COURT OF APPEALS

DECISION

DATED AND FILED

November 4, 2020

Sheila T. Reiff

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. 2020AP820-FT Cir. Ct. No. 2000ME422

STATE OF WISCONSIN IN COURT OF APPEALS

DISTRICT II

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

WAUKESHA COUNTY,

 PETITIONER-RESPONDENT,

 V.

L.J.M.,

 RESPONDENT-APPELLANT.

APPEAL from an order of the circuit court for Waukesha County: 

PAUL BUGENHAGEN, JR., Judge. Affirmed. 
No. 2020AP820-FT

2

¶1 DAVIS, J.1 “Lisa”2appeals from an order extending her 

involuntary commitment under WIS. STAT. ch. 51. We find that there was 

sufficient evidence that Lisa had a mental illness, was a proper subject for 

treatment, and was dangerous. See WIS. STAT. § 51.20(1)(a). Accordingly, we 

affirm.

BACKGROUND

¶2 Lisa has diagnosed schizoaffective disorder and has been subject to a 

WIS. STAT. ch. 51 commitment order since 2000. On August 27, 2019, the trial 

court held a hearing on the County’s petition for a yearlong extension of Lisa’s 

most recent order. Three witnesses testified: Katherine Andrews, Lisa’s case 

manager; Dr. Terrill Bruett, a court-appointed psychologist; and Lisa. Andrews 

and Bruett also wrote reports which were entered into evidence. 

¶3 Andrews testified that she had been Lisa’s case manager for “[a]bout 

a year” and that she recommended that Lisa “remain on a [WIS. STAT. ch.] 51 

commitment at this time.” Andrews explained that Lisa was generally subject to 

outpatient commitment and was currently living in the community; however, the 

previous April, Lisa’s “mental health started to decompensate.” This led to Lisa’s

temporary admission to inpatient care “to get her a little bit more medically stable, 

because she was becoming unsafe in my vehicle, as well as [in another case 

worker’s] vehicle ... from the amount of screaming and hitting that she was 

doing.” Lisa had also been unhappy with her intramuscular medication Haldol, so

 

1

 This appeal is decided by one judge pursuant to WIS. STAT. § 752.31(2)(d) (2017-18). 

All references to the Wisconsin Statutes are to the 2017-18 version.

2

 For ease of reading, we refer to L.J.M. by the pseudonym “Lisa.”
No. 2020AP820-FT

3

inpatient staff used the admission as an opportunity to transition Lisa to oral 

medication. This attempt, however, was unsuccessful—Lisa tried several oral 

medications but refused to keep taking any of them after three or four days. Lisa 

told Andrews that “she just [did]n’t like to take oral medications,” but she also did 

not want to take the specific drug Zyprexa because she believed it contained 

yellow dye, to which she was allergic. 

¶4 Andrews further elaborated on her recommendation that Lisa remain 

under a commitment order. She explained that Lisa “continue[d] to have 

delusional thoughts that ... [we]re unsafe.” She cited as examples Lisa’s belief

that her soul was “gone,” that someone was murdered in her apartment, and that 

her Haldol was “actually meth and crack.” Lisa also did not believe that she was 

mentally ill, instead blaming her psychiatric symptoms on the Haldol. Thus, she

“expressed ... that she would not take medications without a court order.” 

According to Andrews, if Lisa discontinued psychotropic medication, she would 

decompensate and again require inpatient care and, eventually, a new commitment 

order. This prediction was based on Lisa’s current behavior even while on 

medication. Andrews noted, for example, that Lisa had a recent episode where she 

was “pulling her hair and screaming at me.” 

¶5 When asked whether Lisa had “[h]istorically ... engaged in

dangerous behavior when she was not taking medications,” Andrews responded, “I 

do not know her from that time, I can only comment when I’ve had her and even 

on the medications, I’ve observed her hitting her head, has hit the vehicle.” These 

behaviors were “usually better ... right after [Lisa] [got] her [biweekly injection 

of] Haldol. It is a week that she’s a little bit less agitated, and as we get close to 

the second week that she needs it, the agitation does increase.” The hair pulling 
No. 2020AP820-FT

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described above, for example, occurred three days before Lisa was due for an 

injection. 

