Court Opinion

ID: 9387503
Source: CourtListenerOpinion
Date Created: 2023-04-18 12:04:20.685276+00
Date Added: 2024-06-11T17:18:13.865378
License: Public Domain

IN THE COURT OF APPEALS OF NORTH CAROLINA

                                          No. COA22-639

                                        Filed 18 April 2023

Wake County, No. 22 SPC 895

IN THE MATTER OF: D.H.

      Appeal by respondent from order entered 11 April 2022 by Judge Mark Stevens

in Wake County District Court. Heard in the Court of Appeals 7 February 2023.

      Attorney General Joshua H. Stein, by Special Deputy Attorney General Robert
      T. Broughton, for the State.

      Appellate Defender Glenn Gerding, by Assistant Appellate Defender David W.
      Andrews, for respondent-appellant.

      ZACHARY, Judge.

      D.H.1 (“Respondent”) appeals from an Involuntary Commitment Order entered

against him. Respondent argues that the trial court’s ultimate finding that he posed

a danger to himself was not supported by its underlying findings regarding whether,

absent inpatient mental health treatment, there was a reasonable probability that

Respondent would suffer serious physical debilitation in the near future; in turn,

Respondent contends, these findings were not supported by the evidence. After

careful review, we affirm.

                                            Background

      1   Given the sensitive nature of this appeal, we use initials to protect Respondent’s identity.
                                     IN RE: D.H.

                                  Opinion of the Court

      On 28 March 2022, Respondent’s father executed an Affidavit and Petition for

Involuntary Commitment alleging, inter alia, that Respondent was “hearing voices[,]”

hallucinating, “riding around the city of Raleigh displaying odd [b]ehaviors[,]” and

refusing to participate in therapy or take his medication. The magistrate ordered that

Respondent be taken into custody later that day.

      The next day, Dr. Nancy Clayton of UNC Health Care Crisis and Assessment

Services at WakeBrook, an inpatient 24-hour facility, examined Respondent and

completed a “24 Hour Facility Exam for Involuntary Commitment” form. On the form,

Dr. Clayton marked boxes indicating that Respondent was “[a]n individual with a

mental illness[,]” “[d]angerous to” himself, and “[d]angerous to” others. To support

her conclusions, Dr. Clayton included in the “Description of Findings” that

Respondent

             was telling parents about being Emperor of Japan.
             [Respondent is] distractible and slow to respond.
             [Respondent] appears to respond to internal stimuli and is
             thought blocking in interview. He reports being off meds
             [for] several months and denies need for meds or having a
             mental illness despite this being his 3rd psych
             admit[tance] since March 2021. 1st psychosis noted in
             March 2021 when [Respondent] hospitalized at Old
             Vineyard. [Respondent] had taken off and driven for long
             periods when unwell in the past and more recently. Family
             report he is having poor sleep. [Respondent] recently fired
             from job a week ago due to poor performance. [Respondent]
             needs inpatient hospitalization for safety/stabilization.

                                           2
                                             IN RE: D.H.

                                         Opinion of the Court

       This matter came on for hearing on 7 April 2022 in Wake County District

Court.2 The trial court heard testimony from Respondent, Respondent’s father, and

Dr. Clayton, and on 11 April 2022, the court entered an Involuntary Commitment

Order. In the order, the trial court marked boxes indicating that Respondent was

mentally ill and dangerous to himself. To support those conclusions, the trial court

marked another box that stated: “Based on the evidence presented, the Court . . . by

clear, cogent, and convincing evidence finds . . . facts supporting involuntary

commitment”; the court attached to the order and incorporated by reference a

document titled “Findings of Fact in Support of Inpatient Commitment.” The trial

court found, in relevant part, the following additional facts in support of involuntary

commitment:

                                      I. As to Mental Illness

               The Court finds by clear, cogent, and convincing evidence
               that . . . Respondent suffers from a mental illness —
               specifically, the mental illness of schizophrenia. . . .

                       ....

