COURT OF APPEALS

DECISION

DATED AND FILED

May 24, 2022

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. 2021AP2046-CR Cir. Ct. No. 2008CF831

STATE OF WISCONSIN IN COURT OF APPEALS

DISTRICT I

STATE OF WISCONSIN,

PLAINTIFF-RESPONDENT,

V.

JARROD J. JOHNSON,

DEFENDANT-APPELLANT.

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

MILTON L. CHILDS, SR., Judge. Reversed and cause remanded with directions. 

Before Brash, C.J., Dugan and White, JJ. 

Per curiam opinions may not be cited in any court of this state as precedent 

or authority, except for the limited purposes specified in WIS. STAT. RULE 809.23(3). 
No. 2021AP2046-CR

2

¶1 PER CURIAM. Jarrod J. Johnson appeals an order entered by the 

trial court, in which the trial court granted a motion for his involuntary medication

and treatment pursuant to WIS. STAT. § 971.17(3) (2019-20).1 We conclude that 

the factors in Sell v. United States, 539 U.S. 166 (2003), were erroneously applied 

when the trial court granted the State’s motion.

2

 We also conclude that Johnson 

forfeited his argument that the reports3submitted by Johnson’s treating 

psychiatrist, Dr. Odette Anderson, were erroneously considered as evidence. We 

further conclude that the State failed to meet its burden to show that Johnson was 

dangerous and that Dr. Anderson provided Johnson with a reasonable explanation 

of the advantages and disadvantages of, and alternatives to, treatment with the

psychotropic medication, Haloperidol. Accordingly, we reverse the trial court’s

order, and we remand this matter with directions to deny the motion for 

involuntary medication and treatment.

BACKGROUND

¶2 Johnson was charged with arson in 2008, after he reportedly set fire 

to his apartment because he believed the government had placed cameras inside 

his apartment and was filming and monitoring him. Johnson was found not guilty 

 

1

 All references to the Wisconsin Statutes are to the 2019-20 version unless otherwise 

noted.

2

 We refer to the motion as a motion by the State. However, we recognize that the 

statute specifies that a motion of this type is one made by the “institution.” See WIS. STAT.

§ 971.17(3). In this case, Dr. Odette Anderson filed this motion as a representative of the 

Mendota Mental Health Institute (MMHI), which is an institution operated by the State.

3

 Dr. Anderson submitted two documents dealing with the motion for involuntary 

medication—one dated September 13, 2021, and one dated October 27, 2021. Dr. Anderson, 

counsel, and the trial court interchangeably refer to the documents as reports or letters. For 

consistency and ease of reading, we refer to them as reports.
No. 2021AP2046-CR

3

by reason of mental disease or defect (NGI) and committed for an indeterminate 

time, not to exceed twenty-five years. He was sent to a mental health facility for 

treatment from which Johnson was subsequently discharged on conditional release 

for the first time in 2011. His release was revoked in 2013, and Johnson was again 

placed at a mental health facility. Johnson was discharged on conditional release 

for a second time in April 2020. His second conditional release was revoked, and

Johnson was placed at MMHI starting on May 11, 2021. 

¶3 On September 13, 2021, MMHI, by Dr. Anderson, filed a motion for 

involuntary medication and treatment pursuant to WIS. STAT. § 971.17(3)(c). 

Dr. Anderson filed a corresponding report in which she described Johnson’s 

treatment history, beginning from the time he was originally committed until the 

time of her report. She further described that, since the time of Johnson’s return to 

MMHI, he had been declining recommendations to start medication, and 

Johnson’s “symptoms and concerning behaviors have been increasing in 

frequency and severity.” Dr. Anderson then provided several examples of 

Johnson’s symptoms and concerning behaviors, including threatening letters that 

Johnson had written, aggressive and hostile interactions with MMHI staff, 

incidents involving Johnson throwing his lunch tray, and urinating on the walls, 

floor, and linens in his room. Ultimately, Dr. Anderson wrote, “Mr. Johnson has a 

chronic history of poor insight into the seriousness of his illness and the 

importance of treatment with psychotropic medication. He has had a history of 

declining his prescribed psychotropic medication.” Dr. Anderson requested an 

order to involuntarily medicate Johnson because he “clearly has a disorder of 

cognition and impaired reality testing which grossly impairs his judgment.” She 

also requested an order to involuntarily medicate Johnson because he “is not 

capable of repeating back information presented to him regarding the risk, 
No. 2021AP2046-CR

4

benefits, and alternatives to taking medication,” and she stated that Johnson “is not 

capable of applying this information to his current situation.” 

