In the Matter of the Civil Commitment of: Nadezdha Dmitrieva.

This opinion is nonprecedential except as provided by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
A25-0233

In the Matter of the Civil Commitment of: Nadezdha Dmitrieva.

Filed August 4, 2025
Affirmed
Ede, Judge

Hennepin County District Court
File No. 27-MH-PR-25-8

Gabe Monson, Hennepin County Adult Representation Services, Minneapolis, Minnesota
(for appellant Nadezdha Dmitrieva)

Mary F. Moriarty, Hennepin County Attorney, Annsara Lovejoy Elasky, Assistant County
Attorney, Minneapolis, Minnesota (for respondent Fairview Range Medical Center)

Considered and decided by Ede, Presiding Judge; Slieter, Judge; and Bond, Judge.
NONPRECEDENTIAL OPINION
EDE, Judge
Appellant challenges the district court’s order civilly committing her as a person
who poses a risk of harm due to mental illness, contending that the record does not establish
(A) that she poses a substantial likelihood of physical harm based on a failure to provide
herself with necessary food or shelter and (B) that she poses a substantial likelihood of
physical harm based on a future risk of significant psychiatric deterioration. We affirm.

2
FACTS
In January 2025, respondent Hennepin County petitioned to civilly commit
appellant Nadezdha Dmitrieva. The matter proceeded to a commitment hearing. The
following factual summary stems from the hearing record and the district court’s findings
of fact in the resulting civil commitment order.1
In late December 2024, Dmitrieva was treated at Fairview Riverside Medical Center
(Fairview Riverside) after members of her family called emergency medical services with
concerns about her safety. Dmitrieva’s mother found Dmitrieva “in her bed shaking.”
Although she at first agreed to go to the hospital, Dmitrieva later refused after she “ask[ed]
the voices if she should go” and “[t]hey told her no.” Her family reported that she was
diagnosed with schizophrenia and had not been taking her medications for two months,
that she had lost over 40 pounds in the previous few months because she was not eating,
that she was not cleaning up animal feces in her house, and that she was having auditory
and visual hallucinations. Her mother also noted how weak Dmitrieva had become because
she was not eating or drinking.
At Fairview Riverside , Dmitrieva presented with “acute decompensation.”
2 Her
medical records indicate that she had a past psychiatric history of schizophrenia, bipolar

1 Because Dmitrieva does not challenge the district court’s findings of fact as clearly
erroneous, we rely primarily on those factual findings in addressing Dmitrieva’s appellate
arguments. Our summary of the hearing record is presented only as it relates to Dmitrieva’s
arguments that the record does not contain clear and convincing evidence to support the
district court’s conclusion that she met the statutory criteria for commitment.

2 See United States v. Mitchell, 11 F.4th 668, 670–71 n.2 (8th Cir. 2021) (noting that
“decompensation is a breakdown in an individual’s defense mechanisms, resulting in
3
disorder, attention deficit hyperactivity disorder, depression, and anxiety. During her
treatment, Dmitrieva exhibited delusions. For example, she claimed that she works for Elon
Musk, that he communicates with her through advanced technology, that she is a “prophet,”
and that she is on a “karmic journey.” After receiving treatment in the Fairview Riverside
emergency department, Dmitrieva was transferred to the Fairview Range Medical Center
(Fairview Range) on December 31, 2024.
On January 2, 2025, Hennepin County placed Dmitrieva on a 72- hour hold and
petitioned to commit her as a person who poses a risk of harm due to mental illness. Her
medical records reflect that she “remain[ed] in a decompensated state” through the first
week of January.
Before the commitment hearing, a court-appointed examiner (the examiner)
submitted a report to the court. The examiner diagnosed Dmitrieva with “[u]nspecified
schizophrenia spectrum and other psychotic disorder.” Although the examiner stated that
Dmitrieva had not “failed to obtain necessary food, clothing, shelter, or medical care” and
that “there was insufficient evidence that [Dmitrieva had] . . . caused harm to herself by
failing to obtain food or by maintaining unsanitary living c onditions,” the examiner also
opined that, “[g]iven the direct impact of her symptoms on her oral intake, it [was] likely
she would continue reduced oral intake in the future, which could have result[ed] in more
significant medical concerns, unless appropriate treatment [was] provided.” And the
examiner reported that “[t]he prominence of her symptoms, in conjunction with her poor