¶6 Bruett, the psychologist, also testified. Bruett explained that he was 

appointed to examine Lisa by telephone and write a report for the hearing. Lisa, 

however, was uncooperative, “stat[ing] that, I won’t talk to you or the other 

doctor, they only want ... recommitment, they only do it for the money.” When 

Bruett told Lisa that he would still need to file a report, “she began a monolog of 

telling me, again, how people are just wanting to re-commit her and that she 

wasn’t going to cooperate.” Bruett had examined Lisa more fully the year before, 

however, in connection with a prior commitment hearing; he had also reviewed 

Andrews’s report. Thus, from the brief telephone call, the past examination, and 

Andrews’s report, Bruett was able to form an opinion about Lisa’s case. 

¶7 Bruett testified that Lisa had schizoaffective disorder with paranoia, 

which manifested as a “substantial disorder of ... thought, mood and perception” 

that “grossly impair[ed] her judgment and behavior.” Medication, when taken 

consistently, enabled Lisa to live in the community and be treated on an outpatient 

basis; however, Lisa did not “recognize that she require[d] treatment with 

psychotropic medication.” Bruett noted that Lisa displayed “mood instability, 

extreme irritability, paranoia and delusional thinking” even with medication, but 

he felt that medication nonetheless provided some benefit: “she’s living out in the 

community now, rather than in a group home or a sheltered setting, so there has 

been some improvement.” 

¶8 It was Bruett’s further opinion that Lisa “would be a proper subject 

for commitment, if treatment were withdrawn.” Bruett based this conclusion on 

“[t]he 33 admissions that she’s had to the Mental Health Center, her affect, her 
No. 2020AP820-FT

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denial of her illness and her denial of her need for medications,” which together 

indicated that if Lisa “were not on commitment ... it is highly unlikely she would 

... take medication and then [she would] regress and require inpatient treatment.” 

Bruett also explained why Lisa was incompetent to refuse medication: she held 

“patently false beliefs about the medications” which rendered her substantially 

incapable of applying to her own situation an understanding of the advantages and

disadvantages of, and alternatives to, accepting medication, so as to make an 

informed choice to accept or refuse medication. 

¶9 Lisa testified too. She stated that she did not see any benefit from 

the Haldol and that she experienced “[a] lot” of side effects. Lisa explained that 

she did not like drugs and that if she were not subject to a commitment order she 

would “get weaned off” medication. From our review of the transcript, it appears 

that Lisa was at times disruptive and agitated during the hearing, although not 

violent, and she made several statements that indicated delusional or disordered 

thinking (for example, she said that there were “spirits ... like demons” in her 

apartment because “[p]eople have died in that apartment”). 

¶10 The trial court found that Lisa was mentally ill and a proper subject 

for commitment. The trial court expressly determined that Lisa was dangerous, 

given her history of inpatient treatment and the testimony that she would be a 

proper subject for commitment if treatment were withdrawn. The court further

noted that Lisa was dangerous because the “attempt to transition to another 

medication ... didn’t go well” and “she had to be treated inpatient again”; because 

Lisa was “becoming unsafe. She’s screaming and hitting. She hits herself in the 

head”; and because “she’s delusional.” In addition, “the history of the case shows 

that without proper medication, she does decompensate and becomes in need of 

inpatient care again.” The court also determined that Lisa was not competent to 
No. 2020AP820-FT

6

refuse medication and treatment. Therefore, the court entered orders for a twelvemonth extension of outpatient commitment and for involuntary medication and 

treatment. This appeal followed.

DISCUSSION

¶11 A county seeking to commit an individual under WIS. STAT. ch. 51 

must prove by clear and convincing evidence that the individual is mentally ill, a 

proper subject for treatment, and dangerous under one of the five standards of

WIS. STAT. § 51.20(1)(a)2.a.-e. Portage County v. J.W.K., 2019 WI 54, ¶17, 386 

Wis. 2d 672, 927 N.W.2d 509; § 51.20(1)(a), (13)(e). Each of these standards 

requires proof of recent acts or omissions demonstrating that the individual is a 

danger to him or herself or to others. Langlade County v. D.J.W., 2020 WI 41, 

¶30, 391 Wis. 2d 231, 942 N.W.2d 277. 

