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In re Necessity for Hospitalization of Naomi B.

Supreme Court of Alaska

January 11, 2019

In the Matter of the Necessity for the Hospitalization of NAOMI B. In the Matter of the Necessity for the Hospitalization of LINDA M.

          Appeal in File No. S-15859 from the Superior Court, Nos. 3AN-15-00204 PR, 3AN-16-01656 PR Appeal in of the State of Alaska, Third Judicial District, Anchorage, John Suddock, Judge. Appeal in File No. S-16467 from the Superior Court of the State of Alaska, Third Judicial District, Anchorage, Mark Rindner, Judge.

          Rachel Cella, Assistant Public Defender, and Quinlan Steiner, Public Defender, Anchorage, for Appellant

          Naomi B. James B. Gottstein, Law Project for Psychiatric Rights, Inc., Anchorage, for Appellant

          Linda M. Joanne M. Grace and Laura Fox, Assistant Attorneys General, Anchorage, and JahnaLindemuth, AttorneyGeneral, Juneau, for Appellee State of Alaska.

          Before: Stowers, Chief Justice, Winfree, Maassen, Bolger, and Carney, Justices.

          STOWERS, Chief Justice, and CARNEY, Justice.



         We are presented with two separate appeals from involuntary commitment orders, brought by two appellants, one of whom also appeals a related involuntary medication order. The challenged orders expired while the respective appeals were pending; we consolidated the cases for briefing on whether to revisit our mootness jurisprudence in involuntary commitment and involuntary medication appeals. We now hold that all appeals of involuntary admissions for treatment and involuntary medication are categorically exempt from the mootness doctrine. After reviewing each case on its merits and finding no error in the orders appealed, we affirm.

         II. FACTS AND PROCEEDINGS A. Naomi B.[1]

         In January 2015 Adult Protective Services petitioned for an ex parte order committing Naomi B. to the Alaska Psychiatric Institute (API). She agreed to stay voluntarily and to take medication, attend groups and meetings, and plan for her discharge. But after her admission she refused to take medication or participate in treatment.

         Naomi's state soon worsened. She reported being repeatedly raped, hit, and assaulted, but API found no evidence to support her allegations after conducting a physical exam and reviewing tapes from the facility's surveillance cameras. Her treating psychiatrist, Dr. David Mack, concluded that Naomi's reports were delusions caused by mental illness, and he diagnosed her with schizoaffective disorder, bipolar subtype.

         Naomi never demanded to be discharged from API, and while she ate and maintained her personal hygiene, she could not or would not cooperate with API staff to plan for her discharge. Concerned that she could not manage her treatment or housing outside of API, hospital staff filed a petition later that month to involuntarily commit Naomi for 30 days. The petition alleged that Naomi was "gravely disabled and there [was] reason to believe that [her] mental condition could be improved by the course of treatment sought." API also petitioned the court to approve involuntary administration of psychotropic drugs.

         That same day a magistrate judge held hearings on both petitions. Naomi was represented by an attorney at the hearings, but declined to participate in person. The court visitor[2] testified that Naomi had refused to meet with her, that she was therefore unable to offer an opinion about Naomi's capacity to give informed consent to medication, and that she had been unable to find any advance health care directive in Naomi's medical records.[3]

         The court next addressed the involuntary commitment petition. Dr. Mack testified that outpatient treatment would not be adequate for Naomi because she was "at great risk for exposure to disorganized, aggressive behaviors if she's not surround[ed] by a professional staff." Dr. Mack also indicated that Naomi was "unable to engage with [API's] treatment team on basic needs due to her delusional construct" and that API had not been able to confirm that Naomi had a safe place to live. As a result he believed there was no less restrictive placement where Naomi could receive treatment. The court granted the petition, finding that Naomi was "mentally ill and, as a result, gravely disabled," and that there was no less restrictive treatment alternative.

         The court then turned to the petition for court approval of administration of psychotropic medication. Dr. Mack testified that API sought to administer two medications to Naomi: olanzapine, an antipsychotic to address her delusions, and lorazepam to reduce anxiety and irritability and to treat some side effects of olanzapine. Dr. Mack acknowledged risks associated with both medications but concluded that the benefits outweighed the risks. He hoped that the medications could improve Naomi's condition within a week. He believed that Naomi had no ability to give or withhold informed consent to the administration of the medications, that the medications were in her best interests, and that there was no less intrusive means of treating Naomi's schizoaffective disorder. He also said that Naomi would be offered various forms of group treatment to help her manage her illness, but that the group therapies alone would not successfully treat Naomi's disorder. The court granted the petition for medication "with the amendment that the lorazepam [was to be administered] only as needed."

