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 

Supreme Court No. S-18219 

Superior Court No. 3PA-21-00620 PR 

O P I N I O N 

No. 7670 – November 9, 2023 

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

Judicial District, Palmer, Kristen C. Stohler, Judge. 

Appearances: Sharon Barr, Assistant Public Defender, and 

Samantha Cherot, Public Defender, Anchorage, for Declan 

P. Kimberly D. Rodgers, Assistant Attorney General, 

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

for State of Alaska. 

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

Henderson, and Pate, Justices. 

PATE, Justice. 

INTRODUCTION 

A man with a bipolar diagnosis stopped taking his medication, 

experienced a manic episode, and as a result was hospitalized. Hospital staff petitioned 

to have him involuntarily committed for 30 days. After a hearing the superior court 

granted the petition. The man appeals, arguing that the superior court erred by 

In the Matter of the Necessity of the 

Hospitalization of 

DECLAN P. 

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determining he was likely to cause harm to others; he was gravely disabled; and there 

was no less restrictive alternative to involuntary commitment.

Applying our recent decision in In re Hospitalization of Sergio F.,

1 we 

hold that the man’s rights were violated because there was a feasible, less restrictive 

alternative treatment to involuntary commitment. Further, even assuming the identified 

outpatient treatment proposal was not feasible, the State failed to meet its burden of 

proving that no less restrictive alternative existed because it did not consider any 

additional treatment options beyond the man’s proposal. We vacate the commitment 

order on these grounds.

FACTS AND PROCEEDINGS

A. Declan P. Is Detained And Held For Evaluation; The State Petitions 

For Involuntary Commitment.

In September 2021 in Anchorage, police observed Declan P.2 dancing in 

the street with cars driving around him. He had cuts on his feet and a bloody nose, and 

told the police to kill him and that he wanted to be killed. Declan was taken into 

emergency custody and delivered to the Alaska Native Medical Center. The superior 

court issued an order authorizing hospitalization for evaluation. Declan was transferred 

to Mat-Su Regional Medical Center (Mat-Su Regional) the following day.

Three days later, providers at Mat-Su Regional filed a petition for 30-day 

involuntary commitment. The petition alleged Declan was mentally ill, likely to cause 

harm to himself or others, and gravely disabled. It noted Declan’s “history of bipolar 

disorder” and stated he exhibited “delusional” thinking and was “paranoid of being 

drugged by hospital staff and sexually assaulted outside the hospital.” The petition 

asserted Declan had been “minimally cooperative with treatment” and “refused 

1

In re Hospitalization of Sergio F., 529 P.3d 74 (Alaska 2023).

2 We use a pseudonym to protect Declan P.’s privacy.
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medications.” A separate petition was filed seeking approval to involuntarily 

administer psychotropic medication.

B. The Superior Court Holds A 30-Day Commitment Hearing.

A hearing on the petitions was held on September 16 before a superior 

court master. Five witnesses testified at the commitment hearing: Declan’s longtime 

outpatient provider; Declan’s neighbor; a psychiatric nurse practitioner who testified as 

the State’s expert witness; Declan; and a court visitor who testified regarding the

involuntary medication petition, which the State ultimately withdrew.

1. Testimony

a. Testimony about Declan’s mental health history

Testimony established that Declan had previously been hospitalized at the 

Alaska Psychiatric Institute (API) in 2014, where he was diagnosed with bipolar 

disorder. Since that time Declan had returned to full-time work, successfully lived 

independently, and participated in ongoing psychiatric treatment, including consistently 

taking medication since at least 2015. Declan’s longtime outpatient provider testified 

Declan had been “stable” for the past six years while on medication.

b. Declan’s neighbor

Declan’s neighbor, an attorney, testified that he had known Declan since 

2015 and had worked with him on various legal issues. The neighbor testified he sees 

Declan regularly; that he lives five minutes from Declan’s home; and that Declan had 

been stable since 2015. He described Declan as “fully functional,” “100% stable,” and 

