Title: Outagamie County v. Michael H.
Citation: 2014 WI 127
Docket Number: 2013AP001638-FT
State: Wisconsin
Issuer: Wisconsin Supreme Court
Date: December 16, 2014

2014 WI 127 
 
SUPREME COURT OF WISCONSIN 
 
 
 
 
 
CASE NO.: 
2013AP1638-FT 
COMPLETE TITLE: 
In the matter of the mental commitment of 
Michael H.: 
 
Outagamie County, 
          Petitioner-Respondent, 
     v. 
Michael H., 
          Respondent-Appellant-Petitioner.   
 
 
 
 
 
REVIEW OF A DECISION OF THE COURT OF APPEALS 
(Reported at 352 Wis. 2d 248, 841 N.W.2d 582) 
(Ct. App. 2013 – Unpublished) 
 
 
OPINION FILED: 
December 16, 2014 
SUBMITTED ON BRIEFS: 
        
ORAL ARGUMENT: 
October 7, 2014 
 
 
SOURCE OF APPEAL: 
 
 
COURT: 
Circuit 
 
COUNTY: 
Outagamie 
 
JUDGE: 
Dee R. Dyer 
 
 
 
JUSTICES: 
 
 
CONCURRED: 
      
 
DISSENTED: 
      
 
NOT PARTICIPATING:          
 
 
 
ATTORNEYS: 
 
For the respondent-appellant-petitioner, there were briefs 
by Suzanne L. Hagopian, assistant state public defender, and 
oral argument by Suzanne L. Hagopian. 
 
For the petitioner-respondent, there was a brief by Patrick 
M. Taylor, assistant Outagamie County corporation counsel, and 
oral argument by Patrick M. Taylor. 
 
 
 
 
2014 WI 127
NOTICE 
This opinion is subject to further 
editing and modification.  The final 
version will appear in the bound 
volume of the official reports.   
No.   2013AP1638-FT 
(L.C. No. 
2012ME87A) 
STATE OF WISCONSIN  
 
 
   : 
IN SUPREME COURT 
 
 
In the matter of the mental commitment of  
Michael H.: 
 
Outagamie County,   
 
 
Petitioner-Respondent,   
 
 
v. 
 
Michael H.,   
 
 
Respondent-Appellant-Petitioner.   
FILED 
 
DEC 16, 2014 
 
Diane M. Fremgen 
Clerk of Supreme Court 
 
 
 
 
REVIEW of a decision of the Court of Appeals.  Affirmed.   
 
¶1 
N. PATRICK CROOKS, J.  Outagamie County filed a 
petition for the involuntary commitment of Michael H., and based 
on the jury's determination that he was dangerous to himself, 
the Outagamie County Circuit Court ordered him committed for 
treatment 
pursuant 
to 
Wisconsin's 
involuntary 
commitment 
statute, Wis. Stat. § 51.20.  The heart of the case is the 
dispute over the evidence that he was dangerous.  Michael 
challenges the sufficiency of the evidence, and we must 
determine whether the evidence was sufficient to support the 
jury's conclusion that he was dangerous within the meaning of 
No. 
2013AP1638-FT   
 
2 
 
Wis. Stat. § 51.20(1)(a)2.a. or 2.c. or both——that there was a 
substantial probability of injury to himself, based either on 
threats of suicide or impaired judgment.1  Because we cannot 
evaluate the sufficiency of the evidence without examining the 
meaning of the statute's words, we also must decide what 
satisfies the statute's requirement of "evidence of recent 
threats . . . of suicide"——specifically, whether the acts in 
this case can constitute a threat.  Jurors are asked in these 
difficult cases to determine whether clear and convincing 
evidence2 supports a finding of dangerousness, knowing they 
should neither wrongly deprive a person of liberty nor fail to 
authorize intervention before a dangerous person harms himself. 
¶2 
Wisconsin Stat. § 51.20 (2011-12)3, which establishes 
the prerequisites for involuntary commitment for treatment, 
requires a determination that a person is dangerous and provides 
five grounds for making such a determination.  The statute 
spells out what may serve as grounds for such a determination.  
In this case, the two grounds alleged relate to Michael's 
                                                 
1 Michael does not dispute Outagamie County's allegation 
that he is mentally ill and a proper subject for treatment under 
Wis. Stat. § 51.20(1)(a)1. 
2 State v. Randall, 192 Wis. 2d 800, 818, 532 N.W.2d 94 
(1995) (stating, "In civil commitment proceedings, the state is 
required to prove by clear and convincing evidence that a 
proposed committee is mentally disabled and dangerous.  This is 
often referred to as the Addington burden, named for the 
decision that first stated the principle.")  See ¶26, infra. 
3 All subsequent references to the Wisconsin Statutes are to 
the 2011-12 version unless otherwise indicated. 
No. 
2013AP1638-FT   
 
3 
 
dangerousness to himself. Wisconsin Stat. §§ 51.20(1)(a)2.a., 
(1)(a)2.c.  The County did not allege that Michael qualified for 
commitment on the basis of his dangerousness to others.  What 
the County must prove by clear and convincing evidence in this 
case is that there was a substantial probability that Michael 
was dangerous to himself.  This can be demonstrated by either 
"recent threats . . . of suicide or serious bodily harm";4 
"impaired judgment, evidenced by a pattern of recent acts or 
omissions";5 or both.     
¶3 
As 
to 
the 
first 
basis 
alleged 
for 
finding 
dangerousness, relating to "recent threats of  . . . suicide," 
Michael contends that the sole evidence is the fact that he 
answered "yes" to a nurse who asked if he was suicidal.  He 
                                                 
