IN THE SUPREME COURT OF IOWA
No. 12–0158
Filed January 4, 2013
IN THE MATTER OF B.B., Alleged to be
Seriously Mentally Impaired,
B.B.,
Appellant.
Appeal from the Iowa District Court for Woodbury County, John D.
Ackerman, Judge.
An appellant appeals a district court order finding him “seriously
mentally impaired.” AFFIRMED.
Zachary S. Hindman of Bikakis, Mayne, Arneson, Hindman &
Hisey, Sioux City, for appellant.
Thomas J. Miller, Attorney General, Gretchen Witte Kraemer,
Assistant Attorney General, Patrick A. Jennings, County Attorney, and
Joshua D. Widman, Assistant County Attorney, for appellee.
2
APPEL, Justice.
In this case, we must determine whether an appeal from a finding
of “serious mental impairment” resulting in an involuntary commitment
under Iowa Code chapter 229 (2011) becomes moot when the appellant is
released and the proceedings are terminated. We agree with the
jurisdictions that hold such an appeal is not moot. On the merits
presented, we conclude substantial evidence supports the conclusion of
the district court that the appellant was “seriously mentally impaired.”
We therefore affirm the judgment of the district court.
I. Factual and Procedural Background.
On December 14, 2011, police brought B.B. to the emergency room
at Mercy Medical Center in Sioux City after he entered a restricted area
at an Iowa Air National Guard base. A judge then ordered B.B.’s
emergency hospitalization pursuant to Iowa Code section 229.22(3). The
judge found probable cause to believe B.B. was “seriously mentally
impaired” and “a threat to harm himself or others” because B.B. was in a
very agitated and confused state when police brought him to the
hospital, was “making wild threats to harm himself and others,” and
required “[three] police officers to keep him subdued.”
Shortly after B.B.’s emergency hospitalization, an application
alleging serious mental impairment pursuant to Iowa Code section 229.6
was filed with the District Court for Woodbury County. Two affidavits
accompanied the application. The first affidavit, made by Marlene
Sorensen, stated B.B. attempted to board a plane in Omaha, Nebraska,
with a fake passport. It further indicated that B.B. then drove to Sioux
City, Iowa, and tried to follow a worker into a secured area at the air base
in Sergeant Bluff. The affidavit further stated B.B. was paranoid when
authorities brought him into the hospital. A second affidavit, filed by
3
Jane Hoffman, was substantially the same, except it stated that B.B.
attempted to board the plane with a fake boarding pass instead of a fake
passport and also stated B.B.’s wife “fears that he might harm her or
their children if released” from the hospital.
A physician’s report was also attached to the application. The
report, authored by Dr. Ejiro Idahosa, a psychiatrist, diagnosed B.B. with
psychosis, not otherwise specified, and noted symptoms of paranoia.
Dr. Idahosa concluded B.B. lacked sufficient judgment to make
responsible decisions with respect to his hospitalization or treatment
because of the mental illness. The report further stated that, because of
his mental illness, if left at liberty without treatment B.B. was more likely
to physically injure himself or others, to inflict serious emotional injury
on members of his family or others who lacked a reasonable opportunity
to avoid contact with him, and to be unable to satisfy his need for
nourishment, clothing, essential medical care, or shelter such that it
made it likely he would suffer physical injury, debilitation, or death.
Dr. Idahosa also noted B.B. had a history of mental illness,
recommended B.B. return to inpatient treatment for further stabilization,
and opined B.B. would need outpatient treatment upon release for
medication management and therapy.
A hearing was held on the application on December 20. The
Sorensen and Hoffman affidavits and Dr. Idahosa’s report were admitted
into evidence. Dr. Idahosa testified that B.B. met the statutory
requirements as one who is seriously mentally impaired. She explained
B.B. was a danger to himself or others based on B.B.’s irritability,
arguments with his wife, and symptoms of paranoia. Elaborating, she
stated that B.B. “feels people are trying to do something to him,” that he
believes people are trying to remove his brain or other organs from his
4
body, and that his wife “is afraid for him to come home.” Dr. Idahosa
further stated that “[B.B.’s wife] has a restraining order and he has
nowhere to go.” Dr. Idahosa noted the observations made in the two
affidavits in the application. She testified that B.B.’s wife advised her
B.B. had a history of paranoia that had been ongoing for twelve years
and that recently the symptoms were “the worst [B.B.’s wife] has seen.”