                                II. As to Dangerousness to Self

               The Court also finds by clear, cogent, and convincing
               evidence that . . . Respondent is dangerous to self because
               within the relevant past he has acted in such a way as to
               show that he would be unable, without care, supervision,

       2  A transcript of the commitment hearing, which was conducted via Webex, was unavailable
due to a malfunction in the recording equipment. In lieu of a transcript, the parties requested that the
hearing participants submit their notes and written recollections of the testimony in narrative form,
pursuant to N.C.R. App. P. 9(c)(1). The participants’ responses are included in the record on appeal,
which was settled by the parties’ stipulation and agreement. See N.C.R. App. P. 11(b).

                                                   3
                         IN RE: D.H.

                     Opinion of the Court

and the continued assistance of others not otherwise
available to exercise self-control, judgment, and discretion
in the conduct of his daily responsibilities and social
relations, and there is a reasonable probability of
Respondent suffering serious physical debilitation within
the near future unless adequate inpatient treatment is
given. In support of this finding of ultimate fact, this Court
finds the following evidentiary facts based upon the
competent evidence from the hearing:

      ....

       3. Respondent’s psychiatric state was declining prior
to his admission to Wake[B]rook as evidenced by the
following events and behaviors occurring within the
relevant past:

             i. In June 2021 Respondent believed himself
      to be involved with the FBI and drove to northern
      Virginia for this reason. Similarly, in August or
      September 2021 Respondent believed himself to be
      President of the United States and drove to
      Washington DC for this reason.

            ii. In January 2022 Respondent quit taking
      medication prescribed for the treatment of his
      mental illness. He did so because he did not like the
      medicine, and because he had secured a job driving
      for Amazon.

            iii. After becoming medication non-compliant,
      Respondent began talking and laughing to himself
      with increasing frequency and regularity. He also
      regularly paced throughout his home and his sleep
      habits changed. . . .

             ....

             vi. During this time Respondent lost his
      delivery job with Amazon, having held it for only
      approximately two weeks. He held his prior delivery
      job with UPS for more than one year, and

                              4
                        IN RE: D.H.

                     Opinion of the Court

      Respondent’s father attributed the loss of the
      Amazon job to Respondent’s increasingly erratic
      behavior.

             ....

            ix.   When       Respondent   arrived     at
      Wake[B]rook[’s] Crisis and Assessment unit on 28
      March 2022 he displayed delusional and
      disorganized thought processes as well as thought
      blocking,   endorsed     auditory  hallucinations,
      displayed a blunted affect, and was observed
      responding to internal stimuli.

      4. Since being admitted to Wake[B]rook[’s] Inpatient
unit on 29 March 2022 Respondent has continued to
display many of these same symptoms. . . . In addition, he
has resisted cooperating with lab-work and his medication
regimen.

      5. It is the opinion of Dr. Clayton that when
Respondent arrived at Wake[B]rook on 28 March 2022 he
was acutely psychotic. Further, it is the opinion of Dr.
Clayton that Respondent remains acutely psychotic as of
the date of this hearing. This Court finds Dr. Clayton’s
opinions to be credible. If released from Wake[B]rook in
this current condition, Respondent’s state of acute
psychosis makes it reasonably probable that he would
suffer serious physical debilitation within the near
future. Further inpatient treatment at Wake[B]rook is
therefore required to prevent such a result.

      6. It is the opinion of Dr. Clayton that Respondent
has really poor insight [in]to his mental illness, and has no
insight into the fact that he is currently acutely psychotic.
This Court finds Dr. Clayton’s opinions to be credible, and
concludes that Respondent has severely impaired insight
and judgment. As a result, this Court concludes
Respondent is currently unable to care for himself. This
conclusion is further supported by Respondent’s testimony
regarding his plans for discharge. If released from
Wake[B]rook in this current condition, Respondent’s

                              5
                         IN RE: D.H.

                     Opinion of the Court

inability to care for himself makes it reasonably probable
that he would suffer serious physical debilitation within
the near future. Further inpatient treatment at
Wake[B]rook is therefore required to prevent such a result.