         Naomi's lawyer did not question witnesses, raise objections, or make any arguments to the court.

         The magistrate judge issued a written report detailing the factual and legal findings from the hearing; the superior court adopted the magistrate judge's recommended findings and signed the attached orders in February.

         Naomi appeals, arguing that the superior court erred in finding that she was gravely disabled, that there was no less intrusive alternative to involuntary medication, and that forced medication was in her best interests. Naomi requests that we reverse or vacate the commitment and medication orders.

         B. Linda M.

         Linda M. has a history of mental health issues spanning most of her adult life. By 2016 she had exhibited paranoia and aggressive behavior, such as spitting at people, and kicking and throwing things. The Anchorage Police Department's crisis intervention team responded several times to calls from Linda's mother reporting that Linda was threatening her. The police described Linda as "agitated" and "very volatile," and they eventually arrested Linda for threatening her mother with a shovel and spitting on her. At the time Linda was already facing a criminal charge for reckless driving in connection with a car accident.

         While in custody for the two criminal cases, Linda was sent to API for an evaluation and restoration of her competency to stand trial. In July 2016 API filed a petition to commit Linda for 30 days. During the commitment hearing, Linda's testimony seemed paranoid and delusional, including statements that members of a drug cartel had attempted to poison her; a psychiatric nurse practitioner testified that Linda had schizophrenia. The court found that Linda had a mental illness and as a result posed a "substantial risk of harm to others." It granted API's petition to commit Linda for up to 30 days. During her commitment, Linda voluntarily participated in therapy, but she also swore, lunged, and swung at various API staff members, raising concerns about her unpredictability and aggressive behavior. The therapy did not lead to improvement, and the efficacy of the drugs administered by API remained unclear.

         In August 2016 API filed a petition to commit Linda for another 90 days and Linda requested a jury trial. During the trial Linda offered further testimony reflecting paranoid delusions. The jury unanimously found by clear and convincing evidence that Linda was mentally ill and that as a result she was "likely to cause harm to others."

         Approximately one week after the jury verdict, the superior court held an evidentiary hearing on whether there was any less restrictive alternative to hospitalization at API. Various experts testified and several alternatives were explored. An API mental health clinician who was certified as an expert in API discharge planning testified that, because Linda was not taking medication as prescribed, she would not be accepted into a publicly funded assisted living home. The clinician also testified that a halfway house for formerly incarcerated individuals would not be appropriate for Linda, even in conjunction with a community support program, and that privately operated assisted living facilities would likely reject Linda because of her unpredictability and aggressiveness. An API psychiatric nurse practitioner similarly testified that Linda needed to be stabilized using medication at API before her release, that she still needed "24/7 . . . supervision," and that releasing Linda into the community at that time would set her up for failure.

         Finally, a clinical psychiatrist testified that Linda could be discharged to an outpatient community support program if safe housing could also be arranged for her, such as an assisted living facility or other location with professional staff that could "retain her" if she became agitated. He also discussed a closed facility, Soteria-Alaska, as a less restrictive alternative to API. He testified that Soteria-Alaska had operated for seven years in Anchorage and had offered an alternative to the psychiatric inpatient hospitalization offered at API, but one that still provided "24/7" supervision. But he testified that Soteria-Alaska was shut down due to funding issues. He opined Soteria-Alaska would have been a good option for Linda if it were still in operation.

         Linda's counsel asserted during closing argument that the evidence had not established a high probability that a less restrictive alternative would be unsuccessful. Counsel also argued that Linda "ha[d] the constitutional right to a Soteria-like setting." More specifically, counsel argued that "the state cannot de-fund Soteria-Alaska and then say that because we haven't funded it, there is no less-restrictive alternative."

