Notice: This opinion is subject to correction before publication in the PACIFIC REPORTER. 

Readers are requested to bring errors to the attention of the Clerk of the Appellate Courts, 

303 K Street, Anchorage, Alaska 99501, phone (907) 264-0608, fax (907) 264-0878, email 

corrections@akcourts.gov. 

THE SUPREME COURT OF THE STATE OF ALASKA 

In the Matter of the Necessity for the 

Hospitalization of 

DOMINIC N. 

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Supreme Court No. S-18282 

Superior Court No. 3AN-21-02585 PR 

O P I N I O N 

No. 7696 – April 26, 2024 

Appeal from the Superior Court of the State of Alaska, Third 

Judicial District, Anchorage, Gregory Miller, Judge. 

Appearances: Claire De Witte, Assistant Public Defender, 

and Samantha Cherot, Public Defender, Anchorage, for 

Dominic N. Laura Fox, Senior Assistant Attorney General, 

Anchorage, and Treg R. Taylor, Attorney General, Juneau, 

for State of Alaska. 

Before: Maassen, Chief Justice, and Carney, Borghesan, and 

Henderson, Justices. [Pate, Justice, not participating.] 

CARNEY, Justice. 

INTRODUCTION 

 A man appeals his involuntary civil commitment for mental health 

treatment. He argues that the State failed to prove that he was mentally ill as defined 

by statute and that his diagnoses were the type of intellectual and developmental 

disabilities excluded from the definition. Because there was clear and convincing 
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evidence that he suffered from mental illness that is more than his excluded disabilities,

we affirm the superior court’s order.

FACTS AND PROCEEDINGS

A. Facts

Dominic N.1 has been repeatedly charged with sexual abuse of a minor. 

He has been sent to the Alaska Psychiatric Institute (API) “numerous times” to attempt

to regain competency to stand trial in the criminal cases, but each time has been deemed 

incompetent to stand trial. Dominic was also previously committed to API following a 

civil proceeding in 2015. 

Dominic has been diagnosed with numerous mental health and behavioral 

conditions as a child and as an adult. These include childhood diagnoses of oppositional 

defiant disorder and attention-deficit/hyperactivity disorder, and adult diagnoses of 

major depressive disorder, selective mutism, other specified neurodevelopmental 

disorder associated with prenatal alcohol disorder, fetal alcohol spectrum disorder, and 

borderline intellectual functioning. 

In 2020 Dominic was charged with sexual abuse of a minor. Following a

2021 court-ordered competency examination,2a forensic examiner determined he was 

not competent to stand trial. The superior court held a competency hearing and found 

him mentally incompetent. The court ordered his commitment to API for further 

evaluation and restoration in July 2021.

3 While at API for competency restoration, 

Dominic was diagnosed with an additional intellectual disability, alcohol and cannabis 

1 We use a pseudonym to protect the appellant’s privacy. 

2 See AS 12.47.100(b) (authorizing court to “have the defendant examined 

by at least one qualified psychiatrist or psychologist, who shall report to the court 

concerning the competency of the defendant”).

3 See AS 12.47.110(a) (providing that upon finding defendant incompetent 

to stand trial, court “shall commit a defendant charged with a felony . . . for further 

evaluation and treatment until the defendant is mentally competent to stand trial”).
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use disorders, and antisocial personality disorder, and provisionally diagnosed with an

unspecified paraphilic disorder.4

B. Proceedings

In November 2021 the State petitioned for an order authorizing Dominic’s 

evaluation to determine whether he was mentally ill and as a result was likely to cause 

harm to others.

5 The superior court granted the petition. In addition to the allegations 

in the petition, the court relied on testimony from the petitioner, findings related to 

competency in Dominic’s criminal case, and the presumption per AS 12.47.110(e)6that 

Dominic presented a likelihood of serious harm to self or others. 

API staff filed a petition for 30-day civil commitment a few days later.

7

A superior court master conducted a hearing at which two witnesses testified on behalf 

of API: a psychologist and Dominic’s treating psychiatrist. Each was qualified as an 

expert in their respective fields. 

4 Paraphilic disorders are a category of mental disorders involving sexual 

behaviors that “make[] the person a serious threat to the psychological and physical 

well-being of other individuals.” Paraphilic Disorders, AMERICAN PSYCHIATRIC 

ASSOCIATION (2013), https://www.psychiatry.org/File%20Library/Psychiatrists/

Practice/DSM/APA_DSM-5-Paraphilic-Disorders.pdf.