¶12 The court may extend the commitment for up to one year upon proof 

of the same elements. J.W.K., 386 Wis. 2d 672, ¶18; WIS. STAT. § 51.20(13)(g)1., 

3. Because the commitment itself may have diminished the individual’s 

dangerous behavior without obviating the need for continued commitment, the 

county may then rely on the “alternative evidentiary path” of § 51.20(1)(am). 

J.W.K., 386 Wis. 2d 672, ¶19; § 51.20(13)(g)3. That is, the county may prove 

dangerousness in extension proceedings not with reference to the individual’s 

recent behavior but instead by showing “that there is a substantial likelihood, 

based on the subject individual’s treatment record, that the individual would be a 

proper subject for commitment if treatment were withdrawn.” Sec. 51.20(1)(am). 

This “standard is not more or less onerous” than the standard for initial 

commitment, in that both proceedings “require[] proof of current dangerousness.” 

J.W.K., 386 Wis. 2d 672, ¶24 (alteration in original). The purpose of 
No. 2020AP820-FT

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§ 51.20(1)(am) is merely “to avoid the ‘revolving door’ phenomena whereby there 

must be proof of a recent overt act to extend the commitment but because the 

patient was still under treatment, no overt acts occurred and the patient was 

released from treatment only to commit a dangerous act and be recommitted.” 

State v. W.R.B., 140 Wis. 2d 347, 351, 411 N.W.2d 142 (Ct. App. 1987).

¶13 Last April, our supreme court clarified that “going forward circuit 

courts in recommitment proceedings are to make specific factual findings with 

reference to the subdivision paragraph of [WIS. STAT.] § 51.20(1)(a)2. on which 

the recommitment is based.” D.J.W., 391 Wis. 2d. 231, ¶40 (emphasis added). 

As this requirement is prospective, it does not apply to Lisa’s August 2019 

hearing. Therefore, although the trial court here was required to find “a 

substantial likelihood” of current dangerousness, as defined under 

§ 51.20(1)(a)2.a.-e., it was not required to explain on the record how the relevant 

facts met any specific dangerousness standard(s). See § 51.20(1)(am); Winnebago 

County v. S.H., 2020 WI App 46, ¶¶13-14, 393 Wis. 2d 511, 947 N.W.2d 761.

¶14 Review of an extension order presents a mixed question of fact and 

law. Waukesha County v. J.W.J., 2017 WI 57, ¶15, 375 Wis. 2d 542, 895 

N.W.2d 783. We uphold the trial court’s factual findings unless clearly erroneous, 

but we review de novo whether those facts meet the statutory standard. Id.

¶15 As a threshold matter, we must determine whether to resolve Lisa’s 

appeal despite the expiration of her August 27, 2019 commitment order. Lisa 

concedes that her appeal is moot; that is, she does not argue that she suffers any 

collateral consequences from the expired order, such that our decision would have 

a “practical effect upon an existing controversy.” See J.W.K., 386 Wis. 2d 672, 

¶11 (citation omitted). Lisa instead argues that we should exercise our discretion 
No. 2020AP820-FT

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to reach the merits of her appeal, because at least three recognized mootness 

exceptions apply. According to Lisa, her appeal presents issues that (1) arise so 

often that “a definitive decision is essential to guide the trial courts”; (2) are 

“likely to arise again and should be resolved by the court to avoid uncertainty”; 

and (3) are “capable and likely of repetition and yet evade[] review.” See id., ¶12 

(citation omitted). 

