Case Facts and Legal Standard

Several weeks before hospitalization, Ms. D had stopped taking her medication. Subsequently, Ms. D began walking naked outdoors.

She accused her daughters of using "supernatural powers" to play inside her genitalia. She rubbed olive oil on her neighbors' doors

"to keep demons inside" and accused her neighbors of "doing witchcraft" to harm her. While walking on a bike trail, Ms. D hit a man's dog on the head with a stick, saying the animal was

"possessed with demons." She also took her 2-year-old grandson on a trip out of town without telling his parents, although she returned the boy in good health. Ms. D was arrested for throwing plates at passing cars while she was naked and covered in cooking grease, and soon thereafter underwent emergency hospitalization.

At her commitment hearing, the treating psychiatrist testified that Ms. D was "psychotic" upon admission and that she appeared "very agitated and aggressive." Once Ms. D started taking her regular antipsychotic medication again, however, she began "doing much better." The psychiatrist also testified that Ms. D had a history of noncompliance with medication. Ms. D testified that she was taking her medication, that grease was an inexpensive moisturizer, and that when she took her grandson, she had left his parents a message.

Concerning the dog incident, Ms. D said she "had started carrying a stick just to warn dogs off... I thought they were demons. I didn't want to get bit by a dog."

Under the statute (Iowa Code 229.1[15]), civil commitment may occur only if clear and convincing evidence shows that the respondent has a mental illness, cannot make responsible decisions about treatment, and is likely:

1. to physically injure herself or others if left untreated, or
2. to inflict serious emotional injury on others if left untreated, or
3. to suffer physical harm because she cannot satisfy her needs for food, clothing, medical care, or shelter

To prove (a), the jurisdiction requires an "overt act," i.e., a past aggressive act or threat that makes probably the commission of an act that would likely cause someone physical injury. Does Ms. D meet commitment criteria? Describe your rationale.