4  Wisconsin Stat. §51.20 (1)(a)2.a. states, "The individual 
is dangerous because he or she . . . [e]vidences a substantial 
probability of physical harm to himself or herself as manifested 
by evidence of recent threats of or attempts at suicide or 
serious bodily harm." 
5 Wisconsin Stat. § 51.20(1)(a)2.c. states: 
The individual is dangerous because he or she . . . 
[e]vidences such impaired judgment, manifested by 
evidence of a pattern of recent acts or omissions, 
that there is a substantial probability of physical 
impairment or injury to himself or herself. The 
probability of physical impairment or injury is not 
substantial under this subd. 2. c. if reasonable 
provision for the subject individual's protection is 
available in the community and there is a reasonable 
probability that the individual will avail himself or 
herself of these services, if the individual may be 
provided protective placement or protective services 
under ch. 55 . . . .  
No. 
2013AP1638-FT   
 
4 
 
asserts that this is evidence only of thoughts, and that such 
thoughts do not constitute clear and convincing evidence of 
threats because the word "threat"6 has a common meaning of an 
expression of an intention to act, and he expressed no intent to 
act.  As to the second way of demonstrating dangerousness, 
relating to a pattern of acts indicating impaired judgment, 
Michael contends that the evidence is insufficient to support 
the verdict because the only pattern was a pattern of asking to 
be taken to a hospital, which he did four times in the span of 
five days, and because there was not enough other evidence of 
impaired judgment to satisfy the "substantial probability" 
requirement. 
¶4 
The statute does not define "threat."  The word's 
common meanings are "an expression of an intention to inflict 
injury"7 and "an indication of impending danger or harm."8   As 
mental health scholarship recognizes, "suicidal" is commonly 
used by persons with intent to act and persons without intent to 
                                                 
6 State v. Perkins, 2001 WI 46, ¶43, 243 Wis. 2d 141, 626 
N.W.2d 762 (stating that "[t]he common definition of threat is 
an expression of an intention to inflict injury on another"). 
7 1868 American Heritage Dictionary of the English Language 
(3d ed. 1992).  This definition was mentioned in Perkins, 243 
Wis. 2d 141, ¶43, in which this court distinguished the common 
definition from the narrower definition for purposes of a 
statute criminalizing threats to judges. 
8 1868 American Heritage Dictionary of the English Language 
(3d ed. 1992). 
No. 
2013AP1638-FT   
 
5 
 
act.9  Where credible evidence supports an inference that a 
person who affirmed that he was suicidal had an intent to act, 
we will not reverse a jury's dangerousness finding on the 
grounds that the person was not specific enough in articulating 
his intent.  Although we need not adopt a precise definition for 
"threat" for purposes of Wis. Stat. § 51.20, we do conclude that 
the acts alleged here (which are not in dispute) can satisfy the 
term's common meanings.  
¶5 
We turn to the sufficiency of the evidence challenge, 
and we view the following evidence in a manner that is most 
favorable to sustaining the verdict: Michael had recently been 
given a knife and usually carried it with him; after a week of 
increasingly disturbing and delusional behavior, when a nurse 
asked if he was "suicidal," he answered that he was; when asked 
immediately thereafter by his mother to clarify if he had a 
specific plan to kill himself, he stated that it was too hard to 
explain; when talking to police officers he answered that he 
wanted to harm himself; he had a pattern of refusing medication; 
and he had demonstrated multiple instances of impaired judgment 
on a daily basis during the preceding week.   
                                                 
9 See infra, ¶36, for discussion of scholarship on suicidal 
ideation.  
No. 
2013AP1638-FT   
 
6 
 
¶6 
We conclude that an articulated plan is not a 
necessary component of a suicide threat.10 If we were to hold 
otherwise, it would require a person in a confused mental state 
to 
articulate 
a 
plan 
before 
obtaining 
treatment 
through 
involuntary commitment.  That would write into the statute a 
potential barrier to treatment that is inconsistent with its 
purpose.  We also conclude that the evidence was sufficient to 
support 
Michael's 
involuntary 
commitment 
because 
credible 
evidence existed in the record supporting inferences that there 
was a substantial probability that he was dangerous to himself 
within the meaning of Wis. Stat. §§ 51.20(1)(a)2.a., based on 
threats of suicide or serious bodily harm, and (1)(a)2.c., based 
on impaired judgment, manifested by a pattern of recent acts.11   
                                                 
10 Michael's petition for review stated this issue thus: "Do 
thoughts of suicide or self-harm, without an articulated plan 
for acting on those thoughts, constitute 'threats' of suicide or 
serious bodily harm necessary to establish dangerousness under 
Wis. Stat. § 51.20(1)(a)2.a.?" Our conclusion is that an 
articulated plan is not a requirement for a threat of suicide 
for purposes of the statute. 
11 The special verdict returned by the jury stated as 
follows: 
Question 1: Is Michael [H.] mentally ill? Answer: Yes. 
Question 2: If you answered question 1 "yes," then 
answer this question: Is Michael [H.] dangerous to 
himself? Answer: Yes. 
Question 3: If you answered both questions 1 and 2 
"yes," then answer this question: Is Michael [H.] a 
proper subject for treatment? Answer: Yes. 
 The jury had been instructed with WI JI-Civil 7050, which 
included both grounds for dangerousness relevant here. 
No. 
2013AP1638-FT   
 