       7. Respondent’s delusional, disorganized, and
irrational thought content continues to motivate his
actions, and is inconsistent with a person who has the
ability to care [for] himself. If released from Wake[B]rook
in this current condition, Respondent’s inability to care for
himself makes it reasonably probable that he would suffer
serious physical debilitation within the near future.
Further inpatient treatment at Wake[B]rook is therefore
required to prevent such a result.

      ....

       9. Respondent does not believe that anything is
wrong with him, does not believe that he needs any
medication, and has testified that he will not take the
medication once discharged from Wake[B]rook. He ceased
voluntarily taking his medication while in the community
prior to coming to Wake[B]rook, and at various times since
arriving at Wake[B]rook has been resistive to voluntarily
taking the medication. . . .

       10. It is the opinion of Dr. Clayton that if discharged
in his current condition Respondent would not comply with
any treatment regimen and that an abrupt psychiatric
decompensation would result. This Court finds Dr.
Clayton[’s] opinion to be credible.

     11. The Court concludes based on these facts that
Respondent — if released in his current condition — will
immediately become medication non-compliant.

      12. If released before an effective medication
regimen can be established or if Respondent becomes non-
compliant with an effective regimen, this Court finds that
it is reasonably probable that a rapid decline in
Respondent’s psychiatric condition would occur in the near
future, with a reemergence in the acutely psychotic

                              6
                                       IN RE: D.H.

                                   Opinion of the Court

             symptoms that caused him to present to Wake[B]rook on
             28 March 2022. A rapid decline in Respondent’s psychiatric
             condition would make it reasonably probable that
             Respondent would suffer serious physical debilitation
             within the near future. Further inpatient treatment at
             Wake[B]rook is therefore required to prevent such a result.

      The trial court ordered that Respondent be committed for 60 days to UNC

Hospitals at WakeBrook. Respondent timely appealed.

                                      Discussion

      On appeal, Respondent argues that the trial court erred by involuntarily

committing Respondent because the evidence did not support the court’s finding that

it was “reasonably probable that Respondent would suffer serious physical

debilitation within the near future” absent inpatient mental health treatment, and

thus there was no support for the court’s determination that Respondent was

“dangerous to himself[.]”

      As a preliminary matter, we note that although Respondent’s Involuntary

Commitment Order has expired, the argument before us is not moot because “the

challenged judgment may cause collateral legal consequences for the appellant.” In

re Booker, 193 N.C. App. 433, 436, 667 S.E.2d 302, 304 (2008); see also, e.g., In re C.G.,

383 N.C. 224, 236, 881 S.E.2d 534, 543 (2022) (“Although the involuntary

commitment order at issue in this case has long since expired, [the] respondent’s

appeal is not moot.”).

                                            7
                                        IN RE: D.H.

                                     Opinion of the Court

       When deciding whether to involuntarily commit an individual for inpatient

treatment, the trial court must make two specific findings “by clear, cogent, and

convincing evidence[.]” N.C. Gen. Stat. § 122C-268(j) (2021). The trial court must first

find “that the respondent is mentally ill[.]” Id. The trial court must then find that the

respondent is “dangerous to self . . . or dangerous to others[.]” Id. In its order, the trial

court “shall record the facts that support its findings.” Id.

       Upon review of a commitment order, we “determine whether the ultimate

finding[s] concerning the respondent’s [mental illness and] danger to [him]self . . .

[are] supported by the court’s underlying findings, and whether those underlying

findings, in turn, are supported by competent evidence.” In re W.R.D., 248 N.C. App.

512, 515, 790 S.E.2d 344, 347 (2016). The required findings “must actually be made

by the trial court and cannot simply be inferred from the record.” C.G., 383 N.C. at

240, 881 S.E.2d at 546 (citation and internal quotation marks omitted). “However, it

is for the trier of fact to determine whether the competent evidence offered in a

particular case met the burden of proof, that is, whether the evidence of [the]

respondent’s mental illness and dangerousness was clear, cogent and convincing.” In

re J.P.S., 264 N.C. App. 58, 61, 823 S.E.2d 917, 920 (2019) (citation and internal

quotation marks omitted).

       In the instant case, Respondent challenges whether there was evidentiary

support for the trial court’s determination that he was “dangerous to himself.”

