COURT OF APPEALS

DECISION

DATED AND FILED

May 7, 2024

Samuel A. Christensen

Clerk of Court of Appeals

NOTICE

This opinion is subject to further editing. If 

published, the official version will appear in 

the bound volume of the Official Reports. 

A party may file with the Supreme Court a 

petition to review an adverse decision by the 

Court of Appeals. See WIS. STAT. § 808.10 and 

RULE 809.62. 

Appeal No. 2024AP206 Cir. Ct. No. 2016ME946

STATE OF WISCONSIN IN COURT OF APPEALS

DISTRICT III

IN THE MATTER OF THE MENTAL COMMITMENT OF R. J. M.:

BROWN COUNTY,

 PETITIONER-RESPONDENT,

 V.

R. J. M.,

 RESPONDENT-APPELLANT.

APPEAL from orders of the circuit court for Brown County: 

TIMOTHY A. HINKFUSS, Judge. Affirmed. 
No. 2024AP206

2

¶1 HRUZ, J.1 Richard2appeals orders for his recommitment and for his 

involuntary medication, entered pursuant to WIS. STAT. §§ 51.20 and 51.61(1)(g)3., 

respectively. He argues that there was insufficient evidence to support a 

determination that he is a proper subject for treatment and that he is dangerous. 

Richard additionally argues that the circuit court failed to make specific factual 

findings regarding his dangerousness, as required by Langlade County v. D.J.W., 

2020 WI 41, 391 Wis. 2d 231, 942 N.W.2d 277, and that Brown County did not 

meet its burden to prove he received statutorily required information to support the 

court’s issuance of an involuntary medication order. 

¶2 We conclude that the County presented clear and convincing evidence 

that Richard is a proper subject for treatment and is dangerous under the applicable 

statutes. We also conclude that the circuit court made sufficient factual findings to 

satisfy D.J.W. and that the County met its burden for the involuntary medication 

order. Accordingly, we affirm.

BACKGROUND

¶3 Richard was emergently detained in 2016 after he stopped taking his 

medication, began drinking alcohol and smoking marijuana, destroyed property at 

his family’s business, threatened and assaulted his brother, and threatened to kill his 

sister and her dogs. Following a hearing, Richard was involuntarily committed for 

a period of six months, pursuant to WIS. STAT. § 51.20. Since then, Richard has 

 

1

 This appeal is decided by one judge pursuant to WIS. STAT. § 752.31(2) (2021-22). All 

references to the Wisconsin Statutes are to the 2021-22 version unless otherwise noted.

2

 For ease of reading, we refer to the appellant in this confidential matter using a

pseudonym, rather than his initials.
No. 2024AP206

3

been recommitted seven times for periods of twelve months each, the last of which

is the subject of this appeal. 

¶4 In March 2023, the County timely petitioned to extend Richard’s 

commitment. The circuit court held a hearing on the petition in May 2023, during 

which the County presented testimony from two witnesses: psychiatrist 

Marshall Bales and case manager Trenton Estano. Bales testified that Richard 

suffers from bipolar disorder and from substance abuse problems. Bales stated that 

Richard’s condition is treatable and that he discussed with Richard the advantages

and disadvantages of, and alternatives to, medication for Richard’s condition. Bales 

testified that Richard responded that he believed he did not experience any benefits 

from his medication, and that Richard embellished the side effects that he suffers 

from using the medication. 

¶5 Doctor Bales stated that Richard is incompetent to refuse medication3

and that Richard would be a proper subject for commitment if treatment were 

withdrawn. Specifically, Bales testified, “[w]hat happened in 2016 will happen 

again,” and Bales noted that Richard has a pattern of being given the opportunity to 

take his medication on a voluntary basis, not taking his medication, and once again 

becoming dangerous and threatening others. According to Bales, Richard “made it 

very clear” that he will stop taking medication and stop all mental health care if his 

medication and treatment are voluntary. Bales also noted that Richard had 

threatened his doctors and repeatedly threatened to kill himself. 