Dr. Idahosa also opined B.B. did not have sufficient judgment to make
responsible decisions with regard to his hospitalization or treatment. In
Dr. Idahosa’s opinion, hospitalization was the least restrictive form of
treatment available for B.B. at that time.
B.B. also testified. B.B. denied attempting to board a flight with a
fake passport. B.B. asserted it was all a misunderstanding because he
found some boarding passes that did not belong to him and he was
simply attempting to give them to an airline employee. He then left the
Omaha airport and drove to the air base in Sergeant Bluff because he
was emotional due to marital problems and “was considering getting into
the National Guard.” B.B. testified that he accidentally drove into a
secured area. He further stated he did not believe he suffered from a
mental illness or was a danger to himself or others.
The district court concluded the record established by clear and
convincing evidence that B.B. was seriously mentally impaired. The
court based its decision on the report and testimony of Dr. Idahosa,
which it found credible; admissions made by B.B.; and the Sorensen and
Hoffman affidavits. The court also concluded that B.B. lacked sufficient
judgment to make responsible decisions regarding his hospitalization
and treatment, illustrated by his failure to recognize that he had a
mental illness, and that B.B. was likely to inflict serious injury to himself
or others if he was not hospitalized. The court stated B.B.’s testimony
5
“just does not make sense on a great part of it” and that his testimony
about his trips to the airport and air base was not credible. The court
entered its order that day. B.B. appealed, alleging the district court’s
finding that B.B. was seriously mentally impaired was not supported by
substantial evidence.
During the pendency of the appeal, B.B. was released to outpatient
treatment at the University of Nebraska Medical Center (UNMC) in
Omaha. Because an entry in the court file indicated B.B. was no longer
a patient at UNMC as of January 28, 2012, and because B.B. did not
have family or employment connections in Woodbury County, the State
filed a motion to discharge and terminate the proceedings. The district
court granted the motion, terminated the proceedings, discharged B.B.
from court-ordered treatment and placement, and stated interested
parties could reinitiate court proceedings if B.B. returned to Iowa and
was believed to be seriously mentally impaired.
This proceeding is not B.B.’s first involuntary commitment
proceeding. He testified that he was involuntarily committed
approximately fourteen years ago for depression with psychotic features.
II. Standard of Review.
We review challenges to the sufficiency of the evidence in
involuntary commitment proceedings for errors at law. In re J.P., 574
N.W.2d 340, 342 (Iowa 1998). The allegations made in an application for
involuntary commitment must be proven by clear and convincing
evidence. Id. Clear and convincing evidence is less burdensome than
evidence establishing proof beyond a reasonable doubt, but more
burdensome than a preponderance of the evidence. Id. “It means that
there must be no serious or substantial doubt about the correctness of a
6
particular conclusion drawn from the evidence.” Id. (citation and
internal quotation marks omitted).
III. Discussion.
We are confronted with two issues in this appeal. First, we must
address whether an appeal from a finding that a person is seriously
mentally impaired under chapter 229 becomes moot when the person is
released from involuntary commitment and the proceedings are
terminated. 1 Second, if the matter is not moot, we must determine
whether the district court’s finding that B.B. is seriously mentally
impaired is supported by substantial evidence.
