2014 WI 127

SUPREME COURT OF WISCONSIN

CASE NO.: 2013AP1638-FT

COMPLETE TITLE: In the matter of the mental commitment of 

Michael H.:

Outagamie County,

 Petitioner-Respondent,

 v.

Michael H.,

 Respondent-Appellant-Petitioner. 

REVIEW OF A DECISION OF THE COURT OF APPEALS

(Reported at 352 Wis. 2d 248, 841 N.W.2d 582)

(Ct. App. 2013 – Unpublished)

OPINION FILED: December 16, 2014

SUBMITTED ON BRIEFS: 

ORAL ARGUMENT: October 7, 2014

SOURCE OF APPEAL:

COURT: Circuit

COUNTY: Outagamie

JUDGE: Dee R. Dyer

JUSTICES:

CONCURRED:

DISSENTED:

NOT PARTICIPATING: 

ATTORNEYS:

For the respondent-appellant-petitioner, there were briefs 

by Suzanne L. Hagopian, assistant state public defender, and 

oral argument by Suzanne L. Hagopian.

For the petitioner-respondent, there was a brief by Patrick 

M. Taylor, assistant Outagamie County corporation counsel, and 

oral argument by Patrick M. Taylor.
2014 WI 127

NOTICE

This opinion is subject to further 

editing and modification. The final 

version will appear in the bound 

volume of the official reports. 

No. 2013AP1638-FT

(L.C. No. 2012ME87A)

STATE OF WISCONSIN : IN SUPREME COURT

In the matter of the mental commitment of 

Michael H.:

Outagamie County, 

Petitioner-Respondent, 

v.

Michael H., 

Respondent-Appellant-Petitioner. 

FILED

DEC 16, 2014

Diane M. Fremgen

Clerk of Supreme Court

REVIEW of a decision of the Court of Appeals. Affirmed. 

¶1 N. PATRICK CROOKS, J. Outagamie County filed a 

petition for the involuntary commitment of Michael H., and based 

on the jury's determination that he was dangerous to himself, 

the Outagamie County Circuit Court ordered him committed for 

treatment pursuant to Wisconsin's involuntary commitment 

statute, Wis. Stat. § 51.20. The heart of the case is the 

dispute over the evidence that he was dangerous. Michael 

challenges the sufficiency of the evidence, and we must

determine whether the evidence was sufficient to support the 

jury's conclusion that he was dangerous within the meaning of 
No. 2013AP1638-FT 

2

Wis. Stat. § 51.20(1)(a)2.a. or 2.c. or both——that there was a 

substantial probability of injury to himself, based either on 

threats of suicide or impaired judgment.

1 Because we cannot 

evaluate the sufficiency of the evidence without examining the 

meaning of the statute's words, we also must decide what

satisfies the statute's requirement of "evidence of recent 

threats . . . of suicide"——specifically, whether the acts in 

this case can constitute a threat. Jurors are asked in these

difficult cases to determine whether clear and convincing 

evidence

2 supports a finding of dangerousness, knowing they 

should neither wrongly deprive a person of liberty nor fail to 

authorize intervention before a dangerous person harms himself.

¶2 Wisconsin Stat. § 51.20 (2011-12)3, which establishes 

the prerequisites for involuntary commitment for treatment, 

requires a determination that a person is dangerous and provides 

five grounds for making such a determination. The statute 

spells out what may serve as grounds for such a determination. 

In this case, the two grounds alleged relate to Michael's 

 

1 Michael does not dispute Outagamie County's allegation 

that he is mentally ill and a proper subject for treatment under 

Wis. Stat. § 51.20(1)(a)1.

2 State v. Randall, 192 Wis. 2d 800, 818, 532 N.W.2d 94

(1995) (stating, "In civil commitment proceedings, the state is 

required to prove by clear and convincing evidence that a 

proposed committee is mentally disabled and dangerous. This is 

often referred to as the Addington burden, named for the 

decision that first stated the principle.") See ¶26, infra.

3 All subsequent references to the Wisconsin Statutes are to 

the 2011-12 version unless otherwise indicated.
No. 2013AP1638-FT 

3

dangerousness to himself. Wisconsin Stat. §§ 51.20(1)(a)2.a., 

(1)(a)2.c. The County did not allege that Michael qualified for 

commitment on the basis of his dangerousness to others. What 

the County must prove by clear and convincing evidence in this 

case is that there was a substantial probability that Michael

was dangerous to himself. This can be demonstrated by either 

"recent threats . . . of suicide or serious bodily harm";

4

"impaired judgment, evidenced by a pattern of recent acts or 

omissions";5 or both. 

¶3 As to the first basis alleged for finding 

dangerousness, relating to "recent threats of . . . suicide,"

Michael contends that the sole evidence is the fact that he 

answered "yes" to a nurse who asked if he was suicidal. He 

 

4 Wisconsin Stat. §51.20 (1)(a)2.a. states, "The individual 

is dangerous because he or she . . . [e]vidences a substantial 

probability of physical harm to himself or herself as manifested 

by evidence of recent threats of or attempts at suicide or 

serious bodily harm."

5 Wisconsin Stat. § 51.20(1)(a)2.c. states:

The individual is dangerous because he or she . . . 