7 
 
¶7 
Ultimately, our conclusion on the sufficiency of the 
evidence is dictated by the deferential review of jury verdicts.  
In such cases, we view the evidence in a light most favorable to 
the jury's determination.  The jury could have drawn another 
inference from the evidence, but the one it did draw was 
supported by credible evidence.  We will not strike down a jury 
verdict where we see "credible evidence in the record on which 
the jury could have based its decision,"12 and we "accept the 
particular inference reached by the jury."13  In light of that 
standard, we affirm the court of appeals. 
I. 
BACKGROUND 
¶8 
The incidents that gave rise to this case occurred 
when Michael came to Wisconsin for a weeklong family visit in 
February of 2013.  Michael had moved to Minnesota the previous 
year following a hospitalization in Wisconsin for treatment of a 
mental illness.  Family members said he had told them he did so 
to avoid a court order that he take anti-psychotic medication.  
His visit was planned to coincide with celebrations of family 
birthdays and a belated Christmas gift exchange. 
¶9 
As the jury heard, it was a difficult week.  Michael 
drove in from Minnesota, arriving at his mother's home about 
5:00 a.m. on a Saturday.  His mother testified that when she 
first saw him on Saturday afternoon, his symptoms had returned 
                                                 
12 Morden v. Cont'l AG, 2000 WI 51, ¶38, 235 Wis. 2d 325, 
611 N.W.2d 659. 
13 Id., ¶39. 
No. 
2013AP1638-FT   
 
8 
 
and he had a look in his eyes that reminded her of his 
appearance prior to his hospitalization.   
¶10 On Sunday, he abruptly and without explanation became 
shaken and distressed and refused to go to the mall for a 
planned family photo studio appointment.  
¶11 On Monday, he walked two miles through very cold 
weather with his five-year-old niece to demand a car from a 
sister because he believed that another sister was in danger.  
Later that day, he asked to go the hospital and was taken but 
refused medication and did not stay.  
¶12 On Tuesday, after a family birthday dinner, he again 
stated he wanted to go to the hospital and was taken but refused 
medication and did not stay.  
¶13 On Wednesday, he asked to go to the hospital, was 
taken, refused medication and did not stay.  While he was with 
his father, his mother went to the police department, seeking 
help.  Although the officer contacted the crisis worker, both 
told her there was nothing that could be done at that point. 
¶14 On Thursday, he picked up his niece, age 5, saying 
they were just going for lunch at McDonald's.  They were gone 
for hours, and repeated calls to his phone were unanswered, 
which 
alarmed 
family 
members 
and 
sent 
them 
scrambling 
frantically to find the child.  Family members reached a car 
repair shop where he had taken his vehicle and learned that he 
had been there three times but two times did not appear to have 
the child with him.  Michael's sister went to the police for 
help.  When Michael returned to his mother's, the child was safe 
No. 
2013AP1638-FT   
 
9 
 
with him, but he was oblivious to their worry and furious about 
several unrelated events, such as clothing he was missing and 
cell phones he could not activate, which he viewed as proof that 
unidentified people were following him.  
¶15 On Friday evening after dinner, he returned to his 
mother's house, asking yet again to go to the hospital.  As 
Michael's mother later testified at trial, he told her that 
evening, "[M]om, something's not right in my head.  . . . I 
can't think straight. I don't know what's going on.  I need to 
go to the hospital . . . ."  She testified that when she 
reminded him that the hospital could not help him if he would 
not take medication, he did not answer.  She described how he 
went into a bedroom and laid down, and she asked him what was 
wrong.  She testified that, at that point, "He just said I'm so 
lonely.  I don't know what's going on in my head."  She said she 
got him to agree to take medication this time if they went back 
to the hospital, and she agreed to take him.  
¶16 The 
statements 
made 
during 
that 
Friday 
evening 
emergency room visit are the ones on which Michael's argument 
primarily focuses.  When he arrived at the hospital, the nurse 
asked him, with his mother nearby, if he was suicidal.  He said 
yes.  This answer alarmed his mother; she said he had never made 
such a statement before.  Concerned at this indication that he 
may have been planning to kill himself, his mother then asked 
him, as the nurse left to contact a mental health crisis worker, 
what his plan was.  Rather than denying a plan, he responded 
that it was too hard to explain, it was too long, he could not 
No. 
2013AP1638-FT   
 
10 
 
explain, and he did not know.  Moments later, he took his jacket 
and ran from the hospital. 
¶17 Police officers found him shortly thereafter in a park 
and returned him to the hospital.  He denied thinking of suicide 
and told one of the officers that he had only wanted to hurt 
himself. 
¶18 An 
officer 
placed 
Michael 
under 
an 
emergency 
detention.  Following a probable cause hearing, a jury trial was 
held to determine whether clear and convincing evidence existed 
to commit Michael involuntarily for treatment under Wis. Stat. 
§ 51.20.  The jury heard testimony from the emergency room 
nurse, the police officer who brought Michael back to the 
hospital, a doctor who examined him prior to trial, and 
Michael’s mother.  Among the evidence heard by the jury were the 
following facts: 
- He had made repeated statements to his mother and sister 
that "nobody's safe." 
- He had acknowledged that he was suicidal to a nurse and 
made ambiguous statements about being suicidal to his 
mother. 
- He had acknowledged to a police officer that he wanted to 
harm himself. 
- He had delusional behavior and behaved in a paranoid 
manner, stating to his mother that she and his father 
should not sleep at home because unnamed persons were after 
him and would also be after them. 
No. 
2013AP1638-FT   
 
