COURT OF APPEALS

DECISION

DATED AND FILED

July 15, 2020

Sheila T. Reiff

Clerk of Court of Appeals

NOTICE

This opinion is subject to further editing. If 

published, the official version will appear in 

the bound volume of the Official Reports. 

A party may file with the Supreme Court a 

petition to review an adverse decision by the 

Court of Appeals. See WIS. STAT. § 808.10 

and RULE 809.62. 

Appeal No. 2020AP274-FT Cir. Ct. No. 2019ME20

STATE OF WISCONSIN IN COURT OF APPEALS

DISTRICT II

IN THE MATTER OF THE MENTAL COMMITMENT OF S.N.W.:

FOND DU LAC COUNTY,

 PETITIONER-RESPONDENT,

 V.

S.N.W.,

 RESPONDENT-APPELLANT.

APPEAL from orders of the circuit court for Fond du Lac County: 

PETER L. GRIMM, Judge. Affirmed. 
No. 2020AP274-FT

2

¶1 REILLY, P.J.1 S.N.W. appeals from an order of the circuit court 

extending his involuntary commitment and from an order for involuntary 

medication and treatment. S.N.W. argues that Fond du Lac County (the County) 

failed to establish that he is dangerous pursuant to WIS. STAT. § 51.20(1)(a), (am). 

We conclude that the evidence supports the circuit court’s conclusion that S.N.W. 

is mentally ill, is a proper subject for treatment, and would be a proper subject for 

commitment if treatment were withdrawn. See § 51.20(1)(a)1.-2., (am). 

Accordingly, we affirm.

BACKGROUND

¶2 S.N.W. was first subject to orders for involuntary commitment and 

involuntary medication and treatment in February 2019.

2

 Those orders were 

effective for six months. In June 2019, the County petitioned to extend S.N.W’s

commitment based on an examination report by Dr. J.R. Musunuru, M.D., in 

support of the extension. 

¶3 In August 2019, the circuit court held an extension hearing. 

Musunuru was the only witness to testify, and the County also introduced his 

examination report into evidence. According to Musunuru, S.N.W. “has been 

suffering from chronic mental illness,”

3 has reported in the past hearing voices, 

 

1

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

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

2

 We upheld these orders on appeal. Fond du Lac County v. S.N.W., 

No. 2019AP2073, unpublished slip op. (WI App June 17, 2020).

3

 At the hearing, Musunuru testified that S.N.W. was diagnosed with schizophrenia, 

although his report reflected “Schizoaffective Disorder—Bipolar Type.” The “mental illness” 

element of WIS. STAT. § 51.20(1)(a)1. is not being challenged by S.N.W., and we need not 

address whether schizophrenia and “Schizoaffective Disorder—Bipolar Type” are separate 

diagnoses and constitute a “contradict[ion]” as alleged by S.N.W.
No. 2020AP274-FT

3

and has displayed paranoia to the point that he was “afraid to put food into his 

mouth thinking about it being poisoned.” Musunuru testified that S.N.W. is a 

proper subject for treatment and that his condition had improved as a result of the 

treatment, but he is incapable of understanding the advantages and disadvantages 

of taking the medication, which led to S.N.W. “cheeking” his medications to avoid 

taking them. Musunuru opined that “[S.N.W.] can be a danger to himself or others 

if he’s not taking the treatment.” When pressed on cross-examination, Musunuru 

explained that S.N.W. was “getting into fights or arguments,” and it was 

Musunuru’s understanding that S.N.W. was threatening people during these 

arguments, although he was unable to detail what exact threats were made. 

Musunuru explained that it was this “threatening behavior [that] led to change out 

his medications a few months ago.” Musunuru concluded, based on S.N.W.’s 

treatment record, that S.N.W. would be a proper subject for commitment if 

treatment were withdrawn. 

¶4 The circuit court granted the County’s request for an extension and 

entered the orders for the extension of the involuntary commitment and 

involuntary medication and treatment effective for one year.

4

 S.N.W. appeals.

DISCUSSION

¶5 WISCONSIN STAT. § 51.20 governs involuntary commitment for 

treatment. To involuntarily commit a person, the county has the burden to prove 

by clear and convincing evidence that the person is (1) mentally ill, (2) a proper 

subject for treatment, and (3) dangerous. See § 51.20(1)(a)1.-2., (13)(e); Fond du 

 

4

 S.N.W. does not present any arguments concerning the order for involuntary 

medication and treatment. We address it no further.
No. 2020AP274-FT

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Lac County v. Helen E.F., 2012 WI 50, ¶20, 340 Wis. 2d 500, 814 N.W.2d 179; 

see also Portage County v. J.W.K., 2019 WI 54, ¶17, 386 Wis. 2d 672, 927 

N.W.2d 509. The circuit court may extend the individual’s commitment for up to 

one year. Sec. 51.20(13)(g)1.; J.W.K., 386 Wis. 2d 672, ¶¶17-18. The same 

standards apply to extensions of the commitment, except the county may satisfy 

the showing of dangerousness by demonstrating that “there is a substantial 

likelihood, based on the subject individual’s treatment record, that the individual 

would be a proper subject for commitment if treatment were withdrawn.” 