“competent” at all times while on medication. The neighbor stated he trusts Declan and 

that Declan assured him he would take his medication if released. The neighbor further 

stated: “I would . . . go to [Declan]’s house three times a day . . . and check on [Declan] 

and report . . . if [Declan]’s not acting normal. I’d be happy to even pick [Declan] up 

at the hospital upon discharge and . . . drive him to his house and make sure he’s safe

and operative.” The neighbor reiterated he would make sure Declan took his 

medication and would call the police department if he did not.
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c. The State’s expert witness

Next a psychiatric nurse practitioner, who was also one of Declan’s 

treatment providers at Mat-Su Regional, testified for the State. The superior court 

master qualified her as an expert in psychiatry. The expert had evaluated Declan and 

spoken with him daily. She asserted Declan’s diagnosis was bipolar disorder, based on 

symptoms including “irritable mood state, decreased sleep, high energy, risky and 

impulsive behavior,” and psychosis. She stated that Declan appeared to be suffering 

from paranoia and delusions manifesting in beliefs that hospital staff were drugging 

him and would possibly murder or sexually assault him. 

The expert testified as to each of the required findings for involuntary 

commitment. First, she stated “there is a risk” that Declan was still likely to cause 

serious harm to himself or others. She identified two main incidents of concern: a 

statement made by Declan regarding violence and an elopement from the hospital 

followed by suspected property damage. She explained that when she had mentioned 

getting records from Declan’s prior hospitalization, he expressed frustration and stated, 

“I can’t be violent without killing people.” She later testified this was “merely a 

statement,” and that Declan did not attempt to harm her or other staff. 

The expert then testified Declan “eloped from the unit” at around 4:00 

a.m. on the day before the hearing. She stated she believed Declan was picked up by 

police a couple hours later and returned to the hospital. She testified it was her 

understanding that Declan broke somebody’s car window.

3

 She stated Declan had not 

made any threats toward anyone else and had not attempted to harm anyone in the 

hospital. 

3 On cross-examination, the treatment provider stated: “I think there was 

concern about him being violent against a car of somebody who was going to help him 

and he broke their window out.”
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Second, the expert testified she believed Declan continued to be gravely 

disabled because he was “fearful that [the hospital staff] were going to sexually assault 

him, drug him, murder him. He . . . screamed rape when nothing was happening, no 

one was near him . . . . He seems to be paranoid that others are out to get him.” She

stated Declan had been involuntarily medicated while at Mat-Su Regional. According 

to the expert, Declan’s behavior — including elopement and delusions — continued to 

be “a substantial deterioration from his previous ability to function independently” as a 

result of “[l]ikely not taking his psychiatric medications.” She also testified Declan had 

been “intermittently [taking] medications voluntarily” at the hospital.

The expert acknowledged that Declan was doing “significantly better” at 

the time of the hearing than the previous day and that his thinking was “clearer” and 

had “improved.” She testified Declan stated his willingness to take his medication, but 

wanted “to vary his dose.” She testified Declan appeared to be eating well, staying 

hydrated, and was adequately dressed.

Third, she testified there was no less restrictive alternative to inpatient 

treatment because Declan “continues to show impaired judgment.” She stated: “I think 

that [Declan] needs to get stabilized on his medications before he can be safe in the 

community.” However, she also testified that “if [Declan is] willing to take [his 

medication] every day, same dose” he would likely continue to stabilize and remain that 

way, and that this could be done on an outpatient basis.

d. Declan’s testimony

Declan testified that if released from the hospital he had a house to go to, 

and his neighbor could pick him up and drive him to his house. Declan stated he had 

no desire, intention, or plans to cause harm to anyone, either at the time of the hearing 

or after release. Declan acknowledged that the event that led to his hospitalization was 

preceded by a failure to take his medication, but repeatedly stated that his intention 

moving forward was to take medications as prescribed. Declan testified he no longer 

felt that the hospital was going to rape, murder, or drug him, stating, “I understand now 
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that it’s not a threat.” But he also asserted he had “good reasons for believing” those 

things at the time.

