In the Matter of the Civil Commitment of: Lisa Jo Breitkreutz

This opinion is nonprecedential except as provided by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
A25-1052

In the Matter of the Civil Commitment of: Lisa Jo Breitkreutz.

Filed January 12, 2026
Affirmed
Smith, Tracy M., Judge

McLeod County District Court
File No. 43-PR-25-549

Lisa Jo Breitkreutz, Hutchinson, Minnesota (self-represented appellant)

Ryan Hansch, McLeod County Attorney, Carol J. Mayer, Assistant County Attorney,
Glencoe, Minnesota (for respondent McLeod County Social Services)

Considered and decided by Smith, Tracy M., Presiding Judge; Slieter, Judge; and

Harris, Judge.

NONPRECEDENTIAL OPINION

SMITH, TRACY M., Judge

Appellant Lisa Breitkreutz challenges her civil commitment by the district court as

a person who poses a risk of harm due to mental illness. Breitkreutz, who is self-represented

in this appeal, appears to argue that (1) the district court denied her procedural and

substantive due process of law; (2) the necessary elements for civil commitment were not

proved because she is not a danger to herself or others, she has not been diagnosed with a

mental illness, the district court did not consider less restrictive alternatives, and her
commitment was based, in part, on perjured evidence; and (3) she was not provided

adequate assistance of counsel. We affirm.

FACTS

Between May and December 2024, Breitkreutz was charged with various crimes

across several files in McLeod County. The district court ordered Breitkreutz to undergo a

competency evaluation pursuant to Minnesota Rule of Criminal Procedure 20, following

which Breitkreutz was determined to be incompetent to proceed. See Minn. R. Crim. P.

20.01-.04. The McLeod County prepetition screening committee then screened Breitkreutz

for mental-health commitment and unanimously determined that she met all the criteria for

a civil-commitment petition to be filed. McLeod County Health and Human Services

(MCHHS) filed a petition to civilly commit Breitkreutz as a person who is mentally ill and

poses of risk of harm.

The district court appointed an attorney for Breitkreutz, appointed Dr. Linda

Marshall as a court-appointed examiner, and held a preliminary hearing. The district court

concluded that “serious physical harm to [Breitkreutz] or others is likely if [she] is not

immediately confined” and specified that Breitkreutz must remain at the McLeod County

jail until her commitment hearing. As requested by Breitkreutz during the hearing, the

district court reserved her right to have a second examiner appointed.

A commitment hearing was scheduled. Two days before the commitment hearing,

Dr. Marshall conducted a psychological examination of Breitkreutz and filed a report of

her findings. Dr. Marshall’s report concluded that “there is sufficient evidence to support

commitment of [Breitkreutz] as a person who poses a risk of harm due to mental illness.”

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 At the commitment hearing, Dr. Marshall, Breitkreutz, and Breitkreutz’s friend

D.H. testified. Also admitted into evidence were police reports and criminal complaints

from each criminal matter, Breitkreutz’s rule 20 evaluation, the prepetition screening

report, and Dr. Marshall’s report. The district court found “that Ms. Breitkreutz has a major

mental illness” and “is a threat to others.” The district court also found that there were no

suitable less restrictive alternatives to judicial commitment. The district court determined

that “the State has proven by clear and convincing evidence that a full commitment is

necessary at this time.”

Breitkreutz appeals.

DECISION

I. Breitkreutz was not deprived of her constitutional right to procedural or
substantive due process.

Breitkreutz broadly argues that her “procedural and substantive legal due processes

were not upheld in the case.” Appellate courts review whether a person’s due process rights

have been violated de novo. Bendorf v. Comm’r of Pub. Safety, 727 N.W.2d 410, 413

(Minn. 2007).

A. Procedural Due Process

Under the United States and Minnesota Constitutions, the government may not

deprive an individual of life, liberty, or property without due process of law. U.S. Const.

amend. XIV, § 1; Minn. Const. art. I, § 7. “Because civil commitment deprives a person of

liberty, the protections of the Due Process Clause apply to civil-commitment proceedings.”