11 
 
- He owned a knife that he had received that week as a 
belated Christmas gift and usually carried it with him. 
- He had access to guns. 
- He had walked with a young child through the snow for two 
miles based on his fear that one of his sisters was in 
danger. 
- He had purchased several cell phones and explained that 
he did so to avoid being tracked by unnamed persons; he had 
thrown one phone out the car window believing it to be 
bugged. 
- He had been unable to sleep. 
- He had repeatedly told his mother that his head was not 
right and that he could not think straight and was lonely 
and sad. 
- He had refused medication, and according to a doctor who 
examined him, he "could [be dangerous] without treatment." 
¶19 The jury found that Michael was mentally ill, was a 
proper subject for treatment, and was dangerous.  Based on that 
verdict, the Outagamie County Circuit Court, the Honorable Dee 
R. 
Dyer 
presiding, 
issued 
an 
order 
committing 
Michael 
involuntarily for treatment for six months.14   
                                                 
14 The court made a finding that Michael was incompetent to 
refuse medication and an order for involuntary medication was 
also entered; that order was not appealed and is not before us. 
No. 
2013AP1638-FT   
 
12 
 
¶20 The court of appeals affirmed the jury verdict.15  As 
to the dangerousness requirement, it affirmed on the grounds 
that evidence supported a finding of dangerousness under 
subsection (1)(a)2.a., relating to threats of suicide or self-
harm.  In its analysis, it employed a common definition of 
"threat" as "an expression of an intention to inflict injury" 
and cited the evidence of Michael's statements that he was 
thinking of suicide and harming himself, as well as his 
statements implying that he had a plan to do so even though he 
refused to share it with his mother because it was "too hard to 
explain."16   Because it found the evidence sufficient to satisfy 
the requirement under subsection (1)(a)2.a., the court of 
appeals did not address the question of whether evidence was 
sufficient to satisfy dangerousness grounds under subsection 
(1)(a)2.c., relating to impaired judgment that leads to a 
substantial probability of harm to oneself. 
II. STANDARD OF REVIEW 
¶21 The standard of review is significant in this case.    
The challenge is to the sufficiency of evidence to support a 
jury verdict, and in such a challenge, a reviewing court views 
evidence most favorably to sustaining a verdict.  Tammy W-G. v. 
Jacob T., 2011 WI 30, ¶17, 333 Wis. 2d 273, 797 N.W. 2d 854.  We 
"review as a question of law whether the evidence presented to a 
                                                 
15 Outagamie 
County 
v. 
Michael 
H., 
No. 
2013AP1638, 
unpublished slip op. (Wis. Ct. App. Nov. 26, 2013). 
16 Id., ¶25. 
No. 
2013AP1638-FT   
 
13 
 
jury is sufficient to sustain its verdict."  Sheboygan Cnty. 
Dep't of Health & Human Services v. Tanya M.B., 2010 WI 55, ¶18, 
325 Wis. 2d 524, 785 N.W.2d 369 (citing State v. Booker, 2006 WI 
79, ¶12, 292 Wis. 2d 43, 717 N.W.2d 676).  "A jury's verdict 
must be sustained if there is any credible evidence, when viewed 
in a light most favorable to the verdict, to support it."  Id., 
¶49.  We have emphasized the narrowness of our review in this 
type of case: 
Our review of a jury's verdict is narrow. Appellate 
courts in Wisconsin will sustain a jury verdict if 
there 
is 
any 
credible 
evidence 
to 
support 
it. 
Moreover, if there is any credible evidence, under any 
reasonable view, that leads to an inference supporting 
the jury's finding, we will not overturn that finding. 
In applying this narrow standard of review, this court 
considers the evidence in a light most favorable to 
the jury's determination. We do so because it is the 
role of the jury, not an appellate court, to balance 
the credibility of witnesses and the weight given to 
the testimony of those witnesses. To that end, 
appellate courts search the record for credible 
evidence that sustains the jury's verdict, not for 
evidence to support a verdict that the jury could have 
reached but did not. If we find that there is "any 
credible evidence in the record on which the jury 
could have based its decision," we will affirm that 
verdict. Similarly, if the evidence gives rise to more 
than 
one 
reasonable 
inference, 
we 
accept 
the 
particular inference reached by the jury. This court 
will uphold the jury verdict "even though [the 
evidence] 
be 
contradicted 
and 
the 
contradictory 
evidence be stronger and more convincing." 
Morden v. Cont'l AG, 2000 WI 51, ¶¶38-39, 235 Wis. 2d 325, 611 
N.W.2d 659 (emphasis added). 
¶22 The questions presented about the meaning of the word 
"threat" in Wis. Stat. § 51.20 require us to interpret the 
No. 
2013AP1638-FT   
 
14 
 
meaning of a statute, and that is a question subject to de novo 
review.  Fond du Lac County v. Helen E.F., 2012 WI 50, ¶10, 340 
Wis. 2d 500, 814 N.W.2d 179.  
III. DISCUSSION 
A. 
Involuntary Commitment and  
the History of the Requirement of Dangerousness 
¶23 Up until the early 1970s, there were few requirements 
for the government to meet in order to commit a person 
involuntarily for mental treatment.       
In 1961, the American Bar Association published an 
analysis of then-existing state statutes governing 
involuntary hospitalization.  In the late 1950s, just 
seven states required some sort of dangerousness (to 
self, others, or property) as justification for 
involuntary hospitalization.  In twenty-two states, 
simply needing care or treatment was sufficient 
grounds, and seven other states permitted commitment 
if it seemed necessary for the patient's welfare or 
the 
welfare 
of 
others. 
Massachusetts 
permitted 
commitment of persons deemed "likely" to violate "the 
established laws, ordinances, conventions, or morals 
of the community."  Seventeen states had no specific 
statutory criteria for commitment, apparently leaving 
the choice of rationale entirely to legal decision-
makers. 
Douglas Mossman, M.D. et al., Risky Business Versus Overt Acts: 
What Relevance Do "Actuarial," Probabilistic Risk Assessments 
Have 
for 
Judicial 
Decisions 
on 
Involuntary 
Psychiatric 
Hospitalization?, 11 Hous. J. Health L. & Pol'y 365, 373-76 
(2012) (footnotes omitted).  Wisconsin's statutory scheme for 
involuntary commitment at that time was characterized as 
follows:  
No. 
2013AP1638-FT   
 