2. The superior court master’s oral findings and conclusions 

approving involuntary commitment

The superior court master found that Declan was suffering from a mental 

illness — bipolar disorder — and was experiencing a manic episode. The master found 

“there has been some improvement,” and that “[Declan] is doing better today,” but that 

the 30-day commitment was necessary because “ongoing hospitalization is still 

needed.”

The master found that Declan was likely to cause harm to others and was 

gravely disabled. The master explained Declan appeared to have a “very tenuous hold”

on the recent improvement in his condition and that the master was not required to “take 

a snapshot of this moment,” but rather look at the “ups and downs.” The master found 

it was not likely that Declan was “going to follow through at this point.” And although

the master noted the treatment option of the neighbor providing help to Declan, the 

master concluded Declan was not ready to be released.

The master further found that Declan was “suffering from severe 

abnormal mental, emotional, and physical distress,” and that although Declan had 

improved, he “cannot be released safely into the community quite yet” due to the recent 

elopement and the expert’s testimony about Declan breaking a window. The master

found that involuntary commitment was the least restrictive alternative, despite noting 

that Declan’s outpatient treatment proposal was “a better outpatient option than I’m 

used to seeing.” The master stated he hoped Declan could be released “in the next few 

days.” The master did not consider any treatment alternatives beyond Declan’s 

proposal.
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3. The court visitor’s testimony; the master reconsiders and then 

affirms his conclusions 

Immediately following the involuntary commitment proceedings, the 

State called a court visitor to testify in support of the involuntary medication petition. 

Earlier that day the court visitor had spoken with Declan for about 20 minutes. The 

court visitor testified Declan was “competent to give or withhold informed consent” 

because he could “clearly describe why he was here” and could explain his situation “in 

ways that were clear and coherent.” The court visitor stated Declan was not 

“delusional”; that he was “clear and concise” about his diagnosis and treatment 

protocol; and that he could have rational conversations. 

The court visitor also explained Declan was “not objecting to medication,” 

only expressing preferences about how it was delivered. For instance, the court visitor 

stated Declan prefers to take his medications throughout the day rather than all at once. 

The State then withdrew its petition for involuntary psychotropic medication because 

Declan was willing to take his medications. 

Declan then asked the master to reconsider the involuntary commitment 

determination in light of the court visitor’s testimony. Declan argued outpatient 

treatment would be appropriate because the testimony established that he was willing 

and likely to take his medications. The master briefly considered this argument, but 

concluded that he would not change his original finding. The master stated he had much 

more confidence in Declan following through on medication in the hospital compared 

to the outpatient option. Finally, based on Declan’s “belief narrative” that led to 

elopement, the master found involuntary commitment was still needed. 

C. The Superior Court Authorizes A 30-Day Involuntary Commitment. 

On September 16, 2021, the superior court issued a written order 

authorizing a 30-day involuntary commitment. The order stated Declan was likely to 

cause serious harm to others and was gravely disabled. The order also stated that Declan 

“is in a persistent paranoid state” that would “likely . . . escalate to physical violence.”
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The order concluded Declan was “suffering from severe delusions of imminent harm”

and that “[h]is decisions in response to these fears put him at risk of harm through being 

unsafe in the community.”

The court further found that Declan “still maintained the validity of his 

original paranoid fears,” and that the “recent step forward” was unlikely to be “the end 

of his paranoid delusions and reluctance towards taking appropriate medication.” The 

court found that “outpatient treatment is unlikely to adequately protect [Declan] and the 

public.” It concluded there were no feasible, less restrictive alternatives to involuntary 

commitment.

Declan was released from the hospital four days later with no treatment 

plan or requirements for further supervision. He now appeals the 30-day commitment 

order, contending the superior court erred by concluding there was clear and convincing 

evidence he was likely to cause harm to others; he was gravely disabled; and there was 

no less restrictive alternative to involuntary commitment. We address only Declan’s

least restrictive alternative argument because it is dispositive.

