IN THE COURT OF APPEALS OF NORTH CAROLINA

No. COA22-639

Filed 18 April 2023

Wake County, No. 22 SPC 895

IN THE MATTER OF: D.H.

Appeal by respondent from order entered 11 April 2022 by Judge Mark Stevens

in Wake County District Court. Heard in the Court of Appeals 7 February 2023.

Attorney General Joshua H. Stein, by Special Deputy Attorney General Robert 

T. Broughton, for the State.

Appellate Defender Glenn Gerding, by Assistant Appellate Defender David W. 

Andrews, for respondent-appellant.

ZACHARY, Judge.

D.H.1 (“Respondent”) appeals from an Involuntary Commitment Order entered 

against him. Respondent argues that the trial court’s ultimate finding that he posed 

a danger to himself was not supported by its underlying findings regarding whether, 

absent inpatient mental health treatment, there was a reasonable probability that 

Respondent would suffer serious physical debilitation in the near future; in turn, 

Respondent contends, these findings were not supported by the evidence. After 

careful review, we affirm.

Background

1 Given the sensitive nature of this appeal, we use initials to protect Respondent’s identity.
IN RE: D.H.

Opinion of the Court

2

On 28 March 2022, Respondent’s father executed an Affidavit and Petition for 

Involuntary Commitment alleging, inter alia, that Respondent was “hearing voices[,]” 

hallucinating, “riding around the city of Raleigh displaying odd [b]ehaviors[,]” and 

refusing to participate in therapy or take his medication. The magistrate ordered that 

Respondent be taken into custody later that day.

The next day, Dr. Nancy Clayton of UNC Health Care Crisis and Assessment 

Services at WakeBrook, an inpatient 24-hour facility, examined Respondent and 

completed a “24 Hour Facility Exam for Involuntary Commitment” form. On the form, 

Dr. Clayton marked boxes indicating that Respondent was “[a]n individual with a 

mental illness[,]” “[d]angerous to” himself, and “[d]angerous to” others. To support 

her conclusions, Dr. Clayton included in the “Description of Findings” that 

Respondent

was telling parents about being Emperor of Japan. 

[Respondent is] distractible and slow to respond. 

[Respondent] appears to respond to internal stimuli and is 

thought blocking in interview. He reports being off meds 

[for] several months and denies need for meds or having a 

mental illness despite this being his 3rd psych 

admit[tance] since March 2021. 1st psychosis noted in 

March 2021 when [Respondent] hospitalized at Old 

Vineyard. [Respondent] had taken off and driven for long 

periods when unwell in the past and more recently. Family 

report he is having poor sleep. [Respondent] recently fired 

from job a week ago due to poor performance. [Respondent] 

needs inpatient hospitalization for safety/stabilization. 
IN RE: D.H.

Opinion of the Court

3

This matter came on for hearing on 7 April 2022 in Wake County District 

Court.2 The trial court heard testimony from Respondent, Respondent’s father, and 

Dr. Clayton, and on 11 April 2022, the court entered an Involuntary Commitment 

Order. In the order, the trial court marked boxes indicating that Respondent was 

mentally ill and dangerous to himself. To support those conclusions, the trial court 

marked another box that stated: “Based on the evidence presented, the Court . . . by 

clear, cogent, and convincing evidence finds . . . facts supporting involuntary 

commitment”; the court attached to the order and incorporated by reference a 

document titled “Findings of Fact in Support of Inpatient Commitment.” The trial 

court found, in relevant part, the following additional facts in support of involuntary 

commitment:

I. As to Mental Illness

The Court finds by clear, cogent, and convincing evidence 

that . . . Respondent suffers from a mental illness —

specifically, the mental illness of schizophrenia. . . .

. . . .

II. As to Dangerousness to Self

The Court also finds by clear, cogent, and convincing 

evidence that . . . Respondent is dangerous to self because 

within the relevant past he has acted in such a way as to 

show that he would be unable, without care, supervision, 

2 A transcript of the commitment hearing, which was conducted via Webex, was unavailable 

due to a malfunction in the recording equipment. In lieu of a transcript, the parties requested that the 

hearing participants submit their notes and written recollections of the testimony in narrative form, 

pursuant to N.C.R. App. P. 9(c)(1). The participants’ responses are included in the record on appeal, 

which was settled by the parties’ stipulation and agreement. See N.C.R. App. P. 11(b).
IN RE: D.H.