Sec. 51.20(1)(am); J.W.K., 386 Wis. 2d 672, ¶19.

¶6 WISCONSIN STAT. § 51.20(1)(am) recognizes that “an individual’s 

behavior might change while receiving treatment” and, accordingly, “provides a 

different avenue for proving dangerousness if the individual has been the subject 

of treatment for mental illness immediately prior to commencement of the 

extension proceedings” as the individual “may not have exhibited any recent overt 

acts or omissions demonstrating dangerousness because the treatment ameliorated 

such behavior.”5 J.W.K., 386 Wis. 2d 672, ¶19. In that way, § 51.20(1)(am) is an 

“alternative evidentiary path, reflecting a change in circumstances occasioned by 

an individual’s commitment and treatment.” J.W.K., 386 Wis. 2d 672, ¶19. 

“However, dangerousness remains an element to be proven to support both the 

initial commitment and any extension.” Id. “Each extension hearing requires the 

County to prove the same elements with the same quantum of proof required for 

the initial commitment.” Id., ¶24. “The dangerousness standard is not more or 

 

5

 The specific parameters of WIS. STAT. § 51.20(1)(am) have recently been the subject of 

cases in this court as well as our supreme court. Langlade Cty. v. D.J.W., 2020 WI 41, 391 

Wis. 2d 231, 942 N.W.2d 277; Winnebago County v. S.H., No. 2019AP2277-FT, slip op. 

recommended for publication (WI App June 17, 2020).
No. 2020AP274-FT

5

less onerous during an extension proceeding; the constitutional mandate that the 

County prove an individual is both mentally ill and dangerous by clear and 

convincing evidence remains unaltered.” Id.

¶7 Our review of an extension order presents a mixed question of fact 

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

N.W.2d 783. We will uphold the court’s findings of fact unless clearly erroneous. 

Id. Whether the facts in the record satisfy the statutory standard for recommitment 

is a question of law that this court reviews de novo. Id.

¶8 S.N.W. argues that the County’s evidence was insufficient to prove 

S.N.W. is dangerous, claiming that “[i]nstead of demonstrating a substantial 

likelihood that S.N.W. will cause physical harm to himself or others absent 

continued commitment ... the county showed that S.N.W. remains ‘boisterous’ 

and ‘argumentative.” The County disagreed, arguing that the testimony and report 

of Musunuru “showed there was a substantial probability that physical harm to 

others would ensue if treatment were withdrawn” pursuant to WIS. STAT.

§ 51.20(1)(a)2.b. and (1)(am). We conclude that pursuant to § 51.20(1)(am), 

Musunuru’s testimony sufficiently established that S.N.W. is a proper subject for 

commitment if treatment is withdrawn.

¶9 The evidence in the record before us establishes that S.N.W. has a 

history of “singling out a staff member ... to accuse them of being against him, 

having paranoid thoughts and behaviors toward staff and others, and delusional 

beliefs.” These thoughts, behaviors, and beliefs have then caused S.N.W. to “get[] 

into fights or arguments,” which “will escalate and he will get into some trouble.” 

Musunuru testified that it was his “understanding” that S.N.W. threatened
No. 2020AP274-FT

6

individuals during these arguments. Additionally, the “unprovoked shoutings and 

arguments” and “threatening behavior led to change out his medication.” 

¶10 WISCONSIN STAT. § 51.20(1)(am) provides in pertinent part that “the 

requirements of a recent overt act, attempt or threat to act under par. (a)2.a. or b.[],

or pattern of recent acts or omissions under par. (a)2.c. or e., ... may be satisfied 

by a showing that there is a substantial likelihood, based on the subject 

individual’s treatment record, that the individual would be a proper subject for 

commitment if treatment were withdrawn.” The plain language of the statute 

includes not only an “overt act” or “attempt,” but also a “threat to act” to do 

“physical harm” or “a pattern of recent acts or omissions” demonstrating a 

“substantial probability of physical impairment or injury to himself or herself or 

other individuals.” Sec. 51.20(1)(a)2.a., b., c.; (1)(am). We are confident that 

based on the evidence of fights, arguments, and threats, Musunuru’s testimony and 

report supports a finding “that there is a substantial likelihood” that S.N.W. is 

dangerous pursuant to § 51.20(1)(a)2. such that S.N.W. “would be a proper subject 

for commitment if treatment were withdrawn.” See § 51.20(1)(am); see also

Langlade County v. D.J.W., 2020 WI 41, ¶41, 391 Wis. 2d 231, 942 N.W.2d 277 

(“Para. (1)(am) ... mandates that circuit courts ground their conclusions in the 

subdivision paragraphs of subd. 2.”)