15 
 
it failed to require effective and timely notice of 
"charges" justifying detention; failed to require 
notice of rights including right to jury trial, 
permitted detention longer than 48 hours without 
hearing on probable cause; permitted detention longer 
than two weeks without full hearing on necessity for 
commitment; permitted commitment based on hearing in 
which person detained was not represented by adversary 
counsel, at which hearsay evidence was admitted, and 
in which psychiatric evidence was presented without 
patient having been given benefit of privilege against 
self-incrimination; permitted commitment without proof 
of mental illness and dangerousness beyond reasonable 
doubt; and failed to require those seeking commitment 
to consider less restrictive alternatives.17 
¶24 Then, two cases changed the landscape of involuntary 
commitment law dramatically.  One was O'Connor v. Donaldson,18 
which held that in order to commit a person involuntarily, the 
state must prove that a mentally ill person was "dangerous to 
himself or others":  
The modern history of involuntary commitment began 
with the Supreme Court decision in O'Connor v. 
Donaldson in 1975. Donaldson, diagnosed with paranoid 
schizophrenia, was kept in a state-run mental hospital 
for nearly fifteen years following an involuntary 
commitment initiated by his father. He repeatedly 
asked for his release, arguing that he was not being 
treated for his mental condition and did not pose a 
danger to himself or others. 
The Supreme Court agreed, holding that in order to 
constitutionally commit and confine an individual, the 
state must show that the person is dangerous to 
himself or others and that they are not capable of 
living safely under the supervision of family or 
friends. 
                                                 
17 Lessard v. Schmidt, 349 F. Supp. 1078 (E.D. Wis. 
1972) (vacated and subsequently reinstated).    
18 O'Connor v. Donaldson, 422 U.S. 563 (1975). 
No. 
2013AP1638-FT   
 
16 
 
Dan Moon, The Dangerousness of the Status Quo: A Case for 
Modernizing Civil Commitment Law, 20 Widener L. Rev. 209, 212 
(2014) (footnotes omitted). 
¶25 The other was Lessard v. Schmidt,19 a Wisconsin case 
that established substantive and procedural rights for those 
undergoing commitment procedures.  In that case, a federal 
three-judge panel held that in order to satisfy due process 
guarantees, 
persons 
subject 
to 
involuntary 
commitment 
proceedings were entitled to written and oral notice of various 
rights, a probable cause hearing within a limited period of time 
with appointed counsel, written notice of the final hearing, and 
a full hearing within 14 days of the original detention.  
¶26 The case is regarded as groundbreaking.  The Wisconsin 
Supreme 
Court 
called 
the 
change 
resulting 
from 
Lessard 
"radical": 
                                                 
19 The case has a complicated procedural history, but the 
substance of its holding was never overruled; the original order 
was altered to add more specificity and ultimately reinstated. 
The first order, Lessard v. Schmidt (Lessard I), 349 F.Supp. 
1078 (E.D. Wis. 1972), generally held that the state's existing 
involuntary commitment statutory scheme was unconstitutional.  
When the order was appealed, the United States Supreme Court 
held that the injunctive relief granted needed to be specific 
and remanded to the district court for that purpose.  Lessard 
II, 414 U.S. 473 (1974)).  On remand, in Lessard III, 379 
F.Supp. 1376, 1380-82 (E.D. Wis. 1974), the district court 
stated the injunctive relief from its original order in more 
specific terms.  When the case was again appealed, the United 
States Supreme Court remanded for further consideration in light 
of another recently decided case.  Lessard IV, 421 U.S. 957 
(1975).  On remand, the district court reinstated the prior 
order of the court. Lessard V, 413 F.Supp. 1318 (E.D. Wis. 
1976). 
No. 
2013AP1638-FT   
 
17 
 
Wisconsin law regarding the institutionalization of 
the mentally disabled underwent radical change with 
the landmark federal district court decision in 
Lessard v. Schmidt, in which Wisconsin's involuntary 
civil commitment law was held unconstitutional. In 
response to Lessard, the legislature enacted three new 
civil 
commitment 
laws . . . [including] 
one 
for 
persons who are acutely mentally ill . . . . [T]hese 
laws authorize court ordered institutionalization of 
mentally disabled individuals for the purpose of care 
and custody. 
Watts v. Combined Cmty. Servs. Bd. of Milw. Cnty., 122 Wis. 2d 
65, 72, 362 N.W.2d 104 (1985) (citations omitted).  But the 
changes reverberated far beyond Wisconsin.  "Lessard's legal 
model launched a sweeping trend toward stricter commitment 
criteria and greater procedural protection not only in the 
courts, but in the state legislatures as well."  Ronald L. 
Wisor, Jr., Community Care, Competition and Coercion: A Legal 
Perspective on Privatized Mental Health Care, 19 Am. J.L. & Med. 
145, 150 (1993).   
Passage 
of 
. . . statutes 
[encouraging 
community 
treatment rather than institutionalization] coincided 
with several court decisions that elaborated the 
substantive and procedural due process rights of 
individuals subject to civil commitment. . . . [T]he 
most significant of these cases is Lessard v. Schmidt, 
a 1972 Wisconsin federal district court decision that 
sparked 
a 
nationwide 
transformation 
in 
civil 
commitment statutes. 
Mossman, supra at 373-376 (footnotes omitted). 
¶27 Lessard's requirements have generally stood the test 
of time, although the burden of proof it imposed was lowered in 
a subsequent case by the United States Supreme Court to the 
No. 
2013AP1638-FT   
 