[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. The 

probability of physical impairment or injury is not 

substantial under this subd. 2. c. if reasonable 

provision for the subject individual's protection is 

available in the community and there is a reasonable 

probability that the individual will avail himself or 

herself of these services, if the individual may be 

provided protective placement or protective services 

under ch. 55 . . . .
No. 2013AP1638-FT 

4

asserts that this is evidence only of thoughts, and that such 

thoughts do not constitute clear and convincing evidence of

threats because the word "threat"

6 has a common meaning of an

expression of an intention to act, and he expressed no intent to 

act. As to the second way of demonstrating dangerousness, 

relating to a pattern of acts indicating impaired judgment, 

Michael contends that the evidence is insufficient to support 

the verdict because the only pattern was a pattern of asking to 

be taken to a hospital, which he did four times in the span of 

five days, and because there was not enough other evidence of 

impaired judgment to satisfy the "substantial probability" 

requirement.

¶4 The statute does not define "threat." The word's 

common meanings are "an expression of an intention to inflict 

injury"7 and "an indication of impending danger or harm."8 As 

mental health scholarship recognizes, "suicidal" is commonly 

used by persons with intent to act and persons without intent to

 

6 State v. Perkins, 2001 WI 46, ¶43, 243 Wis. 2d 141, 626 

N.W.2d 762 (stating that "[t]he common definition of threat is 

an expression of an intention to inflict injury on another").

7 1868 American Heritage Dictionary of the English Language 

(3d ed. 1992). This definition was mentioned in Perkins, 243 

Wis. 2d 141, ¶43, in which this court distinguished the common 

definition from the narrower definition for purposes of a 

statute criminalizing threats to judges.

8 1868 American Heritage Dictionary of the English Language 

(3d ed. 1992).
No. 2013AP1638-FT 

5

act.9 Where credible evidence supports an inference that a 

person who affirmed that he was suicidal had an intent to act, 

we will not reverse a jury's dangerousness finding on the 

grounds that the person was not specific enough in articulating 

his intent. Although we need not adopt a precise definition for 

"threat" for purposes of Wis. Stat. § 51.20, we do conclude that 

the acts alleged here (which are not in dispute) can satisfy the 

term's common meanings. 

¶5 We turn to the sufficiency of the evidence challenge, 

and we view the following evidence in a manner that is most 

favorable to sustaining the verdict: Michael had recently been 

given a knife and usually carried it with him; after a week of 

increasingly disturbing and delusional behavior, when a nurse 

asked if he was "suicidal," he answered that he was; when asked 

immediately thereafter by his mother to clarify if he had a 

specific plan to kill himself, he stated that it was too hard to 

explain; when talking to police officers he answered that he 

wanted to harm himself; he had a pattern of refusing medication;

and he had demonstrated multiple instances of impaired judgment 

on a daily basis during the preceding week.

 

9 See infra, ¶36, for discussion of scholarship on suicidal 

ideation.
No. 2013AP1638-FT 

6

¶6 We conclude that an articulated plan is not a 

necessary component of a suicide threat.10 If we were to hold 

otherwise, it would require a person in a confused mental state 

to articulate a plan before obtaining treatment through 

involuntary commitment. That would write into the statute a 

potential barrier to treatment that is inconsistent with its 

purpose. We also conclude that the evidence was sufficient to 

support Michael's involuntary commitment because credible 

evidence existed in the record supporting inferences that there 

was a substantial probability that he was dangerous to himself 

within the meaning of Wis. Stat. §§ 51.20(1)(a)2.a., based on 

threats of suicide or serious bodily harm, and (1)(a)2.c., based 

on impaired judgment, manifested by a pattern of recent acts.11 

 

10 Michael's petition for review stated this issue thus: "Do 

thoughts of suicide or self-harm, without an articulated plan 

for acting on those thoughts, constitute 'threats' of suicide or 

serious bodily harm necessary to establish dangerousness under 

Wis. Stat. § 51.20(1)(a)2.a.?" Our conclusion is that an 

articulated plan is not a requirement for a threat of suicide 

for purposes of the statute.

11 The special verdict returned by the jury stated as 

follows:

Question 1: Is Michael [H.] mentally ill? Answer: Yes.

Question 2: If you answered question 1 "yes," then 

answer this question: Is Michael [H.] dangerous to 

himself? Answer: Yes.

Question 3: If you answered both questions 1 and 2 

"yes," then answer this question: Is Michael [H.] a 

proper subject for treatment? Answer: Yes.

The jury had been instructed with WI JI-Civil 7050, which 

included both grounds for dangerousness relevant here.
No. 2013AP1638-FT 

7

¶7 Ultimately, our conclusion on the sufficiency of the 

evidence is dictated by the deferential review of jury verdicts. 

In such cases, we view the evidence in a light most favorable to 

the jury's determination. The jury could have drawn another 

inference from the evidence, but the one it did draw was

supported by credible evidence. We will not strike down a jury 

verdict where we see "credible evidence in the record on which 

the jury could have based its decision,"12 and we "accept the 

particular inference reached by the jury."13 In light of that 

standard, we affirm the court of appeals.