Opinion of the Court

4

and the continued assistance of others not otherwise 

available to exercise self-control, judgment, and discretion 

in the conduct of his daily responsibilities and social 

relations, and there is a reasonable probability of

Respondent suffering serious physical debilitation within 

the near future unless adequate inpatient treatment is 

given. In support of this finding of ultimate fact, this Court 

finds the following evidentiary facts based upon the 

competent evidence from the hearing:

. . . .

3. Respondent’s psychiatric state was declining prior 

to his admission to Wake[B]rook as evidenced by the 

following events and behaviors occurring within the 

relevant past:

i. In June 2021 Respondent believed himself 

to be involved with the FBI and drove to northern 

Virginia for this reason. Similarly, in August or 

September 2021 Respondent believed himself to be 

President of the United States and drove to 

Washington DC for this reason. 

ii. In January 2022 Respondent quit taking 

medication prescribed for the treatment of his 

mental illness. He did so because he did not like the 

medicine, and because he had secured a job driving 

for Amazon.

iii. After becoming medication non-compliant, 

Respondent began talking and laughing to himself 

with increasing frequency and regularity. He also 

regularly paced throughout his home and his sleep 

habits changed. . . .

. . . .

vi. During this time Respondent lost his 

delivery job with Amazon, having held it for only 

approximately two weeks. He held his prior delivery 

job with UPS for more than one year, and 
IN RE: D.H.

Opinion of the Court

5

Respondent’s father attributed the loss of the 

Amazon job to Respondent’s increasingly erratic 

behavior.

. . . .

ix. When Respondent arrived at 

Wake[B]rook[’s] Crisis and Assessment unit on 28 

March 2022 he displayed delusional and 

disorganized thought processes as well as thought 

blocking, endorsed auditory hallucinations, 

displayed a blunted affect, and was observed 

responding to internal stimuli.

4. Since being admitted to Wake[B]rook[’s] Inpatient 

unit on 29 March 2022 Respondent has continued to 

display many of these same symptoms. . . . In addition, he 

has resisted cooperating with lab-work and his medication 

regimen.

5. It is the opinion of Dr. Clayton that when 

Respondent arrived at Wake[B]rook on 28 March 2022 he 

was acutely psychotic. Further, it is the opinion of Dr. 

Clayton that Respondent remains acutely psychotic as of 

the date of this hearing. This Court finds Dr. Clayton’s 

opinions to be credible. If released from Wake[B]rook in 

this current condition, Respondent’s state of acute 

psychosis makes it reasonably probable that he would 

suffer serious physical debilitation within the near 

future. Further inpatient treatment at Wake[B]rook is 

therefore required to prevent such a result.

6. It is the opinion of Dr. Clayton that Respondent 

has really poor insight [in]to his mental illness, and has no 

insight into the fact that he is currently acutely psychotic. 

This Court finds Dr. Clayton’s opinions to be credible, and 

concludes that Respondent has severely impaired insight 

and judgment. As a result, this Court concludes 

Respondent is currently unable to care for himself. This 

conclusion is further supported by Respondent’s testimony 

regarding his plans for discharge. If released from 

Wake[B]rook in this current condition, Respondent’s 
IN RE: D.H.

Opinion of the Court

6

inability to care for himself makes it reasonably probable 

that he would suffer serious physical debilitation within 

the near future. Further inpatient treatment at 

Wake[B]rook is therefore required to prevent such a result.

7. Respondent’s delusional, disorganized, and 

irrational thought content continues to motivate his 

actions, and is inconsistent with a person who has the 

ability to care [for] himself. If released from Wake[B]rook 

in this current condition, Respondent’s inability to care for 

himself makes it reasonably probable that he would suffer 

serious physical debilitation within the near future. 