A. Mootness. Ordinarily, an appeal is moot if the “issue becomes
nonexistent or academic and, consequently, no longer involves a
justiciable controversy.” State v. Hernandez-Lopez, 639 N.W.2d 226, 234
(Iowa 2002). We will generally not review moot issues, but our caselaw
and that of other jurisdictions recognize exceptions. Relevant to this
appeal, one exception permits appellate review of otherwise moot issues
when the issue is one of broad public importance likely to recur. Id.; In
re M.T., 625 N.W.2d 702, 704 (Iowa 2001). Another exception provides
that an appeal is not moot if a judgment left standing will cause the
appellant to suffer continuing adverse collateral consequences. See
Sibron v. New York, 392 U.S. 40, 53–57, 88 S. Ct. 1889, 1898–1900, 20
L. Ed. 2d 917, 929–31 (1968).
For example, in M.T. we stated that an appeal from an involuntary
commitment was moot when the party had been released from inpatient
treatment, the State no longer sought to have the party committed for
1For a discussion of the history of involuntary commitment under chapter 229,
see Note, Involuntary Hospitalization of the Mentally Ill in Iowa: The Failure of the 1975
Legislation, 64 Iowa L. Rev. 1284 (1979).
7
inpatient treatment, and the party did not challenge his commitment to
outpatient treatment. 625 N.W.2d at 705. Nonetheless, we reached the
merits of whether the party’s statutory right to be present at his
involuntary commitment proceeding had been violated because it was an
issue of broad public importance capable of recurring, yet likely to evade
appellate review. Id.
Similarly, B.B.’s case is arguably moot because he was no longer
subject to inpatient treatment and had been discharged from court-
ordered treatment and placement. B.B., however, argues his case
warrants our review because he will continue to suffer adverse collateral
consequences. 2 Although we have not yet adopted this exception to the
mootness doctrine in this context, we now hold that a party who has
been adjudicated seriously mentally impaired and involuntarily
committed is presumed to suffer collateral consequences justifying
appellate review.
A number of jurisdictions recognize the notion that one who is
involuntarily committed due to a mental illness suffers collateral
consequences. See, e.g., In re Ballay, 482 F.2d 648, 651–52 (D.C. Cir.
1973); In re Joan K., 273 P.3d 594, 597–98 (Alaska 2012); In re Morris,
482 A.2d 369, 371–72 (D.C. 1984); Bradshaw v. State, 816 P.2d 986,
989 (Idaho 1991); In re McCaskill, 603 N.W.2d 326, 329 (Minn. 1999); In
re Splett, 572 N.E.2d 883, 885 (Ill. 1991); In re Walter R., 850 A.2d 346,
349–50 (Me. 2004); In re Hatley, 231 S.E.2d 633, 634–35 (N.C. 1977); In
re D.B.W., 616 P.2d 1149, 1150–51 (Okla. 1980); State v. Lodge, 608
S.W.2d 910, 912 (Tex. 1980); In re Giles, 657 P.2d 285, 286–87 (Utah
1982); State v. J.S., 817 A.2d 53, 55–56 (Vt. 2002). One commonly cited
2We also note the parties in M.T. did not address mootness in their briefs.
8
collateral consequence of involuntary commitment is the accompanying
stigma. 3 See, e.g., Joan K., 273 P.3d at 597–98; Bradshaw, 816 P.2d at
989; Splett, 572 N.E.2d at 885; D.B.W., 616 P.2d at 1150–51; Lodge, 608
S.W.2d at 912; J.S., 817 A.2d at 55–56. The United States Supreme
Court relied in part on the stigmatization of being labeled mentally ill in
holding that a child has a liberty interest in not being confined
unnecessarily. See Parham v. J.R., 442 U.S. 584, 601, 99 S. Ct. 2493,
2503, 61 L. Ed. 2d 101, 118 (1979). The Court has also observed,
[I]t is indisputable that involuntary commitment to a mental
hospital after a finding of probable dangerousness to self or
others can engender adverse social consequences to the
individual. Whether we label this phenomena “stigma” or
choose to call it something else is less important than that
we recognize that it can occur and that it can have a very
significant impact on the individual.
Addington v. Texas, 441 U.S. 418, 425–26, 99 S. Ct. 1804, 1809, 60
L. Ed. 2d 323, 330–31 (1979).
In In re Guardianship of Hedin, 528 N.W.2d 567, 574 (Iowa 1995),
we recognized the existence of stigma in observing that one has a
protected liberty interest in not being labeled mentally ill. Many courts
rely heavily on the stigma of mental illness in holding that a case
involving an involuntary commitment is not moot simply because the
person alleged to be mentally ill has been released from commitment.
