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For the state to lock up the mentally ill against their will, patients must be either a danger to themselves or others or so disabled by illness that they "cannot survive safely in freedom," the Alaska Supreme Court ruled Friday.
In a unanimous opinion, the high court upheld the Alaska law that allows involuntary commitments at the state mental hospital. But it strengthened protections for the mentally ill by defining who can be committed as those who could not otherwise survive safely.
The justices also disapproved the forced drugging of a specific patient. Although forced drugging is allowed in some circumstances, this particular case was mishandled, they said.
The high court ruled in a case brought by Anchorage psychiatric rights lawyer Jim Gottstein. He sued in 2005 on behalf of a woman who had bipolar disorder. Roslyn Wetherhorn was committed to API for 30 days after going off her medicine and making statements some found bizarre, such as that the owner of a local grocery store was going to take her to the pope's funeral. She later said she had joked about using the governor's jet and that maybe someone misunderstood her.
It was acceptable for API to seek forced commitment in the case, the justices said. Questions involving the standard used are moot since Wetherhorn is long out of API but the tightened definition should apply in future cases.
In recent years, Gottstein has filed a series of suits against the state over confinement or forced medication at API. He currently is embroiled in a battle with drug giant Eli Lilly over its best selling drug, Zyprexa, and documents he released about the drug's dangers that the company wanted to remain secret.
Holding people against their will for mental treatment is a "massive curtailment of liberty," according to a characterization by the U.S. Supreme Court in an opinion cited by the Alaska court.
There's a danger people may be confined just because they are "physically unattractive or socially eccentric," says another case cited.
Alaska's law generally provides enough protection, including a requirement that evidence of the person's deterioration be "clear and convincing," Alaska Supreme Court Chief Justice Dana Fabe wrote.
As to forced medication, the justices noted they have already ruled that a series of steps must be completed before doctors can force intrusive psychiatric drugs on unwilling patients.
That procedure wasn't followed for Wetherhorn, the court said.
Ron Adler, chief executive officer of API, said the hospital already is working more closely with patients. Many who arrive at the hospital involuntarily agree to stay without a court order, he said.
"People get better quicker when they become partners in the treatment," he said.
The court cases have led to increased scrutiny of hospital practices, and that's a good thing, he said.
Daily News reporter Lisa Demer can be reached at ldemer@adn.com and 257-4390.