5

 See AS 47.30.700(a)-(b) (outlining process for petitioning superior court 

for order authorizing hospitalization of individual for full evaluation of whether 

individual meets civil commitment criteria and addressing petition’s requirements); 

AS 47.30.710 (requiring mental health professional to perform emergency examination 

within 24 hours of respondent’s detention under AS 47.30.705 and to apply for ex parte

order authorizing hospitalization for evaluation under AS 47.30.700 if one has not yet 

been obtained).

6 AS 12.47.110(e) (“A defendant charged with a felony and found to be 

incompetent to proceed under this section is rebuttably presumed to be mentally ill and 

to present a likelihood of serious harm to self or others in proceedings under 

AS 47.30.700 – 47.30.915.”).

7 AS 47.30.730 (setting out procedure for health care professionals 

conducting mental health evaluation under AS 47.30.710 to file petition for 30-day 

commitment for treatment). 
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The psychologist testified that she conducted forensic evaluations of 

Dominic in September and November 2021. She testified that she had also considered 

the records from Dominic’s previous competency evaluations and his previous and 

ongoing admissions to API. The psychologist diagnosed Dominic with other specified 

neurodevelopmental disorder potentially due to prenatal alcohol exposure, borderline 

intellectual functioning, and alcohol use disorder. She testified that Dominic was 

incompetent to stand trial because he “rationally didn’t seem to understand” the judicial 

process or appreciate the severity of his charges. 

Dominic’s psychiatrist testified that he probably had more opportunity to 

observe and interact with Dominic than the psychologist. The psychiatrist agreed with 

the psychologist’s diagnoses and testified that he would add diagnoses of “impulse 

control disorder separate from developmental delay” and pedophilic disorder. On 

cross-examination the psychiatrist testified that Dominic’simpulse control disorder was 

not a developmental disability.

The master recommended that Dominic be committed to API for 30 days.

The master found that Dominic’s diagnoses included both developmental disabilities 

and mental illnesses, and that the doctors’ testimony showed that Dominic “certainly

does have some mental illness.” The master also found that the State had presented

clear and convincing evidence that Dominic continued to pose a serious risk of harm to 

others, and that there was a nexus between his mental illnesses — specifically “some 

intellectual impairments and impulse control” — and the risk of harm that he posed. 

And the master found that the State had met its burden of demonstrating that 

commitment to API was the least restrictive option available. 

Dominic objected to the master’s findings, arguing that he was not 

“mentally ill” as defined by statute and that the State had failed to prove by clear and 

convincing evidence that he was likely to cause harm to others. After the State replied,

the superior court reviewed both sides’ arguments and the recording of the hearing 

before the master. The superior court adopted the master’s recommendations and
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ordered Dominic committed to API for 30 days. It found that Dominic was mentally 

ill and was likely to cause harm to others. The superior court based its finding that 

Dominic was mentally ill on both doctors’ testimony, specifically referring to the 

psychiatrist’s additional diagnoses of impulse control disorder and pedophilic disorder. 

The superior court order noted “a nexus between [Dominic’s] mental 

illnesses (including intellectual impairments) and risk of harm to others.” It concluded 

that he continued to pose a risk of harm “because he is impulsive and lacks insight” into 

“the severity of his conduct towards young girls.” The court also listed Dominic’s “poor 

problem solving, antisocial behavior, deviant sexual propensities, social skill deficits 

and lack of remorse” as factors that heightened the risk of harm that Dominic presented, 

and pointed to statements Dominic had made during evaluations and to staff at API as 

further indication of the risk. The court noted that Dominic required treatment for 

impulse control and that he was unlikely to take medication on his own. The court 

agreed with the master’s findings and ordered Dominic’s commitment.

Dominic appeals. He argues that the State did not prove that his symptoms 

were the result of mental illness rather than an intellectual or developmental disability. 

STANDARD OF REVIEW

“We review the superior court’s factual findings in involuntary 

commitment or medication proceedings for clear error.”

8 We will disturb those findings 

only where there is a “definite and firm conviction that a mistake has been made.”9 We

will not reweigh evidence if the record supports the trial court’s finding.10 “[W]hether 

8

In re Hospitalization of Naomi B., 435 P.3d 918, 923 (Alaska 2019).

9

Id. (quoting In re Hospitalization of Jacob S., 384 P.3d 758, 764 (Alaska 

2016)).

10 In re Jacob S., 384 P.3d at 766.
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those findings meet the statutory requirements for involuntary commitment or 

medication is a question of law to which we apply our independent judgment.”

11

DISCUSSION

A. There Was Clear And Convincing Evidence That Dominic Was 

Mentally Ill.