I. BACKGROUND

¶8 The incidents that gave rise to this case occurred 

when Michael came to Wisconsin for a weeklong family visit in 

February of 2013. Michael had moved to Minnesota the previous 

year following a hospitalization in Wisconsin for treatment of a 

mental illness. Family members said he had told them he did so 

to avoid a court order that he take anti-psychotic medication. 

His visit was planned to coincide with celebrations of family 

birthdays and a belated Christmas gift exchange.

¶9 As the jury heard, it was a difficult week. Michael 

drove in from Minnesota, arriving at his mother's home about 

5:00 a.m. on a Saturday. His mother testified that when she 

first saw him on Saturday afternoon, his symptoms had returned 

 

12 Morden v. Cont'l AG, 2000 WI 51, ¶38, 235 Wis. 2d 325, 

611 N.W.2d 659.

13 Id., ¶39.
No. 2013AP1638-FT 

8

and he had a look in his eyes that reminded her of his 

appearance prior to his hospitalization. 

¶10 On Sunday, he abruptly and without explanation became 

shaken and distressed and refused to go to the mall for a 

planned family photo studio appointment. 

¶11 On Monday, he walked two miles through very cold 

weather with his five-year-old niece to demand a car from a 

sister because he believed that another sister was in danger. 

Later that day, he asked to go the hospital and was taken but 

refused medication and did not stay. 

¶12 On Tuesday, after a family birthday dinner, he again 

stated he wanted to go to the hospital and was taken but refused 

medication and did not stay. 

¶13 On Wednesday, he asked to go to the hospital, was 

taken, refused medication and did not stay. While he was with 

his father, his mother went to the police department, seeking 

help. Although the officer contacted the crisis worker, both 

told her there was nothing that could be done at that point.

¶14 On Thursday, he picked up his niece, age 5, saying 

they were just going for lunch at McDonald's. They were gone 

for hours, and repeated calls to his phone were unanswered, 

which alarmed family members and sent them scrambling 

frantically to find the child. Family members reached a car 

repair shop where he had taken his vehicle and learned that he 

had been there three times but two times did not appear to have 

the child with him. Michael's sister went to the police for 

help. When Michael returned to his mother's, the child was safe 
No. 2013AP1638-FT 

9

with him, but he was oblivious to their worry and furious about 

several unrelated events, such as clothing he was missing and 

cell phones he could not activate, which he viewed as proof that 

unidentified people were following him. 

¶15 On Friday evening after dinner, he returned to his 

mother's house, asking yet again to go to the hospital. As 

Michael's mother later testified at trial, he told her that 

evening, "[M]om, something's not right in my head. . . . I 

can't think straight. I don't know what's going on. I need to 

go to the hospital . . . ." She testified that when she 

reminded him that the hospital could not help him if he would 

not take medication, he did not answer. She described how he 

went into a bedroom and laid down, and she asked him what was 

wrong. She testified that, at that point, "He just said I'm so 

lonely. I don't know what's going on in my head." She said she 

got him to agree to take medication this time if they went back 

to the hospital, and she agreed to take him. 

¶16 The statements made during that Friday evening 

emergency room visit are the ones on which Michael's argument 

primarily focuses. When he arrived at the hospital, the nurse 

asked him, with his mother nearby, if he was suicidal. He said 

yes. This answer alarmed his mother; she said he had never made 

such a statement before. Concerned at this indication that he 

may have been planning to kill himself, his mother then asked 

him, as the nurse left to contact a mental health crisis worker, 

what his plan was. Rather than denying a plan, he responded 

that it was too hard to explain, it was too long, he could not 
No. 2013AP1638-FT 

10

explain, and he did not know. Moments later, he took his jacket 

and ran from the hospital.

¶17 Police officers found him shortly thereafter in a park 

and returned him to the hospital. He denied thinking of suicide 

and told one of the officers that he had only wanted to hurt 

himself.

¶18 An officer placed Michael under an emergency 

detention. Following a probable cause hearing, a jury trial was 

held to determine whether clear and convincing evidence existed 

to commit Michael involuntarily for treatment under Wis. Stat. 

§ 51.20. The jury heard testimony from the emergency room 

nurse, the police officer who brought Michael back to the 

hospital, a doctor who examined him prior to trial, and 

Michael’s mother. Among the evidence heard by the jury were the 

following facts:

- He had made repeated statements to his mother and sister 

that "nobody's safe."

- He had acknowledged that he was suicidal to a nurse and 

made ambiguous statements about being suicidal to his 

mother.

- He had acknowledged to a police officer that he wanted to 

harm himself.

- He had delusional behavior and behaved in a paranoid 

manner, stating to his mother that she and his father 

should not sleep at home because unnamed persons were after 

him and would also be after them.
No. 2013AP1638-FT 

11

- He owned a knife that he had received that week as a 

belated Christmas gift and usually carried it with him.

- He had access to guns.

- He had walked with a young child through the snow for two 

miles based on his fear that one of his sisters was in 

danger.

- He had purchased several cell phones and explained that 

he did so to avoid being tracked by unnamed persons; he had 

thrown one phone out the car window believing it to be 

bugged.