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Beaulieu v. Minn. Dep’t of Hum. Servs., 798 N.W.2d 542, 548-49 (Minn. App. 2011), aff’d,

825 N.W.2d 716 (Minn. 2013).

To determine the sufficiency of procedural protections, courts balance (1) the

private interest that will be affected by the governmental action; (2) the risk of erroneous

deprivation of such interest through the procedures used and the probable value, if any, of

additional procedural safeguards; and (3) the government’s interest, including the function

involved and the burdens that additional procedural requirements would impose. Mathews

v. Eldridge, 424 U.S. 319, 335 (1976); see Bendorf, 727 N.W.2d at 415-16 (applying

Mathews in driver’s license revocation case).

The Minnesota Commitment and Treatment Act (MCTA or the act), Minnesota

Statutes sections 253B.01 to .24 (2024), outlines the procedures for the civil commitment

process. The MCTA identifies the notice and procedural requirements for prepetition

screening, the notice and procedural requirements for the filing of a petition for

commitment, the requirements for holding a proposed patient pending a commitment order,

and the requirements of a preliminary hearing. Minn. Stat. § 253B.07. The MCTA provides

a proposed patient the right to counsel during any proceeding under the act. Id., subd. 2c.

The act also establishes procedural requirements regarding a commitment hearing. Minn.

Stat. § 253B.08. The proposed patient has the right to attend and testify and to present and

cross-examine witnesses, including court examiners. Id. The proposed patient also has the

right to request a second court examiner. Minn. Stat. § 253B.07, subd. 1(c)(1).

Applying the three-factor due-process test, we see no indication that these

procedural protections—which Breitkreutz does not claim were not followed in this case—

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were inadequate. See Mathews, 424 U.S. at 335. As to the first factor, Breitkreutz certainly

has a liberty interest in the commitment proceedings. As to the second factor, the

procedures used did not create a risk of erroneous deprivation of that interest. At the

preliminary and commitment hearings, Breitkreutz was represented by counsel. At the

commitment hearing, Breitkreutz testified at length and called a friend as a witness.

Breitkreutz’s attorney cross-examined Dr. Marshall, the court examiner. As to the third

factor, the county has a strong interest in protecting the public and ensuring that persons

who pose a risk of harm due to mental illness receive treatment. This interest is especially

strong when, as here, the proposed patient is facing criminal charges for such crimes as

assault with a dangerous weapon and making threats of violence. Balancing the three

factors, we conclude Breitkreutz’s right to procedural due process was not violated.

B. Substantive Due Process

Breitkreutz also argues that her substantive due process rights were violated.

“[S]ubstantive due process protects individuals from certain arbitrary, wrongful

government actions regardless of the fairness of the procedures used to implement them.”

In re Linehan, 594 N.W.2d 867, 872 (Minn. 1999) (quotations omitted). But “the state long

has had the power to civilly commit certain persons in narrow circumstances.” Id. “A

cognizable claim of a Fourteenth Amendment substantive due process violation must

describe governmental conduct so egregious that it ‘shocks the conscience.’” Mumm v.

Mornson, 708 N.W.2d 475, 487 (Minn. 2006) (citing Rochin v. California, 342 U.S. 165,

172-74 (1952)).

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 Breitkreutz makes no argument, and our review of the record reveals no evidence,

of egregious conduct or arbitrary decision-making by the county. Breitkreutz’s substantive-

due-process challenge therefore fails.

II. The district court did not err by determining that Breitkreutz meets the
statutory criteria for civil commitment.

Appellate courts review de novo “whether there is clear and convincing evidence in

the record to support the district court’s conclusion that appellant meets the standards for

commitment.” In re Thulin, 660 N.W.2d 140, 144 (Minn. App. 2003). A district court’s

civil-commitment determination “must be justified by findings based upon evidence at the

hearing.” In re Knops, 536 N.W.2d 616, 620 (Minn. 1995). A district court may consider

any evidence that is sufficiently reliable, including hearsay. In re Civ. Commitment of

Williams, 735 N.W.2d 727, 730-33 (Minn. App. 2007), rev. denied (Minn. Sept. 26, 2007).

