In the Matter of the Civil Commitment of: Amy Jeankyoung Oh

• Court: Court of Appeals of Minnesota
• Decided: November 20, 2023
• Docket: a230936
• Status: Unpublished

Opinion

This opinion is nonprecedential except as provided by Minn. R. Civ. App. P. 136.01, subd. 1(c).

STATE OF MINNESOTA IN COURT OF APPEALS A23-0936

In the Matter of the Civil Commitment of: Amy Jeankyoung Oh.

Filed November 20, 2023 Affirmed Gaïtas, Judge

Hennepin County District Court File No. 27-MH-PR-23-437

Kurt M. Anderson, Minneapolis, Minnesota (for appellant Amy Jeankyoung Oh)

Mary F. Moriarty, Hennepin County Attorney, Brittany D. Lawonn, Senior Assistant County Attorney, Minneapolis, Minnesota (for respondent Hennepin County Medical Center)

Considered and decided by Gaïtas, Presiding Judge; Slieter, Judge; and Halbrooks,

Judge. ∗

NONPRECEDENTIAL OPINION

GAÏTAS, Judge

Appellant Amy Jeankyoung Oh challenges her civil commitment as a person who

poses a risk of harm due to mental illness. Because we conclude that the district court did

not err in its commitment decision, we affirm.

∗ Retired judge of the Minnesota Court of Appeals, serving by appointment pursuant to Minn. Const. art. VI, § 10. FACTS

This appeal arises out of a district court order civilly committing Oh as a person

who poses a risk of harm due to her mental illness and authorizing the involuntary

administration of medication. Oh has a history of mental-health diagnoses and past civil

commitments, most recently in 2019. In 2023, Oh’s family became concerned for her

welfare and sought assistance from mental-health assessors. Oh initially agreed to go to

the hospital but then later asked to leave and declined assistance. Her behavior at this time

was described as “paranoid, confused, tangential, and sometimes nonsensical.” Oh was

placed on a 72-hour hold and admitted into inpatient psychiatry at respondent Hennepin

County Medical Center (HCMC).

A few days later, HCMC petitioned for judicial commitment and for an order

authorizing the use of neuroleptic medication. It submitted a medical examiner’s statement

in support of this petition. The medical examiner reported that Oh was “significantly

disorganized,” “rambling,” “paranoid,” and “delusional.” According to the medical

examiner, “[d]ue to [Oh’s] significant thought disorganization, paranoia and delusions,

[she] appears at risk of harm to self and unable to care for self.” Oh also lacked “sufficient

awareness of [her] situation” to make a decision for herself regarding her treatment and

medication. The medical examiner concluded that Oh had schizophrenia and should be

committed to a treatment facility and treated with neuroleptic medication.

HCMC also submitted a report from a psychologist in support of the petition. The

psychologist opined that Oh had schizophrenia and posed a substantial risk of harm to

herself or to others. According to the psychologist’s report, Oh’s mental illness prevented

2 her from obtaining necessary food, clothing, shelter, and medical care. The psychologist

observed that Oh showed “symptoms of delusions, paranoia, disorganization, loose

associations, perseveration, and preoccupations.” Further, the psychologist opined that Oh

would not be able to follow through with treatment on a voluntary basis.

The district court held a trial on the petition. Oh agreed that the district court could

take judicial notice of the psychologist’s report, and the district court excused the

psychologist from attending the trial. Additionally, Oh agreed that the district court could

consider her medical records and other documentary evidence. 1 HCMC relied on the

documentary evidence and did not present witness testimony at the trial.

Oh testified at trial. She did not have an opinion as to whether she had a mental

illness, stating that she could not “really gauge that [herself].” On direct examination, Oh’s

attorney asked Oh if she had difficulty managing money and purchasing food for herself.

Oh responded that she uses most of her money for pet care. On one occasion, she testified,

she “completely ran out of money” at the end of the month and could not purchase food

for herself for several days. But Oh testified that she was in “good health,” and that she

would take her medications, keep appointments, and cooperate with a social worker.