1. Statutory background

A court may commit a respondent to a treatment facility for up to 30 days 

“if it finds, by clear and convincing evidence, that the respondent is mentally ill and as 

a result is likely to cause harm to the respondent or others.”12 Evidence is clear and 

convincing if it produces “a firm belief or conviction about the existence of a fact to be 

proved.”13 We have characterized this standard as “evidence that is greater than a 

preponderance, but less than proof beyond a reasonable doubt.”14 

Alaska law also establishes a rebuttable presumption under which a 

criminal defendant charged with a felony and found incompetent to stand trial is 

presumed to be mentally ill and pose a risk of harm to self or others.15 The defendant 

may rebut the presumption by clear and convincing evidence that the defendant is “not 

presently suffering from any mental illness that causes [them] to be dangerous to the 

public.”16

11 In re Naomi B., 435 P.3d at 923-24.

12 AS 47.30.735(c).

13 In re Hospitalization of Luciano G., 450 P.3d 1258, 1262-63 (Alaska 

2019).

14 Id. at 1263.

15 AS 12.47.110(e).

16 AS 12.47.090(c); see Palmer v. State, 379 P.3d 981, 988 (Alaska App. 

2016).
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2. Clear and convincing evidence of mental illness 

After the superior court determined that Dominic was incom

d the involuntary commitment process by filing a petition for e

petent, the 

State initiate valuation, 

which was granted based upon the statutory presumption. Following its evaluation of 

Dominic, API filed a petition for civil commitment. After a hearing on the petition, the 

superior court concluded that the expert testimony provided clear and convincing 

evidence that Dominic was mentally ill.

17 Dominic was committed and now appeals.

Because we agree there was clear and convincing evidence that Dominic suffered from

mental illness, we need not reach the question of whether Dominic successfully rebutted 

the statutory presumption.18

Dominic argues that the State failed to prove that he was mentally ill as 

defined by former AS 47.30.915(14).19 That statute defines mental illness as: 

an organic, mental, or emotional impairment that has substantial adverse 

effects on an individual’s ability to exercise conscious control of the 

individual’s actions or ability to perceive reality or to reason or 

understand; intellectual disability, developmental disability, or both, 

epilepsy, drug addiction, and alcoholism do not per se constitute mental 

illness, although persons suffering from these conditions may also be 

suffering from mental illness[.]

Dominic asserts that all of his diagnoses are intellectual or developmental disabilities, 

which do not per se constitute mental illness. 

17 The superior court did not refer to or rely on the statutory presumption in 

making this finding. 

18 Dominic also raised a cursory substantive due process argument against 

applying the statutory presumption of mental illness in a footnote in his reply brief. 

This argument was waived for inadequate briefing. See Hagen v. Strobel, 353 P.3d 799, 

805 (Alaska 2015) (“Where a point is given only a cursory statement in the argument 

portion of a brief, the point will not be considered on appeal.” (internal brackets 

omitted)).

19 The definition of mental illness (which has not changed) is now provided 

in AS 47.30.915(17). 
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Dominic questioned both experts about their diagnoses. In response the 

psychiatrist testified that at least one of the diagnoses, impulse control, was not a 

developmental disability, that “it can be a separate thing,” but that it was “probably 

related in some sense” to one or more of his developmental disabilities. The court 

concluded that although Dominic “does have some developmental disabilities that may 

or may not qualify per se as mental illnesses . . . there are some other mental illnesses, 

particularly the impulse control disorder among some others . . . that are mental 

illnesses that could be treated.” 

Dominic argues that the evidence was not sufficient to prove by clear and 

convincing evidence that he was mentally ill. The State responds by pointing to the 

expert testimony that Dominic is mentally ill and suffers from a number of intellectual 

and developmental disabilities. 

Mental illness in involuntary commitment proceedings is generally 

established by expert testimony from the mental health professional who treated and 

often diagnosed the respondent or confirmed the diagnosis.20 The treating 

professional’s testimony, especially when based on personal interactions with the 

respondent, is critical.21

20 See, e.g., In re Hospitalization of Joan K., 273 P.3d 594, 599 (Alaska 

2012); In re Hospitalization of Jacob S., 384 P.3d 758, 762 (Alaska 2016); In re 

Hospitalization of Tracy C., 249 P.3d 1085, 1087 (Alaska 2011); In re Hospitalization 

of Naomi B., 435 P.3d 918, 921-22 (Alaska 2019); In re Hospitalization of Jonas H., 

513 P.3d 1019, 1021 (Alaska 2022).

21 Compare In re Naomi B., 435 P.3d at 932 (upholding 30-day commitment 

order because treating physician’s uncontroverted testimony was sufficient to support 

a finding of grave disability), and In re Hospitalization of Marvin S., 2019 WL 2880963 

at *6 n.20 (Alaska July 3, 2019) (rejecting respondent’s argument that order for civil 

commitment was “improperly speculative” where court relied on testimony of doctor 

who had treated respondent directly), with In re Hospitalization of Stephen O., 314 P.3d 