18 
 
"clear and convincing evidence" standard.20  Addington v. Texas, 
441 U.S. 418, 419-20 (1979). 
B. What it Takes to Satisfy the Wisconsin Statute's 
Requirement of Dangerousness 
¶28 As noted, Wisconsin involuntary commitment statutes, 
which did not previously contain a requirement of dangerousness, 
were accordingly revised.  Wisconsin Stat. § 51.20, the 
                                                 
20 The United States Supreme Court's analysis on the issue 
is summarized thus: 
The question of what standard of proof courts should 
apply to satisfy the Due Process Clause of the 
Fourteenth 
Amendment 
in 
an 
involuntary 
civil 
commitment proceeding remained unanswered until the 
Supreme Court addressed the issue in Addington v. 
Texas, 441 U.S. 418, 419-20, 432-33 (1979). . . .  The 
Court balanced the individual's interest in not being 
involuntarily committed for an open-ended period of 
time against the state's interest in confining the 
dangerous mentally ill. The Court carefully considered 
the criminal standard of proof of "beyond a reasonable 
doubt" 
but 
rejected 
that 
standard, 
finding 
it 
practically impossible to prove in the context of the 
uncertain 
and 
imperfect 
character 
of 
psychiatric 
diagnosis. 
The 
Court 
similarly 
rejected 
the 
"preponderance of 
the evidence" standard as too 
minimal to satisfy due process requirements, given the 
serious 
deprivation 
of 
freedom 
involved 
in 
the 
involuntary civil commitment process. Instead, the 
Court held that the intermediate standard of "clear 
and convincing" satisfies due process requirements in 
cases of involuntary civil commitment. 
Alison Pfeffer, "Imminent Danger" and Inconsistency: The Need 
for National Reform of the "Imminent Danger" Standard for 
Involuntary Civil Commitment in the Wake of the Virginia Tech 
Tragedy, 30 Cardozo L. Rev. 277, 285-86 (2008) (citations 
omitted). 
No. 
2013AP1638-FT   
 
19 
 
involuntary commitment statute, requires the county to prove by 
clear 
and 
convincing 
evidence 
that 
the 
individual 
whose 
commitment is sought is mentally ill and is a proper subject for 
treatment, and that the person is dangerous to himself or 
herself, or others.  Wis. Stat. §§ 51.20(1)(a)1., (1)(a)2. 
¶29 The statute identifies five ways the county can meet 
its burden to prove dangerousness, two of which are relevant 
here.  (As previously noted, Michael does not contest that he 
meets the first qualification for commitment, that he is 
mentally ill and a proper subject for treatment.) 
¶30 The County can demonstrate that "[t]he individual is 
dangerous because he or she . . . [e]vidences a substantial 
probability of physical harm to himself or herself as manifested 
by evidence of recent threats of or attempts at suicide or 
serious bodily harm." Wis. Stat. §51.20 (1)(a)2.a.   
¶31 The County can also demonstrate dangerousness by 
showing clear and convincing evidence of a pattern of acts 
showing such impaired judgment that he was dangerous to himself: 
The individual is dangerous because he or she . . . 
[e]vidences such impaired judgment, manifested by 
evidence of a pattern of recent acts or omissions, 
that there is a substantial probability of physical 
impairment or injury to himself or herself. The 
probability of physical impairment or injury is not 
substantial under this subd. 2. c. if reasonable 
provision for the subject individual's protection is 
available in the community and there is a reasonable 
probability that the individual will avail himself or 
herself of these services, if the individual may be 
provided protective placement or protective services 
under ch. 55 . . . .   
Wis. Stat. §51.20 (1)(a)2.c. 
No. 
2013AP1638-FT   
 
20 
 
C. Whether Credible Evidence Supported the Commitment Under 
2.a., Relating to Threats of Suicide or Self-harm 
¶32 The first of Michael's challenges is to the jury's 
verdict that the evidence was sufficient to find him dangerous 
if that is demonstrated under the (1)(a)2.a. standard, which 
bases dangerousness on "recent threats of . . . suicide or 
serious bodily harm."  The evidence that he answered "yes" when 
he was asked if he was suicidal is not evidence of a recent 
threat of suicide, he contends, because thoughts are not threats 
and because he took no act in furtherance of the thoughts.  He 
points to the common definition of "threat" cited in State v. 
Perkins, "an expression of an intention to inflict injury,"21 and 
argues that his statements fall short of expressing "an 
intention."  He cites to two cases to illustrate the contrast 
between specific intentional plans and a lack of evidence of 
specific dangerous conduct.  In support of the former, he cites 
R.J. v. Winnebago County, 146 Wis. 2d 516 (Ct. App. 1988), in 
which the court held that graphic threats to seriously harm 
another person were sufficient to support involuntary commitment 
even if the intended person was unaware of the threat.  As an 
illustration of the latter, he cites to Milwaukee County v. 
Cheri V., unpublished slip op. (Ct. App., Dec. 18, 2012), which 
held that evidence was insufficient on the dangerousness prong 
where all the evidence showed was that the person was upset, 
                                                 