See, e.g., Joan K., 273 P.3d at 597–98; Bradshaw, 816 P.2d at 989;
Splett, 572 N.E.2d at 885; D.B.W., 616 P.2d at 1150–51; Lodge, 608
3We acknowledge that social stigma attaching to those with mental illnesses is
unfairly prejudicial, but any potential unfairness does not eliminate the collateral
consequences of an involuntary commitment. See State v. Van Tassel, 484 P.2d 1117,
1122 (Or. Ct. App. 1971) (noting, in holding appeal not moot, that “[w]hether a society
should view mental illness as carrying with it more stigma than any other form of
illness, it, in fact, does”).
9
S.W.2d at 912; J.S., 817 A.2d at 55–56. But see Westlake v. State, 440
So. 2d 74, 75 (Fla. Dist. Ct. App. 1983) (holding that an appeal is moot
despite stigma because courts look to legal consequences, not social
consequences).
Another collateral consequence stemming from a finding that one
is mentally ill is the potential to use one’s involuntary commitment as
evidence in future proceedings. In Ballay, the District of Columbia
Circuit explained it this way:
Indeed, such an adjudication, while not always crippling, is
certainly always an ominous presence in any interaction
between the individual and the legal system. Such evidence
will frequently be revived to attack the capacity of a trial
witness. Depending upon the diagnosis, it may be
admissible for impeachment purposes. Indeed, even in a
criminal trial it may be available to attack the character of a
defendant if he has put character in issue. Most
significantly, records of commitments to a mental institution
will certainly be used in any subsequent proceedings for civil
commitment, a factor which may well have been influential
in the present case.
482 F.2d at 652. Other courts have made similar observations. See,
e.g., Joan K., 273 P.3d at 597; In re Amey, 40 A.3d 902, 909 (D.C. 2012);
In re Alfred H.H., 910 N.E.2d 74, 84 (Ill. 2009); Hatley, 231 S.E.2d at
634–35; Giles, 657 P.2d at 287; see also Walter R., 850 A.2d at 349–50
(holding possibility of longer commitment period following adjudication of
incompetence is a collateral consequence); In re Webber, 689 S.E.2d 468,
474 (N.C. Ct. App. 2009) (discussing an analogous situation involving
defendants placed on probation).
Although persons adjudicated seriously mentally impaired suffer
the foregoing collateral consequences, 4 Iowa Code chapter 229 preserves
4Courts have recognized other collateral consequences, such as restrictions on
voting rights, jury service, the ability to obtain a driver’s license, and adverse
employment restrictions. See In re Ballay, 482 F.2d 648, 651–52 (D.C. Cir. 1973); In re
10
many legal rights the person previously enjoyed. Section 229.27(1)
provides:
Hospitalization of a person under this chapter, either
voluntarily or involuntarily, does not constitute a finding of
nor equate with nor raise a presumption of incompetency,
nor cause the person so hospitalized to be deemed a person
of unsound mind nor a person under legal disability for any
purpose, including but not limited to any circumstances to
which sections 6B.15, 447.7, section 488.603, subsection 6,
paragraph “c”, sections 488.704, 597.6, 600B.21, 614.8,
614.19, 614.22, 614.24, 614.27, and 633.244 are applicable.
Iowa Code § 229.27(1). The South Dakota Supreme Court relied on a
similar provision in holding that an appeal of an involuntary commitment
proceeding is moot once the person is released and the proceedings are
terminated. See In re Woodruff, 567 N.W.2d 226, 228–29 (S.D. 1997).
The court reasoned the provision demonstrated the legislature’s intent to
protect the legal rights of persons who were involuntarily committed and
encompassed all collateral consequences alleged by the parties who had
been adjudicated mentally ill. Id. at 228. The court went on to explain
that the stigma resulting from involuntary commitment was not, by itself,
sufficient to constitute a collateral consequence that would keep the
controversy alive. Id. at 229.