Further inpatient treatment at Wake[B]rook is therefore 

required to prevent such a result.

. . . .

9. Respondent does not believe that anything is 

wrong with him, does not believe that he needs any

medication, and has testified that he will not take the 

medication once discharged from Wake[B]rook. He ceased 

voluntarily taking his medication while in the community 

prior to coming to Wake[B]rook, and at various times since 

arriving at Wake[B]rook has been resistive to voluntarily 

taking the medication. . . .

10. It is the opinion of Dr. Clayton that if discharged 

in his current condition Respondent would not comply with 

any treatment regimen and that an abrupt psychiatric 

decompensation would result. This Court finds Dr. 

Clayton[’s] opinion to be credible.

11. The Court concludes based on these facts that 

Respondent — if released in his current condition — will 

immediately become medication non-compliant.

12. If released before an effective medication 

regimen can be established or if Respondent becomes noncompliant with an effective regimen, this Court finds that 

it is reasonably probable that a rapid decline in 

Respondent’s psychiatric condition would occur in the near 

future, with a reemergence in the acutely psychotic 
IN RE: D.H.

Opinion of the Court

7

symptoms that caused him to present to Wake[B]rook on 

28 March 2022. A rapid decline in Respondent’s psychiatric 

condition would make it reasonably probable that 

Respondent would suffer serious physical debilitation 

within the near future. Further inpatient treatment at 

Wake[B]rook is therefore required to prevent such a result.

The trial court ordered that Respondent be committed for 60 days to UNC 

Hospitals at WakeBrook. Respondent timely appealed.

Discussion

On appeal, Respondent argues that the trial court erred by involuntarily 

committing Respondent because the evidence did not support the court’s finding that

it was “reasonably probable that Respondent would suffer serious physical 

debilitation within the near future” absent inpatient mental health treatment, and 

thus there was no support for the court’s determination that Respondent was 

“dangerous to himself[.]”

As a preliminary matter, we note that although Respondent’s Involuntary

Commitment Order has expired, the argument before us is not moot because “the 

challenged judgment may cause collateral legal consequences for the appellant.” In 

re Booker, 193 N.C. App. 433, 436, 667 S.E.2d 302, 304 (2008); see also, e.g., In re C.G., 

383 N.C. 224, 236, 881 S.E.2d 534, 543 (2022) (“Although the involuntary 

commitment order at issue in this case has long since expired, [the] respondent’s 

appeal is not moot.”).
IN RE: D.H.

Opinion of the Court

8

When deciding whether to involuntarily commit an individual for inpatient 

treatment, the trial court must make two specific findings “by clear, cogent, and 

convincing evidence[.]” N.C. Gen. Stat. § 122C-268(j) (2021). The trial court must first

find “that the respondent is mentally ill[.]” Id. The trial court must then find that the 

respondent is “dangerous to self . . . or dangerous to others[.]” Id. In its order, the trial 

court “shall record the facts that support its findings.” Id.

Upon review of a commitment order, we “determine whether the ultimate 

finding[s] concerning the respondent’s [mental illness and] danger to [him]self . . . 

[are] supported by the court’s underlying findings, and whether those underlying 

findings, in turn, are supported by competent evidence.” In re W.R.D., 248 N.C. App. 

512, 515, 790 S.E.2d 344, 347 (2016). The required findings “must actually be made 

by the trial court and cannot simply be inferred from the record.” C.G., 383 N.C. at 

240, 881 S.E.2d at 546 (citation and internal quotation marks omitted). “However, it 

is for the trier of fact to determine whether the competent evidence offered in a 

particular case met the burden of proof, that is, whether the evidence of [the] 

respondent’s mental illness and dangerousness was clear, cogent and convincing.” In 

re J.P.S., 264 N.C. App. 58, 61, 823 S.E.2d 917, 920 (2019) (citation and internal 

quotation marks omitted).

In the instant case, Respondent challenges whether there was evidentiary 

support for the trial court’s determination that he was “dangerous to himself.”

According to the definition set forth by our General Assembly, an individual is 
IN RE: D.H.

