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Wisconsin Supreme Court holds individual with Alzheimer’s disease not a proper subject for involuntary commitment

On May 18, 2012, the Wisconsin Supreme Court issued its decision in Helen E.F. v. Fond du Lac County, regarding the use of Chapter 51 mental health involuntary commitment procedures for individuals whose only diagnosis is Alzheimer’s with “behaviors.” Helen E.F., an 85-year-old woman with Alzheimer’s Disease, resided at a Fond du Lac County nursing home when she began to exhibit aggressive and agitated behaviors. The nursing home responded by calling the police and having Helen taken to the local hospital on an emergency detention. Eventually, Helen was involuntarily committed to a locked psychiatric unit where she was given psychotropic medications to manage her behavior. Helen’s public defender appealed this commitment.

DRW submitted amicus briefs at both the Appellate and Wisconsin Supreme Court levels. DRW’s position in this case was that a protective placement under Chapter 55 was much more suited to meet the needs of individuals with degenerative brain disorders such as Helen. The intent behind Chapter 51 mental health commitment law was to recognize the applicability of recovery concepts for individuals with mental illness. Involuntary hospitalization constitutes a severe restriction of an individual’s liberty and should be used for the shortest time possible, allowing the individual to return to their home and community and resume their daily lives. Any need that Helen might have for services to deal with her agitation and aggression could have been sought out under that system. More likely than not, this could have been accomplished right at her existing placement, thus avoiding the confusion and trauma of moving her to a locked psychiatric unit. In fact, it is often because of the lack of appropriate services in the community that crisis situations emerge which then lead to traumatizing emergency detentions.

The Supreme Court held that because Helen’s condition was not capable of cure or treatment, only behavior management, she was not “a proper subject for treatment” as required under Chapter 51. Although DRW agrees with the exclusion of Alzheimer’s and other degenerative brain disorders, standing alone, as a basis for involuntary commitment under the Wisconsin Mental Health laws, it needs to be recognized that this is an area fraught with public policy issues that must be addressed. The Supreme Court mentioned in its concurrence that it hoped that the newly formed Legislative Council Study Committee on this topic would be able to dig into these questions so that crisis situations such as Helen’s can be averted in the future.

Click here to read the decision.