Winnebago County v. J.M., 2024AP1554, 4/2/25, District II (1-judge decision, ineligible for publication); case activity
COA affirmed the circuit court’s order recommitting J.M. (referred to as “James Moore”) for twelve months and authorizing involuntarily administering medication. The Court found that Moore suffers from schizoaffective disorder, which caused him to drink an excessive amount of water to the point that he needed to be transported to the emergency room for low sodium levels in his body. The Court therefore found that Moore is a danger to himself, and that he is a proper subject for treatment because his condition is treatable with medication.
At the recommitment hearing, Jenna Nelson, a psychologist at WRC, diagnosed Moore with schizoaffective disorder, which causes him to experience manic and depressive states. When asked whether his condition might make him a danger to himself or others, Nelson said Moore has psychogenic polydipsia, which is a condition from drinking too much water and can cause medical problems. She said Moore does not have insight into this condition and denies that he needs to restrict his water intake. (¶ 5). Nelson reported that Moore said he would take his medications if there was not a court order in place, but said he refused medication one week before the hearing. (¶¶ 7-8).
Dr. Wilbur Sarino, a psychiatrist at WRC, also testified that Moore suffers from schizoaffective disorder, which he said is treatable with psychotropic medications. Sarino said he explained to Moore the advantages, disadvantages, and alternatives to accepting medication and treatment, but testified that Moore is not capable of applying an understanding of those advantages, disadvantages, and alternatives to himself because he does not believe he suffers from schizoaffective disorder. (¶ 11). Sarino also said if Moore is not committed, he will decompensate without treatment and noted that “this has been shown by prior histories of refusing medications only . . . for recommitment to be pursued.” (¶ 13). Sarino confirmed that Moore was diagnosed with psychogenic polydipsia, which was caused by his mental illness and required multiple trips to the emergency room for low sodium. (¶ 14).
Kirk Kaufman – the psychiatric care supervisor at the Wisconsin Resource Center (WRC) – testified that, when Moore is not on medication, his thoughts are “much more disorganized,” his behavior “becomes more inappropriate,” he is harder to manage, and he often gets into trouble. When he is on medication, however, Kaufman said Moore was more calm, acts appropriately, and is not as manic. (¶ 3).
On appeal, Moore challenged the circuit court’s finding that he was dangerous, a proper subject for treatment, and was incompetent to refuse medications. The COA found that the evidence was sufficient that Moore was dangerous because he “’[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 or other individuals.’” (¶ 22) (quoting Wis. Stat. § 51.20(1)(a)2.c.). The Court cited Nelson’s testimony that Moore’s psychogenic polydipsia causes him to drink an excessive amount of water and he recently needed to have his water intake regulated because he becomes a danger to himself. (¶ 23). The Court noted that this condition required Moore to be sent to an emergency room for low sodium. Although the Court considered that the County “could have done better to tease out additional details related to the extent of harm psychogenic polydipsia can lead to . . . the trips from prison to the hospital, particularly the ER, allow for a reasonable inference that because of Moore’s excessive water intake caused by his mental illness, there is a substantial probability of physical impairment or injury to himself.” (¶ 24).
The Court also concluded that Moore was a proper subject for treatment, which required the County to prove that he has rehabilitative potential. (¶ 26). Although the Court observed that Moore’s schizoaffective disorder is a permanent condition, the experts testified that his condition improved with medications; therefore, the evidence was sufficient that Moore has rehabilitative potential and is a proper subject for treatment. (¶ 29).
Regarding involuntarily administering medication to Moore, the Court cited Dr. Sarino’s testimony that he does not believe he suffers from schizoaffective disorder, his judgment is impaired, and has poor insight into his condition. (¶ 32). Although there was evidence that Moore said he would take medications if a court order was not in place, the Court noted contrary evidence that Moore refused medication days prior to the hearing. (¶ 34). The Court therefore concluded that the circuit court did not err in finding that Moore is substantially incapable of applying an understanding of the advantages, disadvantages, and alternatives to medication. (¶ 35).