 

3

 Doctor Bales did not testify as to why, specifically, Richard is incompetent to refuse 

medication. However, as will be discussed shortly, Bales’ report was admitted into evidence at the 

hearing and provides Bales’ reasons in support of that conclusion. 
No. 2024AP206

4

¶6 Doctor Bales’ report was offered into evidence without objection, and 

Bales was subject to cross-examination regarding its contents. The report noted that 

in April 2023, Richard stopped taking his medication and started “making 

inappropriate calls excessively.” Specifically, Richard made “dozens of calls and 

left messages,” some of which “contained suicidal and homicidal statements.” The 

report also noted an incident in which Richard “punched a window and broke his 

wrist,” which, according to Richard, was done “so he would not kill” one of his 

psychiatrists. Further, the report states that Richard continues to drink alcohol even 

though it worsens the symptoms of his bipolar disorder. The report did indicate that 

Richard had slightly improved in 2023 but also stated that he still had intermittent 

periods of dangerousness. 

¶7 Regarding Richard’s competency to refuse medication, Dr. Bales’ 

report stated that Bales explained to Richard the advantages and disadvantages of, 

and alternatives to, medication that would help treat Richard. The report also listed

each of the advantages, disadvantages, and alternatives to such medication. 

However, the report stated that Richard is “substantially incapable of applying an 

understanding” of his medication to his condition “in order to make an informed 

choice as to whether to accept or refuse the recommended medication or treatment.” 

This incapability is because Richard was unable to list the benefits of his 

medication, “cited many side effects, including many not usually encountered,” and 

“could not weigh the pros and cons” of his medication. 

¶8 Estano testified that Richard had experienced “some periods with 

homicidal and suicidal ideation” during the prior year. Estano specifically testified 

that he conducted a home visit with Richard during March 2023 and that Richard 

“appeared to be escalated” when Estano arrived. During their discussion, Richard 

voluntarily disclosed to Estano that “every day he thinks about cutting” Estano’s 
No. 2024AP206

5

throat. Richard testified that his medications cause him health issues, but he intends 

to take his medication. 

¶9 The circuit court found that Richard is mentally ill, suffers from 

bipolar disorder and substance abuse disorder, and that he is a proper subject for 

treatment. Referring to WIS. STAT. § 51.20(1)(a)2.c.,

4

the court found that Richard 

is dangerous because he evidenced a “substantial probability of physical impairment 

or injury to himself ... or other individuals,” as manifested by “a pattern of recent 

acts or omissions” and a “substantial likelihood that [Richard] would become a 

proper subject for treatment under this standard if treatment were withdrawn.” The 

court later stated, “I would also add the dangerousness requirement about [Estano,

who] testified about [Richard] slitting [Estano’s] throat.... [I]t’s not a good thing 

to say. So that’s part of the dangerousness requirement as well.” The court further

found that Richard is not competent to refuse medication or treatment because he is 

“substantially incapable of applying an understanding” of his medication to his 

condition “in order to make an informed choice as to whether to accept or refuse” 

medication. 

¶10 The circuit court entered orders extending Richard’s commitment for 

twelve months and for his involuntary medication or treatment. Richard now 

appeals. Additional facts will be provided below as necessary. 

DISCUSSION

 

4

 The circuit court also found that Richard is dangerous under WIS. STAT. § 51.20(1)(a)2.a. 

Richard contests this finding as well. However, because we conclude that there was sufficient 

evidence to support the court’s finding of dangerousness under § 51.20(1)(a)2.c. and that the court 

made sufficient findings with respect to that subdivision paragraph under Langlade County v.

