Alaska justices affirm commitment despite skipped consent inquiry

The Alaska Supreme Court on Friday upheld a 90-day involuntary commitment and an order to medicate an Anchorage man against his will, even though the lower court never checked whether the hospital had first offered him voluntary treatment.

State law requires a hospital seeking commitment to allege that the patient was advised of the need for treatment but did not accept it voluntarily. The Alaska Psychiatric Institute's petition said that had happened. But an API doctor testified at a March 13, 2024 hearing that she did not think anyone at the hospital had discussed voluntary admission with the patient, identified in the opinion as Derius L.

"We conclude that it was an obvious error for the court to commit" him without inquiring further, Justice Henderson wrote.

The error did not change the outcome. Henderson wrote that a "plain error involves an 'obvious mistake' that is 'obviously prejudicial.'" The record showed Derius wanted out of API. He repeatedly said he was ready to be discharged, and his doctor predicted he would seek discharge the day after signing in voluntarily.

Because no party objected to the court master's findings within 10 days, as Alaska Probate Rule 2(f)(1) requires, the Supreme Court reviewed all three issues raised on appeal for plain error.

Derius is homeless. He has diagnoses of schizoaffective disorder bipolar type, traumatic brain injury and polysubstance dependence, and had been admitted to API 42 times. The superior court found him gravely disabled with no less restrictive option. He had been barred from Anchorage assisted living facilities and shelters. An Arizona home his brother, Aurthur, offered by phone was not workable at the time because Derius was not safe for air travel and his doctor called the home too relaxed. The court said the option could become feasible later. Derius's mother opposed the plan.

At a March 27, 2024 hearing, the superior court granted the medication petition, authorizing seven medications together, including two antipsychotics and a mood stabilizer, after finding Derius lacked capacity to consent. The Supreme Court affirmed, finding his earlier complaints to his brother about feeling sedated did not clearly amount to a competent refusal of future medication.

Separately, state agencies are taking public comment from Sept. 15 through Oct. 6 on a report required under House Bill 172. The report must recommend changes to Alaska's involuntary admission and medication processes and assess how the state collects data on patient grievances, appeals, and reports of harm or restraint.