progressive loss of normal functioning or worsening of psychiatric symptoms” (quotation
omitted)).
4
insight, indicate[d] she would likely suffer significant psychiatric deterioration if
appropriate treatment and services [were] not provided.” The examiner therefore stated that
the least restrictive, appropriate treatment for Dmitrieva was civil commitment and
continued inpatient treatment until her mental status was stabilized.
On January 10, 2025, the district court held the commitment hearing on Hennepin
County’s petition. The district court took judicial notice of the examiner’s report. Hennepin
County offered four exhibits: (1) medical notes about neuroleptic medication for purposes
of Jarvis3 proceedings; (2) Fairview Riverside medical records; (3) initial Fairview Range
medical records; and (4) updated Fairview Range medical records. In addition, the district
court heard testimony from one of Dmitrieva’s medical providers (the medical provider) ,
the examiner, and Dmitrieva.
The medical provider testified that he worked at Fairview Range and was
Dmitrieva’s provider at that facility during her hospitalization. He explained that, although
Dmitrieva was eating and drinking under his care,
he still had concerns about her lack of
food intake and her weight loss arising from mental illness.
The examiner testified that, based on her review of relevant records and her
interview with Dmitrieva, there was insufficient evidence to conclude that Dmitrieva had
harmed herself by maintaining an unsanitary home or by failing to obtain food. But the

3 See Jarvis v. Levine , 418 N.W.2d 139, 150 (Minn. 1988) (holding that “medical
authorities seeking to treat [a patient] involuntarily with neuroleptic drugs must obtain pre-
treatment judicial review”).
5
examiner also stated that she was concerned about Dmitrieva’s future food intake because,
when Dmitrieva had visions, she sometimes did not have an appetite.
Dmitrieva claimed that she was “on a spiritual journey” and that, “[i]n the spiritual
community,” people felt “ill when they . . . [had] visions or premonitions or downloads;
things like that.” She also agreed that her visions “impact[ed her] eating in a way that [was]
unhealthy” and testified that, when she had “visions,” they would “make[ her] sick.” But
Dmitrieva denied that she had lost 40 pounds in the last two months, asserting that this was
“a major exaggeration from [her] mom.”
Following closing argument from counsel for both parties, the district court took the
matter under advisement. The district court later filed an order committing Dmitrieva as a
person who poses a risk of harm due to mental illness and an order authorizing the use of
neuroleptic medications.
Dmitrieva appeals from the district court’s civil commitment order.4
DECISION
In challenging the district court’s civil commitment order, Dmitrieva maintains that
the record does not establish (A) that she posed a substantial likelihood of physical harm
based on a failure to provide herself with necessary food or shelter and (B) that she posed
a substantial likelihood of physical harm based on a future risk of significant psychiatric
deterioration. We respectfully disagree.

4 In this appeal, Dmitrieva does not challenge the district court’s order authorizing the use
of neuroleptic medications.
6
Whether the record contains clear and convincing evidence to support the district
court’s conclusion that an individual meets the statutory criteria for commitment is a
question of law that appellate courts review de novo. In re Linehan, 518 N.W.2d 609, 613
(Minn. 1994); In re Civ. Commitment of Crosby, 824 N.W.2d 351, 356 (Minn. App. 2013),
rev. denied (Minn. Mar. 27, 2013). The evidence must be sufficient to support the district
court’s legal conclusion that an individual meets the statutory criteria for commitment. In
re Thulin, 660 N.W.2d 140, 144 (Minn. App. 2003).
The Minnesota Commitment and Treatment Act (MCTA) provides that the district
court may civilly commit an individual “[i]f the court finds by clear and convincing
evidence that the proposed patient is a person who poses a risk of harm due to mental
illness” and there is “no suitable alternative to judicial commitment.” Minn. Stat.
§ 253B.09, subd. 1(a) (2024). A person poses a risk of harm due to mental illness if they
have “an organic disorder of the brain or a substantial psychiatric disorder of thought,
mood, perception, orientation, or memory” and, because of their condition, “pose[] a
substantial likelihood of physical harm to self or others.” Minn. Stat. § 253B.02,
subd. 17a(a) (2024). A “substantial likelihood of physical harm to self or others” is shown
by:
(1) a failure to obtain necessary food, clothing, shelter,
or medical care as a result of the impairment;