D.J.W., 2020 WI 41, 391 Wis. 2d 231, 942 N.W.2d 277, we need not address Richard’s arguments 

regarding § 51.20(1)(a)2.a. See Turner v. Taylor, 2003 WI App 256, ¶1 n.1, 268 Wis. 2d 628, 673 

N.W.2d 716 (this court need not address all issues raised by the parties if one is dispositive).
No. 2024AP206

6

¶11 Richard argues that the County failed to provide sufficient evidence 

showing that he is a proper subject for treatment. In particular, he contends that the 

County only presented evidence that bipolar disorders, in general, are treatable and 

not that Richard specifically is treatable. Richard also contends that the County 

failed to provide sufficient evidence showing that he is dangerous and, relatedly, 

that the circuit court failed to make the specific dangerousness findings required by

D.J.W.5 Finally, Richard argues that the County presented insufficient evidence to 

support the involuntary medication order. We reject all of Richard’s arguments. 

¶12 Whether the County met its burden of proof to support orders 

extending Richard’s commitment pursuant to WIS. STAT. § 51.20 and involuntary 

medication pursuant to WIS. STAT. § 51.61(1)(g) are mixed questions of law and 

fact. See D.J.W., 391 Wis. 2d 231, ¶¶24-25; Outagamie County v. Melanie L., 

2013 WI 67, ¶¶37-39, 349 Wis. 2d 148, 833 N.W.2d 607. “[W]e will uphold a 

circuit court’s findings of fact unless they are clearly erroneous. A finding of fact 

is clearly erroneous if it is against the great weight and clear preponderance of the 

evidence.” D.J.W., 391 Wis. 2d 231, ¶24. “Whether the facts satisfy the statutory 

standard is a question of law that we review de novo.” Waukesha County v. J.W.J., 

2017 WI 57, ¶15, 375 Wis. 2d 542, 895 N.W.2d 783. 

¶13 “In order to involuntarily commit a person pursuant to [WIS. STAT.]

ch. 51, the petitioner must demonstrate that three elements are fulfilled: the subject 

must be (1) mentally ill; (2) a proper subject for treatment; and (3) dangerous to 

themselves or others.” Sheboygan County v. M.W., 2022 WI 40, ¶17, 402 Wis. 2d 

 

5

 Richard does not contest that he is mentally ill. 
No. 2024AP206

7

1, 974 N.W.2d 733. These same three elements are necessary for a petitioner to 

prevail in a recommitment proceeding, such as the one in this case. Id., ¶18. 

¶14 A person has rehabilitative potential—and thus is a proper subject for 

treatment—if treatment will “‘go beyond controlling ... activity’ and will ‘go to 

controlling [the] disorder and its symptoms.’” Fond du Lac County v. Helen E.F., 

2012 WI 50, ¶36, 340 Wis. 2d 500, 814 N.W.2d 179 (alterations in original; citation 

omitted). WISCONSIN STAT. § 51.20(1)(a)2.a.-e. lists five standards under which a 

petitioner can prove an individual is currently dangerous. The third standard, at 

issue here, is met if an individual “[e]vidences such impaired judgment, manifested 

by evidence of a pattern of recent acts or omissions, that there is a substantial 

probability of physical impairment or injury to himself or herself or other 

individuals.” Sec. 51.20(1)(a)2.c.

¶15 Here, the County presented sufficient evidence that Richard is a 

proper subject for treatment and is dangerous. Richard is correct in that Dr. Bales’ 

testimony was, at times, somewhat vague and generalized, particularly regarding 

Richard’s treatability. However, Bales’ report was also entered into evidence before 

the circuit court. See supra ¶6. Bales’ report described Richard as having a pattern 

of being mentally ill, being forced to take his medication, improving and 

subsequently no longer being forced to take his medication, and consequently 

reverting to a state in which he becomes dangerous. Further, Bales’ report noted

that Richard had improved in 2023. 

¶16 These facts indicate that Richard’s disorder and his symptoms are 

controllable with medication or treatment and that Richard’s symptoms worsen 

when he stops taking his medication. The record is clear that Richard chooses to 

frequently undermine the efficacy of his treatment in several ways, including 
No. 2024AP206

8

drinking alcohol and not taking his medication. But, that fact does nothing to 

disprove the County’s evidence that with the proper treatment, Richard’s condition 

will improve. Indeed, as the County aptly states in its brief, “[j]ust because 

treatment has not been successful due to deliberate actions of [Richard] to sabotage 

that treatment, does not mean [that Richard’s condition] is any less treatable.” 