Appellate courts review the district court’s findings of fact for clear error, viewing the

record in the light most favorable to the district court’s findings. In re Civ. Commitment of

Spicer, 853 N.W.2d 803, 807 (Minn. App. 2014). Appellate courts defer to a district court’s

credibility determinations. Knops, 536 N.W.2d at 620.

To order Breitkreutz’s judicial commitment under the MCTA, the district court had

to find by clear and convincing evidence that Breitkreutz “poses a risk of harm due to

mental illness” and that there is “no suitable alternative” to commitment. Minn. Stat.

§ 253B.09, subd. 1(a). A “person who poses a risk of harm due to a mental illness” includes

any person who has an organic disorder of the brain or a
substantial psychiatric disorder of thought, mood, perception,
orientation, or memory that grossly impairs judgment,
behavior, capacity to recognize reality, or to reason or

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 understand, that is manifested by instances of grossly disturbed
behavior or faulty perceptions and who, due to this impairment,
poses a substantial likelihood of physical harm to self or others
as demonstrated by:

....

(3) a recent attempt or threat to physically harm self or
others.

Minn. Stat. § 253B.02, subd. 17a.

Breitkreutz appears to make four arguments as to why the statutory criteria for civil

commitment were not adequately proved: (1) the district court erred by determining that

she poses a danger to herself or others; (2) Breitkreutz has not actually been diagnosed with

a mental illness; (3) the district court did not adequately consider less restrictive

alternatives; and (4) her commitment was based, at least in part, on perjured evidence. We

address each argument in turn.

A. Danger to Self or Others

For the district court to commit Breitkreutz, the county had to prove by clear and

convincing evidence that she poses a substantial likelihood of physical harm to herself or

others. See In re McGaughey, 536 N.W.2d 621, 624 (Minn. 1995). “[U]nsupported

speculation” about what a person may do in the future and evidence of inappropriate but

not “assaultive” behaviors are not sufficient to establish a substantial likelihood of harm.

Id.

The district court concluded that “[t]here is clear and convincing evidence that

[Breitkreutz] poses a danger to self or others.” There is ample evidence in the record to

support that conclusion. The record includes evidence that, in May 2024, Breitkreutz was

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charged with threats of violence made against relatives via voicemail, including threats to

“claw [victim’s] eyes out” and subsequently waiting on the relative’s front steps. This

incident, and another incident in which Breitkreutz picked up her young nephew from

school without informing anyone, led to domestic-assault no-contact orders (DANCOs)

and orders for protection protecting some of Breitkreutz’s family members. The record also

shows that, in October 2024, Breitkreutz was charged with violating two of those orders.

The record also includes evidence that, in December 2024, after Breitkreutz called

a family member crying and making statements that made the family member concerned

about Breitkreutz’s safety, police conducted a welfare check. According to police reports,

when officers entered Breitkreutz’s home, she held scissors and a hot curling iron toward

officers and threatened to shoot and “use deadly force” against the officers. Breitkreutz

was charged with assault with a dangerous weapon, threats of violence, obstruction of legal

process, and violation of a DANCO.

Finally, the record also includes Dr. Marshall’s testimony. She testified that

“[Breitkreutz’s] behaviors that she’s exhibited and threatened behaviors makes her a

danger to others.” Additionally, Dr. Marshall testified that “if [Breitkreutz] were released

back into the community untreated, I believe she would be a danger to others.”

Breitkreutz argues in her appellate brief that she has “never been a danger to

[herself] or others” and she similarly testified during the commitment hearing. Breitkreutz

also testified that her actions during the welfare check were a result of fear due to the police

unexpectedly entering her home, not due to mental illness. Breitkreutz’s friend D.H.

testified that, in his opinion, Breitkreutz is “all talk” and “would never harm anybody.”