We disagree with the South Dakota Supreme Court insofar as it
suggests Iowa Code section 229.27(1) renders this action moot. The
decision in Woodruff underestimates the stigma stemming from a finding
that one is seriously mentally impaired. Such a finding has a “very
significant impact on the individual.” Addington, 441 U.S. at 426, 99
S. Ct. at 1809, 60 L. Ed. 2d at 331. We thus agree with the many
_____________________
Joan K., 273 P.3d 594, 597 (Alaska 2012); In re Alfred H.H., 910 N.E.2d 74, 84 (Ill.
2009).
11
jurisdictions that find significant the stigma associated with a finding of
serious mental impairment.
Some courts have considered the impact of prior involuntary
commitments on the right of a person to appeal subsequent involuntary
commitment. In Joan K., the Alaska Supreme Court concluded that
“there are sufficient general collateral consequences, without the need for
a particularized showing, to apply the doctrine in an otherwise-moot
appeal from a person’s first involuntary commitment order.” 273 P.3d at
598. Although the court agreed collateral consequences are presumed, it
noted that “some number of prior involuntary commitment orders would
likely eliminate the possibility of additional collateral consequences,
precluding the doctrine’s application.” Id.
The Illinois Supreme Court took the opposite approach in Alfred
H.H. The court held that the determination of potential collateral
consequences for the purposes of mootness must be made on a case-by-
case basis. Alfred H.H., 910 N.E.2d at 84. Thus, in Illinois the person
must present evidence sufficient to justify application of the collateral
consequences exception.
We agree with the Alaska Supreme Court that the better approach
is to presume that a person adjudicated seriously mentally impaired and
involuntarily committed suffers adverse collateral consequences. Such
an adjudication not only requires a finding that the person suffers a
mental illness, but also that the person poses a danger to himself or
others, is likely to inflict serious emotional injury upon another, or is
unable to satisfy his own bodily needs for survival. The stigma arising
from this adjudication is significant. In addition, the potential for the
adjudication to be used in future proceedings is likely present in each
case. Further, we recognize collateral consequences are mitigated if the
12
person has previously been involuntarily committed under chapter 229.
For example, under federal law he or she will not lose the right to
possess firearms because the right was already lost following the first
commitment. See 18 U.S.C. § 922(d) (2006). Nonetheless, we believe
prior involuntary commitments are better used as evidence to rebut the
presumption of collateral consequences, rather than to deny the
existence of collateral consequences. See Joan K., 273 P.3d at 597.
We further agree with the Alaska Supreme Court that the
presumption of collateral consequences may likely be rebutted by “some
number of prior involuntary commitment orders.” Id. at 598. For
example, a series of recent, successive involuntary commitments that
were either not appealed or upheld on appeal might effectively remove
any stigma resulting from a later involuntary commitment proceeding.
In this case, however, the record reveals that B.B.’s prior involuntary
commitment occurred thirteen years ago. We do not think such a single
and remote prior involuntary commitment is sufficient to eliminate the
stigma resulting from the adjudication in this case. As a result, we now
consider the merits of this appeal. 5
B. Sufficiency of the Evidence. B.B. alleges the determination
that he is seriously mentally impaired is not supported by substantial
evidence. Iowa Code section 229.1 defines “seriously mentally impaired”
in the following way:
17. “Seriously mentally impaired” or “serious mental
impairment” describes the condition of a person with mental
illness and because of that illness lacks sufficient judgment
to make responsible decisions with respect to the person’s
5As a result of our holding, it is not necessary for us to consider the application
of the public interest exception to the mootness doctrine in this case.
13
hospitalization or treatment, and who because of that illness
meets any of the following criteria:
a. Is likely to physically injure the person’s self or
others if allowed to remain at liberty without treatment.
b. Is likely to inflict serious emotional injury on
members of the person’s family or others who lack
reasonable opportunity to avoid contact with the person with
mental illness if the person with mental illness is allowed to
remain at liberty without treatment.
c. Is unable to satisfy the person’s needs for
nourishment, clothing, essential medical care, or shelter so
that it is likely that the person will suffer physical injury,
physical debilitation, or death.