According to the definition set forth by our General Assembly, an individual is

                                              8
                                     IN RE: D.H.

                                  Opinion of the Court

“dangerous to self” if the individual has done any of the following “[w]ithin the

relevant past”:

             1. The individual has acted in such a way as to show all of
             the following:

                   I. The individual would be unable, without care,
                   supervision, and the continued assistance of others
                   not otherwise available, to exercise self-control,
                   judgment, and discretion in the conduct of the
                   individual’s daily responsibilities and social
                   relations, or to satisfy the individual’s need for
                   nourishment, personal or medical care, shelter, or
                   self-protection and safety.

                   II. There is a reasonable probability of the
                   individual’s suffering serious physical debilitation
                   within the near future unless adequate treatment is
                   given pursuant to [Chapter 122C]. A showing of
                   behavior that is grossly irrational, of actions that the
                   individual is unable to control, of behavior that is
                   grossly inappropriate to the situation, or of other
                   evidence of severely impaired insight and judgment
                   shall create a prima facie inference that the
                   individual is unable to care for himself or herself.

             2. The individual has attempted suicide or threatened
             suicide and that there is a reasonable probability of suicide
             unless adequate treatment is given pursuant to [Chapter
             122C].

             3. The individual has mutilated himself or herself or has
             attempted to mutilate himself or herself and that there is
             a reasonable probability of serious self-mutilation unless
             adequate treatment is given pursuant to [Chapter 122C].

             Previous episodes of dangerousness to self, when
             applicable, may be considered when determining
             reasonable probability of physical debilitation, suicide, or
             self-mutilation.

                                           9
                                      IN RE: D.H.

                                   Opinion of the Court

N.C. Gen. Stat. § 122C-3(11)(a).

      “The trial court must find sufficient evidence to support one of the three prongs

of this statute in order to conclude that an individual is a danger to himself.” J.P.S.,

264 N.C. App. at 62, 823 S.E.2d at 920–21; see also N.C. Gen. Stat. § 122C-3(11)(a).

      The “trial court’s involuntary commitment of a person cannot be based solely

on findings of the individual’s history of mental illness or behavior prior to and

leading up to the commitment hearing, but must include findings of a reasonable

probability of some future harm absent treatment as required by” § 122C-3(11)(a).

J.P.S., 264 N.C. App. at 62, 823 S.E.2d at 921 (citation and internal quotation marks

omitted). “Any commitment order that fails to include such findings is insufficient to

support its conclusions that the respondent presented a danger to himself and

others.” Id. (citation and internal quotation marks omitted).

      Here, Respondent does not challenge the trial court’s ultimate finding that

Respondent is mentally ill, as evinced by his schizophrenia diagnosis. Instead,

Respondent argues that the trial court’s ultimate finding that he posed a danger to

himself was not supported by its underlying findings, which, in turn, were not

supported by the evidence. We disagree.

      As noted above, to establish dangerousness to self, N.C. Gen. Stat. § 122C-

3(11)(a)(1) requires a showing of: (1) the individual’s inability without assistance to

either “exercise self-control, judgment, and discretion” when carrying out daily

responsibilities, or “satisfy the individual’s need for nourishment, personal or medical

                                           10
                                     IN RE: D.H.

                                  Opinion of the Court

care, shelter, or self-protection and safety”; and (2) “a reasonable probability of the

individual’s suffering serious physical debilitation within the near future unless

adequate treatment is given[.]” N.C. Gen. Stat. § 122C-3(11)(a)(1).

      Here, the trial court’s underlying findings are supported by the evidence, and

they are adequate to sustain the court’s determination that Respondent was

dangerous to himself. First, there was ample evidence by way of Dr. Clayton’s

testimony that in Respondent’s current “state of acute psychosis” he suffers from

“severely impaired insight and judgment” and is “unable to care for himself”

adequately, making it “reasonably probable that he would suffer serious physical

debilitation within the near future” in the absence of inpatient mental health

treatment.

      There was also substantial evidence that “Respondent — if released in his

current condition [of acute psychosis] — will immediately become medication non-

compliant[,]” rendering it even more likely that he will suffer serious physical

debilitation in the near future in the absence of inpatient mental health treatment.