¶16 We conclude that Lisa’s appeal should be decided on the merits for 

two reasons. First, the County did not respond to Lisa’s argument, thereby 

implicitly acknowledging that at least one mootness exception applies. See 

Charolais Breeding Ranches, Ltd. v. FPC Sec. Corp., 90 Wis. 2d 97, 109, 279

N.W.2d 493 (Ct. App. 1979) (“Respondents on appeal cannot complain if 

propositions of appellants are taken as confessed which they do not undertake to 

refute.” (citation omitted)). Second, trial courts and interested parties might 

benefit from further guidance on what is often a tricky question: the sufficiency of 

the evidence supporting the legal determination of dangerousness in an extension 

proceeding. Although our courts have frequently addressed this topic, including in 

recent decisions,

3

an additional example may be helpful. This is certainly an issue 

that occurs frequently but is very often mooted by the passage of time (even 

where, as here, the parties take advantage of the “fast track” appellate process).

See WIS. STAT. RULE 809.17. We therefore turn to the merits of Lisa’s appeal.

¶17 Lisa appears to concede that she has a mental illness and is a proper 

subject for treatment, but she disputes that she is dangerous. Specifically, she 

 

3

 See, e.g., Winnebago County v. S.H., 2020 WI App 46, ¶¶13-14, 393 Wis. 2d 511, 947

N.W.2d 761; Winnebago County v. L.F.-G., No. 2019AP2010, unpublished slip op. (WI App 

May 20, 2020).
No. 2020AP820-FT

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argues that the County “made no attempt to present evidence that showed that if 

treatment were withdrawn, [she] would become dangerous under one of the five 

standards listed in WIS. STAT. § 51.20(1)(a)(2)a.-e.” We disagree. The County 

perhaps could have done more to elicit additional evidence indicating current 

dangerousness, and we read D.J.W. to suggest that it would be well advised to do 

more in the future. See D.J.W., 391 Wis. 2d. 231, ¶¶40-43, 50-58. But we also 

note that, in fact, neither party at the extension hearing placed much emphasis on 

the dangerousness element—indeed, in neither party’s summations to the trial 

court does the word “danger” or “dangerousness” (or any synonym) ever appear in 

the transcript. As a general rule, this required element should not be given such 

short shrift. 

¶18 Nonetheless, it is also clear that the trial court recognized the need to 

make the requisite factual findings supporting dangerousness, and did so (the court 

did not reference the specific statutory criteria on which dangerousness was based, 

but contrary to Lisa’s assertion, it was not then required to do so). See id., ¶40. In 

reviewing those findings, we conclude that they are supported by the evidence,

along with reasonable inferences therefrom. See S.H., 393 Wis. 2d 511, ¶14; see 

also Outagamie County v. Melanie L., 2013 WI 67, ¶38, 349 Wis. 2d 148, 833 

N.W.2d 607 (“We accept reasonable inferences from the facts available to the 

circuit court.”). 

¶19 We agree with Lisa that the relevant dangerousness standard is WIS.

STAT. § 51.20(1)(a)(2)c. Putting that together with the recommitment standard, 

§ 51.20(1)(am), the County was required to establish, by clear and convincing 

evidence, that there was a “substantial likelihood, based on [Lisa’s] treatment 

record, that ... if treatment were withdrawn,” Lisa would have “such impaired 
No. 2020AP820-FT

10

judgment ... that there [would be] a substantial probability of physical impairment 

or injury to ... herself or other individuals.” See § 51.20(1)(a)(2)c., (1)(am). 

¶20 We find that the County met that standard, but we first acknowledge 

that the testimony was at times confusing and, for this reason, likely caused the 

trial court to draw one conclusion that we view as unsupported by the entirety of 

the record. Andrews’s report stated that Lisa had been admitted to inpatient care 

thirty-three times over the course of her nineteen years under WIS. STAT. ch. 51 

commitment. There were nonspecific references to these inpatient admissions 

throughout the extension hearing. The trial court assumed that the admissions were 

caused by Lisa’s changing, refusing, or transitioning off of medications (the 

County too makes this argument on appeal). Andrews, Bruett, and Lisa herself 

testified that Lisa would not take psychotropic medications without a commitment 

order. Therefore, the trial court concluded that Lisa’s medical history clearly 

indicated that, in a nonmedicated state, she would exhibit behavior sufficiently 

dangerous to warrant inpatient admission and recommitment. 

