In re: D.H. ( 2023 )

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-