¶4 The trial court set the motion for a hearing. When the hearing was 

rescheduled, Dr. Anderson sent a supplemental report to the trial court on 

October 27, 2021, in which she requested a new hearing date as a result of her 

increasing concerns over what she described as Johnson’s deteriorating condition. 

In her report, Dr. Anderson explained that Johnson had begun to decline his meals, 

was not eating, and had been placed on suicide watch. Thus, she requested that 

the court reschedule the hearing for an earlier date so that she may be able to treat 

Johnson as soon as possible. 

¶5 The trial court held a hearing on November 9, 2021, at which 

Dr. Anderson testified. Dr. Anderson testified that she began treating Johnson in 

August 2021 and they had been meeting “sometimes on a monthly basis” but 

“usually on a weekly or more frequent basis.” In all, she estimated that she had 

met with Johnson approximately twenty times. Based on these meetings and a 

review of Johnson’s treatment records, Dr. Anderson diagnosed Johnson with 

schizoaffective disorder, bipolar type. 

¶6 She further testified that although she had prescribed a psychotropic 

medication—Haloperidol—to treat Johnson’s condition,4 he had not been on 

medication since he arrived back at MMHI in May. She testified that Johnson had 

refused to take the medication that she had prescribed. Dr. Anderson 

 

4

 Dr. Anderson testified that Johnson had not been prescribed Haloperidol before, but he 

had been on other medications in the same class as Haloperidol that have been successful at 

treating his condition. 
No. 2021AP2046-CR

5

acknowledged that Johnson was currently being treated with certain alternatives to 

medication; however, she anticipated that Johnson would not demonstrate any 

improvement without taking a medication. 

¶7 Some of the alternatives that Dr. Anderson described included using 

restraints and seclusion in order to control Johnson’s behaviors and calm him 

down over an eighteen hour period in August 2021. She also described a method 

she called “show of force,” in which staff make their presence known to a patient 

in order to de-escalate a situation before other methods, such as restraints or 

seclusion, would become necessary. She similarly described another method 

called “chill time” where staff would send a patient to his or her room to calm 

down and de-escalate a situation. She further testified that it had been months 

since Johnson had been restrained and secluded because staff were able to 

successfully intervene using “show of force” and “chill time” methods before 

Johnson’s behavior escalated. Despite these methods, Dr. Anderson was of the 

opinion that there was not any other less intrusive means than medication to 

restore Johnson to where he was before, and she testified that Johnson “has 

required a lot of these types of interventions.” 

¶8 Overall, she described Johnson’s mental state as declining, and she 

based her description of Johnson’s mental state on Johnson’s symptoms of 

psychosis and significant mood symptoms. She also testified that Johnson had 

recently been “declining oral intake” and, even though the situation had improved, 

that has been one of her primary concerns. She further acknowledged the

threatening letters Johnson had written, but she testified that there was little risk 

that those letters posed a harm to others as a result of Johnson’s current placement 

at MMHI. 
No. 2021AP2046-CR

6

¶9 At the conclusion of Dr. Anderson’s testimony, both parties argued 

their respective positions under the Sell factors, and the trial court summarized the

testimony from Dr. Anderson and granted the motion for involuntary medication.

5

 

In the amended order for placement filed after the hearing, the trial court 

additionally checked the box on the form that it found that the involuntary 

administration of medication was needed because Johnson was not competent to 

refuse medication or treatment as a result of his mental illness, which rendered 

him “incapable of expressing an understanding of the advantages and 

disadvantages of accepting psychotropic medication or treatment and the 

alternatives.” Johnson now appeals.6 

DISCUSSION

I. Application of the Sell Factors to Johnson’s Case

¶10 As a threshold matter, we address the application of the Sell factors 

to the motion for involuntary medication and treatment that were applied below. 