(2) an inability for reasons other than indigence to
obtain necessary food, clothing, shelter, or medical care as a
result of the impairment and it is more probable than not that
the person will suffer substantial harm, significant psychiatric
deterioration or debilitation, or serious illness, unless
appropriate treatment and services are provided;
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(3) a recent attempt or threat to physically harm self or
others; or

(4) recent and volitional conduct involving significant damage to
substantial property.

Id., subd. 17a(a)(1)–(4).
In ordering civil commitment, the district court need only find one of the factors
above to determine that a person poses a substantial likelihood of physical harm to themself
or others. See id. “The [district] court shall make its determination upon the entire record
pursuant to the Rules of Evidence.” Minn. Stat. § 253B.08, subd. 7 (2024). And the district
court must “find the facts specifically, and separately state its conclusions of
law . . . specifically stat[ing] the proposed patient’s conduct which is a basis for
determining that each of the requisites for commitment is met .” Minn. Stat. § 253B.09,
subd. 2(a) (2024).
As noted above, Dmitrieva argues that the district court’s factual findings do not
support the determination that she met the statutory criteria for commitment, specifically
as to the factors enumerated in Minnesota Statutes section 253B.02, subdivision 17a(a)(1)
and (2). Below, we address each of Dmitrieva’s contentions in turn.
A. The district court did not err in determining that Dmitrieva posed a
substantial likelihood of physical harm based on her failure to provide
herself with necessary food.