21 Perkins, 243 Wis. 2d 141, ¶43. 
No. 
2013AP1638-FT   
 
21 
 
angry, and agitated but made no statements regarding harm to 
herself or others.22    
¶33 The County argues that the evidence on this point was 
sufficient to support the verdict.  It argues that the four 
witnesses were credible.  It notes that he answered that he was 
suicidal, and in a separate conversation he told police he 
wanted to harm himself, and those answers did constitute 
evidence of a threat of suicide or serious bodily harm.  The 
County notes that in addition to the narrow definition of 
"threat" discussed by Michael, the word has common meanings that 
are more broad, such as "an indication of impending danger or 
harm."  It also argues that in response to his mother's question 
about a suicide plan, it would have been reasonable to expect 
him to deny having a plan, if that were the case; instead, his 
answers were evasive, and he fled the room.  The County argues 
that a narrow interpretation of the word "threat" would 
undermine the purposes of the involuntary commitment statute by 
limiting 
such 
commitments 
to 
situations 
where 
a 
person 
articulates a clear intention of plans for self-harm. 
                                                 
22 Michael also cites to two involuntary commitment cases 
from the Oregon Court of Appeals as instructive.  Michael does 
not address the fact that the statutes involved, Oregon Rev. 
Stats. §§  426.005 and 426.130, differ significantly from the 
Wisconsin statute; the statute does not provide what constitutes 
grounds for a finding of dangerousness, for example, so there is 
no provision comparable to the ones we consider here.  For that 
reason the cases are of little help in interpreting the 
provision concerning threats of self-harm in Wis. Stat. § 51.20. 
No. 
2013AP1638-FT   
 
22 
 
¶34 As noted, the statute does not define "threat." 
Perkins merely recited a common meaning of the word in contrast 
to the more narrow meaning given to it in a particular criminal 
statute; therefore, that case provides little guidance for 
purposes of defining "threat" in this context.  The ordinary 
definitions of threat include "an indication of impending danger 
or harm," and under that definition, the jury could reasonably 
have considered Michael's statements to be threats.   
¶35 As the County correctly points out, one of the 
purposes of Chapter 51 is to facilitate treatment for the 
dangerous mentally ill who will benefit from it.  It would be 
unreasonable to expect a person who is in a poor or confused 
mental state to be capable of making a clear and coherent 
statement of intention of what his or her plans are.  Doing so 
would render the statute unworkable for the very people for whom 
it is designed.     
¶36 Michael did undisputedly acknowledge that he was 
suicidal.  The meaning of "suicidal," according to mental health 
professionals 
and 
established 
instruments 
for 
treatment, 
encompasses both suicidal ideation that is without intent and 
suicidal ideation that is made with intent to harm.  The 
Columbia 
Suicide 
Severity 
Rating 
Scale 
(C-SSRS)23 
is 
a 
                                                 
23 The Columbia Suicide Severity Rating Scale (C-SSRS) 
"involves a series of probing questions to inquire about 
possible suicidal thinking and behavior."  3 Draft Guidance For 
Industry Suicidality: Prospective Assessment Of Occurrence In 
Clinical Trials, Food and Drug Administration, Center for Drug 
Evaluation and Research (September 2010).   
No. 
2013AP1638-FT   
 
23 
 
questionnaire in extensive use by mental health professionals to 
assess suicide risk.  In the category of "suicidal ideation," 
the scale lists five categories, some without intent to act and 
some with intent to act: "wish to be dead," "suicidal thoughts," 
"suicidal thoughts with method (but without specific plan or 
intent to act)," "suicidal intent (without specific plan)," and 
"suicidal intent with specific plan."  There is extensive debate 
in the mental health treatment community about how to predict 
which 
suicidal 
patients 
are 
at 
highest 
risk 
of 
killing 
themselves.24  It is within the realm of ordinary experience that 
some suicidal people have an intent to follow through and harm 
themselves and others do not.  The jury could have drawn the 
inference from Michael's statement and the other evidence 
presented that he was not making a "threat of suicide or bodily 
harm."  But it did not draw that inference.     
¶37 We see no reason to hold that an articulation of a 
specific plan is necessary in order to constitute a threat for 
purposes of this statute.  Therefore, we conclude that the 
                                                 
24 The challenge posed by the lack of useful, universal 
nomenclature for the study and prevention of suicide was 
discussed in one seminal academic writing that noted what it 
called "a basic, almost incredible reality: Despite hundreds of 
years of writing and thinking about suicide, and many decades of 
focused suicide research, there is to this day no generally 
accepted 
nomenclature 
for 
referring 
to 
suicide-related 
behaviors——not even at the most basic, conversational level." 
Patrick W. O'Carroll, et al., 238 Beyond the Tower of Babel: A 
Nomenclature 
for 
Suicidology, 
Suicide 
and 
Life-Threatening 
Behavior, Vol. 26(3), Fall 1996. 
No. 
2013AP1638-FT   
 
24 
 
verdict as to the basis in Wis. Stat. § 51.20 (1)(a)2.a. is 
supported by credible evidence and we will not disturb it. 
D. Whether Credible Evidence Supported the Commitment Under 
2.c., Relating to a Pattern of Acts Indicating Impaired Judgment 
¶38 Wisconsin Stat. § 51.20 (1)(a)2.c., the second grounds 
for dangerousness relevant here, states: 
The individual is dangerous because he or she . . . 
[e]vidences such impaired judgment, manifested by 
evidence of a pattern of recent acts or omissions, 
that there is a substantial probability of physical 
impairment or injury to himself or herself. The 
probability of physical impairment or injury is not 
substantial under this subd. 2. c. if reasonable 
provision for the subject individual's protection is 
available in the community and there is a reasonable 
probability that the individual will avail himself or 
herself of these services, if the individual may be 
provided protective placement or protective services 
under ch. 55 . . . . 
The question is therefore whether the evidence was sufficient to 
support the jury's finding that Michael was dangerous to himself 
if that finding was based on facts demonstrating that he had 
shown "such impaired judgment, manifested by evidence of a 
pattern of recent acts or omissions, that there [was] a 
substantial probability of physical impairment or injury to 
himself or herself."   
 
