In the Matter of the Civil Commitment of: Nathaniel Joseph Galster.

This opinion is nonprecedential except as provided by
Minn. R. Civ. App. P. 136.01, subd. 1(c).

STATE OF MINNESOTA
IN COURT OF APPEALS
A24-0146

In the Matter of the Civil Commitment of: Nathaniel Joseph Galster.

Filed July 15, 2024
Affirmed
Cochran, Judge

Clay County District Court
File No. 14-PR-23-3890

Alexis Madlom, Vickers Law Office, Fargo, North Dakota (for appellant Nathaniel Joseph
Galster)

Brian J. Melton, Clay County Attorney, Moorhead, Minnesota (for respondent Clay
County Social Services)

Considered and decided by Cochran, Presiding Judge; Wheelock , Judge; and Ede,
Judge.
NONPRECEDENTIAL OPINION
COCHRAN, Judge
On appeal from a judgment of civil commitment as a chemically dependent and
mentally ill person, appellant seeks reversal of an order involuntarily committing him to a
treatment facility. He argues that there is insufficient evidence to support the district
court’s determination that full commitment is the least restrictive means to meet his
treatment needs. We affirm.
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FACTS
Respondent Clay County Social Services (the county) filed a petition for civil
commitment of appellant Nathaniel Joseph Galster to an inpatient treatment facility on the
basis that he is mentally ill, chemically dependent, and poses a risk of “serious imminent,
physical harm” to himself or others. The county filed the petition following Galster’s
hospitalization for self-inflicted injuries.
According to a screening report prepared by the county, police brought Galster to
the emergency department after he sent text messages to his family members that contained
images of self-inflicted injuries, including cuts on his arm. Galster’s family found him in
his bedroom intoxicated, with a loaded gun by his bed, and holding a knife. A family
member wrestled the knife away from Galster and called 911. Family reported that Galster
was engaging in suicidal ideations.
Law enforcement transferred Galster to the emergency department, where a hold
was placed on him after he expressed his desire to leave. According to the screening report,
Galster had “multiple self-injury lacerations” including ones on his left arm that “were 6-
10 inches long but superficial.” Galster admitted to drinking “six hard liquor beverages”
prior to his arrival at the hospital. Galster’s urine also tested positive for opiates. The
screening report noted that, in the week preceding hospitalization, there were “multiple
calls [to police] and ongoing safety concerns for [Galster].” During that time, police were
called to Galster’s residence several times due to his behavior and “extreme” intoxication.
The district court held a hearing on the petition, at which both a court-appointed
psychologist and Galster testified. The dist rict court also received the psychologist’s
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evaluation into evidence. In the evaluation, the psychologist concluded that Galster meets
the statutory criteria to be committed as mentally ill and chemically dependent. The
psychologist wrote that “[d]ismissal of the petition and a stay of civil commitment were
considered as less-restrictive alternatives; however, these do not seem appropriate at this
time.” In her evaluation, the psychologist also emphasized that the outpatient care that
Galster was receiving prior to his hospitalization was insufficient to manage his symptoms.
In addition, the psychologist noted Galster’s “lack of follow through with services in the
past” and that “he has not followed all recommendations during his current hospital stay”
as reasons for full commitment.
During her testimony at the hearing, the psychologist reiterated her opinion that
Galster meets the criteria for full commitment at an inpatient treatment facility. The
psychologist testified that she considered less-restrictive alternatives than commitment.
The psychologist stated that Galster had “limited insight into the issues he’s experiencing”
and “seemed to minimize his situation.” The psychologist added that Galster failed to
follow-through with treatment in various ways, such as by refusing to take medications and
failing to participate in group treatment. Given these occurrences, the psychologist was
concerned about Galster’s “adherence to treatment” on an outpatient basis.
Galster testified that he was in a depressed state when he cut himself and that he
would not harm himself again. Galster also testified that he created a safety plan for dealing
with his condition and learned coping mechanisms, such as “positive self-talk” and “self-
care.” And he disputed the psychologist’s claim that he was not following treatment
recommendations. He further testified that his plan after discharge was to move into his