Respondent’s father testified that Respondent previously ceased taking his

medication because he “did not like” the medication; Dr. Clayton testified that

Respondent “had repeatedly stated [during his assessments] that he would stop

medication and not follow up with any outpatient mental health treatment on

discharge”; and Respondent testified that he would not take his medication because

he believed that he did not suffer from any mental illness.

                                          11
                                       IN RE: D.H.

                                    Opinion of the Court

      Dr. Clayton explained that if Respondent were to become non-compliant with

his medication, “she would expect Respondent to experience a worsening of his

psychotic symptoms in the near future.” She stated that during his commitment at

WakeBrook, Respondent displayed symptoms of hearing voices, responding to

internal stimuli, experiencing delusions and paranoia, having disorganized thinking

with “thought blocking,” and demonstrating poor concentration and memory issues.

Respondent’s father also testified that Respondent’s mental condition had worsened

previously when he stopped participating in his mental health treatment, which

caused Respondent to “laugh[ ] to himself, talk[ ] to himself, and pac[e] around the

home for 5-10 minutes at a time.”

      Based on this evidence, the trial court found that Respondent “has severely

impaired insight and judgment[,]”and is unable to care for himself. See id. § 122C-

3(11)(a)(1)(II). The trial court then directly linked Respondent’s inability to care for

himself based on his past behavior and current symptoms to a risk of future harm:

“If released from Wake[B]rook in this current condition, Respondent’s inability to

care for himself makes it reasonably probable that he would suffer serious physical

debilitation within the near future.” In so finding, the trial court appropriately drew

the requisite “nexus between [R]espondent’s past conduct and future danger.” C.G.,

383 N.C. at 249, 881 S.E.2d at 551 (citation omitted).

      We conclude that the trial court made the “forward-looking findings of fact”

necessary to support its ultimate finding of a reasonable probability that Respondent

                                            12
                                    IN RE: D.H.

                                 Opinion of the Court

would suffer serious physical debilitation in the near future absent inpatient mental

health treatment, and that these findings were supported by the evidence. Id. at 250,

881 S.E.2d at 552 (Newby, C.J., concurring in part and dissenting in part). Thus, the

trial court’s findings support the court’s determination that Respondent suffers from

mental illness and poses a danger to himself, warranting involuntary commitment

for inpatient mental health treatment.

                                    Conclusion

      For the foregoing reasons, we affirm the Involuntary Commitment Order.

      AFFIRMED.

      Judge GORE concurs.

      Judge TYSON dissents by separate opinion.

                                         13
 No. COA22-639 – In re D.H.

      TYSON, Judge, dissenting.

      The trial court failed to draw the requisite “nexus between the [R]espondent’s

past conduct and future danger” to reach the conclusion it was reasonably probable

Respondent would suffer serious physical debilitation within the near future. In re

C.G., 383 N.C. 224, 249, 2022-NCSC-123, ¶ 41, 881 S.E.2d 534, 551 (2022) (citation,

internal quotation marks, and alterations omitted). Even if Respondent reverted to

his prior behaviors, petitioner’s evidence and the record demonstrates his past

psychotic symptoms and delusions were neither harmful to himself nor others to

warrant involuntary commitment. Respondent’s past symptoms alone cannot serve

as a sufficient basis of future danger to support the trial court’s conclusion. The trial

court’s order is properly vacated and remanded. I respectfully dissent.

                             I.   Standard of Review

      “The State’s burden of proof to deprive Respondent of [his] liberty demands

competent and relevant evidence and findings of fact to be based upon clear, cogent,

and convincing evidence at the involuntary commitment hearing.”              In re E.B.

AAU/MPU Wards Granville Cnty., __ N.C. App. __, __, 2022-NCCOA-839, ¶ 15, 882

S.E.2d 379, 383 (2022).

      “The trial court’s conclusions of law to involuntarily commit and deprive

Respondent of [his] liberty must be supported by its findings of fact and supporting

evidence on each required statutory element and those conclusions are reviewed de

novo on appeal.” Id. at __, ¶ 17, 882 S.E.2d at 384. This Court reviews “the trial
                                        IN RE D.H.