¶17 Similarly, Dr. Bales’ testimony regarding Richard’s dangerousness 

was also somewhat vague and generalized. However, Bales’ report documented 

multiple incidents indicating dangerousness, and other parts of the record also 

reflect evidence of recent dangerousness in the form of Richard’s persistent threats 

to himself and others. For example, Richard made “dozens” of calls and left 

messages containing “suicidal and homicidal statements” just one month prior to

his recommitment hearing; Richard felt the need to break his own wrist to prevent 

himself from killing a psychiatrist; and Richard would stop taking his medication

and drink alcohol, thereby undermining his otherwise effective treatment. See 

supra ¶6. Further, and notably, Estano testified that Richard voluntarily told Estano 

that he thought about “cutting” Estano’s throat every day. 

¶18 On appeal, Richard does not address the incidents of dangerousness 

described in Dr. Bales’ report. He does, however, contend that his statement about 

wanting to cut Estano’s throat every day does not mean that he is dangerous. In 

support of this argument, Richard cites Portage County v. E.R.R., No. 2020AP870-

FT, unpublished slip op. ¶¶18-19 (WI App Oct. 1, 2020),

6

for the notion that the 

petitioner’s statement in that case that he wanted to “snap people’s necks” was not 

enough to establish dangerousness under WIS. STAT. § 51.20(1)(a)2.b. Given the 

 

6

 Unpublished opinions authored by a single judge and issued on or after July 1, 2009, may 

be cited for their persuasive value. See WIS. STAT. RULE 809.23(3)(b).
No. 2024AP206

9

record in this case, we disagree with Richard’s contentions, including the alleged 

aptness of E.R.R.

¶19 We first note that we have no duty to distinguish or otherwise discuss

E.R.R. See WIS. STAT. RULE 809.23(3)(b). In any event, we do not find that case 

persuasive. In E.R.R., this court did not categorically conclude that a statement of 

wanting to “snap people’s necks” was insufficient to establish dangerousness. 

Rather, in contemplation of our supreme court’s directive in D.J.W., this court 

declined to find the petitioner dangerous under WIS. STAT. § 51.20(1)(a)2.b. when 

the circuit court itself did not find the petitioner dangerous under that standard and 

did not make any factual findings regarding the petitioner’s statement.7 See E.R.R., 

No. 2020AP870-FT, ¶17. 

¶20 Perhaps more importantly, the facts of this appeal are materially 

distinguishable from those in E.R.R. Unlike in E.R.R., the circuit court here clearly 

found credible the testimony that Richard wanted to cut Estano’s throat. Further, 

Richard’s statement was directed toward a specific person with whom he regularly 

met—indeed, his case worker—and Richard stated that he thought about cutting 

Estano’s throat “every day.” Finally, Richard’s threats to kill somebody were not 

an isolated incident. Rather, Richard’s commitment in 2016 began when he 

threatened to “rip his [brother’s] head off” and kill his sister and her dogs. 

Additionally, evidence was introduced at the recommitment hearing that Richard 

more recently made “dozens” of phone calls with homicidal and suicidal statements. 

 

7

 This court did also note in Portage County v. E.R.R., No. 2020AP870-FT, unpublished 

slip op. ¶¶19, 21 (WI App Oct. 1, 2020), that there was a lack of evidence indicating that the 

petitioner would act on his desire to “snap people’s necks.” However, this court’s primary concern 

appears to have been a violation of D.J.W. See E.R.R., No. 2020AP870-FT, ¶¶17, 21. Regardless, 

as we will explain momentarily, Richard’s statement differs from E.R.R.’s statement in several 

material ways. 
No. 2024AP206

10

The specificity of the person and the manner of killing conveyed by Richard’s 

statement to Estano—along with the frequency and continuing nature of Richard’s

homicidal threats—is enough to support a finding of dangerousness. See generally 

R.J. v. Winnebago County, 146 Wis. 2d 516, 523, 431 N.W.2d 708 (Ct. App. 1988) 

(concluding that the petitioner’s statement that she wanted to stab or kill her 

coworker was sufficient to establish dangerousness). 