1185, 1195 (Alaska 2013) (reversing 30-day commitment order because the court relied 
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At Dominic’s 30-day commitment hearing, two mental health 

professionals testified about Dominic’s diagnoses. Both of them had observed and 

interacted with him on multiple recent occasions. Their diagnoses were based on these 

interactions and Dominic’s API records. They also took into account his recent 

behavior, including reports of Dominic’s threats and inappropriate behavior with other 

patients and API staff treating him during his current stay. 

Dominic suffers from a number of conditions that do not meet the 

statutory criteria for mental illness. But the psychiatrist diagnosed him with two 

additional conditions — impulse control disorder and pedophilic disorder. The 

psychiatrist clearly identified Dominic’s impulse control disorder as distinct from his 

intellectual and developmental disabilities. When questioned by Dominic’s attorney he 

testified that the impulse control disorder was “separate from developmental delay” and 

clarified that an underlying cognitive or developmental delay was not required to have 

an impulse control disorder.

22 He also testified that not all people with developmental 

delays have impulse control disorders. And he stated that unlike underlying 

developmental or cognitive delays, which are generally untreatable, impulse control can 

be treated separately. 

Dominic argues that whether a condition can be treated does not determine

whether it falls outside the exceptions to the statutory definition of mental illness. The 

statute does not include factors to guide such a determination. But the fact that one 

disorder can be treated while another cannot helps to distinguish them from one another 

and demonstrates the separation between the two. 

on “partial and unclear” testimony based on uncorroborated hearsay accounts, which 

failed to support finding respondent gravely disabled by clear and convincing 

evidence).

22 He was not cross-examined about Dominic’s pedophilic disorder.
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Dominic also argues that the psychiatrist was “equivocal” about whether 

his impulse control disorder was distinct from a developmental disability. He focuses 

on the psychiatrist’s reluctance to agree that the diagnoses were “entirely separate” and 

suggests that the State failed to demonstrate that impulse control disorder was a 

condition “apart from, and more than,” an intellectual or developmental disability, 

quoting our language in E.P. v. Alaska Psychiatric Institute.

23 But we did not require 

that addiction or intellectual disability be entirely separate from mental illness in E.P.

24

 

There we upheld a 30-day commitment order after observing that the respondent’s brain 

damage was a condition “apart from, and more than,” his drug addiction.25 We 

explained that although E.P.’s brain damage was caused by his addiction to huffing gas, 

it was the brain damage itself that led to greatly impaired ability to exercise judgment, 

loss of perception of reality, and impaired ability to communicate, thus satisfying the 

definition of mental illness.26

In addition Dominic’s argument would expand the statutory exclusions 

beyond the language of the statute. The statute is clear that its listed conditions “do not 

per se constitute mental illness.”27 As the State correctly observes, the expert testimony 

before the court demonstrated that Dominic is mentally ill and suffers from a number 

of intellectual and developmental disabilities. 

“Per se” is a Latin term meaning “[o]f, in, or by itself; standing alone.”28 

Replacing it with its English translation in the statute makes clear that the excluded 

conditions do not by themselves, standing alone constitute mental illness. Dominic’s 

23 205 P.3d 1101, 1109 (Alaska 2009).

24 See id.

25 Id.

26 Id.

27 Former AS 47.30.915(14) (2021).

28 Per se, BLACK’S LAW DICTIONARY (11th ed. 2019).
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treating psychiatrist testified that Dominic’s underlying conditions did not in 

themselves account for his impulse control or pedophilic disorder. 

The psychiatrist testified that Dominic’s impulse control disorder and 

developmental disabilities were “probably related in some sense.” But, as in E.P., the 

relationship between his impulse control disorder and developmental disabilities does 

not mean they were the same. It suggests only that the presence of a developmental 

disorder could have contributed to the development of impulse control disorder. Taken 

as a whole, the psychiatrist’s testimony supports finding Dominic’s impulse control 

disorder was more than his developmental and intellectual disabilities, satisfying the 

statutory definition of mental illness.

The psychiatrist’s expert testimony that, although they were related, 

Dominic’s impulse control was not part of or the same as his other conditions satisfies 

the statutory command that his excluded underlying conditions per se not be the basis 

for a finding that he has a mental illness. The superior court did not clearly err by 

finding that Dominic suffered from a mental illness and, as a result, was likely to cause 

harm to others.

CONCLUSION

We AFFIRM the superior court’s order.