                                  TYSON, J., dissenting

court’s commitment order to determine whether the ultimate finding concerning the

respondent’s danger to self or others is supported by the court’s underlying findings,

and whether those underlying findings, in turn, are supported by competent

evidence” meeting the required burden of proof. In re W.R.D., 248 N.C. App. 512, 515,

790 S.E.2d 344, 347 (2016). Here, they are not.

                                  II.    Analysis

      Petitioner’s showing and the trial court’s findings are not supported by

sufficient evidence to deny Respondent his liberties.

             To find danger to self in these circumstances, the trial court
             must find that Respondent “would be unable, without care,
             supervision, and the continued assistance of others not
             otherwise available, to exercise self-control, judgment, and
             discretion in the conduct of his daily responsibilities and
             social relations, or to satisfy his need for nourishment,
             personal or medical care, shelter, or self-protection and
             safety” and that “there is a reasonable probability of his
             suffering serious physical debilitation within the near
             future” without involuntary commitment.

Id. (citing N.C. Gen. Stat. § 122C-3(11) (2021)). As the majority’s opinion correctly

notes, the lack of transcript makes this Court’s review more difficult.

      The trial court concluded it was “reasonably probable that Respondent would

suffer serious physical debilitation within the near future”, if Respondent were

released. The trial court based its conclusion on the testimony from Dr. Nancy

Clayton, who testified for the State and predicted “it [wa]s reasonably probable that

a rapid decline in Respondent’s psychiatric condition would occur in the near future,

                                           -2-
                                      IN RE D.H.

                                 TYSON, J., dissenting

with a reemergence [sic] in the acutely psychotic symptoms that caused him to

present to Wakebrook on 28 March 2022.”

      The trial court made several findings about Respondent’s past symptoms and

history of mental illness as well as Respondent’s current state. Respondent suffered

from a declining psychiatric state and delusions prior to his admission to Wakebrook.

Respondent hallucinated and occasionally traveled because of his delusions. For

example, Respondent drove to Northern Virginia because he believed he was in the

FBI, and he drove to Washington D.C. because he believed he was the President. At

one point, Respondent told his father he was the “Emperor of Japan.”

      After Respondent stopped taking his medication, he started laughing and

talking to himself; his sleep habits changed; he lost his job as an Amazon driver; and,

he left the scene as law enforcement approached his vehicle at a gas station. None of

these findings demonstrate how Respondent’s actions support a finding of future

danger to himself or others when experiencing delusions or psychotic symptoms. No

loss of liberty comes by one fantasizing or believing they are someone or something

they are not. Others share or profess the same or similar, or even more bizarre

delusions, as Respondent, who are not involuntarily committed.

      Respondent’s non-aggressive, non-violent history is insufficient to support

finding Respondent will be a harm to himself or others in the future to warrant an

involuntary commitment as opposed to home or provider-based treatments. A trial

court finding that “Respondent’s history of mental illness or her behavior prior to and

                                         -3-
                                      IN RE D.H.

                                 TYSON, J., dissenting

leading up to the commitment hearing[ ] . . . do[es] not indicate that these

circumstances rendered Respondent a danger to herself or himself in the future.” In

re Whatley, 224 N.C. App. 267, 273, 736 S.E.2d 527, 531 (2012).

      The present case is distinguishable from In re Moore, wherein an individual

displayed aggressive, harmful tendencies without medication, and the trial court had

evidence such behavior would return if the individual was released from involuntary

commitment without medical treatment. 234 N.C. App. 37, 39, 758 S.E.2d 33, 35

(2014).

      Similarly, this Court affirmed an order for involuntary commitment where an

individual suffered from schizophrenic delusions, which caused her to believe she had

blockages in her bodily systems and, when unmedicated, would self-medicate with

extreme amounts of laxatives and conduct internal self-examinations. In re E.B., __

N.C. App. at __, ¶ 10-11, 33-35, 882 S.E.2d at 382-83, 386. The trial court supported

its conclusion with evidence the individual was presently a danger to herself and

releasing her would result in immediate physical debilitations. Id. at __, ¶ 29-32, 882

S.E.2d at 386. Here, we have no such evidence or findings indicating Respondent

would suffer immediate physical debilitations or engage in aggressive, harmful

tendencies upon release. Sufficient evidence does not overcome the presumption of

Respondent’s sanity and right of liberty to support a finding or conclusion of future

danger to self or others to involuntarily commit.