- He had been unable to sleep.

- He had repeatedly told his mother that his head was not 

right and that he could not think straight and was lonely 

and sad.

- He had refused medication, and according to a doctor who 

examined him, he "could [be dangerous] without treatment."

¶19 The jury found that Michael was mentally ill, was a 

proper subject for treatment, and was dangerous. Based on that 

verdict, the Outagamie County Circuit Court, the Honorable Dee 

R. Dyer presiding, issued an order committing Michael

involuntarily for treatment for six months.

14 

 

14 The court made a finding that Michael was incompetent to 

refuse medication and an order for involuntary medication was 

also entered; that order was not appealed and is not before us.
No. 2013AP1638-FT 

12

¶20 The court of appeals affirmed the jury verdict.15 As 

to the dangerousness requirement, it affirmed on the grounds 

that evidence supported a finding of dangerousness under 

subsection (1)(a)2.a., relating to threats of suicide or selfharm. In its analysis, it employed a common definition of 

"threat" as "an expression of an intention to inflict injury" 

and cited the evidence of Michael's statements that he was 

thinking of suicide and harming himself, as well as his 

statements implying that he had a plan to do so even though he 

refused to share it with his mother because it was "too hard to 

explain."16 Because it found the evidence sufficient to satisfy 

the requirement under subsection (1)(a)2.a., the court of 

appeals did not address the question of whether evidence was 

sufficient to satisfy dangerousness grounds under subsection 

(1)(a)2.c., relating to impaired judgment that leads to a 

substantial probability of harm to oneself.

II. STANDARD OF REVIEW

¶21 The standard of review is significant in this case. 

The challenge is to the sufficiency of evidence to support a 

jury verdict, and in such a challenge, a reviewing court views 

evidence most favorably to sustaining a verdict. Tammy W-G. v.

Jacob T., 2011 WI 30, ¶17, 333 Wis. 2d 273, 797 N.W. 2d 854. We 

"review as a question of law whether the evidence presented to a 

 

15 Outagamie County v. Michael H., No. 2013AP1638, 

unpublished slip op. (Wis. Ct. App. Nov. 26, 2013).

16 Id., ¶25.
No. 2013AP1638-FT 

13

jury is sufficient to sustain its verdict." Sheboygan Cnty. 

Dep't of Health & Human Services v. Tanya M.B., 2010 WI 55, ¶18, 

325 Wis. 2d 524, 785 N.W.2d 369 (citing State v. Booker, 2006 WI 

79, ¶12, 292 Wis. 2d 43, 717 N.W.2d 676). "A jury's verdict 

must be sustained if there is any credible evidence, when viewed 

in a light most favorable to the verdict, to support it." Id., 

¶49. We have emphasized the narrowness of our review in this 

type of case:

Our review of a jury's verdict is narrow. Appellate 

courts in Wisconsin will sustain a jury verdict if 

there is any credible evidence to support it. 

Moreover, if there is any credible evidence, under any 

reasonable view, that leads to an inference supporting 

the jury's finding, we will not overturn that finding.

In applying this narrow standard of review, this court 

considers the evidence in a light most favorable to 

the jury's determination. We do so because it is the 

role of the jury, not an appellate court, to balance 

the credibility of witnesses and the weight given to 

the testimony of those witnesses. To that end, 

appellate courts search the record for credible 

evidence that sustains the jury's verdict, not for 

evidence to support a verdict that the jury could have 

reached but did not. If we find that there is "any 

credible evidence in the record on which the jury 

could have based its decision," we will affirm that 

verdict. Similarly, if the evidence gives rise to more 

than one reasonable inference, we accept the 

particular inference reached by the jury. This court 

will uphold the jury verdict "even though [the 

evidence] be contradicted and the contradictory 

evidence be stronger and more convincing."

Morden v. Cont'l AG, 2000 WI 51, ¶¶38-39, 235 Wis. 2d 325, 611 

N.W.2d 659 (emphasis added).

¶22 The questions presented about the meaning of the word 

"threat" in Wis. Stat. § 51.20 require us to interpret the 
No. 2013AP1638-FT 

14

meaning of a statute, and that is a question subject to de novo 

review. Fond du Lac County v. Helen E.F., 2012 WI 50, ¶10, 340 

Wis. 2d 500, 814 N.W.2d 179.

III. DISCUSSION

A. Involuntary Commitment and 

the History of the Requirement of Dangerousness

¶23 Up until the early 1970s, there were few requirements 

for the government to meet in order to commit a person 

involuntarily for mental treatment. 

In 1961, the American Bar Association published an 

analysis of then-existing state statutes governing 

involuntary hospitalization. In the late 1950s, just 

seven states required some sort of dangerousness (to 

self, others, or property) as justification for 

involuntary hospitalization. In twenty-two states, 

simply needing care or treatment was sufficient 

grounds, and seven other states permitted commitment 

if it seemed necessary for the patient's welfare or 

the welfare of others. Massachusetts permitted 

commitment of persons deemed "likely" to violate "the 

established laws, ordinances, conventions, or morals 

of the community." Seventeen states had no specific 

statutory criteria for commitment, apparently leaving 

the choice of rationale entirely to legal decisionmakers.