         The superior court determined that, given the jury finding that Linda was likely to cause harm to others, "a less restrictive alternative would have to . . . protect others from physical injury." The court reasoned that "none of the less restrictive alternatives that have been proposed by [Linda] or would otherwise be available will protect . . . the public from the danger to others that [Linda] currently [poses]." The court explained that when Linda becomes agitated, it happens quickly, and that no less restrictive alternative was sufficient to protect the public "other than a facility like API that is locked and [that] provides 24/7 care." Finally, with regard to Soteria-Alaska as a proposed alternative, the court stated, "I reject the idea that there's a constitutional right that would require the state to fund particular kinds of programs. There would be separation of powers issues, I believe."

         The superior court found that there was no less restrictive alternative to commitment at API. Linda appeals, arguing that the court erred by rejecting Soteria-Alaska as a feasible less restrictive alternative, and that her commitment order therefore violated her constitutional right not to be hospitalized where a feasible less restrictive alternative exists. She requests that we reverse and vacate the 90-day commitment order.


         "We apply our independent judgment to issues of mootness because as a matter of judicial policy, mootness is a question of law."[4] We review the superior court's factual findings in involuntary commitment or medication proceedings for clear error and reverse those findings only if we have a "definite and firm conviction that a mistake has been made."[5] However, whether those findings meet the statutory requirements for involuntary commitment or medication is a question of law to which we apply our independent judgment.[6] The independent-judgment standard also applies to questions regarding the interpretation of constitutional and statutory provisions, adopting "the rule of law that is most persuasive in light of precedent, reason, and policy."[7]


         A. We Will Consider The Merits Of Naomi's And Linda's Appeals Because We Hold That The Public Interest Exception Applies To All Appeals From Involuntary Admission For Treatment.

         As typically happens in involuntary admission for treatment appeals, Naomi's and Linda's commitment orders and Naomi's medication order expired while their appeals were pending. Under our prior ruling in Wetherhorn v. Alaska Psychiatric Institute, this would render their appeals moot.[8] In its initial briefing in Naomi's case, the State argued that Naomi's case should be dismissed as moot. Naomi argued that her case fell under both the public interest exception to the mootness doctrine[9] and the collateral consequences exception.[10] She also argued, alternatively, that merit-based review of commitment appeals was mandated by federal due process concerns and that she had a statutory right to appeal under AS 47.30.765.[11] We rejected this statutory argument in In re Mark V. (Mark V. I), [12] but Naomi argued that we should overrule that decision.

         In Linda's case the State suggested that we could consider the merits of Linda's case under the public interest exception. Linda agreed that we should do so, or, alternatively, that we should revisit our mootness jurisprudence in the involuntary commitment context and hear all appeals of psychiatric confinement orders on the merits. We consolidated the two cases on appeal and asked all parties for supplemental briefing on whether - and if so, how - we should revisit our case law on moot involuntary commitment and medication appeals.

         We do not lightly overturn our previous decisions. After reexamining our decisions regarding the mootness doctrine as applied to cases involving involuntary admission for treatment and medication, and in light of the broad agreement in the supplemental briefing regarding the practical consequences that have followed from those decisions - discussed in more detail below - we are persuaded that our previous rulings with regard to mootness in these contexts were mistaken and that more good than harm will come from overturning them.

         1. Mootness in commitment appeals - Wetherhorn and its progeny

         A history of our mootness jurisprudence is useful for context. Although the legislature amended Alaska's mental health statutes in 1981 in response to a nationwide shift in mental health treatment, [13] we heard few appeals from such cases until more than 20 years later. In 2007, in Wetherhorn v. Alaska Psychiatric Institute, we considered a constitutional challenge to the statutory definition of "grave disability" and a due process challenge to the proceedings in which the appellant was involuntarily committed to API for 30 days.[14] The appellant also challenged the sufficiency of the evidence underlying her commitment, but we declined to consider that challenge because the commitment period had "long since passed," rendering the question moot.[15] We considered but declined to apply the public interest exception, reasoning that "Wetherhorn was committed based on a specific set of facts," that "[i]fit were to become necessary to seek Wetherhorn's commitment again, the hearing would be based on a different set of facts specific to different circumstances," and that "factual questions are not capable of repetition."[16] Wetherhorn thus established that appeals from commitment orders are moot when the appellant has already been released before the appeal is heard and that the public interest exception would apply only to generally applicable questions of law and not to questions of fact like sufficiency-of-the-evidence challenges.