On appeal, the State argues that the Sell factors do not apply to a motion for 

involuntary medication and treatment within the context of a commitment 

following a NGI finding, but rather, the analysis in this case must proceed under 

 

5

 We pause to note the lack of findings in the hearing transcript. As will be explained 

below, particularly in light of the detail described in Outagamie County v. Melanie L., 2013 WI 

67, 349 Wis. 2d 148, 833 N.W.2d 607, as necessary for the involuntary medication and treatment 

of a person, the trial court must do more than merely summarize the witness’s testimony, and it 

must make specific factual findings and then explain why those facts meet the standard for 

involuntary medication.

6

 Johnson filed a motion for conditional release prior to the filing of the motion 

requesting an order for involuntary medication and treatment. Johnson withdrew his motion for 

conditional release at the conclusion of the hearing addressing the motion for involuntary 

medication and treatment. Johnson’s motion for conditional release is not at issue in this appeal.
No. 2021AP2046-CR

7

WIS. STAT. § 971.17(3). We agree, and we conclude that the application of the 

Sell factors to Johnson’s case, as an individual under a commitment order entered 

under a finding of NGI, was in error. 

¶11 Johnson was found not guilty by reason of mental disease or defect, 

and Johnson has been at MMHI as the subject of a commitment order entered 

under WIS. STAT. § 971.17(3). “After the person has been committed to an 

institution, it sometimes becomes necessary to make a decision about forcibly 

medicating him or her.” State v. Wood, 2010 WI 17, ¶31, 323 Wis. 2d 321, 780 

N.W.2d 63. When confronted with this situation, “[i]f the [S]tate proves by clear 

and convincing evidence that the committed person is not competent to refuse 

medication, the court may issue an order permitting the institution to administer 

medication and treatment without the person’s consent.” Id.; see also

§ 971.17(3)(b)-(c). The standard set forth in WIS. STAT. § 971.16(3) applies for 

determining if a committed person is not competent to refuse medication and 

treatment. Wood, 323 Wis. 2d 321, ¶31. The standard set forth in § 971.16(3) 

provides:

The defendant is not competent to refuse medication or 

treatment if, because of mental illness, developmental

disability, alcoholism or drug dependence, and after the 

advantages and disadvantages of and alternatives to 

accepting the particular medication or treatment have been 

explained to the defendant, one of the following is true:

(a) The defendant is incapable of expressing an 

understanding of the advantages and disadvantages of 

accepting medication or treatment and the alternatives.

(b) The defendant is substantially incapable of applying an 

understanding of the advantages, disadvantages and 

alternatives to his or her mental illness, developmental

disability, alcoholism or drug dependence in order to make 

an informed choice as to whether to accept or refuse 

medication or treatment. 
No. 2021AP2046-CR

8

¶12 The Sell factors, while also applicable to situations involving 

involuntary medication, have clearly been stated to apply to proceedings in which 

a criminal defendant is involuntarily medicated for purposes of restoring the 

defendant’s competency to proceed to trial.7 “In Sell, the United States Supreme 

Court addressed ‘whether the Constitution permits the Government to administer 

antipsychotic drugs involuntarily to a mentally ill criminal defendant—in order to 

render that defendant competent to stand trial for serious, but nonviolent, crimes.’” 

State v. Fitzgerald, 2019 WI 69, ¶13, 387 Wis. 2d 384, 929 N.W.2d 165 (citation 

omitted); see also State v. Green, 2021 WI App 18, ¶14 n.9, 396 Wis. 2d 658, 957 

N.W.2d 583, aff’d in part, 2022 WI 30, ___ N.W.2d ___. 

¶13 Restoring Johnson to competency for trial is not the situation that is

presented here. Instead, we address an order for involuntary medication requested 

in the context of a commitment order entered following a finding of NGI. Such a 

situation has its own procedures under WIS. STAT. § 971.17(3) that we have set 

forth above. See Wood, 323 Wis. 2d 321, ¶29 (“WIS. STAT. § 971.17(3)(c), the 

provision at issue here, specifically applies to the involuntary medication of 

persons committed after being adjudged NGI for a crime.”). Thus, the Sell factors 

were improperly applied below to evaluate the motion for involuntary medication 

given the context of Johnson’s commitment at MMHI under § 971.17(3).