Opinion of the Court

9

“dangerous to self” if the individual has done any of the following “[w]ithin the 

relevant past”:

1. The individual has acted in such a way as to show all of 

the following:

I. The individual would be unable, without care, 

supervision, and the continued assistance of others 

not otherwise available, to exercise self-control, 

judgment, and discretion in the conduct of the 

individual’s daily responsibilities and social 

relations, or to satisfy the individual’s need for 

nourishment, personal or medical care, shelter, or 

self-protection and safety.

II. There is a reasonable probability of the 

individual’s suffering serious physical debilitation 

within the near future unless adequate treatment is 

given pursuant to [Chapter 122C]. A showing of 

behavior that is grossly irrational, of actions that the 

individual is unable to control, of behavior that is 

grossly inappropriate to the situation, or of other 

evidence of severely impaired insight and judgment 

shall create a prima facie inference that the 

individual is unable to care for himself or herself.

2. The individual has attempted suicide or threatened 

suicide and that there is a reasonable probability of suicide 

unless adequate treatment is given pursuant to [Chapter 

122C].

3. The individual has mutilated himself or herself or has 

attempted to mutilate himself or herself and that there is 

a reasonable probability of serious self-mutilation unless 

adequate treatment is given pursuant to [Chapter 122C].

Previous episodes of dangerousness to self, when 

applicable, may be considered when determining 

reasonable probability of physical debilitation, suicide, or 

self-mutilation.
IN RE: D.H.

Opinion of the Court

10

N.C. Gen. Stat. § 122C-3(11)(a).

“The trial court must find sufficient evidence to support one of the three prongs 

of this statute in order to conclude that an individual is a danger to himself.” J.P.S., 

264 N.C. App. at 62, 823 S.E.2d at 920–21; see also N.C. Gen. Stat. § 122C-3(11)(a).

The “trial court’s involuntary commitment of a person cannot be based solely 

on findings of the individual’s history of mental illness or behavior prior to and 

leading up to the commitment hearing, but must include findings of a reasonable 

probability of some future harm absent treatment as required by” § 122C-3(11)(a). 

J.P.S., 264 N.C. App. at 62, 823 S.E.2d at 921 (citation and internal quotation marks 

omitted). “Any commitment order that fails to include such findings is insufficient to 

support its conclusions that the respondent presented a danger to himself and 

others.” Id. (citation and internal quotation marks omitted). 

Here, Respondent does not challenge the trial court’s ultimate finding that 

Respondent is mentally ill, as evinced by his schizophrenia diagnosis. Instead, 

Respondent argues that the trial court’s ultimate finding that he posed a danger to 

himself was not supported by its underlying findings, which, in turn, were not 

supported by the evidence. We disagree.

As noted above, to establish dangerousness to self, N.C. Gen. Stat. § 122C3(11)(a)(1) requires a showing of: (1) the individual’s inability without assistance to 

either “exercise self-control, judgment, and discretion” when carrying out daily 

responsibilities, or “satisfy the individual’s need for nourishment, personal or medical 
IN RE: D.H.

Opinion of the Court

11

care, shelter, or self-protection and safety”; and (2) “a reasonable probability of the 

individual’s suffering serious physical debilitation within the near future unless 

adequate treatment is given[.]” N.C. Gen. Stat. § 122C-3(11)(a)(1). 

Here, the trial court’s underlying findings are supported by the evidence, and 

they are adequate to sustain the court’s determination that Respondent was 

dangerous to himself. First, there was ample evidence by way of Dr. Clayton’s 

testimony that in Respondent’s current “state of acute psychosis” he suffers from 

“severely impaired insight and judgment” and is “unable to care for himself” 

adequately, making it “reasonably probable that he would suffer serious physical 

debilitation within the near future” in the absence of inpatient mental health 

treatment. 

There was also substantial evidence that “Respondent — if released in his 

current condition [of acute psychosis] — will immediately become medication noncompliant[,]” rendering it even more likely that he will suffer serious physical 

debilitation in the near future in the absence of inpatient mental health treatment.