Dmitrieva asserts that the record does not establish that she posed a risk of harm due
to mental illness by failing to provide herself with food or shelter. She focuses on the
examiner’s report, which the district court found “persuasive.” More specifically,
8
Dmitrieva points to those aspects of the examiner ’s report stating that she had not “failed
to obtain necessary food, clothing, shelter, or medical care” and that “there was insufficient
evidence that [Dmitrieva had] . . . caused harm to herself by failing to obtain food or by
maintaining unsanitary living conditions.” According to Dmitrieva, because the evidence
before the district court did “not include any information on [Dmitrieva]’s current weight
or current labs,” and given those aspects of the examiner’s report quoted above, the court’s
commitment determination is not sufficiently supported by clear and convincing evidence.
Dmitrieva’s arguments are unavailing.
“[S]peculation as to whether the person may, in the future, fail to obtain necessary
food, clothing, shelter, or medical care or may attempt or threaten to harm self or others is
not sufficient to justify civil commitment as a mentally ill person.” In re McGaughey, 536
N.W.2d 621, 623 (Minn. 1995). But the Minnesota Supreme Court has explained that it is
not a prerequisite “that the person must either come to harm or harm others before
commitment as a mentally ill person is justified.” Id. Instead, “[t]he statute requires only
that a substantial likelihood of physical harm exists, as demonstrated by an overt failure to
obtain necessary food, clothing, shelter, or medical care or by a recent attempt or threat to
harm self or others.” Id. at 623–24 (footnote omitted).
We conclude that the district court’s civil commitment order is sufficiently
supported by its findings, which are drawn from the record—i.e., the examiner’s report,
medical records, and the testimony of the witnesses, including Dmitrieva. In particular, the
district court found that Dmitrieva “is ill with [u]nspecified schizophrenia spectrum and
other psychotic disorder, which is a substantial psychiatric disorder of her thought, mood,
9
and perception, that grossly impairs her judgment, behavior, capacity to recognize reality,
and ability to reason or understand.” Moreover, the district court found that, “due to this
impairment, [Dmitrieva] poses a substantial likelihood of causing physical harm” for,
among other things, the following reasons. According to her family, Dmitrieva had reduced
her oral intake, had lost weight, was not taking her medication, and was experiencing
hallucinations before her hospitalization. During her hospitalization, Dmitrieva exhibited
thought disorder and delusions relating to visions, which she connected to her decreased
oral intake because she felt sick. And Dmitrieva exhibited poor insight into her mental
illness and remained decompensated through the time of the commitment hearing.
The record reasonably supports these determinations by the district court. The
examiner diagnosed Dmitrieva with “[u] nspecified schizophrenia spectrum and other
psychotic disorder.” Although Dmitrieva was reportedly diagnosed with schizophrenia, her
family stated that she had not been taking her medications for two months, that she had lost
over 40 pounds in the previous few months because she was not eating, and that she was
having auditory and visual hallucinations. Dmitrieva’s mother also noted how weak
Dmitrieva had become because she was not eating or drinking. Medical records reveal that
Dmitrieva remained in a “decompensated state” from the time she began receiving
treatment at Fairview Riverside in December 2024 through the first week of January
2025—just before the commitment hearing was held—and the medical provider and the
examiner both testified about their concerns for Dmitrieva’s oral intake. And Dmitrieva
10
herself affirmed that her “visions” affected her eating in a way that was unhealthy because
they made her sick.5
While we are mindful that the medical records on Dmitrieva’s weight loss are
limited, the district court was nonetheless obligated to “make its determination upon the
entire record pursuant to the Rules of Evidence.” Minn. Stat. § 253B.08, subd. 7. This
means that the district court needed to decide whether to order civil commitment based not
only on those aspects of the examiner’s report and the record that Dmitrieva highlights, but
also on the rest of the evidence that was before the court, which included the facts discussed
above. And despite the portions of the examiner’s report that Dmitrieva relies on, the
examiner also wrote that, “[g]iven the direct impact of her symptoms on her oral intake, it
is likely [Dmitrieva] would continue reduced oral intake in the future, which could result
in more significant medical concerns, unless appropriate treatment is provided.” Moreover,
the examiner testified that she was concerned about Dmitrieva’s future food intake because,
when Dmitrieva had visions, she sometimes did not have an appetite. Thus, the examiner
recommended that the least restrictive, appropriate treatment for Dmitrieva was civil
commitment and continued inpatient treatment until her mental status was stabilized.

5 As noted earlier, Dmitrieva does not challenge any of the district court’s factual findings
on this issue as clearly erroneous. But to the extent that Dmitrieva’s argument asks this
court to reweigh the examiner’s report against other evidence in the record and to reconcile
any conflicts, such an assertion would lack merit. This is because, when reviewing factual
findings for clear error, appellate courts (1) view the evidence in the light most favorable
to the findings, (2) do not find their own facts, (3) do not reweigh the evidence, and (4) do
not reconcile conflicting evidence. In re Civ. Commitment of Kenney, 963 N.W.2d 214,
221–22 (Minn. 2021).
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Consequently, the district court correctly determined that there was clear and
convincing evidence that Dmitrieva posed a substantial likelihood of physical harm to
herself as shown by her failure to obtain necessary food because of her impairment. In
support of this determination, the district court made “sufficiently particular findings of
fact on the key issues” to support its conclusions of law. In re Civ. Commitment of Spicer,
853 N.W.2d 803, 810 (Minn. App. 2014). Based on those findings— which Dmitrieva does
not challenge as clearly erroneous on appeal, and which are reasonably supported by the
record—the district court did not err in determining that there was clear and convincing
evidence that Dmitrieva presented a substantial likelihood of physical harm to herself, as
shown by a failure to obtain necessary food because of her impairment, per subdivision
17a(a)(1) of section 253B.02.
6 See Crosby, 824 N.W.2d at 356.
B. The district court did not err in determining that Dmitrieva poses a
substantial likelihood of physical harm based on a future risk of
significant psychiatric deterioration.