STANDARD OF REVIEW

We review factual findings in involuntary commitment proceedings for 

clear error.4 Whether those factual findings meet statutory standards for involuntary 

commitment is a question of law to which we apply our independent judgment.5

DISCUSSION

We have “characterized involuntary commitment for a mental illness as a 

‘massive curtailment of liberty’ that demands due process of law.”6 A court may issue 

an order committing an individual to a treatment facility for a 30-day period only if two 

4

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

5

Id. at 923-24.

6

Id. at 931 (quoting Wetherhorn v. Alaska Psychiatric Inst., 156 P.3d 371,

375-76 (Alaska 2007), overruled on other grounds by In re Naomi B., 435 P.3d 918).
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conditions are established. First, the petitioner must prove, by clear and convincing 

evidence, that the respondent is (a) mentally ill and as a result is likely to cause harm to 

self or others or (b) is gravely disabled.

7

 Second, the petitioner must establish by clear 

and convincing evidence that no feasible, less restrictive alternative to involuntary 

commitment is available.8

We have explained that “the trial court’s deliberate consideration of 

[whether less restrictive alternatives exist] is critical to the protection of the 

respondent’s liberty interests.”9 The least restrictive alternative means treatment 

facilities and conditions that “are no more harsh, hazardous, or intrusive than necessary 

to achieve the treatment objectives of the patient.”10 A less restrictive alternative must 

also be feasible,11 available,12 and provide “adequate treatment” for a respondent.13

We recently addressed the least restrictive alternative requirement in In re

Hospitalization of Sergio F.14 There we vacated the commitment order, holding that 

the State failed to prove, by clear and convincing evidence, that no less restrictive 

7

Id. (citing AS 47.30.735(c)).

8

Id. at 932.

9

In re Hospitalization of Mark V., 375 P.3d 51, 58 (Alaska 2016),

abrogated on other grounds by In re Hospitalization of Naomi B., 435 P.3d 918, 924-

31 (Alaska 2019).

10 AS 47.30.915(14)(A)-(B) (providing that least restrictive alternative is 

treatment involving “no restrictions on physical movement nor supervised residence or 

inpatient care except as reasonably necessary for the administration of treatment or the 

protection of the patient or others from physical injury”).

11 In re Naomi B., 435 P.3d at 932-33.

12 Id. at 933-34; see also AS 47.30.735(d).

13 In re Hospitalization of Danielle B., 453 P.3d 200, 204 (Alaska 2019) 

(quoting In re Hospitalization of Jacob S., 384 P.3d 758, 768 (Alaska 2016)).

14 529 P.3d 74 (Alaska 2023).
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alternative to involuntary commitment existed.

15

 We noted with disapproval that the 

State did not consider any additional treatment options beyond the respondent’s 

proposed treatment plan.16 We emphasized that “less restrictive alternatives to 

hospitalization in a secure, locked facility must be considered before ordering 

involuntary commitment and that it is the State’s burden — not the respondent’s 

contrary burden — to show that those alternatives do not exist or are not feasible.”17

A. It Was Error To Find That Declan’s Outpatient Treatment Proposal

Was Not A Feasible, Less Restrictive Alternative.

The master noted that Declan’s outpatient treatment proposal would 

include the support of both his longtime outpatient provider and his neighbor, stating 

this was a “better outpatient option than [he was] used to seeing.” The superior court 

found that, given Declan’s improvement, there was “a reasonable question as to whether 

out-patient treatment would now be sufficient.” But the court nonetheless concluded

“outpatient treatment is unlikely to adequately protect [Declan] and the public,” finding 

that it was “unlikely that this recent step forward is the end of his paranoid delusions 

and reluctance towards taking appropriate medication.”

Declan argues the finding that his outpatient treatment proposal was

inadequate was clearly erroneous. Declan asserts he had been reliably taking 

medication for at least six years and was steadily stabilizing after resuming medication. 