Respondent’s father testified that Respondent previously ceased taking his 

medication because he “did not like” the medication; Dr. Clayton testified that 

Respondent “had repeatedly stated [during his assessments] that he would stop 

medication and not follow up with any outpatient mental health treatment on 

discharge”; and Respondent testified that he would not take his medication because 

he believed that he did not suffer from any mental illness. 
IN RE: D.H.

Opinion of the Court

12

Dr. Clayton explained that if Respondent were to become non-compliant with 

his medication, “she would expect Respondent to experience a worsening of his 

psychotic symptoms in the near future.” She stated that during his commitment at 

WakeBrook, Respondent displayed symptoms of hearing voices, responding to 

internal stimuli, experiencing delusions and paranoia, having disorganized thinking 

with “thought blocking,” and demonstrating poor concentration and memory issues. 

Respondent’s father also testified that Respondent’s mental condition had worsened 

previously when he stopped participating in his mental health treatment, which 

caused Respondent to “laugh[ ] to himself, talk[ ] to himself, and pac[e] around the 

home for 5-10 minutes at a time.” 

Based on this evidence, the trial court found that Respondent “has severely 

impaired insight and judgment[,]”and is unable to care for himself. See id. § 122C3(11)(a)(1)(II). The trial court then directly linked Respondent’s inability to care for 

himself based on his past behavior and current symptoms to a risk of future harm: 

“If released from Wake[B]rook in this current condition, Respondent’s inability to 

care for himself makes it reasonably probable that he would suffer serious physical 

debilitation within the near future.” In so finding, the trial court appropriately drew 

the requisite “nexus between [R]espondent’s past conduct and future danger.” C.G., 

383 N.C. at 249, 881 S.E.2d at 551 (citation omitted).

We conclude that the trial court made the “forward-looking findings of fact” 

necessary to support its ultimate finding of a reasonable probability that Respondent 
IN RE: D.H.

Opinion of the Court

13

would suffer serious physical debilitation in the near future absent inpatient mental 

health treatment, and that these findings were supported by the evidence. Id. at 250, 

881 S.E.2d at 552 (Newby, C.J., concurring in part and dissenting in part). Thus, the 

trial court’s findings support the court’s determination that Respondent suffers from 

mental illness and poses a danger to himself, warranting involuntary commitment

for inpatient mental health treatment.

Conclusion

For the foregoing reasons, we affirm the Involuntary Commitment Order.

AFFIRMED.

Judge GORE concurs.

Judge TYSON dissents by separate opinion. 
No. COA22-639 – In re D.H.

TYSON, Judge, dissenting.

The trial court failed to draw the requisite “nexus between the [R]espondent’s 

past conduct and future danger” to reach the conclusion it was reasonably probable 

Respondent would suffer serious physical debilitation within the near future. In re 

C.G., 383 N.C. 224, 249, 2022-NCSC-123, ¶ 41, 881 S.E.2d 534, 551 (2022) (citation, 

internal quotation marks, and alterations omitted). Even if Respondent reverted to 

his prior behaviors, petitioner’s evidence and the record demonstrates his past 

psychotic symptoms and delusions were neither harmful to himself nor others to 

warrant involuntary commitment. Respondent’s past symptoms alone cannot serve 

as a sufficient basis of future danger to support the trial court’s conclusion. The trial 

court’s order is properly vacated and remanded. I respectfully dissent. 

I. Standard of Review

“The State’s burden of proof to deprive Respondent of [his] liberty demands 

competent and relevant evidence and findings of fact to be based upon clear, cogent, 

and convincing evidence at the involuntary commitment hearing.” In re E.B. 

AAU/MPU Wards Granville Cnty., __ N.C. App. __, __, 2022-NCCOA-839, ¶ 15, 882 

S.E.2d 379, 383 (2022). 

“The trial court’s conclusions of law to involuntarily commit and deprive 

Respondent of [his] liberty must be supported by its findings of fact and supporting 

evidence on each required statutory element and those conclusions are reviewed de 

novo on appeal.” Id. at __, ¶ 17, 882 S.E.2d at 384. This Court reviews “the trial 
IN RE D.H.