Following the trial, the district court granted the petition and adjudicated Oh as a

person who poses a risk of harm due to her mental illness. The district court found that Oh

was “ill with [s]chizophrenia” that “grossly impairs her judgment, behavior, capacity to

1 Oh’s attorney stipulated that the district court could consider the experts’ reports, the medical records, and other documents submitted by HCMC “subject to the independent proof of any underlying facts.”

3 recognize reality, and ability to reason or understand.” It also authorized the involuntary

administration of neuroleptic medication. The district court found that Oh “[did] not have

the ability to understand and use information about her mental illness, its symptoms, and

treatment,” and could not “reliably take prescribed neuroleptic medication voluntarily in

the community.”

Oh appeals. 2

DECISION

I. The district court did not err in civilly committing Oh as a person who poses a risk of harm due to her mental illness.

In civil commitment appeals, an appellate court is limited to examining whether the

district court complied with the commitment statute and determining whether the district

court’s findings support its conclusions of law. In re Knops, 536 N.W.2d 616, 620 (Minn.

1995). Appellate courts review the record in the light most favorable to the decision and

defer to the district court’s credibility determinations. Id. The district court’s factual

findings will be affirmed unless they are clearly erroneous. In re Joelson, 385 N.W.2d

810, 811 (Minn. 1986). The scope of clear-error review is narrow, as it “does not

contemplate a reweighing of the evidence, inherent or otherwise; it is a review of the record

to confirm that evidence exists to support the decision.” In re Civ. Commitment of Kenney,

963 N.W.2d 214, 222 (Minn. 2021). Whether the supported factual findings and the record

2 Oh has since been provisionally discharged from commitment into residential treatment. During this provisional period, Oh must comply with the medication order and follow the recommendations of her medical providers, among other conditions. Violations of these provisions could result in her return to HCMC.

4 provide clear and convincing evidence to sustain the district court’s legal conclusion that

the statutory requirements for commitment were and continue to be met is a question of

law, which we review de novo. In re Civ. Commitment of Martin, 661 N.W.2d 632, 638

(Minn. App. 2003), rev. denied (Minn. Aug. 5, 2003).

Oh makes two arguments on appeal regarding the civil commitment order: first,

that the district court did not make sufficient findings of fact to support its decisions, and

second, that the record does not support the factual findings the district court did make.

Upon review, we conclude that the district court made sufficient factual findings and that

clear and convincing evidence in the record supports these findings. Each argument is

addressed in turn.

A. The district court made sufficient findings of fact.

Oh argues that the district court’s findings are inadequate to support an incapacity

determination. The district court must make “sufficiently particular findings of fact on the

key issues.” In re Civ. Commitment of Spicer, 853 N.W.2d 803, 810 (Minn. App. 2014).

It is insufficient for a district court to merely summarize or recite testimony without

commenting on the relative credibility of the witnesses and tying the findings to the

conclusions of law. Id.

Here, the district court did not merely summarize or recite testimony. Rather, its

findings of fact reveal a thorough analysis of the condition of Oh’s mental health. The

district court found that Oh had a “past psychiatric history of schizophrenia.” It described

her current mental-health challenges and the assessment that Oh was “paranoid and talked

about a number of delusional beliefs.” Upon arriving at HCMC, Oh was “acutely

5 psychotic, unable to track conversation, skipping from one topic to another, paranoid . . . ,

and easily distracted.” The district court also identified the testimony it relied on from

Oh’s mental-health providers in determining that Oh should be civilly committed. It

reviewed the report from Oh’s psychologist and found that Oh’s “illness cannot be

adequately treated by dismissal of the [p]etition, voluntary inpatient or outpatient care, the

appointment of a guardian or conservator, or a conditional release.” The district court

further found that “[t]he least restrictive, appropriate, available placement is a commitment

to the Commissioner of Human Services and the head of [HCMC].” While the district

court explained that it “considered voluntary treatment or denying the petition,” it rejected

those alternative options “due to their inability to cope with [Oh’s] present behavior and

needs.” The district court also commented on the credibility of the witnesses, specifically

finding the psychologist’s “report credible and her opinions and conclusions persuasive.”