Iowa Code § 229.1(17). In In re Oseing, 296 N.W.2d 797, 799 (Iowa
1980), we interpreted a previous incarnation of this definition as
containing three elements. We stated that to find a person is seriously
mentally impaired, that person must first be found to be “afflicted with a
mental illness,” and consequently “to lack sufficient judgment to make
responsible decisions with respect to his or her hospitalization or
treatment.” Oseing, 296 N.W.2d at 799 (internal quotation marks
omitted). Third, the person had to “be likely, if allowed to remain at
liberty, to inflict physical injury on himself or others or to inflict
emotional injury on the designated class of persons.” 6 Id.
B.B. agrees sufficient evidence supports the finding that he has a
mental illness, but challenges the sufficiency of the evidence as to
whether he is unable to make responsible decisions about his own
treatment, whether he would have caused serious physical injury to
6Subsequent to Oseing, the legislature amended the third element to provide
that it could be satisfied if the person is “unable to satisfy the person’s needs for
nourishment, clothing, essential medical care, or shelter so that it is likely that the
person will suffer physical injury, physical debilitation, or death.” See 1995 Iowa Acts
ch. 24, § 1; 1989 Iowa Acts ch. 275, § 1. However, because the district court did not
make this finding, we will not consider it here.
14
himself or others, and whether he would have caused serious emotional
injury to his family or others. We disagree with B.B.’s contentions.
In her report, Dr. Idahosa opined B.B. lacked sufficient judgment
to make responsible decisions with respect to his hospitalization and
treatment because of a mental illness. Dr. Idahosa also testified to the
same at the hearing. Dr. Idahosa based her opinion on face-to-face
examinations of B.B. that occurred every day after B.B. was hospitalized
prior to the hearing. While Dr. Idahosa’s opinion was short on specifics,
we believe the district court reasonably relied on her opinion testimony.
Dr. Idahosa testified that B.B. claimed the hospital staff was
attempting to take away his brain and other organs up until at least one
day prior to the hearing, that he was irritable and violent towards
hospital staff when he arrived at the hospital and thereafter, and that he
refused to swallow his medication while hospitalized, prompting
Dr. Idahosa to change his prescription to a medication that would
dissolve under his tongue. In addition, in finding the element was
satisfied, the district court observed that B.B. “can’t even make the
recognition that he has a mental illness, and that is where his problems
begin.” Thus, substantial evidence supports the district court’s finding
that B.B. lacked sufficient judgment to make responsible decisions about
his medical treatment.
B.B. also argues substantial evidence does not support the finding
that he would be likely to inflict serious physical injury on himself or
others or that he would be likely to inflict serious emotional injury to
members of his family or others lacking a reasonable opportunity to
avoid him. In Oseing, we observed that the term “likely” means “probable
or reasonably to be expected.” Oseing, 296 N.W.2d at 801. We also
stated that it “requires a predictive judgment, ‘based on prior
15
manifestations but nevertheless ultimately grounded on future rather
than past danger.’ ” Id. (citation omitted). In In re Mohr, we expanded on
this definition by noting “[t]his element requires that the threat the
patient poses to himself or others be evidenced by a ‘recent overt act,
attempt, or threat.’ ” 383 N.W.2d 539, 542 (Iowa 1986) (quoting Stamus
v. Leonhardt, 414 F. Supp. 439, 451 (S.D. Iowa 1976)).
Dr. Idahosa opined B.B was likely to cause physical injury to
himself or others. She based her opinion in part on the ground that B.B.
is “irritable, he is paranoid, he feels people are trying to do something to
him.” Dr. Idahosa further stated, “He’s always arguing with his wife, she
has a restraining order and he has nowhere to go.” That Dr. Idahosa
based her opinion on the fact that B.B. was paranoid is significant
because the district court could have found the diagnosis of “psychosis,
not otherwise specified” to be directly connected to the finding that B.B.
posed a likely threat to cause physical injury. See Iowa Code § 229.1(17)
(requiring danger of physical harm to be caused by mental illness).