¶14 Moreover, “Sell’s standard was for the involuntary medication of a 

criminal defendant incompetent to stand trial,” and there is a standard separate 

from Sell that applies to “different” purposes “related to the individual’s 

 

7

 Our supreme court described the four Sell factors in State v. Fitzgerald, 2019 WI 69, 

¶¶13-17, 387 Wis. 2d 384, 929 N.W.2d 165, and most recently in State v. Green, 2022 WI 30, 

¶¶15-16, ___ N.W.2d ___. 
No. 2021AP2046-CR

9

dangerousness, or purposes related to the individual’s own interests where refusal 

to take drugs puts his [or her] health gravely at risk.” Winnebago Cnty. v. C.S., 

2020 WI 33, ¶28, 391 Wis. 2d 35, 940 N.W.2d 875 (citations omitted). The court 

further stated that the Sell “standard will permit involuntary administration of 

drugs solely for trial competence purposes in certain instances.” Id., ¶27 (citation 

omitted). Thus, when confronted with an involuntary medication order outside of 

the context of restoring a defendant to competency, our supreme court concluded,

“This case is not controlled by the Sell ... factors. Rather, this case ... involves 

involuntary medication of an inmate for a ‘different purpose’ than competence to 

stand trial.” Id., ¶30 (emphasis in original). 

¶15 Johnson raises several arguments in response to the State’s argument 

that Sell does not apply to his case. First, Johnson argues that a finding of 

incompetence alone is constitutionally insufficient to support an order for 

involuntary medication and the failure to apply the Sell factors violates his right to 

equal protection. We reject Johnson’s arguments on these points as undeveloped 

and unsupported by legal authority. See State v. Pettit, 171 Wis. 2d 627, 646-47, 

492 N.W.2d 633 (Ct. App. 1992). Johnson also argues that judicial estoppel 

applies and requires us to reject the State’s argument. Judicial estoppel is an 

equitable rule applied at the court’s discretion, and we do not accept Johnson’s 

invitation to apply it here, given that Johnson’s argument requires us to ignore the 

law as it is correctly stated. See State v. English-Lancaster, 2002 WI App 74, 

¶18, 252 Wis. 2d 388, 642 N.W.2d 627.

¶16 Thus, having established the correct standard to apply under WIS.

STAT. §§ 971.17(3) and 971.16(3), we next address the primary issue in this case, 

namely whether the State has met its burden to show that Johnson is not competent 

to refuse medication or treatment. The application of the facts to the standard is a 
No. 2021AP2046-CR

10

question of law that this court reviews independently. See Outagamie Cnty. v. 

Melanie L., 2013 WI 67, ¶39, 349 Wis. 2d 148, 833 N.W.2d 607. 

¶17 Furthermore, in analyzing whether Johnson is not competent to 

refuse medication or treatment, we note that we must bear in mind that “a person 

competent to make medical decisions has a ‘significant’ liberty interest in 

avoiding forced medication of psychotropic drugs.” Wood, 323 Wis. 2d 321, ¶25. 

“The forcible injection of medication into a nonconsenting person’s body 

represents a substantial interference with that person’s liberty.” Melanie L., 349 

Wis. 2d 148, ¶43 (citation omitted). Thus, we start from a place where “a person 

has the right to refuse medication unless a court determines that the person is 

incompetent to make such a decision.” See id., ¶53. “Moreover, an individual is 

presumed competent to refuse medication or treatment.” Id., ¶89.