Moreover, the district court’s factual findings are tied to its ultimate conclusion of law that

Oh is a person who poses a risk of harm due to her mental illness.

On this record, we are satisfied that the district court made findings of fact, assessed

the credibility of the witnesses, and tied these findings to its conclusions of law. Thus, the

district court made findings of fact that are sufficient both to support its commitment

determination and to allow for meaningful appellate review.

B. The evidence in the record supports the district court’s findings.

Oh contends that even if the district court made adequate factual findings, the record

evidence is insufficient to show that she poses a risk of harm to herself or to others due to

her mental illness. To civilly commit a person with a mental illness, the district court must

6 “find[] by clear and convincing evidence that the proposed patient is a person who poses a

risk of harm due to mental illness . . . , and after careful consideration of reasonable

alternative dispositions . . . that there is no suitable alternative to judicial commitment.”

Minn. Stat. § 253B.09, subd. 1(a) (2022). The commitment statute defines a “person who

poses a risk of harm due to a mental illness” as a person who has a substantial psychiatric

disorder and who presents a demonstrated substantial likelihood of physical harm to self

or others. Minn. Stat. § 253B.02, subd. 17a(a) (2022). A demonstrated likelihood of harm

may be evidenced by an “inability for reasons other than indigence to obtain necessary

food, clothing, shelter, or medical care as a result of the impairment” and a showing that

“it is more probable than not that the person will suffer substantial harm, significant

psychiatric deterioration or debilitation, or serious illness, unless appropriate treatment and

services are provided.” Id., subd. 17a(a)(2).

The district court determined that Oh poses a risk of harm to herself or to others

under this statutory provision, and the record contains clear and convincing evidence to

support this determination. Record evidence confirms that Oh has a history of

schizophrenia and multiple previous civil commitments. And the record shows that Oh’s

mental health deteriorated in 2023. Oh acknowledged when she met with mental health

assessors in 2023 that she spent most of her money on her pets. She also told the assessors

that people monitored her phone calls, broke into her car, and took money from her bank

account. Oh agreed to go to the hospital, although she denied that she had mental-health

problems and stated that she did not need medication. When she arrived at the hospital,

7 she showed “grossly psychotic symptoms and [an] inability to demonstrate capacity to care

for self.”

The record also contains the professional opinions of two experts who believed that

Oh posed a risk of harm to herself or others when she was hospitalized in 2023. The

medical examiner’s statement in support of the commitment petition states that Oh was

“significantly disorganized,” “rambling,” “paranoid,” and “delusional.” It states that,

“[d]ue to [Oh’s] significant thought disorganization, paranoia and delusions, [Oh] appears

at risk of harm to self and unable to care for self.” The medical examiner indicated that

Oh did not have “sufficient awareness of [her] situation” to make a decision for herself

regarding her treatment or her medication. And the medical examiner concluded that Oh

has schizophrenia and should be committed to a treatment facility and treated with

neuroleptic medication.

The psychologist’s report—which Oh agreed the district court could consider in lieu

of live testimony—states that Oh has schizophrenia and that Oh posed a substantial risk of

harm to herself or to others. According to the psychologist, Oh showed “symptoms of

delusions, paranoia, disorganization, loose associations, perseveration, and

preoccupations.” The psychologist did not believe that Oh could obtain the necessary food,

clothing, shelter, or medical care she needed because of this illness. She also expressed

concern about Oh’s ability to manage her money, to follow through with treatment on a

voluntary basis, and to make medical decisions for herself.

Oh did not present any contrary medical testimony at the trial. Instead, Oh testified

that she did not have an opinion about whether she was mentally ill and preferred to “rely

8 on the doctor’s opinion.” She denied that she frequently runs out of food, although she

acknowledged that most of her money is spent taking care of her pets. Oh admitted that

on one occasion, she “completely ran out of money” at the end of the month and could not

purchase food for herself for several days.