Further, Dr. Idahosa observed that when B.B. went to the emergency
room, “he displayed out of control behavior.” Dr. Idahosa continued by
saying that “[B.B.] was irritable [and] violent” and that B.B. “gets very
angry if you don’t do what he wants you to do and becomes threatening
towards us.” The December 14 emergency hospitalization order notes
B.B. had been brought to the emergency room “in a very agitated and
confused state” and was “making wild threats to harm himself and
others and is currently requiring three police officers to keep him
subdued.” At the time of B.B.’s initial hospitalization, B.B.’s wife was
afraid for him to come home and did not feel safe if he were to be
released. She said the symptoms of paranoia were the worst she had
seen in twelve years. The Hoffman affidavit noted that B.B.’s “wife fears
16
that he might harm her or their children if released.” B.B.’s wife’s fear of
B.B. is illustrated by the fact that she obtained a restraining order
against him. In light of this evidence, we conclude the district court
committed no legal error in finding B.B. was likely to cause serious
physical injury to himself or others if he remained at liberty. See Mohr,
383 N.W.2d at 542 (relying on the “threatening nature” of conduct).
IV. Conclusion.
For the reasons expressed above, we hold that the matter is
justiciable. On the merits, we conclude the district court’s finding that
B.B. was seriously mentally impaired is supported by substantial
evidence.
AFFIRMED.
All justices concur except Waterman and Mansfield, JJ., who
concur in part and dissent in part.
17
#12–0158, In re BB
MANSFIELD, Justice (concurring in part and dissenting in part).
I agree that if we reach the merits, the district court’s order should
be affirmed. However, I would dismiss the appeal as moot.
The majority seemingly holds that an appeal from a civil
commitment order, where the appellant has been released, should only
be dismissed as moot if there have been “a series of recent, successive
involuntary commitments that were either not appealed or upheld on
appeal.” I think this standard opens the door to too many future appeals
of commitment orders where nothing tangible is at stake. I am not in
favor of using our judiciary’s limited resources in this fashion.
This particular case highlights the potential concerns. Here B.B.,
a Nebraskan with a history of mental illness who admitted he was
“distraught,” crossed into Iowa on December 14, 2011, and tried to enter
the restricted area of an Iowa Air National Guard base. He was brought
to a hospital emergency room “in a very agitated and confused state.” He
was “making wild threats to harm himself and others and . . . requiring 3
police officers to keep him subdued.” Based on an emergency order, B.B.
was hospitalized. He refused to take his medication. He denied he had
any mental illness or needed any medication. He claimed the hospital
staff were going to take his brain or his organs from his body.
In addition to getting medical treatment in a Sioux City hospital,
B.B. received a full hearing on December 20. After the hearing, the
district court concluded that B.B. should remain hospitalized for the
reasons set forth in Iowa Code section 229.1(17)(a) and (b). Seven days
later, B.B.’s condition apparently stabilized. He was released for
outpatient treatment and went home to Nebraska.
18
Now B.B. seeks to bring an appeal challenging the sufficiency of
the evidence to sustain his expired commitment order. The taxpayers of
Iowa will pay for all aspects of this appeal, including the expense of
B.B.’s attorney, just as they bore the expense of all lower court
proceedings. 7
No one suggests that we are constitutionally required to hear this
case. This is purely our call. As the majority notes, there is a grab bag
of standards from other jurisdictions, under some of which this appeal
would be moot. See also In re Involuntary Commitment of Skelton, 777
So. 2d 148, 149 (Ala. Civ. App. 2000) (dismissing appeal from
commitment order as moot where the appellant had been released);
Dickinson v. State, 270 S.W.3d 863, 866–67 (Ark. 2008) (dismissing
appeal from commitment order where the appellant had been released
and no public exception applied); In re Doe, No. 23869, 2003 WL
1264129 at *1–2 (Haw. Mar. 17, 2003) (same); In re Interdiction of C.S.B.,
880 So. 2d 997, 999 (La. Ct. App. 2004) (dismissing appeal as moot).
Furthermore, under our own precedent, this appeal is moot. In In
re M.T., we indicated that an appeal from a civil commitment order
ordinarily becomes moot when the party has been released, stating, “We
think the present appeal is moot. M.T. is no longer subject to the
inpatient treatment order that resulted from the challenged hearing.”