¶21 Richard next argues that the circuit court failed to make specific 

factual findings regarding his dangerousness, as required by our supreme court in 

D.J.W. Although this is a close case in this regard and the court’s specific factual 

findings are scarce, we conclude that its findings are sufficient to satisfy the D.J.W.

mandate. 

¶22 In D.J.W., the appellant was initially committed without a finding 

regarding the specific standard of dangerousness that he met. D.J.W., 391 Wis. 2d 

231, ¶36. On appeal from the original commitment order, this court concluded that 

D.J.W. was dangerous under WIS. STAT. § 51.20(1)(a)2.d. D.J.W., 391 Wis. 2d 

231, ¶37. When he appealed his recommitment, D.J.W. focused his briefing on 

dangerousness under § 51.20(1)(a)2.d., and the County did not specify any standard 

of dangerousness. D.J.W., 391 Wis. 2d 231, ¶38. When our supreme court heard 

oral argument in the case, the County argued, for the first time, that D.J.W. was 

dangerous under § 51.20(1)(a)2.c. D.J.W., 391 Wis. 2d 231, ¶39.

¶23 Our supreme court noted that the confusion as to which standard of 

dangerousness applied resulted in an unhelpful record and “conflicting messages” 

from the County and the court of appeals. Id., ¶40. To prevent this issue in the 

future, our supreme court concluded that, in recommitment proceedings, a circuit 

court is required to “make specific factual findings with reference to the subdivision 
No. 2024AP206

11

paragraph of [WIS. STAT.] § 51.20(1)(a)2. on which the recommitment is based.” 

D.J.W., 391 Wis. 2d 231, ¶40. The purpose of this mandate is to provide “clarity 

and extra protection to patients regarding the underlying basis for a recommitment,” 

due to the important liberty interest at stake. Id., ¶42. Further, this mandate ensures 

clarity of the issues raised on appeal and ensures the “soundness of judicial decision

making.” Id., ¶44.

¶24 Here, while the circuit court’s decision could have been more robust, 

the concerns underlying our supreme court’s decision in D.J.W. are not present. 

Unlike in D.J.W., the court identified the standard under which Richard is 

dangerous—specifically, WIS. STAT. § 51.20(1)(a)2.c. The County has been 

consistent in arguing that Richard is dangerous under this standard. In turn, Richard 

was able to directly address the sufficiency of the evidence regarding his 

dangerousness, the result of which has been a circuit court record with a unified 

understanding of the standard of dangerousness at issue. 

¶25 Further, the circuit court identified the specific actions for which it 

found Richard dangerous. In particular, the court stated, “I would also add the 

dangerousness requirement about [Estano, who] testified about [Richard] slitting 

[Estano’s] throat.... [I]t’s not a good thing to say. So that’s part of the 

dangerousness requirement as well.” While the court could have—and should 

have—provided more factual findings supporting its finding of dangerousness, this 

finding was sufficient to satisfy the D.J.W. mandate. See generally Winnebago 

County v. B.R.C., No. 2023AP1842, unpublished slip op. ¶¶9, 21 (WI App Feb. 14, 

2024) (concluding that the circuit court’s statement that it was “[r]elying heavily 

upon the opinion of the medical professional”—in combination with the detailed 

evidence from the medical professional and other witnesses—was sufficient to 

satisfy D.J.W. and ensure meaningful review).
No. 2024AP206

12

¶26 Finally, Richard argues that the County presented insufficient 

evidence to support the involuntary medication order. Richard contends that the 

County failed to prove that it gave him an adequate explanation of the advantages, 

disadvantages, and alternatives to his medication or treatment. Richard also asserts 

that the County failed to adequately explain how he is incompetent to refuse 

medication. 