Douglas Mossman, M.D. et al., Risky Business Versus Overt Acts:

What Relevance Do "Actuarial," Probabilistic Risk Assessments 

Have for Judicial Decisions on Involuntary Psychiatric 

Hospitalization?, 11 Hous. J. Health L. & Pol'y 365, 373-76 

(2012) (footnotes omitted). Wisconsin's statutory scheme for 

involuntary commitment at that time was characterized as 

follows: 
No. 2013AP1638-FT 

15

it failed to require effective and timely notice of 

"charges" justifying detention; failed to require 

notice of rights including right to jury trial, 

permitted detention longer than 48 hours without 

hearing on probable cause; permitted detention longer 

than two weeks without full hearing on necessity for 

commitment; permitted commitment based on hearing in 

which person detained was not represented by adversary 

counsel, at which hearsay evidence was admitted, and 

in which psychiatric evidence was presented without 

patient having been given benefit of privilege against 

self-incrimination; permitted commitment without proof 

of mental illness and dangerousness beyond reasonable 

doubt; and failed to require those seeking commitment 

to consider less restrictive alternatives.17

¶24 Then, two cases changed the landscape of involuntary 

commitment law dramatically. One was O'Connor v. Donaldson,

18

which held that in order to commit a person involuntarily, the 

state must prove that a mentally ill person was "dangerous to 

himself or others": 

The modern history of involuntary commitment began 

with the Supreme Court decision in O'Connor v. 

Donaldson in 1975. Donaldson, diagnosed with paranoid 

schizophrenia, was kept in a state-run mental hospital 

for nearly fifteen years following an involuntary 

commitment initiated by his father. He repeatedly 

asked for his release, arguing that he was not being 

treated for his mental condition and did not pose a 

danger to himself or others.

The Supreme Court agreed, holding that in order to 

constitutionally commit and confine an individual, the 

state must show that the person is dangerous to 

himself or others and that they are not capable of 

living safely under the supervision of family or 

friends.

 

17 Lessard v. Schmidt, 349 F. Supp. 1078 (E.D. Wis. 

1972) (vacated and subsequently reinstated). 

18 O'Connor v. Donaldson, 422 U.S. 563 (1975).
No. 2013AP1638-FT 

16

Dan Moon, The Dangerousness of the Status Quo: A Case for 

Modernizing Civil Commitment Law, 20 Widener L. Rev. 209, 212 

(2014) (footnotes omitted).

¶25 The other was Lessard v. Schmidt,

19 a Wisconsin case 

that established substantive and procedural rights for those 

undergoing commitment procedures. In that case, a federal 

three-judge panel held that in order to satisfy due process 

guarantees, persons subject to involuntary commitment 

proceedings were entitled to written and oral notice of various 

rights, a probable cause hearing within a limited period of time 

with appointed counsel, written notice of the final hearing, and 

a full hearing within 14 days of the original detention. 

¶26 The case is regarded as groundbreaking. The Wisconsin 

Supreme Court called the change resulting from Lessard

"radical":

 

19 The case has a complicated procedural history, but the 

substance of its holding was never overruled; the original order 

was altered to add more specificity and ultimately reinstated. 

The first order, Lessard v. Schmidt (Lessard I), 349 F.Supp. 

1078 (E.D. Wis. 1972), generally held that the state's existing 

involuntary commitment statutory scheme was unconstitutional. 

When the order was appealed, the United States Supreme Court

held that the injunctive relief granted needed to be specific 

and remanded to the district court for that purpose. Lessard 

II, 414 U.S. 473 (1974)). On remand, in Lessard III, 379 

F.Supp. 1376, 1380-82 (E.D. Wis. 1974), the district court 

stated the injunctive relief from its original order in more 

specific terms. When the case was again appealed, the United 

States Supreme Court remanded for further consideration in light 

of another recently decided case. Lessard IV, 421 U.S. 957 

(1975). On remand, the district court reinstated the prior 

order of the court. Lessard V, 413 F.Supp. 1318 (E.D. Wis. 

1976).
No. 2013AP1638-FT 

17

Wisconsin law regarding the institutionalization of 

the mentally disabled underwent radical change with 

the landmark federal district court decision in 

Lessard v. Schmidt, in which Wisconsin's involuntary 

civil commitment law was held unconstitutional. In 

response to Lessard, the legislature enacted three new 

civil commitment laws . . . [including] one for 

persons who are acutely mentally ill . . . . [T]hese 

laws authorize court ordered institutionalization of 

mentally disabled individuals for the purpose of care 

and custody.

Watts v. Combined Cmty. Servs. Bd. of Milw. Cnty., 122 Wis. 2d 

65, 72, 362 N.W.2d 104 (1985) (citations omitted). But the 

changes reverberated far beyond Wisconsin. "Lessard's legal 

model launched a sweeping trend toward stricter commitment 

criteria and greater procedural protection not only in the 

courts, but in the state legislatures as well." Ronald L. 

Wisor, Jr., Community Care, Competition and Coercion: A Legal 

Perspective on Privatized Mental Health Care, 19 Am. J.L. & Med. 

145, 150 (1993). 