                                         -4-
                                       IN RE D.H.

                                   TYSON, J., dissenting

       Additionally, the trial court’s conclusion Respondent would be unable to care

for himself is insufficient to support its finding that Respondent will “suffer serious

physical debilitation in the near future.” “[F]indings that an individual suffers from

a mental illness, exhibits symptoms associated with that mental illness, and may not

be able to take care of his or her needs are not sufficient to satisfy the second prong

of the statutory test for the presence of a ‘danger to self.’” In re C.G., 383 N.C. at 246,

¶ 38, 881 S.E.2d at 549. The trial court “must draw a nexus between past conduct and

future danger.” Id. at 246, ¶ 37, 881 S.E.2d at 549 (emphasis original) (citation and

quotation marks omitted).

       The trial court’s finding that “Respondent would not comply with any

treatment regimen and that an abrupt psychiatric decompensation would result” is

speculative, unsupported and not sufficient to order involuntary commitment. A

finding that an individual does not plan to continue treatment, without evidence of

future harm, does not support an ultimate finding of “dangerous to self.” See In re

Whatley, 224 N.C. App. at 273, 736 S.E.2d at 531 (citing N.C. Gen. Stat. § 122C-

3(11)(a)(1)).   Again, the evidence does not support a finding Respondent’s state

without treatment is or will be harmful to himself or others in the future.

       A person’s decision to reduce or discontinue prescribed medication is also not

evidence or a basis to support an involuntary commitment. In re N.U., 270 N.C. App.

427, 432-33, 840 S.E.2d 296, 300 (2020) (“[T]he findings that Respondent lacks

‘insight into her mental illness’ and is ‘unable to care for herself for daily

                                           -5-
                                       IN RE D.H.

                                  TYSON, J., dissenting

responsibilities and taking medications’ are also insufficient to show that Respondent

was a danger to herself as there is ‘no evidence that Respondent’s refusal to take [her]

medication creates a serious health risk in the near future.’”) (citation omitted);

accord In re W.R.D., 248 N.C. App. at 516, 790 S.E.2d at 348 (explaining that findings

indicating respondent “refus[ed] to acknowledge his mental illness, and refus[ed] to

take his prescription medication” failed to demonstrate how a “health risk w[ould]

occur in the near future”) (citation and internal quotation marks omitted). The trial

court’s findings are insufficient to support a conclusion and order of involuntary

commitment. In re Whatley, 224 N.C. App. at 273, 736 S.E.2d at 531.

                                III.   Conclusion

      This Court cannot affirm a conclusion and order of involuntary commitment

without findings based upon clear, competent evidence supporting such findings and

conclusion of future harm to himself or others. N.C. Gen. Stat. § 122C-3(11). While

the trial court attempts to project a connection between Respondent’s past and

present conduct with a future risk of harm, it fails to do so, as a lawful order “must

draw a nexus between past conduct and future danger.” In re C.G., 383 N.C. at 246,

¶ 37, 881 S.E.2d at 549 (emphasis original) (citation and quotation marks omitted).

A person has a right to refuse treatment and medication without loss of freedom. In

re Whatley, 224 N.C. App. at 273, 736 S.E.2d at 531; In re N.U., 270 N.C. App. at 432-

33, 840 S.E.2d at 300; In re W.R.D., 248 N.C. App. at 516, 790 S.E.2d at 348.

Respondent’s past state, or even his present status, does not sufficiently prove he will

                                          -6-
                                      IN RE D.H.

                                 TYSON, J., dissenting

harm himself or others in the future to support involuntarily depriving him of his

liberty. Id.; In re Whatley, 224 N.C. App. at 273, 736 S.E.2d at 531. The trial court’s

order is properly vacated and remanded. I respectfully dissent.

                                         -7-