6

; Winnebago County v. S.H., 

No. 2019AP2277-FT, slip op. recommended for publication, ¶13 (WI App 

June 17, 2020) (“It is also true that proof of the ultimate finding of fact under ... 

 

6

 We understanding that our supreme court clarified that “going forward circuit courts in 

recommitment proceedings are to make specific factual findings with reference to the subdivision 

paragraph of [WIS. STAT.] § 51.20(1)(a)2. on which the recommitment is based.” D.J.W., 391 

Wis. 2d. 231, ¶¶40-41 (emphasis added). The circuit court does not appear to have made such 

findings; regardless, the decision in this case occurred prior to D.J.W.’s release and S.N.W. does 

not argue this as a basis for reversal.
No. 2020AP274-FT

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§ 51.20(1)(am)—‘a substantial likelihood ... that the individual would be a proper 

subject for commitment if treatment were withdrawn’—necessarily requires proof 

of a substantial likelihood of dangerousness, as defined under § 51.20(1)(a)2.a.-

e.”).

¶11 We acknowledge, as the circuit court did, that Musunuru did not 

provide details about what kind of threats S.N.W. made toward others. On that 

issue, we agree with the circuit court’s evaluation of Musunuru’s testimony. The 

circuit court explained:

 I appreciate the doctor didn’t give a lot of detail, but he 

did review the record. He is, as an expert, allowed to 

render opinions and testimony in more general categories 

without having to recite the minutia of details of actual 

words stated or words said. So when the doctor says that 

the patient has had fights or arguments, yeah, that’s pretty 

generic, but it’s based on the treatment record that he 

reviewed. He referred to trouble in the Dodge County Jail 

regarding paranoia and food and poisoning. He did 

recognize loud arguments at the Berry House, and he did 

feel that the behavior was threatening. Sure, he couldn’t 

give details, but as an expert, he can give summary 

conclusions based on facts in the treatment record. 

Physicians and mental health professionals are charged, pursuant to WIS. STAT.

§ 51.20, with evaluating the subject individual and providing a recommendation 

based on his or her expertise. Where the expert opines, after reviewing an 

individual’s treatment history, that the individual is dangerous and provides a basis 

for his or her opinion pursuant to the statute and discusses specific behavior the 

individual engaged in during the past or present, the opinions and assessments of 

the expert hold great weight.

¶12 This court recently explained in S.H., No. 2019AP2277-FT, ¶13, 

that “neither the statute nor the applicable case law requires an expert or circuit 

court to speculate on the precise course of an individual’s impending 
No. 2020AP274-FT

8

decompensation by identifying specific future dangerous acts or omissions the 

individual might theoretically undertake without treatment.” We continued by 

noting that “[d]angerousness in an extension proceeding can and often must be 

based on the individual’s precommitment behavior, coupled with an expert’s 

informed opinions and predictions (provided, of course, that there is a proper 

foundation for the latter).” Id. As we observed, however, “reliance on 

assumptions concerning a recommitment at some unidentified point in the past, 

and conclusory opinions parroting the statutory language without actually 

discussing dangerousness, are insufficient to prove dangerousness in an extension 

hearing.” Id., ¶17; see also Winnebago County v. L.F.-G., No. 2019AP2010, 

unpublished slip op. ¶5 (WI App May 20, 2020) (“An involuntary mental 

commitment requires proof of a substantial likelihood of dangerousness by clear 

and convincing evidence, not assumptions or inferences.”).7 In this case, 

Musunuru discussed specific dangerous behavior (threats, fights, and arguments)

“that was directly tied to postcommitment paranoid ideations” (paranoid thoughts 

that the staff was against him), which “provided the necessary link between past 

dangerousness and the substantial likelihood of reoccurrence of such behavior 

absent an extension order.” S.H., No. 2019AP2277-FT, ¶17.

By the Court.—Orders affirmed.

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

809.23(1)(b)4.

 

7

 We may cite an unpublished decision “for its persuasive value.” WIS. STAT.

§ 809.23(3)(b).