Declan points out he was willing to continue taking medication; this was confirmed by 

the neighbor and the court visitor; and any alleged “reluctance” to take medication was 

the result of a misunderstanding about how the medication would be taken.18 Declan 

15 Id. at 80-82.

16 Id. at 80.

17 Id. at 82.

18 Declan expressed a preference to take his medication throughout the day, 

rather than in a single dose. The State provided no evidence to suggest this was an 

unreasonable or infeasible solution.
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thus asserts he did not need to be hospitalized to continue taking medication and that 

his outpatient treatment proposal — returning to his house to take medications under 

the neighbor’s supervision — was less restrictive and feasible.

Declan next distinguishes his situation from two prior cases: In re

Hospitalization of Connor J.

19 and In re Hospitalization of Luciano G.20

 Declan argues 

that unlike the respondents in those cases, he was capable of living on his own and 

taking care of his basic needs; had insight into his mental illness; was willing and likely 

to take medication if released; had a stable housing situation; and had a neighbor who 

was willing to look after him and monitor his medication regimen.

21

The State argues in response that the superior court properly found that 

Declan was unlikely to take medication if released and correctly concluded that 

involuntary commitment was the least restrictive treatment option. The State asserts 

Declan continued to be unstable, delusional, and reluctant to take his medication as 

prescribed. The State cites to the expert’s testimony that Declan’s medication required 

three to seven days to build up in his body and stabilize his condition and that Declan 

was not yet ready for outpatient treatment. Relying on In re Hospitalization of Joan 

19 440 P.3d 159, 165-67 (Alaska 2019) (affirming involuntary commitment 

as least restrictive option where respondent had a pattern of anger and violence, would 

likely have been unable to meet many of his basic needs outside of an institution, and 

had refused medication).

20 450 P.3d 1258, 1264-65 (Alaska 2019) (affirming involuntary 

commitment as least restrictive option where respondent “did not appear to have 

anywhere to stay and was unlikely to follow up with treatment if not committed” 

because he lacked insight into his condition and believed he did not need treatment).

21 See id. at 1261, 1264-65; In re Connor J., 440 P.3d at 165-67.
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K.

22 and In re Hospitalization of Mark V.,23 the State further argues that “involuntary 

hospitalization is the least restrictive alternative when it is necessary to ensure 

medication compliance and stabilize a respondent before release.”

24

We find Declan’s position more persuasive because his outpatient 

treatment proposal directly and pointedly addressed the State’s primary concern: the 

possibility that Declan might not continue taking his medication.

The commitment order was premised on the clearly erroneous assumption

that Declan was, within the context of his outpatient treatment proposal, unlikely to 

follow through on medication. But the record establishes that Declan intended to take 

his medications and that his outpatient treatment proposal was both adequate and 

feasible.

Declan, the neighbor, and the court visitor all agreed Declan was willing 

and likely to continue taking his medication. Declan had insight into his illness and a 

long history of successfully taking medications. He was able to take care of his basic 

needs and had a stable housing situation. He had a longtime outpatient provider willing 

22 273 P.3d 594, 602 (Alaska 2012) (affirming conclusion that involuntary 

commitment was least restrictive alternative where respondent lacked sufficient insight 

and perspective about her condition and need for treatment).

23 375 P.3d 51, 59-60 (Alaska 2016) (affirming conclusion that commitment 

was least restrictive option where respondent could not “understand his situation, 

symptoms[,] or current illness” and was thus unlikely to take medication in an 

outpatient setting), abrogated on other grounds by In re Hospitalization of Naomi B., 

435 P.3d 918, 924-31 (Alaska 2019).

24 At oral argument the State further asserted that the fact that Declan was 

released after four days of commitment weighed in favor of concluding that 

commitment was the least restrictive alternative. We reject this argument. When 

determining whether an involuntary commitment order was proper, we consider only 

the information the superior court had at the time of its order. Alaska R. App. P. 210(a). 

It makes no difference in this analysis whether Declan was released after one day or 30 

days.
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to support him and provide a prescription. More specifically, the neighbor was willing 

to check in on Declan multiple times per day and contact the appropriate authorities if 

he did not take his medications.