         Our 2012 opinion in In re Joan K. departed from the strict holding of Wetherhorn and adopted a "collateral consequences exception" to the mootness doctrine in involuntary commitment appeals.[17] The appellant in that case noted that several other jurisdictions had applied the collateral consequences exception to involuntary commitment appeals on the basis of, for example, "social stigma, adverse employment restrictions, application in future legal proceedings, and restrictions on the right to possess firearms."[18] We 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."[19] Because Joan K. involved the appellant's first involuntary commitment, we reviewed the merits of her evidentiary challenges.[20] But we also "note[d] that some number of prior involuntary commitment orders would likely eliminate the possibility of additional collateral consequences, precluding the doctrine's application."[21] To illustrate the point, we cited Bigley v. Alaska Psychiatric Institute, which described a" 'revolving door' pattern of arrest, hospitalization, release and relapse" in which the appellant had been admitted to API at least 68 times.[22] We did not, however, explicitly limit the collateral consequences exception to an appellant's first involuntary commitment or specify what number of prior commitments would render further collateral consequences negligible.

         Joan K. also cursorily presented the question whether AS47.30.765, which provides that the respondent to an involuntary commitment petition "has the right to an appeal from an order of involuntary commitment," supersedes the mootness doctrine in this context.[23] Because we adopted and applied the collateral consequences exception, we did not reach this question, but we expressed some skepticism.[24] We addressed this issue two years later in Mark V. I.[25] There we noted that other statutes also provide "rights of appeal equivalent to those provided by AS 47.30.765"[26] and that "[t]he existence of these statutes ha[d] not in practice compelled us to review otherwise-moot appeals."[27] We concluded the statute did not "requir[e] appellate review of a moot civil commitment dispute."[28]

         Our opinion in In re Dakota K. addressed the question - left unresolved by Joan K. - of which party bears the burden to show the existence or non-existence of collateral consequences.[29] We concluded that the party opposing mootness bears "the burden to establish the fact of collateral consequences."[30] Because the appellant in that case had not made a showing or even alleged that the challenged involuntary commitment was his firstor that any other collateral consequences applied, we dismissed the appeal as moot.[31]

         That same year we addressed a procedural issue concerning mootness in In re Reid K.[32] We recognized that because the mootness issue was first addressed in the State's appellee's brief, the appellant had not had a chance to demonstrate that his claims were not moot or that they fell within a mootness exception doctrine until the reply brief.[33] To remedy this procedural hurdle, we suggested that it would be "best practice for the State to move to dismiss appeals of commitment orders as moot before briefing commences when no mootness exception is readily apparent."[34] We explained that this procedure might "save scarce public attorney and judicial resources by avoiding merits-based briefing" in cases that would ultimately be dismissed as moot.[35]

         2. Our mootness jurisprudence has proved unworkable in practice.

         In their supplemental briefing the parties agree that over the past decade, our mootness jurisprudence as applied to involuntary commitment and medication appeals has resulted in significant time and effort spent addressing mootness issues. Counsel for both the State and Naomi indicate that in commitment appeals, briefing and litigating mootness is often more time- and resource-consuming than addressing the actual merits of any particular case. The State argues that "[t]he collateral consequences exception can be particularly difficult to litigate because its applicability can hinge on facts that may not be in the appellate record."

         The procedure we laid out in Reid K. for a pre-briefing motion to dismiss on mootness grounds was not used in either of these cases. Naomi's attorney, a public defender, indicates that "in appeals involving the Public Defender Agency, it does not appear that the Reid K. [procedure] has been utilized at all." The State concedes that it has not effectively implemented the Reid K. procedure, noting that it can be difficult to determine if the issues raised on appeal would fall within a mootness exception before the appellant's arguments are articulated in the opening brief. Naomi further argues that even if the Reid K. procedure had been used, addressing the potential applicability of a mootness exception "entails reviewing the record, researching the relevant issues, and filing a detailed response to the dismissal motion that is not unlike a merits-based brief." Thus, she argues, if a mootness exception even arguably applies, using the Reid K. procedure merely "shifts resources to an earlier stage in the case but does not meaningfully save them."

         A review of our past and pending cases also indicates that mootness has dominated appeals in the involuntary commitment context: as of February2018 -when we heard oral arguments on this issue - all but three of our prior decisions in post-Wetherhorn commitment appeals directly addressed, to some extent, whether the commitment appeal was moot.[36] Similarly, of the commitment cases pending before us that had been fully briefed at that time, almost all included briefing on mootness.