Dmitrieva also maintains that the examiner ’s opinion “is far too speculative under
the requirements of the commitment statute and the language from the Minnesota Supreme

6 Although we acknowledge that Dmitrieva has also asserted that the record does not
establish that she pose d a risk of harm due to mental illness by failing to provide herself
with necessary shelter, we decline to reach that issue because we conclude that the statutory
basis for civil commitment was met by the clear and convincing evidence of Dmitrieva’s
failure to obtain necessary food. See Minn. Stat. § 253B.02, subd. 17a(a)(1) (stating that a
“substantial likelihood of physical harm to self or others” may be shown by “a failure to
obtain necessary food, clothing, shelter, or medical care as a result of impairment”
(emphasis added)); see also Back v. State, 902 N.W.2d 23, 32 (Minn. 2017) (explaining
that, “[h]ad the [legislature’s] objective [in enacting a statute] been to require only one
of . . . two grounds, making neither ground dependent on the other, then the disjunctive
‘or’ would have been used” (quotation omitted)).
12
Court in McGaughey.” She argues that Hennepin County “cannot prove that [she] will
suffer harm from future food intake issues when it has not been able to show [that she] has
suffered harm from her current level of food intake.” We need not address this argument
because we have already concluded that the district court did not err in ordering civil
commitment based on its determination under subdivision 17a(a)(1) of section 253B.02
that Dmitrieva poses a substantial likelihood of physical harm based on her failure to
provide herself with necessary food. See Minn. Stat. § 253B.02, subd. 17a(a)(1)–(4)
(setting forth the four statutory grounds for establishing a “substantial likelihood of
physical harm to self or others” in the disjunctive); see also Back , 902 N.W.2d at 32. But
in the interest of completeness, even if the district court erred in its subdivision (1)
determination, Dmitrieva’s subdivision 17a(a)(2) argument does not warrant reversal.
Based on the district court’s undisputed and reasonably supported findings, we
conclude that the court did not err in determining that there is clear and convincing
evidence that Dmitrieva met the standard for commitment under subdivision 17a(a)(2). See
Crosby, 824 N.W.2d at 356. The district court found that Dmitrieva exhibited poor insight
into her mental illness , that she believed “she was not experiencing any symptoms of
psychosis,” that she did not participate in her current medical care , and that her family
reported her previous noncompliance with her medication.
The record establishes that Dmitrieva failed to provide herself with medical care
due to her mental illness and that she posed a substantial likelihood of physical harm based
on a future risk of significant psychiatric deterioration. As discussed above, it is not a
prerequisite “that the person must either come to harm or harm others before commitment
13
as a mentally ill person is justified.” McGaughey, 536 N.W.2d at 623. While the most recent
medical report stated that Dmitrieva had been eating and drinking, it was Dmitrieva’s
reduced oral intake because of her delusions that precipitated her emergency room visit,
evincing “an overt failure to obtain necessary food.” Id. Moreover, although the examiner’s
report does not reflect the most current information pertaining to Dmitrieva’s medication
compliance, Dmitrieva’s own testimony revealed that she was no longer taking her
medication and that her delusions were linked to her reduced oral intake. The record also
demonstrates that Dmitrieva remained in a decompensated state up to the time of the
commitment hearing and was declining to participate in her medical care. And her initial
presentation of “acute decompensation” at Fairview Riverside shows that Dmitrieva had
failed to provide herself with medical care because of her mental illness and that she posed
a substantial likelihood of physical harm based on a future risk of significant psychiatric
deterioration.
Given the record on this issue, we conclude that the district court likewise made
“sufficiently particular findings of fact” to support its conclusions of law . Spicer, 853
N.W.2d at 810. The district court did not err in determining that Dmitrieva posed a
substantial likelihood of physical harm because it was more probable than not that she
would suffer significant psychiatric deterioration unless appropriate treatment and services
were provided. See Minn. Stat. § 253B.02, subd. 17a(a)(2).
Affirmed.