II. Dr. Anderson’s Reports Are Properly Considered as Evidence

¶18 Johnson first argues that Dr. Anderson’s two reports cannot be used 

to support the order for involuntary medication because the State never moved

them into evidence. Thus, he argues that the evidence is limited to Dr. Anderson’s 

testimony, and Dr. Anderson’s testimony is insufficient to support the motion for 

involuntary medication and treatment. We reject this contention because Johnson 

failed, despite several opportunities, to object to the use of Dr. Anderson’s reports 

below. See State v. Huebner, 2000 WI 59, ¶10, 235 Wis. 2d 486, 611 N.W.2d 

727 (“Issues that are not preserved at the circuit court, even alleged constitutional 

errors, generally will not be considered on appeal.”). A review of the record 

shows that the parties and the trial court clearly relied on the reports, and Johnson 

cannot now complain of their use without having raised the issue below.
No. 2021AP2046-CR

11

¶19 During the hearing, the State questioned Dr. Anderson regarding the

two reports that she wrote, and after confirming that she wrote them, the State 

asked the trial court to take “judicial notice” of her reports.

8

 After trial counsel 

stated that there was no objection, the trial court took judicial notice of the reports. 

Again, at the conclusion of Dr. Anderson’s testimony, the State stated that it was 

relying on Dr. Anderson’s testimony and what she filed in her two reports in 

support of its case, and trial counsel did not object. Then, in rendering its oral 

ruling, the trial court noted that it had reviewed both of Dr. Anderson’s reports in 

preparation for the hearing. At no point did trial counsel object to the use of 

Dr. Anderson’s reports during the proceedings below. Indeed, trial counsel used 

the reports in cross-examining Dr. Anderson. 

¶20 Consequently, we conclude that Johnson has forfeited any argument 

regarding the use of Dr. Anderson’s reports as evidence to support the order, and 

we conclude that the evidence is not limited to Dr. Anderson’s testimony. See 

State v. Caban, 210 Wis. 2d 597, 608, 563 N.W.2d 501 (1997). Thus, using both 

Dr. Anderson’s reports and her testimony, we turn to the question of whether the 

State met its burden to prove by clear and convincing evidence that Johnson was 

not competent to refuse medication or treatment. Even considering 

Dr. Anderson’s reports, we conclude that it has not.

 

8

 In highlighting this portion of the record, we note that one of Johnson’s arguments is 

that Dr. Anderson’s reports are not properly subject to judicial notice. As a result of our 

conclusion, we do not address whether Dr. Anderson’s reports are properly subject to judicial 

notice, and we simply provide this portion of the record as one of the several opportunities 

presented below that trial counsel had to object to the use of Dr. Anderson’s reports.
No. 2021AP2046-CR

12

III. Dangerousness

¶21 First we address whether the State introduced sufficient evidence to 

support a finding that Johnson was dangerous. Addressing the issue whether WIS.

STAT. § 971.17(3) requires a finding of present dangerousness that serves as a 

basis for a court considering whether to issue an order for involuntary medication, 

our supreme court stated, “[W]e are satisfied that WIS. STAT. § 971.17(3), at a 

minimum, implicitly provides for such a finding [of dangerousness].” Wood, 323 

Wis. 2d 321, ¶34. The court went on to state:

We reach that conclusion based on the language of 

§ 971.17(3)(a) that includes requirements for a 

determination of dangerousness at the time of commitment, 

the language of § 971.17(3)(c) requiring a doctor’s 

examination and report when an institution seeks an order 

to medicate the patient involuntarily, and the language of 

§ 971.17(4)(d) setting forth requirements for periodic 

reviews, which include a dangerousness determination. 

Id.

¶22 The court explained that the “statutory language of WIS. STAT.

§ 971.17(3)(a) requires a finding that is the equivalent of one of dangerousness at 

the time of commitment.” Id., ¶35. It noted that the statute provides “[t]he court 

shall order institutional care if it finds by clear and convincing evidence that 

conditional release of the person would pose a significant risk of bodily harm to 

himself or herself or to others or of serious property damage.” Id. (quoting 

§ 971.17(3)(a)). Further, the court noted that if the institution files a motion for an 

order for involuntary medication, “the statute further requires a licensed physician 

to examine the individual and to issue a written report indicating that the person 

‘needs medication or treatment and that the person is not competent to refuse 

medication or treatment.’” Id., ¶36 (quoting § 971.17(3)(c)). It then stated that 
No. 2021AP2046-CR

13

“[w]e are satisfied that such an assessment further encompasses an assessment of 

‘a significant risk.’” Id. Finally, the court explained that “the court must reassess 

dangerousness when the committed individual petitions for conditional release....” 