¶27 In determining whether an individual is incompetent to refuse 

medication, “the circuit court must first be satisfied that the advantages and 

disadvantages of, and the alternatives to, medication have been adequately 

explained to the patient.” Virgil D. v. Rock County, 189 Wis. 2d 1, 14, 524 N.W.2d 

894 (1994). The explanation of the proposed medication “should include why a 

particular drug is being prescribed, what the advantages of the drug are expected to 

be, what side effects may be anticipated or are possible, and whether there are 

reasonable alternatives to the prescribed medication.” Melanie L., 349 Wis. 2d 148, 

¶67. As relevant to this appeal,8 WIS. STAT. § 51.61(1)(g)4.b. provides that a person 

may be found incompetent to refuse medication if he or she is “substantially 

incapable of applying an understanding of the advantages, disadvantages and 

alternatives to his or her mental illness, developmental disability, alcoholism or drug 

dependence in order to make an informed choice as to whether to accept or refuse 

medication or treatment.”

 

8

 WISCONSIN STAT. § 51.61(1)(g)4. provides two ways in which a person may be found 

incompetent to refuse medication. Outagamie County v. Melanie L., 2013 WI 67, ¶54, 349 Wis. 2d 

148, 833 N.W.2d 607. Doctor Bales opined that Richard is incompetent under both of those 

standards, and Richard contests the sufficiency of the evidence for both standards. However, the 

circuit court found that Richard was incompetent to refuse medication under only one of the 

standards—namely, that Richard is substantially incapable of applying an understanding of his 

medication to his condition. See § 51.61(1)(g)4.b. Because we conclude that there was sufficient 

evidence to support the court’s finding under that standard, we need not address Richard’s 

arguments regarding the other standard in § 51.61(1)(g)4. See Turner, 268 Wis. 2d 628, ¶1 n.1.
No. 2024AP206

13

¶28 Regarding the sufficiency of the medication explanation, Richard 

argues that Dr. Bales’ testimony was vague, did not specify the advantages, 

disadvantages, or alternatives to medication, and did not indicate how many times 

people have tried to explain Richard’s medication to him. We agree with Richard 

that Bales’ testimony was, at times, vague and that Bales should have testified in 

more detail in this regard. However, Bales’ report—which, again, was admitted 

into evidence—provides the details necessary to prove that Richard was given an 

adequate explanation of his medication. The report states that Bales explained to 

Richard the advantages, disadvantages, and alternatives to his medication. The 

report also provides the specific advantages, disadvantages, and alternatives to 

Richard’s medication and, importantly, states that these specifics were explained to 

Richard. Richard is correct that there is no information as to how many times people 

tried to explain his medication to him. However, the County is not required to 

provide such evidence. See generally WIS. STAT. § 51.61(1)(g); Melanie L., 349 

Wis. 2d 148, ¶¶53-54.

¶29 Similarly, Richard argues that Dr. Bales’ testimony was vague as to 

why Richard is incompetent to refuse medication. Again, we agree that Bales’ 

testimony in this regard was vague and did not rise to the level of clear and 

convincing evidence of Richard’s incompetence. Indeed, we find it concerning that 

Bales’ testimony was so ambiguous and that the County did not further flesh out the 

details of Bales’ opinion during his direct examination. 

¶30 Nevertheless, and once again, Dr. Bales’ report provides the details 

necessary to support the circuit court’s findings regarding Richard’s incompetence 

to refuse medication. The report states that Richard is incompetent to refuse 

medication because, during the medication review, Richard could not list any of the 

benefits of his medication, “was unreasonable” in his comments about the 
No. 2024AP206

14

medication, and could not “weigh the pros and cons of psychotropic [medication] 

or apply the information to himself.” Accordingly, we affirm the circuit court’s 

recommitment order and order for Richard’s involuntary medication and treatment. 

By the Court.—Orders affirmed.

This opinion will not be published. See WIS. STAT.

RULE 809.23(1)(b)4.