TYSON, J., dissenting

- 2 -

court’s commitment order to determine whether the ultimate finding concerning the 

respondent’s danger to self or others is supported by the court’s underlying findings, 

and whether those underlying findings, in turn, are supported by competent 

evidence” meeting the required burden of proof. In re W.R.D., 248 N.C. App. 512, 515, 

790 S.E.2d 344, 347 (2016). Here, they are not.

II. Analysis

Petitioner’s showing and the trial court’s findings are not supported by 

sufficient evidence to deny Respondent his liberties. 

To find danger to self in these circumstances, the trial court 

must find that Respondent “would be unable, without care, 

supervision, and the continued assistance of others not 

otherwise available, to exercise self-control, judgment, and 

discretion in the conduct of his daily responsibilities and 

social relations, or to satisfy his need for nourishment, 

personal or medical care, shelter, or self-protection and 

safety” and that “there is a reasonable probability of his 

suffering serious physical debilitation within the near 

future” without involuntary commitment.

Id. (citing N.C. Gen. Stat. § 122C-3(11) (2021)). As the majority’s opinion correctly 

notes, the lack of transcript makes this Court’s review more difficult.

The trial court concluded it was “reasonably probable that Respondent would 

suffer serious physical debilitation within the near future”, if Respondent were 

released. The trial court based its conclusion on the testimony from Dr. Nancy 

Clayton, who testified for the State and predicted “it [wa]s reasonably probable that 

a rapid decline in Respondent’s psychiatric condition would occur in the near future, 
IN RE D.H.

TYSON, J., dissenting

- 3 -

with a reemergence [sic] in the acutely psychotic symptoms that caused him to 

present to Wakebrook on 28 March 2022.”

The trial court made several findings about Respondent’s past symptoms and 

history of mental illness as well as Respondent’s current state. Respondent suffered 

from a declining psychiatric state and delusions prior to his admission to Wakebrook. 

Respondent hallucinated and occasionally traveled because of his delusions. For 

example, Respondent drove to Northern Virginia because he believed he was in the 

FBI, and he drove to Washington D.C. because he believed he was the President. At 

one point, Respondent told his father he was the “Emperor of Japan.”

After Respondent stopped taking his medication, he started laughing and 

talking to himself; his sleep habits changed; he lost his job as an Amazon driver; and, 

he left the scene as law enforcement approached his vehicle at a gas station. None of 

these findings demonstrate how Respondent’s actions support a finding of future 

danger to himself or others when experiencing delusions or psychotic symptoms. No 

loss of liberty comes by one fantasizing or believing they are someone or something 

they are not. Others share or profess the same or similar, or even more bizarre 

delusions, as Respondent, who are not involuntarily committed.

Respondent’s non-aggressive, non-violent history is insufficient to support 

finding Respondent will be a harm to himself or others in the future to warrant an 

involuntary commitment as opposed to home or provider-based treatments. A trial 

court finding that “Respondent’s history of mental illness or her behavior prior to and 
IN RE D.H.

TYSON, J., dissenting

- 4 -

leading up to the commitment hearing[ ] . . . do[es] not indicate that these 

circumstances rendered Respondent a danger to herself or himself in the future.” In 

re Whatley, 224 N.C. App. 267, 273, 736 S.E.2d 527, 531 (2012).

The present case is distinguishable from In re Moore, wherein an individual 

displayed aggressive, harmful tendencies without medication, and the trial court had 

evidence such behavior would return if the individual was released from involuntary 

commitment without medical treatment. 234 N.C. App. 37, 39, 758 S.E.2d 33, 35 

(2014). 

Similarly, this Court affirmed an order for involuntary commitment where an 

individual suffered from schizophrenic delusions, which caused her to believe she had 

blockages in her bodily systems and, when unmedicated, would self-medicate with 

extreme amounts of laxatives and conduct internal self-examinations. In re E.B., __ 

N.C. App. at __, ¶ 10-11, 33-35, 882 S.E.2d at 382-83, 386. The trial court supported 

its conclusion with evidence the individual was presently a danger to herself and 

releasing her would result in immediate physical debilitations. Id. at __, ¶ 29-32, 882 

S.E.2d at 386. Here, we have no such evidence or findings indicating Respondent 

would suffer immediate physical debilitations or engage in aggressive, harmful 

tendencies upon release. Sufficient evidence does not overcome the presumption of 

Respondent’s sanity and right of liberty to support a finding or conclusion of future 

danger to self or others to involuntarily commit.
IN RE D.H.