Id., ¶37.

¶23 The court then concluded that “[t]hose requirements, taken together, 

create at least an implicit finding of dangerousness, if not an express finding, that 

serves as the basis for a court to consider granting a motion for an involuntary 

medication order.” Id., ¶38. Thus, to obtain an order to involuntarily medicate 

Johnson, the State was required to show, by clear and convincing evidence, that 

Johnson was dangerous to himself or others. We note that the State does not 

dispute that it had that burden on appeal. Rather, it argues that it met that burden. 

We disagree.

¶24 In its brief on appeal, the State’s only reference to Johnson being 

dangerous is its statement that “[t]he State sought an involuntary medication order 

primarily because Johnson was trying to starve himself to death in institutional 

care.” In her report9and her testimony, Dr. Anderson indicated that Johnson was 

dangerous because he was refusing to eat and had sent threatening letters to the 

mayor of Madison, a judge, and the clerk of courts. However, Dr. Anderson also 

acknowledged that Johnson was now taking one or two meals a day, plus some 

snacks from MMHI’s canteen, and was no longer losing as much weight. She also 

acknowledged that Johnson had written threatening letters; however, she also 

 

9

 In her initial report dated September 10, 2021, Dr. Anderson did not raise any issue 

about Johnson refusing to eat. It was not until she submitted her supplemental report dated 

October 27, 2021, that she mentions that she is concerned about Johnson not eating. In that report 

she states that Johnson “started to decline meals intermittently approximately ten days ago, and 

then, for approximately the past five days, has now been declining all meals.”
No. 2021AP2046-CR

14

testified that the letters were not a threat that he could implement based on his 

current placement at MMHI. 

¶25 Moreover, Dr. Anderson testified that Johnson was being treated 

with alternatives to medication. As noted, some of the alternatives that 

Dr. Anderson described included a method she called “show of force,” in which 

staff make their presence known to a patient in order to de-escalate a situation 

before other methods, such as restraints or seclusion, would become necessary. 

She similarly described another method called “chill time” where staff would send 

a patient to his or her room to calm down and de-escalate a situation. Although 

she testified that in August 2021, Johnson required three seclusion and restraint 

events over an eighteen hour period of time in order to calm him down, she also 

testified that it had been months since Johnson had been restrained and secluded 

because staff were able to successfully intervene using “show of force” and “chill 

time” methods before Johnson’s behavior escalated. 

¶26 We also note that the trial court did not make any factual findings to 

support a determination that Johnson was dangerous to himself or others. See 

Langlade Cnty. v. D.J.W., 2020 WI 41, ¶¶44-45, 47, 391 Wis. 2d 231, 942 

N.W.2d 277 (stating that dangerousness is a legal determination for which 

“specific factual findings” should be made). Rather, the court merely referred to 

the doctor’s testimony stating:

[Dr. Anderson] noted that there was a decline of 

oral intake but he has been improving since that time. And 

the positives are, definitely, that he’s been, you know, 

eating more frequently than what he was before and not 

losing as much weight. But again, this was a concern with 

the facility, regards to his intake of food.
No. 2021AP2046-CR

15

Thus, we conclude that the trial court did not make any factual findings to support 

a determination that Johnson was dangerous to himself or to others, and also failed 

to connect any factual findings to any legal determination that Johnson was 

dangerous. See D.J.W., 391 Wis. 2d 231, ¶¶44-45, 47.

¶27 Given that Dr. Anderson recognized improvement in the danger 

Johnson posed to himself, the fact that the trial court made no finding that Johnson 

was dangerous to himself or anyone else, Johnson’s inability to carry out a threat 

of harm to others in the letters he sent because of his placement in MMHI, and 

Dr. Anderson’s testimony regarding the success of the alternative treatment 

methods used at MMHI, we thus conclude that the State failed to meet its burden 

to show by clear and convincing evidence that Johnson is dangerous to himself or 

others.