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 But, even though Breitkreutz provided contrary evidence, the record as a whole

contains sufficient evidence to prove, under a clear-and-convincing standard, that

Breitkreutz poses a danger to self or others. The district court’s determination was based

on past, assaultive conduct; the examiner’s evaluation; and the absence of a history of

Breitkreutz treating her mental illness. The district court’s determination was therefore not

based on “unsupported speculation” or merely “inappropriate” behavior. See McGaughey,

536 N.W.2d at 624.

B. Diagnosis

Breitkreutz appears to argue that she has not been diagnosed with a mental illness

and is therefore not a “person who has a mental illness” under Minnesota Statutes section

235B.02, subdivision 17. As defined by statute, a “person who has a mental illness” is one

who has “an organic disorder of the brain or a substantial psychiatric disorder of thought,

mood, perception, orientation, or memory that grossly impairs judgment, behavior,

capacity to recognize reality, or to reason or understand, and is manifested by instances of

grossly disturbed behavior or faulty perceptions.” Minn. Stat. § 235B.02, subd. 17. That

fact must be proved by clear and convicting evidence. Minn. Stat. § 253B.09, subd. 1(a).

Breitkreutz’s rule 20 evaluation, which was admitted into evidence, states that

Breitkreutz “evidence[s] symptoms of bipolar disorder v delusional disorder v

substance/medication induced psychotic disorder, and further diagnostic clarification is

warranted.” And Dr. Marshall testified that “Breitkreutz is diagnosed with a major mental

illness, which is a substantial psychiatric disorder of mood, thought, orientation, or

memory. Her diagnosis is a mood disorder, and I would concur with the diagnosis . . . from

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the Rule 20 [evaluation] of unspecified bipolar or other related disorder.” Dr. Marshall’s

report also states that Breitkreutz is “diagnosed with a major mental illness (Unspecified

Bipolar disorder or related disorder)” and “her diagnoses are considered to be substantial

psychiatric disorders of mood, thought, orientation, perception or memory.” Dr. Marshall’s

testimony and report seem to suggest that Breitkreutz did receive a diagnosis via her rule

20 evaluation.

Regardless of whether Breitkreutz was officially diagnosed with a mental illness in

the rule 20 evaluation, however, the record includes clear and convincing evidence that she

is a person with a mental illness as defined by statute. 1 This evidence includes the rule 20

description of Breitkreutz’s symptoms, Dr. Marshall’s concurrence that Breitkreutz has

unspecified bipolar or other related disorder, and Breitkreutz’s behavior in past interactions

with police and others. The record is sufficient to prove by clear and convincing evidence

that Breitkreutz has an organic disorder of the brain or a substantial psychiatric disorder of

thought, mood, perception, or orientation.

C. Less Restrictive Alternatives

Breitkreutz appears to argue that the district court failed to consider less restrictive

alternatives, such as outpatient treatment options. A district court must make findings of

fact to support its conclusion that no less restrictive treatment program exists that could

meet the needs of the committed person. In re Civ. Commitment of Ince, 847 N.W.2d 13,

1
We note that Minnesota Statutes section 253B.12 provides that the treatment report
required for a committed patient who remains in treatment for more than 60 days must set
forth the patient’s “diagnosis.”

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26 (Minn. 2014) (reversing and remanding for findings in an appeal from commitment as

a sexually dangerous person under earlier version of statute, Minn. Stat. § 253B.185, subd.

1(d) (2012)). “Although there is no statutory definition for a ‘less restrictive treatment

program,’ the district court must consider a proposed less restrictive alternative in light of

the objectives of commitment: ‘the patient’s treatment needs and the requirements of public

safety.’” Id. A reviewing court will not reverse a district court’s findings regarding the least

restrictive means of treatment unless they are clearly erroneous. Thulin, 660 N.W.2d at

144.

The district court concluded that “[t]here is clear and convincing evidence that there

is no less restrictive alternative than judicial commitment.” To support this conclusion, the

district court pointed to Breitkreutz’s denial of her diagnosis, the fact that she has not

previously participated in therapy or medical management, and the fact that she poses a

substantial likelihood of harm to others. The district court specifically found:

[Breitkreutz] requires the structure and control of court
intervention and an in-patient facility to oversee treatment for
mental illness. A full judicial commitment is the least
restrictive alternative because [Breitkreutz] will receive the
necessary support, care, and supervision that will provide
[Breitkreutz] an opportunity to take control of mental illness.