There was some evidence to support a finding that Declan was reluctant

to take medication exactly as prescribed. But both Declan and the court visitor testified 

that Declan was willing to take the medication, and the State’s withdrawal of the 

petition for forced medication effectively conceded that forcing Declan to take 

medication exactly as prescribed was not necessary to his recovery. Given these 

undisputed facts, including the neighbor’s proposal to verify that Declan took 

medication, it was clear error to find that Declan would not take the medication 

necessary for his recovery outside of API.

Thus, it is clear that commitment was not necessary to ensure that Declan 

would take his medication. His outpatient treatment proposal could have achieved the 

same result by less restrictive means.

25

 The State’s withdrawal of the involuntary 

medication petition practically admitted as much. This case is not like those situations 

in which we have previously affirmed least restrictive alternative determinations.26 The

outpatient treatment proposal directly and pointedly addressed the concern that Declan 

might discontinue medication. The plan was feasible and would have provided

adequate protection to both Declan and the public. Under these circumstances, a finding 

to the contrary was clearly erroneous.

25 See AS 47.30.915(14)(A) (defining “least restrictive alternative” as 

treatment facilities and conditions that “are no more harsh, hazardous, or intrusive than 

necessary to achieve the treatment objectives of the patient”).

26 See In re Joan K., 273 P.3d at 602; In re Mark V., 375 P.3d at 59-60; In 

re Connor J., 440 P.3d at 165-67; In re Luciano G., 450 P.3d at1264-65.
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B. The State Failed To Meet Its Burden By Not Considering Any 

Treatment Alternatives Beyond Declan’s Proposal.

Even assuming Declan’s outpatient treatment proposal had not been 

feasible, our recent decision in In re Hospitalization of Sergio F. would still mandate 

vacating the commitment order because the State failed to consider any additional less 

restrictive treatment options. In In re Sergio F., the State rejected the respondent’s 

proposed discharge plan of living with a friend and taking medication on an outpatient 

basis.27 The superior court agreed with the State and, without considering any other 

options, concluded no less restrictive treatment was available.28 As we explained in In 

re Sergio F., the failure to consider any additional options severely undermines the 

validity of a least restrictive alternative determination.29 The reason for this is clear: 

Had Declan not suggested the one alternative, there may have been no consideration of 

less restrictive alternatives at all. And generally speaking, respondents are not in a 

position to propose adequate less restrictive alternatives. The State is the party with the 

knowledge and resources to meaningfully consider alternatives, and it is the State’s 

burden to show that it has done so.

Here, the State did not discuss or explore any treatment alternatives 

beyond the one outpatient treatment plan Declan proposed. The State argues Declan’s 

discharge plan was inadequate, but the standard is not whether the one alternative 

suggested by the respondent is suitable. The standard is whether there is clear and 

convincing evidence that no less restrictive alternative is available.30

27 529 P.3d 74, 76, 77 (Alaska 2023).

28 Id. at 77-78.

29 Id. at 80-82.

30 Id. at 82.
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“The State need not ‘prove the unavailability of every imaginable 

alternative.’ ”

31

 But in this case, the State failed to explore even a single alternative 

outpatient treatment option beyond Declan’s proposal.

32 The State thus failed to meet 

its burden of proving by clear and convincing evidence “that there are no less restrictive 

alternatives.”33 Thus, even if Declan’s proposal had not been feasible, we would

resolve the present case in the same way as In re Sergio F. and vacate the commitment 

order.34

We have repeatedly emphasized the importance of a rigorous least 

restrictive alternative requirement.35 We reject the State’s position because if we were 

to affirm the commitment order, the least restrictive alternative requirement could be 

rendered meaningless in two ways.

The first is by requiring complete stability prior to release. The superior 

court found, and the State argues, that involuntary commitment was still necessary 

because Declan was not yet completely stable. If complete stability is required for 

31 Id. at 80 (quoting In re Hospitalization of Vern H., 486 P.3d 1123, 1131 

n.31 (Alaska 2021)).