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own apartment and set up appointments with healthcare providers. In closing argument,
Galster asserted that there was no need for a full commitment and that he was “ready to
work on [his] treatment out in the community.”
The district court found that Galster is mentally ill and chemically dependent, and
“agree[d] the least restrictive alternative is the full commitment.” Following the hearing,
the district court issued its written findings of fact, conclusions of law, and order for
judgment. The district court noted that it considered less-restrictive alternatives but found
that they “have been tried in the past and currently [Galster] is not sufficiently stabilized to
allow for less[] restrictive alternatives.”
Galster appeals.
DECISION
On appeal from a judgment of civil commitment, our review is limited to whether
the district court complied with the requirements of the Minnesota Commitment and
Treatment Act (MCTA), Minnesota Statutes sections 253B.01-. 24 (2022 & Supp. 2023).
In re Civ. Commitment of J anckila, 657 N.W.2d 899, 902 (Minn. App. 2003). Under the
MCTA, commitment is appropriate if the district court finds by clear and convincing
evidence that the person “poses a risk of harm due to mental illness” or “is a person who
has a . . . chemical dependency” and there is no “suitable alternative” to commitment.
Minn. Stat. § 253B.09, subd. 1(a). If a district court orders commitment, it must commit
the individual “to the least restrictive treatment program . . . which can meet the patient’s
treatment needs.” Id. In making its decision regarding a committed person’s treatment
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program, the court must consider alternative programs as well as the patient’ s treatment
preferences. Id., subd. 1(b).
Galster does not dispute the district court’s findings that he is mentally ill and
chemically dependent. Instead, Galster argues that there was “insufficient evidence to
place [him] under full commitment . . . as this was not the least restrictive means for [him]
to be treated.”
We will not reverse the district court’s findings concerning the least restrictive
means of treatment unless clearly erroneous. In re Thulin, 660 N.W.2d 140, 144 (Minn.
App. 2003). When reviewing factual findings for clear error, we (1) view the evidence in
the light most favorable to the findings, (2) do not reweigh the evidence, ( 3) do not
reconcile conflicting evidence; and (4) “need not go into an extended discussion of the
evidence to prove or demonstrate the correctness of the findings of the [district] court.” In
re Civ. Commitment of Kenney, 963 N.W.2d 214, 221-22 (Minn. 2021) (quotation omitted).
“[A]n appellate court’s duty is fully performed after it has fairly considered all the evidence
and has determined that the evidence reasonably supports the decision.” Id. at 222
(quotations omitted). And “[w]here the findings of fact rest almost entirely on expert
testimony, the [district] court’s evaluation of credibility is of particular significance.”
Thulin, 660 N.W.2d at 144 (quotation omitted).
We have previously affirmed a commitment even when the district court’s findings
on alternatives were “scant” because the record contained evidence supporting the
commitment. In re King, 476 N.W.2d 190, 193-94 (Minn. App. 1991). In King, the
appellant opposed full commitment to a secure hospital and instead requested commitment
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to a regional treatment center. Id. at 192-93. Evidence showed that the appellant repeatedly
engaged in “drug seeking behavior” and assaulted staff at previous facilities. Id. at 192.
And a court-appointed examiner testified that the appellant “probably lived more
comfortably at the security hospital than he could anywhere else,” and so recommitment
was in the appellant’s best interest. Id. The district court found that the appellant
“require[d] continued hospitalization in a highly structured setting” and ordered
commitment into the secure hospital. Id. at 193. The district court noted that it considered
“[o]ther placements,” but ultimately rejected them. Id.
In King, we noted that our review was “hampered in part by the scant [district] court
findings.” Id. at 194. And we were troubled that “the record include[d] so little evidence
and no findings on the [appellant’s proposed] alternatives.” Id. Notwithstanding these
concerns, we concluded that “the record [was] adequate . . . to support the [district] court’s
findings of fact and conclusions of law.” Id. In reaching this decision, we emphasized that
the record evidence included “the conclusions of the examiner and other staff, premised on
contact with appellant over a period of years, that the regional treatment center is not a
suitable alternative placement for appellant.” Id. Consequently, we determined there was