TYSON, J., dissenting

- 5 -

Additionally, the trial court’s conclusion Respondent would be unable to care 

for himself is insufficient to support its finding that Respondent will “suffer serious 

physical debilitation in the near future.” “[F]indings that an individual suffers from 

a mental illness, exhibits symptoms associated with that mental illness, and may not 

be able to take care of his or her needs are not sufficient to satisfy the second prong 

of the statutory test for the presence of a ‘danger to self.’” In re C.G., 383 N.C. at 246, 

¶ 38, 881 S.E.2d at 549. The trial court “must draw a nexus between past conduct and 

future danger.” Id. at 246, ¶ 37, 881 S.E.2d at 549 (emphasis original) (citation and 

quotation marks omitted). 

The trial court’s finding that “Respondent would not comply with any 

treatment regimen and that an abrupt psychiatric decompensation would result” is 

speculative, unsupported and not sufficient to order involuntary commitment. A 

finding that an individual does not plan to continue treatment, without evidence of 

future harm, does not support an ultimate finding of “dangerous to self.” See In re 

Whatley, 224 N.C. App. at 273, 736 S.E.2d at 531 (citing N.C. Gen. Stat. § 122C3(11)(a)(1)). Again, the evidence does not support a finding Respondent’s state 

without treatment is or will be harmful to himself or others in the future. 

A person’s decision to reduce or discontinue prescribed medication is also not 

evidence or a basis to support an involuntary commitment. In re N.U., 270 N.C. App. 

427, 432-33, 840 S.E.2d 296, 300 (2020) (“[T]he findings that Respondent lacks 

‘insight into her mental illness’ and is ‘unable to care for herself for daily 
IN RE D.H.

TYSON, J., dissenting

- 6 -

responsibilities and taking medications’ are also insufficient to show that Respondent 

was a danger to herself as there is ‘no evidence that Respondent’s refusal to take [her] 

medication creates a serious health risk in the near future.’”) (citation omitted); 

accord In re W.R.D., 248 N.C. App. at 516, 790 S.E.2d at 348 (explaining that findings 

indicating respondent “refus[ed] to acknowledge his mental illness, and refus[ed] to 

take his prescription medication” failed to demonstrate how a “health risk w[ould] 

occur in the near future”) (citation and internal quotation marks omitted). The trial 

court’s findings are insufficient to support a conclusion and order of involuntary 

commitment. In re Whatley, 224 N.C. App. at 273, 736 S.E.2d at 531.

III. Conclusion

This Court cannot affirm a conclusion and order of involuntary commitment 

without findings based upon clear, competent evidence supporting such findings and 

conclusion of future harm to himself or others. N.C. Gen. Stat. § 122C-3(11). While 

the trial court attempts to project a connection between Respondent’s past and 

present conduct with a future risk of harm, it fails to do so, as a lawful order “must 

draw a nexus between past conduct and future danger.” In re C.G., 383 N.C. at 246, 

¶ 37, 881 S.E.2d at 549 (emphasis original) (citation and quotation marks omitted). 

A person has a right to refuse treatment and medication without loss of freedom. In 

re Whatley, 224 N.C. App. at 273, 736 S.E.2d at 531; In re N.U., 270 N.C. App. at 432-

33, 840 S.E.2d at 300; In re W.R.D., 248 N.C. App. at 516, 790 S.E.2d at 348. 

Respondent’s past state, or even his present status, does not sufficiently prove he will 
IN RE D.H.

TYSON, J., dissenting

- 7 -

harm himself or others in the future to support involuntarily depriving him of his 

liberty. Id.; In re Whatley, 224 N.C. App. at 273, 736 S.E.2d at 531. The trial court’s 

order is properly vacated and remanded. I respectfully dissent.