32 The State acknowledged at oral argument that there was no evidence in 

the record regarding consideration of any other alternatives to involuntary commitment.

33 In re Sergio F., 529 P.3d at 78-79.

34 Id. at 82.

35 See In re Hospitalization of Joan K., 273 P.3d 594, 601 (Alaska 2012)

(“An important principle of civil commitment in Alaska is to treat persons ‘in the least 

restrictive alternative environment consistent with their treatment needs.’ ” (quoting

AS 47.30.655(2))); In re Hospitalization of Naomi B., 435 P.3d 918, 933 (Alaska 2019)

(“[F]inding that no less restrictive alternative exists is a constitutional prerequisite to 

involuntary hospitalization.” (quoting In re Hospitalization of Mark V., 375 P.3d 51, 59 

(Alaska 2016), abrogated on other grounds by In re Naomi B., 435 P.3d at 924-31)); In

re Mark V., 375 P.3d at 58 (“[T]he trial court’s deliberate consideration of [whether less 

restrictive alternatives exist] is critical to the protection of the respondent’s liberty 

interests”).
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release, then outpatient treatment would never be a feasible option. Any continued 

instability could be grounds for commitment. Requiring complete stability prior to 

release would defeat a core purpose of the least restrictive treatment alternative: 

facilitating outpatient recovery in a less restrictive setting when a respondent is 

approaching stability, but has not yet achieved it.

The second would be to permit the court to simply invoke the “likely to 

cause harm” or “gravely disabled” findings to conclude that the only viable option is 

involuntary commitment in a secure psychiatric facility. As we explained in In re 

Sergio F., a finding of grave disability does not presuppose a finding that involuntary 

commitment is the least restrictive alternative.36 These are separate, constitutionally 

required determinations. The least restrictive alternative requirement adds a crucial

layer of protection for respondents. The State must do more than show that a respondent 

cannot live safely in the community without treatment.37 Proving that no less restrictive 

alternative exists requires establishing that the respondent cannot live safely in the 

community even with less restrictive treatment.38

We reiterate that proving there is no less restrictive alternative to inpatient 

hospitalization “is a substantial burden commensurate with the ‘massive curtailment of 

liberty’ imposed by involuntary commitment.”

39

 At the very least, a finding that there 

is no less restrictive alternative must include a determination whether the State has

considered specific less restrictive treatment options. And, if so, why those alternatives 

36 In re Sergio F., 529 P.3d at 79. 

37 Id.; AS 47.30.915(9)(B) (2021) (requirement for gravely disabled 

finding). While this appeal was pending, the legislature amended AS 47.30.915, 

renumbering and modifying several definitions, including that of “gravely disabled.” 

We refer here to the version of the statute in effect at the time of the superior court’s 

order, but also note that our analysis applies equally to the amended statutory scheme. 

38 In re Sergio F., 529 P.3d at 79.

39 Id. at 80-81 (quoting In re Naomi B., 435 P.3d at 928). 
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were infeasible and inadequate to protect the respondent and the public, and provide for 

the respondent’s treatment needs.

40

 There was no such inquiry in Declan’s case. Thus,

it was error to order involuntary commitment without determining whether the State 

meaningfully considered less restrictive alternatives at all, let alone whether it 

demonstrated those alternatives were not available, feasible, or adequate.

CONCLUSION

For the reasons stated above, we VACATE the 30-day commitment order.

40 Id. at 81; see, e.g., In re Naomi B., 435 P.3d at 934 (affirming commitment 

was least restrictive option where “the parties explored several possible alternatives, 

including outpatient community support and assisted living facilities” and “none of the 

proposed less restrictive alternatives would protect the public ‘from the danger to others 

that [respondent] currently [poses],’ and that [respondent] needed ‘a facility like API 

that is locked and . . . provides 24/7 care’ ” (second and fourth alterations in original) 

(quoting superior court order)).