¶21 From our review of the appellate record, however, including an 

earlier transcript of a hearing at which Lisa contested her April 2019 inpatient 

admission, it does not appear that Lisa’s prior inpatient admissions were neatly 

tied to any change in medication status. Instead, Lisa may experience semiregular distress in the community for various reasons, and medical personnel may 

at times have responded by changing her medication. This inference is supported 

by the fact that at all times relevant to this appeal, Lisa was taking Haldol, a longacting intramuscular drug that is administered in a medical setting and that she 

would not have been able to discontinue at will. In addition, the plain language of 

Lisa’s medication order requires drug administration “regardless of ... consent ... 
No. 2020AP820-FT

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during the period of commitment.” Thus, Lisa has never had the capacity to 

simply (as the County puts it) “refuse[] to comply with the medication order.” 

¶22 Therefore, we will not consider the evidence of inpatient admissions

as directly relevant to the “dangerousness” determination: we have no context for 

why those admissions occurred or whether or how they related to Lisa’s behavior 

or medications.

4

 We further agree with Lisa that standing alone, evidence that she 

is merely irritable—or even, as the trial court found, “delusional”—is insufficient 

to establish dangerousness. For example, an individual who believes himself to be

Benjamin Franklin, and accordingly dresses in 18th century garb, is certainly 

delusional, but that does not mean that he is dangerous. Mere eccentricities, 

whether brought on by mental illness or otherwise, cannot form the basis for a 

commitment order. Only where the delusion causes the individual to engage in 

behavior that threatens physical harm—to the individual or others—is 

dangerousness shown. This means that at least some of Lisa’s delusions (for 

example, that her apartment is filled with evil spirits) do not, in of themselves,

support a finding of dangerousness, at least on this record. 

¶23 Nonetheless, the line separating mere delusional thoughts and 

dangerousness was crossed in this case because we have evidence directly linking 

Lisa’s Haldol level to behavior posing a significant risk of physical harm. 

Andrews observed that Lisa was “usually better” right after her biweekly injection. 

As the injection began to wear off in the second week, however, Lisa’s behavior 

 

4

 The only concrete description of these admissions in the extension hearing transcript is 

Bruett’s testimony that “none of those [admissions] [we]re very recent.” To the extent this fact is 

relevant, it weighs against recommitment, because it indicates that there has been no recent 

dangerous behavior necessitating inpatient admission.
No. 2020AP820-FT

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became more erratic: there was “screaming and hitting,” “hitting her head,” and 

“pulling her hair and screaming.” Although generally not life-threatening, such

behavior shows a lack of impulse control and violent tendencies and—particularly 

where it occurs in a vehicle, as happened here at least twice—evidenced a

substantial probability of physical harm to Lisa and others. See WIS. STAT.

§ 51.20(1)(a)(2)c. 

¶24 In addition to this evidence, we have the predictions of Andrews and 

Bruett that Lisa would decompensate to the point of dangerousness without a 

commitment order (which is to say, without medication). We recently stated that 

“conclusory opinions parroting the statutory language without actually discussing 

dangerousness, are insufficient to prove dangerousness,” but here Bruett and, 

especially, Andrews were not merely reciting the legal standard. See S.H., 393 

Wis. 2d 511, ¶17. Bruett perhaps was relying generally on his clinical judgment, 

but Andrews’s opinion was necessarily informed by her frequent interactions with 

and observations of Lisa over the course of a year. Such evidence is relevant to 

the finding of dangerousness.

¶25 Taking these observations and predictions together, we conclude that 

the trial court did not err in finding clear and convincing evidence of current 

dangerousness. The unrebutted evidence and expert testimony showed that Lisa 

would not take medications without a commitment order, that she decompensated 

as her medication wore off, and that this resulted in erratic and potentially 

dangerous behavior. It was reasonable for the trial court to assume that such 

behavior would continue and worsen if medication were discontinued, as would 

almost certainly occur if the order were not extended, leading to a substantial risk 

of physical harm to Lisa and others. We affirm.
No. 2020AP820-FT

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By the Court.—Order affirmed.

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

809.23(1)(b)4.