Passage of . . . statutes [encouraging community 

treatment rather than institutionalization] coincided 

with several court decisions that elaborated the 

substantive and procedural due process rights of 

individuals subject to civil commitment. . . . [T]he 

most significant of these cases is Lessard v. Schmidt, 

a 1972 Wisconsin federal district court decision that 

sparked a nationwide transformation in civil 

commitment statutes.

Mossman, supra at 373-376 (footnotes omitted).

¶27 Lessard's requirements have generally stood the test 

of time, although the burden of proof it imposed was lowered in 

a subsequent case by the United States Supreme Court to the 
No. 2013AP1638-FT 

18

"clear and convincing evidence" standard.20 Addington v. Texas, 

441 U.S. 418, 419-20 (1979).

B. What it Takes to Satisfy the Wisconsin Statute's

Requirement of Dangerousness

¶28 As noted, Wisconsin involuntary commitment statutes, 

which did not previously contain a requirement of dangerousness, 

were accordingly revised. Wisconsin Stat. § 51.20, the 

 

20 The United States Supreme Court's analysis on the issue 

is summarized thus:

The question of what standard of proof courts should 

apply to satisfy the Due Process Clause of the 

Fourteenth Amendment in an involuntary civil 

commitment proceeding remained unanswered until the 

Supreme Court addressed the issue in Addington v. 

Texas, 441 U.S. 418, 419-20, 432-33 (1979). . . . The 

Court balanced the individual's interest in not being 

involuntarily committed for an open-ended period of 

time against the state's interest in confining the 

dangerous mentally ill. The Court carefully considered 

the criminal standard of proof of "beyond a reasonable 

doubt" but rejected that standard, finding it 

practically impossible to prove in the context of the 

uncertain and imperfect character of psychiatric 

diagnosis. The Court similarly rejected the 

"preponderance of the evidence" standard as too 

minimal to satisfy due process requirements, given the 

serious deprivation of freedom involved in the 

involuntary civil commitment process. Instead, the 

Court held that the intermediate standard of "clear 

and convincing" satisfies due process requirements in 

cases of involuntary civil commitment.

Alison Pfeffer, "Imminent Danger" and Inconsistency: The Need 

for National Reform of the "Imminent Danger" Standard for 

Involuntary Civil Commitment in the Wake of the Virginia Tech 

Tragedy, 30 Cardozo L. Rev. 277, 285-86 (2008) (citations 

omitted).
No. 2013AP1638-FT 

19

involuntary commitment statute, requires the county to prove by 

clear and convincing evidence that the individual whose 

commitment is sought is mentally ill and is a proper subject for 

treatment, and that the person is dangerous to himself or 

herself, or others. Wis. Stat. §§ 51.20(1)(a)1., (1)(a)2.

¶29 The statute identifies five ways the county can meet 

its burden to prove dangerousness, two of which are relevant 

here. (As previously noted, Michael does not contest that he 

meets the first qualification for commitment, that he is 

mentally ill and a proper subject for treatment.)

¶30 The County can demonstrate that "[t]he individual is 

dangerous because he or she . . . [e]vidences a substantial 

probability of physical harm to himself or herself as manifested 

by evidence of recent threats of or attempts at suicide or 

serious bodily harm." Wis. Stat. §51.20 (1)(a)2.a. 

¶31 The County can also demonstrate dangerousness by 

showing clear and convincing evidence of a pattern of acts 

showing such impaired judgment that he was dangerous to himself:

The individual is dangerous because he or she . . . 

[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. The 

probability of physical impairment or injury is not 

substantial under this subd. 2. c. if reasonable 

provision for the subject individual's protection is 

available in the community and there is a reasonable 

probability that the individual will avail himself or 

herself of these services, if the individual may be 

provided protective placement or protective services 

under ch. 55 . . . . 

Wis. Stat. §51.20 (1)(a)2.c.
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C. Whether Credible Evidence Supported the Commitment Under 

2.a., Relating to Threats of Suicide or Self-harm

¶32 The first of Michael's challenges is to the jury's 

verdict that the evidence was sufficient to find him dangerous 

if that is demonstrated under the (1)(a)2.a. standard, which 

bases dangerousness on "recent threats of . . . suicide or 

serious bodily harm." The evidence that he answered "yes" when 

he was asked if he was suicidal is not evidence of a recent 

threat of suicide, he contends, because thoughts are not threats 

and because he took no act in furtherance of the thoughts. He 

points to the common definition of "threat" cited in State v. 

Perkins, "an expression of an intention to inflict injury,"21 and 

argues that his statements fall short of expressing "an 

intention." He cites to two cases to illustrate the contrast 

between specific intentional plans and a lack of evidence of 

specific dangerous conduct. In support of the former, he cites 

R.J. v. Winnebago County, 146 Wis. 2d 516 (Ct. App. 1988), in 

which the court held that graphic threats to seriously harm 

another person were sufficient to support involuntary commitment 

even if the intended person was unaware of the threat. As an 

illustration of the latter, he cites to Milwaukee County v.