....

No suitable alternative to commitment exists because
[Breitkeutz] poses a substantial likelihood of harm to self or
others as evident by the preceding findings.

....

A full commitment is necessary due to the severity of
[Breitkreutz’s] untreated symptoms. [Breitkreutz] has no

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 history to show she would follow through with appointments,
medications, or other necessary services to treat her mental
illness. [Breitkreutz] requires the structure of a supervised
setting.

The district court’s findings are supported by the evidence. Dr. Marshall testified

that inpatient psychiatric unit care would be the “best option” for Breitkreutz. Dr. Marshall

testified that she considered outpatient mental-health treatment as an alternative but “was

not sure that [Breitkreutz] would follow through with that” and “was not sure that

[Breitkreutz] would take medications and – and work with a psychiatric provider.” In

addition, the record lacks evidence of a history of Breitkreutz voluntarily treating her

mental illness. Breitkreutz testified that she has “been willing to . . . get help” and would

attend appointments and try prescribed medications, but Breitkreutz also maintained that

many of her symptoms were the result of anxiety due to being in jail and that her primary

mental-health issues are anxiety and depression. And, as described above, the record

contains ample evidence of Breitkreutz’s risk of harm to herself or others.

The district court’s determination that there is no less restrictive alternative to

judicial commitment is based on adequate findings that are supported by the record,

considering both Breitkreutz’s treatment needs and the requirements of public safety. See

Ince, 847 N.W.2d at 26.

D. Commitment Based on Perjured Evidence

Breitkreutz argues that her commitment was, at least in part, based on perjured

evidence from the social worker who filed the petition for commitment. The argument is

unavailing. First, Breitkreutz did not raise this issue in the district court, and it is not

12
properly before us. See Thiele v. Stich, 425 N.W.2d 580, 582 (Minn. 1988) (holding that

appellate courts generally do not consider issues that were not raised in and decided by the

district court). But, even if the issue was properly before us, Breitkreutz has not pointed to

any evidence to support the allegation that the social worker committed perjury.

Additionally, the social worker was only involved in filing the petition for commitment

and was not involved in the screening committee or the commitment hearing and the

statements in the petition were not relied on by the district court in making the commitment

determination. Accordingly, Breitkreutz’s argument that her commitment should be

reversed because of the social worker’s alleged perjury fails.

III. Breitkreutz was not denied effective assistance of counsel.

Breitkreutz argues that her attorney “did not adequately prepare” for her defense

because he failed to call witnesses and because Breitkreutz was not “given the opportunity

for a second examiner.” We review claims of ineffective assistance of counsel de novo. In

re Civ. Commitment of Johnson, 931 N.W.2d 649, 657 (Minn. App. 2019), rev. denied

(Minn. Sept. 17, 2019). “Appellate courts apply a strong presumption that [an attorney’s]

performance falls within the wide range of reasonable professional assistance. General

assertions of error without evidentiary support are inadequate to establish ineffective

assistance of counsel. Moreover, a reviewing court generally will not review attacks on

counsel’s trial strategy.” Id. (citations and internal quotations omitted).

The MCTA provides a statutory right for a person to be represented by counsel

during civil commitment proceedings. Minn. Stat. § 253B.07, subd. 2c. The act requires

the attorney to

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 (1) consult with the person prior to any hearing;
(2) be given adequate time and access to records to
prepare for all hearings;
(3) continue to represent the person throughout any
proceedings under this chapter unless released as counsel by
the court; and
(4) be a vigorous advocate on behalf of the person.

Id. If a person claims denial of their statutory right to counsel, the appellate court “analyzes

the claim by borrowing the analytical framework ordinarily used in criminal cases when

applying the Sixth Amendment right to counsel.” Beaulieu, 798 N.W.2d at 550.

Under the Sixth Amendment standard, counsel is inadequate if they fail to exercise

the “customary skills and diligence” of a reasonably competent attorney under similar

circumstances. Sather v. State, 352 N.W.2d 79, 81 (Minn. App. 1984), rev. denied (Minn.