         We have consistently held that we will not reconsider prior rulings without compelling reasons for doing so: "We will overrule a prior decision only when clearly convinced that the rule was originally erroneous or is no longer sound because of changed conditions, and that more good than harm would result from a departure from precedent."[37] We have recognized that our precedent may be overturned as "originally erroneous" if it has "prove[d] to be unworkable in practice."[38]

         As we explained in Dakota K, "[m]ootness is a judicially created doctrine meant to promote expediency and judicial economy."[39] Our mootness jurisprudence has failed to achieve these goals: more, rather than fewer, resources of public attorneys and the court have been spent litigating mootness since Wetherhorn, with few if any corresponding savings in resources spent on merits-based briefing.

         In light of these factors it is clear to us that our current mootness jurisprudence, as it applies to the involuntary commitment context, has indeed proved to be unworkable in practice. But that does not answer the question of what a more appropriate rule would be. To answer that, we need to reconsider our mootness jurisprudence in more detail.

         3. The public interest exception is categorically applicable to involuntary commitment appeals.

         As explained above, we will hear an otherwise moot case where it falls under the public interest exception to mootness. The State suggests that the public interest exception may always be applicable to justify appellate review of involuntary commitment orders. As we have applied it, the public interest exception depends on three factors: "(1) whether the disputed issues are capable of repetition, (2) whether the mootness doctrine, if applied, may cause review of the issues to be repeatedly circumvented, and (3) whether the issues presented are so important to the public interest as to justify overriding the mootness doctrine."[40]

         The second factor will always favor applying the exception in involuntary commitment appeals: as we explained in E.P. v. Alaska Psychiatric Institute, "[i]t is quite unlikely that an appeal from a 30-day or 90-day commitment, or even a 180-day commitment, could be completed before the commitment has expired."[41] And we have repeatedly held that some issues in involuntary commitment appeals are important to the public interest - the third factor - because an involuntary commitment is a "massive curtailment of liberty."[42]

         Where we have considered the public interest exception in the past, we have generally held that disputed questions are not "capable of repetition" when they "turn on unique facts unlikely to be repeated."[43] In some cases we have applied this rule strictly. For example, in Wetherhorn we concluded that the public interest exception did not apply because "Wetherhorn was committed based on a specific set of facts."[44] Similarly, in In re Reid K. we concluded that a sufficiency-of-the-evidence challenge based on the alleged unreliability of clinical tests presented as evidence did not fall under the public interest exception because "the trial court is the most appropriate forum in which to evaluate and weigh competing fact-based arguments regarding the reliability of evidence."[45]

         However, in other cases we have applied the "capable of repetition" element more flexibly. For example, in E.P. the appellant raised both legal and factual challenges to his commitment order.[46] The latter included the question whether E.P. - whose history of alcohol and inhalant abuse had resulted in organic brain damage, dementia, personality disorder, and psychosis[47] - met the statutory requirements for involuntary commitment.[48] We concluded that "E.P.'s fact-based claims are capable of repetition to any addict whose substance abuse causes organic brain damage," even if the abused substance were something other than inhalants.[49]

         On re-examination, we are persuaded that the "capable of repetition" element should be applied broadly in the context of involuntary commitment appeals, and that a case need not be capable of being repeated identically in order for the public interest exception to apply. Although every involuntary commitment proceeding is based on a particular set of facts, such proceedings occur frequently, and it is not uncommon for similar fact patterns to reoccur, either in a subsequent proceeding involving the same respondent, [50] or in a different case entirely.[51] Accordingly, an opinion considering whether a commitment order in one case was supported by sufficient evidence will likely be useful as guidance by analogy to future commitment proceedings. By contrast, declining review of commitment appeals based on mootness effectively deprives trial courts of guidance on how to apply the statutory requirements to the facts of individual cases.

         We conclude that appeals from involuntary commitment orders are categorically subject to the public interest exception, whether the appeal is premised on a question of statutory or constitutional interpretation or on an evidence-based challenge. While we reaffirm that the trial court is indeed the correct forum for evaluating and weighing the reliability and credibility of evidence[52] and we therefore will not second-guess the trial court's findings of fact where they are supported by evidence in the record, that does not preclude us from considering whether the findings were clearly erroneous or whether they were sufficient to satisfy legal requirements.