625 N.W.2d 702, 705 (Iowa 2001). True, what we said there was
arguably dictum, because we later went on to hear the case under a
separate exception to the ordinary rules of mootness. Id. But our court
7I mean no criticism of B.B.’s court-appointed counsel, who has been zealously
and capably representing his client, as he should. My question is simply whether we
should be voluntarily expanding our own appellate jurisdiction as urged by the
majority.
19
unanimously signed on to the foregoing general statement on mootness,
and it has been repeatedly followed by the court of appeals in dismissing
appeals from commitment orders on mootness grounds. 8
If we are going to overrule what we said in In re M.T., then I would
propose a different standard from the majority’s. Thus, I would hold that
a commitment appeal should automatically go forward if the appellant
has not previously been adjudicated mentally ill (or the statutory
equivalent) in any jurisdiction. If, however, the State can demonstrate
that the appellant has previously been adjudicated mentally ill, e.g., in
papers filed with a motion to dismiss the appeal, then the presumption
would arise that the appeal is moot if the appellant has been released.
The burden then would shift to the appellant to show that he or she will
suffer some specific collateral consequence from the judgment that he or
she seeks to appeal (other than the stigma or potential future evidentiary
value of one more finding that the appellant is mentally ill).
Alternatively, the appellant may show that the appeal falls into the broad
public interest exception (and here I would hold that sufficiency of the
evidence appeals do not meet that exception). 9 If the appellant fails to do
either of these things, the appeal would be dismissed.
8See In re J.R.L., No. 08–0298, 2008 WL 4307997 (Iowa Ct. App. Sept. 17, 2008);
In re J.P., No. 03–1419, 2004 WL 793223 (Iowa Ct. App. Apr. 14, 2004); In re O.T., No.
03–0365, 2003 WL 22700659 (Iowa Ct. App. Nov. 17, 2003); In re D.M.G., Sr., No. 02–
0143, 2002 WL 31424828 (Iowa Ct. App. Oct. 30, 2002); In re D.K., No. 00–1596, 2001
WL 1502825 (Iowa Ct. App. Nov. 28, 2001). Obviously, these kinds of cases will now be
added to the court of appeals’ caseload, as will the many appeals that were not
previously brought because attorneys assumed they were moot (not to mention the
appeals that we dismissed as moot on motion prior to any transfer).
9See Rarey v. State, 616 N.W.2d 531, 532 (Iowa 2000) (finding the public interest
exception did not apply where the issues “relate[d] peculiarly to [the appellant’s]
particular situation”); In re Alfred H.H., 910 N.E.2d 74, 81 (Ill. 2009) (noting that
sufficiency of the evidence claims “are inherently case-specific reviews”).
20
I believe this approach appropriately balances the interests of the
appellant, the State, and the courts, and gives guidance for future cases.
Under this approach, B.B.’s appeal would be dismissed. He has a prior
involuntary commitment, even though it is from a number of years ago,
and he has not shown that he will be subject to any specific collateral
consequence because of his latest commitment order.
I recognize the potential exists for collateral consequences from
any involuntary commitment order. I also acknowledge there can be
stigma, although it bears emphasis that the proceedings are confidential.
See Iowa Code § 229.24 (2011). 10 However, when a person already has a
prior commitment order on his or her record, I think it is not
unreasonable to insist that he or she demonstrate some concrete harm
arising from the expired order he or she is trying to appeal. For the
foregoing reasons, I respectfully dissent in part.
Waterman, J., joins this concurrence in part and dissent in part.
10The United States Supreme Court has recognized that “involuntary
commitment to a mental hospital after a finding of probable dangerousness to self or
others . . . can have a very significant impact on the individual.” See Addington v.
Texas, 441 U.S. 418, 425–26, 99 S. Ct. 1804, 1809, 60 L. Ed. 2d 323, 331 (1979)
(emphasis added). After first quoting this passage accurately, my colleagues then
modify its meaning later in their opinion when they say that such a finding “has a ‘very
significant impact on the individual.’ ” (Emphasis added.)