In the Matter of the Civil Commitment of: Renee P. Sharp.

This opinion will be unpublished and
may not be cited except as provided by
Minn. Stat. § 480A.08, subd. 3 (2018).

STATE OF MINNESOTA
IN COURT OF APPEALS
A19-0875

In the Matter of the Civil Commitment of:
Renee P. Sharp.

Filed October 28, 2019
Affirmed
Cleary, Chief Judge

Hennepin County District Court
File No. 27-MH-PR-19-513

Renee P. Sharp, Minneapolis, Minnesota (pro se appellant)

Michael O. Freeman, Hennepin Coun ty Attorney, Annsara Lovejoy E lasky, Assistant
County Attorney, Minneapolis, Mi nnesota (for respondent Hennepi n County Medical
Center)

Considered and decided by Hooten, Presiding Judge; Cleary, Chi ef Judge; and
Worke, Judge.
U N P U B L I S H E D O P I N I O N
CLEARY, Chief Judge
Appellant challenges the district court’s orders committing her as mentally ill and
authorizing the involuntary administration of neuroleptic medications. Because the district
court’s findings are supported by the record and satisfy the re levant statutory criteria, we
affirm.

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FACTS
Appellant Renee P. Sharp has a history of schizophrenia, alcohol-use disorder, and
mental-health hospitalizations. I n April 2019, staff with Comm unity Outreach for
Psychiatric Emergencies (COPE) b rought her to Hennepin County M edical Center
(HCMC) after her apartment was deemed uninhabitable and was con demned. Appellant
was rendered homeless. She was agitated and delusional and planned to “sleep in the back
of a bus.”
In May 2019, a social-services supervisor petitioned the distri ct court to commit
appellant as mentally ill. A member of appellant’s treatment t eam supplemented the
petition with a written statement and a request to permit the involuntary administration of
neuroleptic medications.
The district court assigned an examiner, who prepared a report. See Minn. Stat.
§ 253B.07, subd. 3 (2018). The examiner noted that appellant h ad a well-documented
history of schizophrenia, which affected her thoughts, mood, an d perception. She
concluded that appellant lacked i nsight into her mental illness and posed a substantial
likelihood of harm to herself b ased upon her inability to care for herself. The examiner
also believed that the least rest rictive treatment was hospital ization, in part, because
appellant “was not taking medications as prescribed.” She further concluded that appellant
did not have the capacity to make competent decisions on whether to accept antipsychotic
medications and did not demonstrate an awareness of her situation.
A district-court referee held a hearing on the petition. Appe llant appeared with
counsel. The petitioner submitted exhibits into evidence, but offered no testimony. The

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exhibits included COPE records, adult-protection records, and appellant’s medical records.
The parties stipulated to the admission of the examiner’s report.
Based on the recommendations of the referee, the district court found that appellant
suffered from schizophrenia and posed “a substantial likelihood of causing physical harm”
based upon her documented lack of shelter and self-care. The c ourt committed appellant,
as a mentally ill person. In a separate order, the court concluded that appellant lacked the
capacity to refuse neuroleptic m edications and authorized the i nvoluntary administration
of several medications. This appeal followed.
D E C I S I O N
I. The record supports the district court’s commitment findings, and the evidence
is sufficient for commitment.

Appellant asserts that commitmen t is unnecessary because she is not mentally ill,
“complex factors” surrounded her commitment, and she has been voluntarily engaging in
psychiatric services. In effect, she argues that she does not meet the statutory requirements
for commitment and that less restrictive options are available.
In reviewing a commitment order, we will not reverse a district court’s findings of
fact unless they are clearly erroneous. In re McGaughey , 536 N.W.2d 621, 623 (Minn.
1995). We review de novo whethe r the evidence is sufficient to meet the standard of
commitment. In re Thulin, 660 N.W.2d 140, 144 (Minn. App. 2003).
An action to commit an individual as mentally ill is commenced by petition. Minn.
Stat. § 253B.07, subd. 2 (2018); In re Brown , 640 N.W.2d 919, 922 (Minn. 2002). A
district court may not grant the petition unless it is supporte d by clear and convincing

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evidence that the proposed patient is mentally ill, as defined by statute, and no suitable
alternative to commitment exists . Minn. Stat. § 253B.09, subd. 1(a) (2018); Brown, 640
N.W.2d at 922. When a district court orders commitment, “its f indings of fact and
conclusions of law must specifi cally state the proposed patient ’s conduct that forms the
basis for determining that each of the requisites for commitmen t has been met.” Brown,
640 N.W.2d at 922.
A “mentally ill” person is defined to include a person with “a substantial psychiatric
disorder” which “grossly impairs” behavior or cognition and cau ses “grossly disturbed
behavior or faulty perceptions,” so long as the disorder “poses a substantial likelihood of
physical harm” to the person or others. Minn. Stat. § 253B.02, subd. 13(a) (2018). A
substantial likelihood of harm may be demonstrated by “a failure to obtain necessary food,
clothing, shelter, or medical care as a result of the impairment.” Id., subd. 13(a)(1).
Here, the district court found that appellant suffered from sch izophrenia, which
affected her “capacity to recogn ize reality.” The court found that appellant appeared
delusional at the time of her e viction, displayed irrational pa ranoia at the time of her
hospitalization, and “continues to exhibit paranoid and disorganized thoughts.” The record
supports these findings.
The district court found that a ppellant posed a substantial lik elihood of causing
physical harm because she was h omeless and had limited plans fo r obtaining shelter; for
example, she planned to “sleep in the back of a bus.” The cour t found that, at the time of
hospitalization, appellant was distressed; disheveled; poorly g roomed; and wearing
inappropriate, torn, and severely soiled clothing. The court f ound that appellant had a