On appeal, Oh argues that the record contains other evidence that compels different

factual findings. But we cannot reweigh the evidence or the district court’s credibility

determinations. See Knops, 536 N.W.2d at 620 (noting that “due regard shall be given to

the opportunity of the trial court to judge the credibility of the witness”). “Where the

findings of fact rest almost entirely on expert testimony, the [fact-finder’s] evaluation of

credibility is of particular significance.” Id. “[C]lear-error review does not permit an

appellate court to weigh the evidence as if trying the matter de novo” or to “engage in fact-

finding anew.” Kenney, 963 N.W.2d at 221-22 (quotations omitted). Here, the district

court relied on the professional opinions of the medical examiner and the psychologist.

Although the district court found Oh’s testimony to be “honest and sincere,” the district

court’s order states that Oh’s testimony was “less persuasive than the documented

evidence.” Because we cannot reweigh the evidence, we decline Oh’s request to make

alternative factual findings.

We conclude that the district court made sufficient findings of fact and that clear

and convincing evidence in the record supports these factual findings. In turn, these

findings support the district court’s legal determination that Oh could not “obtain necessary

food, clothing, shelter, or medical care as a result of the impairment” and that it was “more

probable than not that [she] will suffer substantial harm, significant psychiatric

9 deterioration or debilitation, or serious illness” without medical treatment. Minn. Stat.

§ 253B.02, subd. 17a(a)(2). Accordingly, the district court did not clearly err in making

the findings of fact supporting its issuance of the civil commitment order.

II. Oh is not entitled to relief on her remaining arguments.

A. Oh forfeited her constitutional challenges.

Oh argues that she was deprived of her constitutional rights because the district court

did not meaningfully review the referee’s recommended order prior to signing it. She

further challenges the constitutionality of Minnesota Statutes section 484.70, subdivision

7(f) (2022), which addresses appellate review of civil commitment orders. We conclude

that Oh forfeited her claims by failing to present them to the district court. See Thiele v.

Stich, 425 N.W.2d 580, 582 (Minn. 1988) (declining to review an argument that was not

considered and decided by the district court); see also In re Civ. Commitment of Fugelseth,

907 N.W.2d 248, 252 n.1 (Minn. App. 2018) (applying Thiele in a civil commitment case),

rev. denied (Minn. Apr. 17, 2018). The commitment statute permits a litigant to seek

review of the referee’s proposed findings from a district court judge. Minn. Stat. § 484.70,

subd. 7(d) (2022). Oh’s counsel conceded during oral argument that Oh did not seek this

review, and we appreciate counsel’s candor on this point. Because Oh did not pursue

review by a district court judge, we must deem these claims forfeited.

B. Oh withdrew her challenge to the medication order.

Oh originally challenged the district court’s order authorizing the administration of

neuroleptic medication. She later withdrew this argument in light of our deferential

standard of review and clarified that the medication order should only be reversed if the

10 underlying commitment order is reversed. As discussed above, the district court did not

err in determining that Oh is incapacitated due to her mental illness. Further, the record

supports the medication order because Oh lacks capacity to make informed decisions

regarding her medications. See Minn. Stat. § 253B.092 (2022) (establishing the procedures

governing the administration of neuroleptic medication to patients subject to civil

commitment as mentally ill). Thus, even if we reached the merits of this argument, we

would conclude that the district court did not err by issuing an order authorizing the use of

C. Oh failed to show that the district court relied on improper evidence.

Oh argues that the district court may have improperly relied on hearsay evidence in

making its decision. However, she does not identify the improper hearsay evidence at

issue. And she does not explain how the evidence was improperly admitted under the rules

of evidence or the caselaw. We do not presume error by the district court, and the party

asserting error has the burden of showing it. Horodenski v. Lyndale Green Townhome

Ass’n, 804 N.W.2d 366, 372 (Minn. App. 2011). Because Oh did not identify the alleged

improper hearsay evidence or support her argument with legal authority, we do not address

this argument further.

Affirmed.