sufficient evidence to sustain the district court’s finding that no less-restrictive placement
was suitable. Id.
Here, like in King, the district court’s findings regarding alternatives are “scant” but
the record supports the district court’s determination that full commitment is the least
restrictive alternative. As noted above, the district court received testimony from the
psychologist who evaluated Galster as well as the psychologist’s written evaluation. Based
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on that evidence, the district court agreed with the psychologist’s opinion that “the least
restrictive alternative is the full commitment .” At the hearing, the district court also
acknowledged that Galster had developed his own safety plan for living in the community
but determined that the plan was not appropriate to meet Galster’s existing needs and
instead would “serve [him] well once [he’s] completed [his] treatment.” In addition, the
district court’s written findings reflect that it considered a variety of less -restrictive
treatment alternatives than full commitment but determined that “less-restrictive
alternatives have been tried in the past and currently [Galster] is not sufficiently stabilized
to allow for less-restrictive alternatives.”
Based on our careful review of the record, we conclude that there is sufficient
evidence to support the district court’s finding that full commitment is the least restrictive
suitable treatment alternative for Galster. The record reflects that the psychologist testified
that she considered alternatives such as “a stay of commitment or no commitment and
treatment within the community” but opined that Galster presented a danger to himself or
others if he did not receive treatment in a committed setting. Similarly, in her report, the
psychologist concluded that Galster’s behavior was “very concerning” and outpatient care
was not sufficiently meeting his treatment needs prior to his hospitalization. Consequently,
the report recommended a full commitment as the least restrictive alternative. At the
hearing, t he psychologist also testified that she had concerns about Galster following
through with treatment due to his (1) refusal to take medication; (2) requests “for two
specific medications, both of which are controlled substances”; and (3) failure to participate
in group treatment. And, lastly, the psychologist noted that Galster appeared to minimize
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his situation, and she agreed that Galster engaged in “some deceptive practices” relating to
drugs. Based on this evidence, the district court’s findings regarding previous attempts at
less-restrictive alternatives and Galster’s current instability are not clearly erroneous and
support the district court’s ultimate finding that there is no suitable alternative to full
commitment.
On appeal, Galster argues that outpatient treatment is the least restrictive alternative
that will meet his needs, and the district court failed to consider such an option. The record
refutes this argument. As discussed above, at the hearing, the district court heard Galster’s
testimony that he believed he would be best served by treatment in the community, as well
as his testimony about his safety plan and newly learned coping mechanisms. The district
court’s findings reflect that it considered Galster’s proffered alternative but did not credit
Galster’s testimony, instead crediting the psychologist’s testimony regarding Galster’s
need for commitment. We defer to such a credibility determination. See Thulin,
660 N.W.2d at 144. Accordingly, the record does not demonstrate that the district court
failed to consider Galster’s preferred treatment preferences or other alternatives.1
In sum, the district court’s findings, which are based on the psychologist’s testimony
and written evaluation, are not clearly erroneous. And the record reflects that the district
court considered less-restrictive alternatives to full commitment before committing Galster

1 Despite our decision to affirm the district court’s order, we encourage district courts to
make detailed oral or written findings regarding their consideration of an individual’s
proffered less-restrictive alternatives to commitment. Such findings help to facilitate
appellate review and assist the parties in understanding the basis for the district court’s
decision. See In re Danielson, 398 N.W.2d 32, 37 (Minn. App. 1986) (“The consideration
of less restrictive alternatives is a matter of great significance.” (quotation omitted)).
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to an inpatient treatment facility. Accordingly, the evidence is sufficient to sustain the
district court’s finding that there were no suitable, less- restrictive alternatives to
commitment. See King, 476 N.W.2d at 194.
Affirmed.