1984). In criminal matters, a defendant must show both that counsel’s performance “fell

below an objective standard of reasonableness” and that the deficient performance

prejudiced the defense. Strickland v. Washington, 466 U.S. 668, 687-88 (1984). There is a

strong presumption that an attorney’s performance was reasonable. State v. Jones, 392

N.W.2d 224, 236 (Minn. 1986). Reviewing courts “generally will not review attacks on

counsel’s trial strategy.” Opsahl v. State, 677 N.W.2d 414, 421 (Minn. 2004). “Which

witnesses to call at trial . . . are questions that lie within the proper discretion of the trial

counsel.” Jones, 392 N.W.2d at 236.

A. Second Examiner

Under the MCTA, the proposed patient has a right to receive upon request an

independent second examination by an “examiner of the patient’s choosing to be paid for

by the county.” Minn. Stat. § 253B.07, subd. 3.

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 At the preliminary hearing, Breitkreutz’s attorney reserved Breitkreutz’s right to a

second evaluator. At the beginning of the commitment hearing, Breitkreutz’s attorney

stated that he had discussed with Breitkreutz “the option of having a second examiner

appointed,” that “[s]he’s decided not to have a second examiner appointed, but simply have

a contested hearing,” and that they were ready to proceed. Breitkreutz indicated no

disagreement with this statement by her attorney, did not mention a second examiner when

she testified, and has not cited any evidence that contradicts her attorney’s statements at

the hearing. Breitkreutz asserts that a second examination was “ordered by the court,” but

no such order is reflected in the record. On this record, it appears that Breitkreutz’s attorney

reasonably acted in accordance with Breitkreutz’s wishes when he stated that she waived

her right to a second examiner.

B. Additional Witnesses

Breitkreutz contends that her attorney “refused” to call three witnesses. Breitkreutz

does not specify which witnesses she hoped to call, aside from Dr. Frye, who completed

Breitkreutz’s rule 20 evaluation. Breitkreutz alleges that testimony from Dr. Frye would

“dispute the illiterate ideas proposed by the social workers or clarify my need of mental

health services.”

Breitkreutz does not assert that she actually requested that her attorney present

additional witnesses. But, even assuming that Breitkreutz did request to present additional

witnesses, it is unclear how doing so would have “clarified [Breitkreutz’s] need for mental

health services” as she alleges. Breitkreutz focuses on language about risk of harm in the

rule 20 report and disputes its interpretation. While the rule 20 evaluation was accepted

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into evidence by the district court, the district court’s findings regarding Breitkreutz’s

psychological condition appear to hinge on Dr. Marshall’s report and testimony based on

the examination conducted for civil-commitment purposes. Moreover, Breitkreutz has not

explained how Dr. Frye’s testimony would have changed the outcome, as many of

Dr. Frye’s findings were aligned with Dr. Marshall’s.

Applying the strong presumption that Breitkreutz’s attorney’s performance was

within the range of reasonable professional assistance, considering the lack of evidentiary

support provided by Breitkreutz, and recognizing the trial counsel’s discretion to make

strategic decisions, we conclude that Breitkreutz has failed to establish that she received

ineffective assistance of counsel. Our review of the record reveals that Breitkreutz’s

attorney consulted with Breitkreutz prior to the hearings, was prepared for the hearings,

and was familiar with the relevant documents and Breitkreutz’s pending criminal matters.

Her counsel cross-examined witnesses, called witnesses on Breitkreutz’s behalf, and

generally advocated for her throughout the proceedings, specifically arguing for less

restrictive alternatives to civil commitment. On this record, Breitkreutz’s counsel met the

statutory requirements outlined for representation in civil commitment hearings, see Minn.

Stat. § 253.B.07, subd. 2(c), as well as the Sixth Amendment standard of objectively

reasonable representation, see Strickland, 466 U.S. at 687-88. Breitkreutz’s ineffective-

assistance-of-counsel claim therefore fails.

Affirmed.

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