IV. Dr. Anderson’s Explanation of Haloperidol 

¶28 Next, Johnson argues that the State failed to show that Dr. Anderson 

provided him with a reasonable explanation of Haloperidol and failed to explain 

“the advantages and disadvantages of and alternatives to accepting the particular 

medication or treatment” to Johnson. See WIS. STAT. § 971.16(3). The State 

argues that we should accept reasonable inferences that Dr. Anderson had 

explained the advantages and disadvantages of Haloperidol, and alternatives to it,

to Johnson. We do not agree, and we conclude that the State failed to meet its 
No. 2021AP2046-CR

16

burden to show that Johnson was provided the explanation of Haloperidol to 

which he was entitled.

10

¶29 Addressing identical statutory language regarding an order for 

involuntary medication entered within the context of WIS. STAT. § 51.61(1)(g)4.b., 

our supreme court stated:

A person subject to a possible mental commitment or a 

possible involuntary medication order is entitled to receive 

from one or more medical professionals a reasonable 

explanation of proposed medication. The explanation 

should include why a particular drug is being prescribed, 

what the advantages of the drug are expected to be, what 

side effects may be anticipated or are possible, and whether 

there are reasonable alternatives to the prescribed 

medication. The explanation should be timely, and, ideally, 

it should be periodically repeated and reinforced. Medical 

professionals and other professionals should document the 

timing and frequency of their explanations so that, if 

necessary, they have documentary evidence to help 

establish this element in court.

Melanie L., 349 Wis. 2d 148, ¶67. Thus, we use the standard articulated by our 

supreme court in Melanie L. to evaluate Johnson’s argument, and under this 

standard to provide Johnson a “reasonable explanation” of the proposed 

medication, we conclude that Dr. Anderson’s reports and testimony fall short.

¶30 Dr. Anderson testified at the hearing that she prescribed Haloperidol 

for Johnson. Yet, she did not explain why she chose Haloperidol when Johnson 

had been successfully treated with other medications. She also failed to explain 

 

10

 Because we conclude that the State failed to meet its burden to show that Johnson 

received an explanation of the advantages and disadvantages of and alternatives to Haloperidol, 

we do not reach the question of whether Johnson is “incapable of expressing an understanding” or 

“substantially incapable of applying” the advantages, disadvantages, or alternatives to 

Haloperidol as required by WIS. STAT. § 971.16(3)(a)-(b).
No. 2021AP2046-CR

17

why the other methods currently being employed, such as show of force and chill

time, are not reasonable alternatives to Haloperidol.

¶31 Furthermore, and most importantly, Dr. Anderson also failed to 

explain the details of the conversations she had with Johnson regarding 

Haloperidol, its advantages, its disadvantages, and any alternatives to the 

medication. Instead, she simply stated that she had conversations with Johnson

generally:

Q And is he able to understand the benefits to the 

psychotropic medications that are prescribed to him?

A Not at this time, no.

Q Okay. And have you personally, like, talked 

through those, the benefits and the pros and cons of taking 

the medications, with Mr. Johnson?

A Yes.

Q And what is his—had he—what has his reaction

been, or what does he do with that information?

A He says that he does not need to take any 

psychotropic medication because he is fine. He believes he 

is healthy. He does not believe that he has a mental illness, 

certainly not a significant one. He believes that his reports 

of being neglected by medical staff here at the institute, 

about being wronged by various staff members at the 

institute, are correct. 

¶32 She further described, “And we do work with Mr. Johnson quite 

frequently, at least once per week, if not more, to provide psycho-education and 

encouragement and to repeat to him the benefits of allowing treatment. And that 

really has not effectively swayed him to date.” At no point, however, did 

Dr. Anderson provide the details of the pros and cons and the psycho-education 

that were provided to Johnson as part of the reasonable explanation owed to 

Johnson in the face of being involuntarily medicated using Haloperidol.
No. 2021AP2046-CR

18

¶33 We again note the lack of findings by the trial court regarding this 

issue. The court merely summarized Dr. Anderson’s testimony, without making 

any factual findings or connecting any factual findings to the applicable standard. 