          4. The public interest exception is also categorically applicable to involuntary medication appeals.

         Just like involuntary commitment proceedings, involuntary medication proceedings implicate "fundamental constitutional guarantees of liberty and privacy."[53]And medication petitions are virtually always filed in conjunction with a petition for involuntary commitment, with hearings on the two petitions often taking place before the same judge on the same day. As with involuntary commitment appeals, because "it is doubtful that an appeal from a medication order could ever be completed within the order's period of effectiveness, "[54] such cases are likely to routinely evade timely review.

         We have previously held that the public interest exception applies "in order to clarify the requirements for protecting constitutional rights in [involuntary medication] proceedings."[55] Although every involuntary medication order is of course based on the facts and circumstances of a particular case, similar fact patterns are likely to reoccur. By continuing to apply the mootness doctrine to involuntary medication appeals, we deprive litigants and the superior court of helpful guidance in applying the statutory framework. We therefore also conclude that the public interest exception categorically applies to involuntary medication appeals, and we will hear all such appeals on the merits.[56]

         5. Overturning our mootness jurisprudence would result in more good than harm.

         Now that we have identified a new and better approach to mootness in the involuntary commitment and medication contexts, we must turn to the second requirement to depart from stare decisis, which dictates we "balance the benefits of adopting a new rule against the benefits of stare decisis."[57] The benefits of reaching the merits of involuntary commitment appeals were articulated in the dissenting opinion to In re Joan K.:

Of first importance, the citizen's liberty has been alleged to have been wrongfully taken by court process; the court should afford the citizen the opportunity to prove the error and, if proven, obtain judicial acknowledgment that the order was erroneously issued. Giving the citizen this opportunity will assure the citizen that she will be heard, and that if a lower court has erred, that error will not go unnoticed or unremedied, at least to the extent that the erroneous order will be reversed and vacated. Public confidence in the judicial branch demands that we hold ourselves accountable.
Second, in this age of prevalent information mining, collection, and storage into increasingly large, inter- connected, and searchable data banks, the fact that a citizen has been involuntarily committed to a mental institution will follow that individual for all of her life. She should be given the means to effectively challenge that order through appeal regardless of the fact that by the time her appeal is ripe for decision, the 30 days will have long since expired and she will have been released from State custody. The injury inflicted by an erroneously issued order of involuntary commitment "lives" until the wrong is righted.[58]

         The same reasoning applies to involuntary medication appeals.

         On the other side of the scales are the benefits of stare decisis: "providing guidance for the conduct of individuals, creating efficiency in litigation by avoiding the relitigation of decided issues, and maintaining public faith in the judiciary."[59] Declining to decide such appeals on mootness grounds provides no guidance to the general public, and little to no guidance to litigants and the superior court in involuntary commitment and medication proceedings. On the contrary, as suggested earlier, our mootness jurisprudence may in fact have deprived the superior court of guidance in how to apply the civil commitment and forced medication statutes to the facts of individual cases.

         Second, as discussed above, although our intent was to promote efficiency in litigation, experience has shown that this has not happened. Because the mootness doctrine as we have applied it depends on the specific circumstances and arguments raised on appeal, it has instead caused repeated extended litigation over mootness rather than over the actual merits of a case.

         Finally, we conclude that to the extent public faith in the judiciary may be harmed by our change of direction in this case, the risk is vastly outweighed by holding the judiciary as a whole accountable through merit-based review of involuntary commitment and medication orders.

         6. We will hear all involuntary admission for treatment and involuntary medication appeals on the merits.

         For these reasons, we conclude that the public interest exception applies categorically to appeals from orders for involuntary admission for treatment and involuntary medication.[60] We will hear such cases on their merits even where the underlying order has expired and the respondent has been released or no longer subject to forced medication.[61]

         Because we conclude that all involuntary admission for treatment and medication appeals are subject to the public interest exception, it is not necessary for us to reconsider whether AS 47.30.765 mandates judicial review of otherwise-moot cases, and we decline to do so; we similarly do not address Naomi's argument that judicial review on the merits of commitment appeals is mandated by federal due process concerns. But to the extent that our prior decisions on mootness in the involuntary admission for treatment and medication contexts are inconsistent with this opinion, they are overruled. We emphasize that because our decision here is based on circumstances unique to appeals from ...

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