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“fairly large and new abrasion on the bridge of her nose from a recent fall.” The record
supports these findings.
Clear and convincing evidence supports the commitment. Appella nt has a
substantial psychiatric disorder affecting her thought and caus ing faulty perceptions, and
there is a substantial risk of physical harm due to her disorder. Appellant lost her apartment
because she failed to maintain its livability, she failed to ob tain shelter or make adequate
plans following the condemnatio n, and she lacks the ability to c a r e f o r h e r s e l f w h i l e
homeless. See id.
The district court found that a less restrictive placement was not appropriate. The
court specifically found that appellant’s illness could not be adequately treated by dismissal
of the petition, voluntary care, the appointment of a guardian, or a conditional release.
Appellant argues that she has been voluntarily engaging in psyc hiatric services. The
examiner stated, in her report, that appellant was not taking medications as prescribed and
that hospitalization was the le ast restrictive, appropriate tre atment. Additional evidence
indicates that appellant “is incapable of independently meeting h e r b a s i c n e e d s . ” T h e
record supports the district c ourt’s finding that no suitable a lternative to commitment
exists.
II. The district court did not err by authorizing the involuntary administration of
neuroleptic medications. The district court’s findings are sup ported by the
record and sufficiently address the relevant statutory criteria.

Appellant challenges the distri ct court’s order permitting the involuntary
administration of neuroleptic medications. She argues that the order is unnecessary
because she has been “going to the [c]linic every two weeks for injections.” In Minnesota,

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the administration of neuroleptic medication is governed by Min n. Stat. § 253B.092
(2018). The statute rests upon a body of caselaw addressing th e invasion-of-privacy
considerations inherent in the nonconsensual, nonemergency admi nistration of such
medicine. See, e.g., In re Schmidt, 443 N.W.2d 824, 827 (Minn. 1989); Jarvis v. Levine,
418 N.W.2d 139, 144 (Minn. 1988).
“Court approval is required to a dminister neuroleptic medication to a person who
refuses it.” Thulin, 660 N.W.2d at 145 (citing Minn . Stat. § 253B.092, subd. 8(a)) . “A
patient is presumed to have capacity to make decisions regardin g administration of
neuroleptic medication.” Minn. S tat. § 253B.092, subd. 5(a). To determine whether a
patient has the capacity to refuse, a district court must consider:
(1) whether the person demonstrates an awareness of the nature
of the person’s situation, i ncluding the reasons for
hospitalization, and the possibl e consequences of refusing
treatment with neuroleptic medications; (2) whether the person
demonstrates an understanding of treatment with neuroleptic
medications and the risks, ben efits, and alternatives; and
(3) whether the person communicates verbally or nonverbally
a clear choice regarding trea tment with neuroleptic
medications that is a reasoned one not based on delusion, even
though it may not be in the person’s best interests.

Id., subd. 5(b). With exceptions not relevant here, if the district court finds that the patient
lacks capacity, it must decide wh ether to permit administration of the medication by
determining what a “reasonable person would do,” with consideration of:
(1) the person’s family, commu nity, moral, religious, and
social values;
(2) the medical risks, benefits, and alternatives to the proposed
treatment;
(3) past efficacy and any extenuating circumstances of past use
of neuroleptic medications; and

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(4) any other relevant factors.

Id., subds. 7(c), 8(e).

The district court found that appellant lacked capacity because she “does not admit
that she is mentally ill” and “does not have the ability to und erstand and use information
about her mental illness, its symptoms, and treatment.” The co urt noted evidence in the
record supporting this finding, s uch as the examiner’s report, which stated both that
appellant had intentionally gone off her medications or failed to take them as prescribed,
and that appellant lacked the capacity to make competent decisions about her medication.
The record supports the district court’s findings.
1 The district court sufficiently considered
appellant’s awareness of her situation, her understanding of the treatment, and whether she
made a reasoned choice to refuse medication. See id., subd. 5(b).
The district court also considered what a reasonable person in appellant’s position
would do when faced with a decisi on whether to refuse neuroleptic medications. See id.,
subds. 7(c), 8(e). The court made numerous findings on the ris ks and benefits from
allowing administration of the m edication, and found that appel lant had “experienced no
known significant side effects fro m the use of neuroleptic medi cations in the past.” The
court found that appellant would gain increased benefits from h er other treatment if she

1 Respondent HCMC argues that the standard of proof regarding in capacity is a
preponderance of the evidence. This is consistent with Minn. Stat. § 253B.092, subd. 6(d).
In Thulin, this court suggested that a clear and convincing standard is applicable. 660
N.W.2d at 145 (“The record provides clear and convincing evidence to support the district
court’s finding that appellant lacked the capacity to make dete rminations concerning
neuroleptic medications.”). While we apply a preponderance-of-the-evidence standard, we
note that, even under a clear-and-convincing standard, the evidence here is sufficient.

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was medication compliant. The district court did not err by au thorizing the involuntary
administration of neuroleptic medications.
Affirmed.