Cheri V., unpublished slip op. (Ct. App., Dec. 18, 2012), which 

held that evidence was insufficient on the dangerousness prong 

where all the evidence showed was that the person was upset,

 

21 Perkins, 243 Wis. 2d 141, ¶43.
No. 2013AP1638-FT 

21

angry, and agitated but made no statements regarding harm to 

herself or others.22 

¶33 The County argues that the evidence on this point was 

sufficient to support the verdict. It argues that the four 

witnesses were credible. It notes that he answered that he was 

suicidal, and in a separate conversation he told police he 

wanted to harm himself, and those answers did constitute 

evidence of a threat of suicide or serious bodily harm. The 

County notes that in addition to the narrow definition of 

"threat" discussed by Michael, the word has common meanings that 

are more broad, such as "an indication of impending danger or 

harm." It also argues that in response to his mother's question 

about a suicide plan, it would have been reasonable to expect 

him to deny having a plan, if that were the case; instead, his 

answers were evasive, and he fled the room. The County argues 

that a narrow interpretation of the word "threat" would 

undermine the purposes of the involuntary commitment statute by 

limiting such commitments to situations where a person 

articulates a clear intention of plans for self-harm.

 

22 Michael also cites to two involuntary commitment cases 

from the Oregon Court of Appeals as instructive. Michael does 

not address the fact that the statutes involved, Oregon Rev. 

Stats. §§ 426.005 and 426.130, differ significantly from the 

Wisconsin statute; the statute does not provide what constitutes 

grounds for a finding of dangerousness, for example, so there is 

no provision comparable to the ones we consider here. For that 

reason the cases are of little help in interpreting the 

provision concerning threats of self-harm in Wis. Stat. § 51.20.
No. 2013AP1638-FT 

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¶34 As noted, the statute does not define "threat." 

Perkins merely recited a common meaning of the word in contrast 

to the more narrow meaning given to it in a particular criminal 

statute; therefore, that case provides little guidance for 

purposes of defining "threat" in this context. The ordinary 

definitions of threat include "an indication of impending danger 

or harm," and under that definition, the jury could reasonably 

have considered Michael's statements to be threats. 

¶35 As the County correctly points out, one of the 

purposes of Chapter 51 is to facilitate treatment for the 

dangerous mentally ill who will benefit from it. It would be 

unreasonable to expect a person who is in a poor or confused 

mental state to be capable of making a clear and coherent 

statement of intention of what his or her plans are. Doing so

would render the statute unworkable for the very people for whom 

it is designed. 

¶36 Michael did undisputedly acknowledge that he was 

suicidal. The meaning of "suicidal," according to mental health 

professionals and established instruments for treatment, 

encompasses both suicidal ideation that is without intent and 

suicidal ideation that is made with intent to harm. The 

Columbia Suicide Severity Rating Scale (C-SSRS)23 is a 

 

23 The Columbia Suicide Severity Rating Scale (C-SSRS)

"involves a series of probing questions to inquire about 

possible suicidal thinking and behavior." 3 Draft Guidance For 

Industry Suicidality: Prospective Assessment Of Occurrence In 

Clinical Trials, Food and Drug Administration, Center for Drug 

Evaluation and Research (September 2010). 
No. 2013AP1638-FT 

23

questionnaire in extensive use by mental health professionals to 

assess suicide risk. In the category of "suicidal ideation," 

the scale lists five categories, some without intent to act and 

some with intent to act: "wish to be dead," "suicidal thoughts," 

"suicidal thoughts with method (but without specific plan or 

intent to act)," "suicidal intent (without specific plan)," and 

"suicidal intent with specific plan." There is extensive debate 

in the mental health treatment community about how to predict 

which suicidal patients are at highest risk of killing 

themselves.24 It is within the realm of ordinary experience that 

some suicidal people have an intent to follow through and harm 

themselves and others do not. The jury could have drawn the 

inference from Michael's statement and the other evidence 

presented that he was not making a "threat of suicide or bodily 

harm." But it did not draw that inference. 

¶37 We see no reason to hold that an articulation of a 

specific plan is necessary in order to constitute a threat for 

purposes of this statute. Therefore, we conclude that the 

 

24 The challenge posed by the lack of useful, universal 

nomenclature for the study and prevention of suicide was 

discussed in one seminal academic writing that noted what it 

called "a basic, almost incredible reality: Despite hundreds of 

years of writing and thinking about suicide, and many decades of 

focused suicide research, there is to this day no generally 

accepted nomenclature for referring to suicide-related 

behaviors——not even at the most basic, conversational level." 

Patrick W. O'Carroll, et al., 238 Beyond the Tower of Babel: A 

Nomenclature for Suicidology, Suicide and Life-Threatening 

Behavior, Vol. 26(3), Fall 1996.
No. 2013AP1638-FT 

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verdict as to the basis in Wis. Stat. § 51.20 (1)(a)2.a. is 

supported by credible evidence and we will not disturb it.

D. Whether Credible Evidence Supported the Commitment Under 

2.c., Relating to a Pattern of Acts Indicating Impaired Judgment

¶38 Wisconsin Stat. § 51.20 (1)(a)2.c., the second grounds 

for dangerousness relevant here, states:

The individual is dangerous because he or she . . . 

