Court understands that [appellant] has been
somewhat oppositional regardi ng this case, and I understand
that he opposes the prescrip tions. He also opposes the
commitment. However, based upon the testimony of
Dr. Tinius it is quite clear that [appellant] is struggling with
mental illness, really quite severe symptoms, including a
bipolar condition and schizoaf fective disorder. So a

2 We note that the preprinted form used by the district court omits some of the statutory
language in its conclusion of law that appe llant is mentally ill. The omitted statutory
language states that a substantial likelihood of physical harm to self or others can be
“demonstrated by . . . a failure to obt ain necessary food [and] clothing.” See Minn. Stat.
§ 253B.02, subd. 13(a)(1) (2016).
10
commitment is appropriate for a period not to exceed six
months.

In addition, the district court acknowledge d the risk associated with the neuroleptic
medication but concluded that the benefits outweighed the risks. However, these findings
do not address the basis for co mmitment set forth in Minn. St at. § 253B.02, subd. 13(a),
and lack the specificity required under the statute.
Therefore, we remand to the district c ourt for more detailed findings that address
the statutory factors. See Stiff v. Assoc. Sewing Supply Co., 436 N.W.2d 777, 779 (Minn.
1989) (acknowledging that an appellate court may remand for additional findings necessary
to support a district court’s conclusion on a disputed issue).
Affirmed in part and remanded.