For example, the court stated that 

[Dr. Anderson] did have a conversation with [Johnson] and 

she feels that he is not able to understand the benefits of 

psychotropic meds. She went over the pros and cons of the 

medication with [Johnson], he feels that he doesn’t need to 

take the meds, that he’s fine and healthy, and she feels he 

really has no insight into his current diagnosis. 

The trial court went on to say, “The med proposed, [Dr. Anderson] kind of went 

into details, in regards to the specific medication that is being asked for [] Johnson

to take. I believe that he has not taken it in the past.” 

¶34 However, the court does not state what Dr. Anderson told Johnson 

about the advantages and disadvantages of Haloperidol, and the alternatives to it. 

In fact, Dr. Anderson did not tell the court what the advantages and disadvantages 

of Haloperidol are. She testified that she believed that Johnson had not taken

Haloperidol before and, therefore, since he has not taken it, it is not known how he 

would respond to it. She also testified that she was not aware of what side effects, 

if any, Johnson had from medications that he took in the past and it may be true 

that he had no side effects from those medications. For example, she testified that 

Johnson had taken Lurasidone in the past and it worked. The question is then 

what did she tell Johnson during her discussions with him about Haloperidol and 

what did she tell him about alternatives such as Lurasidone that worked for him in 

the past.

¶35 “These hearings cannot be perfunctory under the law. Attention to 

detail is important.” Melanie L., 349 Wis. 2d 148, ¶94. When Dr. Anderson 
No. 2021AP2046-CR

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responded to questioning in general terms, she should have been required to 

expound on her answers to provide the details required to show that Johnson was 

provided a reasonable explanation of Haloperidol.

11

 See id., ¶91. Thus, under the 

standard set forth in Melanie L., we conclude that Dr. Anderson’s general 

descriptions are insufficient, and we reject the State’s arguments to accept, as 

reasonable inferences, that Dr. Anderson provided a reasonable explanation to 

Johnson of the advantages and disadvantages of, as well as alternatives to,

Haloperidol. Accordingly, we conclude that the State has failed to meet its burden 

because it failed to show that Johnson was provided a reasonable explanation of 

Haloperidol.

CONCLUSION

¶36 In sum, we conclude that the Sell factors were inappropriately 

applied to the motion for involuntary medication or treatment, and the motion 

 

11

 In reaching our conclusion, we also note that we have had a previous occasion to 

recognize that Haldol, the brand name for Haloperidol, has several potentially severe side effects:

Haldol certainly can cause side effects, including sedation, 

slurred speech, a tremor, a feeling of muscle restlessness that we 

refer to as akathisia, a phenomenon that is certainly like tremors 

but referred to as parkinsonism because it mimics the appearance 

of individuals who have Parkinson’s disease. It has the potential 

to affect cardiac conduction and heart rhythm. It has an impact 

on what’s called the QT interval, which is part of the 

electrocardiograph rhythm, and it can certainly have some 

metabolic side effects as well in terms of its impacts on weight 

gain and blood sugar.

State v. Green, 2021 WI App 18, ¶23, 396 Wis. 2d 658, 957 N.W.2d 583, aff’d in part, 2022 WI 

30, ___ N.W.2d ___. The record here is silent as to whether any of these side effects were 

explained to Johnson, and given the substantial nature of these side effects and the applicable 

standard, we cannot ignore the record’s silence on the details of the information provided to 

Johnson.
No. 2021AP2046-CR

20

should be evaluated under WIS. STAT. §§ 971.17(3) and 971.16(3). We also 

conclude that Dr. Anderson’s reports are properly considered as evidence in this 

case because Johnson forfeited his argument by failing to object to the use of 

Dr. Anderson’s reports at the time of the hearing. Nevertheless, even considering 

the reports, we further conclude that the State failed to meet its burden to show 

that Johnson is not competent to refuse medication, both because it failed to prove 

that Johnson was dangerous and because it failed to prove that Johnson was given 

a reasonable explanation of the advantages, disadvantages, and alternatives to 

Haloperidol. Consequently, we reverse the order of the trial court, and we remand 

this matter with directions to vacate the order for involuntary medication and to

deny the motion for involuntary medication.

By the Court.—Order reversed and cause remanded with directions.

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

809.23(1)(b)5.