¶39 We repeat the evidence noted above that the jury heard 
about Michael's behavior because in this case, the same evidence 
supporting the finding of dangerousness demonstrated under 
(1)(a)2.a. also supports a finding of dangerousness demonstrated 
under (1)(a)2.c. because the pattern of his paranoia and 
No. 
2013AP1638-FT   
 
25 
 
increasing distress is relevant to both ways of demonstrating 
dangerousness: 
- He had made repeated statements to his mother and sister 
that "nobody's safe." 
- He had acknowledged that he was suicidal to a nurse and 
made ambiguous statements about being suicidal to his 
mother. 
- He had acknowledged to a police officer that he wanted to 
harm himself. 
- He had delusional behavior and behaved in a paranoid 
manner, stating to his mother that she and his father 
should not sleep at home because unnamed persons were after 
him and would also be after them. 
- He owned a knife that he had received that week as a 
belated Christmas gift and usually carried it with him. 
- He had access to guns. 
- He had walked with a young child through the snow for two 
miles based on his fear that one of his sisters was in 
danger. 
- He had purchased several cell phones and explained that 
he did so to avoid being tracked by unnamed persons; he had 
thrown one phone out the car window believing it to be 
bugged. 
- He had been unable to sleep. 
- He had repeatedly told his mother that his head was not 
right and that he could not think straight and was lonely 
and sad. 
No. 
2013AP1638-FT   
 
26 
 
- He had refused medication, and according to a doctor who 
examined him, he "could [be dangerous] without treatment." 
¶40 Michael argues that the only pattern of recent acts 
was the repeated trips to the hospital to seek help.  But as the 
facts recited above make clear, other inferences could also be 
drawn about patterns of recent acts that week.  The jury was not 
obligated to see only the pattern Michael describes.  Jurors 
might reasonably have seen a pattern of delusional paranoia, a 
pattern of telling family members that people were out to get 
him, a pattern of refusing medication and rejecting medical 
treatment, a pattern of telling people that something was wrong 
with his head, and so on.  Based on the testimony they heard 
about the week's events, there was credible evidence from which 
jurors could conclude that Michael's symptoms were worsening and 
he was becoming distressed to the point that there was a 
substantial probability of injury to himself——the testimony of 
Michael's mother, for instance, made clear that the statement he 
made to the nurse was the first time he had ever spoken of 
suicide. 
¶41 We also note that this provision of the statute makes 
an 
exception 
for 
a 
person 
exhibiting 
such 
judgment 
"if . . . there is a reasonable probability that the individual 
will avail himself . . . of [community] services."  Wis. Stat. 
§ 51.20(1)(a)2.c.  Although there was evidence of Michael's 
repeated trips to the hospital during the week, there was also 
overwhelming evidence that he was unwilling to take medication 
and to avail himself of the help that was offered.  The evidence 
No. 
2013AP1638-FT   
 
27 
 
showed that on three occasions he left after going to a hospital 
without accepting medication.  The evidence showed that on the 
fourth visit to a hospital, he left almost immediately, 
following an intake interview, before a doctor or crisis worker 
could be summoned.  We decline to hold that, as a matter of law, 
merely going to a hospital and declining help satisfies the 
statute's exception concerning a person's willingness to avail 
himself of community services; nor does Michael assert that we 
should.    
¶42 Viewing the evidence most favorably to the jury 
verdict, we conclude that credible evidence supports the verdict 
if dangerousness is based on the grounds stated in Wis. Stat. 
51.20(1)(a) 2.c. 
IV. 
CONCLUSION 
¶43 We conclude that an articulated plan is not a 
necessary component of a suicide threat.  If we were to hold 
otherwise, it would require a person in a confused mental state 
to 
articulate 
a 
plan 
before 
obtaining 
treatment 
through 
involuntary commitment.  That would write into the statute a 
potential barrier to treatment that is inconsistent with its 
purpose.  We also conclude that the evidence was sufficient to 
support 
Michael's 
involuntary 
commitment 
because 
credible 
evidence existed in the record supporting inferences that there 
was a substantial probability that he was dangerous to himself 
within 
the 
meaning 
of 
Wis. 
Stat. 
§§ 51.20(1)(a)2.a. 
and 
(1)(a)2.c.   
No. 
2013AP1638-FT   
 
28 
 
¶44 Ultimately, 
our 
conclusion 
is 
dictated 
by 
the 
deferential review of jury verdicts.  In such cases, we view the 
evidence in a light most favorable to the jury's determination.  
The jury could have drawn another inference from the evidence, 
but the one it did draw was supported by credible evidence.  We 
will not strike down a jury verdict where we see "credible 
evidence in the record on which the jury could have based its 
decision,"25 and we "accept the particular inference reached by 
the jury."26  In light of that standard, we affirm the court of 
appeals.   
By the Court.—Affirmed 
 
  
                                                 
25 Morden, 235 Wis. 2d 325, ¶39. 
26 Id. 
No. 
2013AP1638-FT   
 
 
 
1