[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. The 

probability of physical impairment or injury is not 

substantial under this subd. 2. c. if reasonable 

provision for the subject individual's protection is 

available in the community and there is a reasonable 

probability that the individual will avail himself or 

herself of these services, if the individual may be 

provided protective placement or protective services 

under ch. 55 . . . .

The question is therefore whether the evidence was sufficient to 

support the jury's finding that Michael was dangerous to himself 

if that finding was based on facts demonstrating that he had 

shown "such impaired judgment, manifested by evidence of a 

pattern of recent acts or omissions, that there [was] a 

substantial probability of physical impairment or injury to 

himself or herself." 

¶39 We repeat the evidence noted above that the jury heard 

about Michael's behavior because in this case, the same evidence 

supporting the finding of dangerousness demonstrated under 

(1)(a)2.a. also supports a finding of dangerousness demonstrated 

under (1)(a)2.c. because the pattern of his paranoia and 
No. 2013AP1638-FT 

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increasing distress is relevant to both ways of demonstrating 

dangerousness:

- He had made repeated statements to his mother and sister 

that "nobody's safe."

- He had acknowledged that he was suicidal to a nurse and 

made ambiguous statements about being suicidal to his 

mother.

- He had acknowledged to a police officer that he wanted to 

harm himself.

- He had delusional behavior and behaved in a paranoid 

manner, stating to his mother that she and his father 

should not sleep at home because unnamed persons were after 

him and would also be after them.

- He owned a knife that he had received that week as a 

belated Christmas gift and usually carried it with him.

- He had access to guns.

- He had walked with a young child through the snow for two 

miles based on his fear that one of his sisters was in 

danger.

- He had purchased several cell phones and explained that 

he did so to avoid being tracked by unnamed persons; he had 

thrown one phone out the car window believing it to be 

bugged.

- He had been unable to sleep.

- He had repeatedly told his mother that his head was not 

right and that he could not think straight and was lonely 

and sad.
No. 2013AP1638-FT 

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- He had refused medication, and according to a doctor who 

examined him, he "could [be dangerous] without treatment."

¶40 Michael argues that the only pattern of recent acts 

was the repeated trips to the hospital to seek help. But as the 

facts recited above make clear, other inferences could also be 

drawn about patterns of recent acts that week. The jury was not 

obligated to see only the pattern Michael describes. Jurors 

might reasonably have seen a pattern of delusional paranoia, a 

pattern of telling family members that people were out to get 

him, a pattern of refusing medication and rejecting medical 

treatment, a pattern of telling people that something was wrong 

with his head, and so on. Based on the testimony they heard 

about the week's events, there was credible evidence from which 

jurors could conclude that Michael's symptoms were worsening and 

he was becoming distressed to the point that there was a 

substantial probability of injury to himself——the testimony of 

Michael's mother, for instance, made clear that the statement he 

made to the nurse was the first time he had ever spoken of 

suicide.

¶41 We also note that this provision of the statute makes 

an exception for a person exhibiting such judgment 

"if . . . there is a reasonable probability that the individual 

will avail himself . . . of [community] services." Wis. Stat. 

§ 51.20(1)(a)2.c. Although there was evidence of Michael's 

repeated trips to the hospital during the week, there was also 

overwhelming evidence that he was unwilling to take medication 

and to avail himself of the help that was offered. The evidence 
No. 2013AP1638-FT 

27

showed that on three occasions he left after going to a hospital 

without accepting medication. The evidence showed that on the 

fourth visit to a hospital, he left almost immediately, 

following an intake interview, before a doctor or crisis worker 

could be summoned. We decline to hold that, as a matter of law, 

merely going to a hospital and declining help satisfies the 

statute's exception concerning a person's willingness to avail 

himself of community services; nor does Michael assert that we 

should. 

¶42 Viewing the evidence most favorably to the jury 

verdict, we conclude that credible evidence supports the verdict 

if dangerousness is based on the grounds stated in Wis. Stat. 

51.20(1)(a) 2.c.

IV. CONCLUSION

¶43 We conclude that an articulated plan is not a 

necessary component of a suicide threat. If we were to hold 

otherwise, it would require a person in a confused mental state 

to articulate a plan before obtaining treatment through 

involuntary commitment. That would write into the statute a 

potential barrier to treatment that is inconsistent with its 

purpose. We also conclude that the evidence was sufficient to 

support Michael's involuntary commitment because credible 

evidence existed in the record supporting inferences that there 

was a substantial probability that he was dangerous to himself 

within the meaning of Wis. Stat. §§ 51.20(1)(a)2.a. and 

(1)(a)2.c. 
No. 2013AP1638-FT 

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¶44 Ultimately, our conclusion is dictated by the 

deferential review of jury verdicts. In such cases, we view the 

evidence in a light most favorable to the jury's determination. 

The jury could have drawn another inference from the evidence, 

but the one it did draw was supported by credible evidence. We 

will not strike down a jury verdict where we see "credible 

evidence in the record on which the jury could have based its 

decision,"25 and we "accept the particular inference reached by 

the jury."26 In light of that standard, we affirm the court of 

appeals. 

By the Court.—Affirmed

 

 

25 Morden, 235 Wis. 2d 325, ¶39.

26 Id.
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