In Re Pinal County Mental Health Case Mh202400075

IN THE
ARIZONA COURT OF APPEALS
DIVISION TWO

IN RE PINAL COUNTY MENTAL HEALTH NO. MH202400075

No. 2 CA-MH 2024-0007
Filed November 26, 2024

Appeal from the Superior Court in Pinal County
No. MH202400075
The Honorable Daniel Thorup, Judge Pro Tempore

VACATED

COUNSEL

Kate Milewski, Pinal County Public Defender
By Kevin D. Heade, Deputy Public Defender, Florence
Counsel for Appellant

Kent P. Volkmer, Pinal County Attorney
By Anne Froedge, Deputy County Attorney, Florence
Counsel for Appellee
 IN RE PINAL CNTY. MENTAL HEALTH CASE NO. MH202400075
Opinion of the Court

OPINION

Judge Vásquez authored the opinion of the Court, in which Presiding Judge
O’Neil and Judge Kelly concurred.

V Á S Q U E Z, Judge:

¶1 J.R. appeals from the trial court’s April 2024 order for
involuntary treatment. He challenges the sufficiency of the evidence to
support the court’s finding that he was a danger to self. He also argues the
involuntary treatment order must be vacated because the evaluating
physicians never discussed treatment alternatives with him. Relatedly, he
contends the court failed to consider all available treatment alternatives and
erred by not imposing the least restrictive one. For the following reasons,
we vacate the involuntary treatment order.1

Factual and Procedural Background

¶2 We view the facts in the light most favorable to sustaining the
trial court’s order. In re Maricopa Cnty. Mental Health No. MH 2008-001188,
221 Ariz. 177, ¶ 14 (App. 2009). Thirty-seven-year-old J.R.—who lives with
his mother and his friend S.M.—suffers from epilepsy, attention-deficit
hyperactivity disorder, and anxiety, and he sees a psychiatrist on an
outpatient basis. In March 2024, J.R. got upset and jumped out of the
passenger seat of his mother’s car while she was traveling about five miles
per hour in a parking lot.

¶3 About a week later, J.R. became concerned that his chickens
were dying due to having an extra pleural sac. He watched an online video
about removing the sac and then began performing that procedure on his
more than thirty chickens. While doing so, J.R. grew angry, and his mother
saw him throw a bird against a cement wall. He then picked up a shovel
and began banging it against the ground while continuing to yell and

1This appeal is arguably moot because the ninety-day involuntary

treatment order expired in July 2024. However, given J.R.’s interests at
stake as a result of having a commitment order in his record, we decide the
appeal. See In re Maricopa Cnty. Mental Health No. MH 2007-001236, 220 Ariz.
160, n.3 (App. 2008).

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scream. J.R.’s mother called 9-1-1. J.R. was taken to a hospital, where he
was given medication to calm him down. A crisis interventionist with the
hospital filed an application for involuntary evaluation, which the trial
court ordered.

¶4 J.R. was transferred to Community Bridges, Inc. (CBI), where
Dr. John Lee and Dr. Safdar Chaudhary each evaluated him. Both doctors
concluded that J.R. was a danger to self, a danger to others, and persistently
or acutely disabled (PAD) and was in need of treatment. Dr. Lee diagnosed
J.R. with unspecified bipolar and related disorder, while Dr. Chaudhary
diagnosed him with schizophrenia.

¶5 Following the evaluations, Dr. Lee filed a petition for
court-ordered treatment, requesting combined inpatient and outpatient
treatment for J.R. At a hearing on the petition, both doctors—as well as the
crisis interventionist who had met with J.R. at the hospital, a behavioral
health technician at CBI, J.R.’s mother, and S.M.—testified in support of the
petition. J.R. testified on his own behalf.

¶6 At the end of the hearing, the trial court concluded the
evidence was insufficient to establish that J.R. was a danger to others or
PAD. However, the court found by clear and convincing evidence that he
was a danger to self. The court based its finding on J.R.’s act of getting out
of a moving vehicle. The court explained: “[E]ven if it is going five miles
per hour, that is dangerous behavior and one a normal person would[] not
engage in.” The court thus ordered a program of “combined inpatient and
outpatient treatment . . . for a period of time not to exceed a total of 365
days, with the period of inpatient treatment under this combined order not
to exceed [90] days.” This appeal followed.

Sufficiency of the Evidence

¶7 J.R. contends there was insufficient evidence to establish he
was a danger to self. He maintains the trial court “relied on a single act”—
“exiting a car moving at or below the speed of people walking around it in
a parking lot”—to conclude he was. But, he argues, “No evidence was
offered establishing that exiting a moving vehicle at such a low speed could
pose a risk of serious harm or death.” 2 We will affirm an involuntary

2 In support of his argument, J.R. relies on a magazine article to

reason that if his behavior could be deemed to pose a serious physical harm,
so too would a number of other activities, including skateboarding, skiing,
running, and riding horses. However, he did not present this article below.

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Opinion of the Court

treatment order if it is supported by substantial evidence. In re Maricopa
Cnty. Mental Health No. MH 2007-001236, 220 Ariz. 160, ¶ 15 (App. 2008).
“Substantial evidence is evidence which would permit a reasonable person
to reach the trial court’s result.” In re Maricopa Cnty. Mental Health No. MH
2008-000097, 221 Ariz. 73, ¶ 17 (App. 2009) (quoting In re Estate of Pouser,
193 Ariz. 574, ¶ 13 (1999)).

¶8 As relevant here, “danger to self” means:

[B]ehavior that, as a result of a mental disorder:

(i) Constitutes a danger of inflicting serious
physical harm on oneself, including
attempted suicide or the serious threat
thereof, if the threat is such that, when
considered in the light of its context and
in light of the individual’s previous acts,
it is substantially supportive of an
expectation that the threat will be carried
out.

(ii) Without hospitalization will result in
serious physical harm or serious illness
to the person.

A.R.S. § 36-501(9)(a).3 “Danger to self” covers “irrational, risky behavior
such as compulsively wandering into heavy traffic.” In re Pima Cnty. Mental
Health No. MH-674-5-88, 159 Ariz. 547, 548 (App. 1988); see also Pima County
v. Kaplan, 124 Ariz. 510, 512 (App. 1980) (patient was “danger to self” based
on evidence he had been arrested for driving wrong way on freeway and
found beneath jet preparing for takeoff). And the danger must be

See State v. Schackart, 190 Ariz. 238, 247 (1997) (“Because our court does not
act as a fact-finder, we generally do not consider materials that are outside
the record on appeal.”); Ariz. R. Civ. App. P. 11(a) (record on appeal
consists of documents filed in trial court).
3“Danger to self” does not include “behavior that establishes only

the condition of having a grave disability.” § 36-501(9)(b); see also
§ 36-501(16) (“‘Grave disability’ means a condition evidenced by behavior
in which a person, as a result of a mental disorder, is likely to come to
serious physical harm or serious illness because the person is unable to
provide for the person’s own basic physical needs.”).

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imminent. See In re Pima Cnty. Mental Health No. MH1717-1-85, 149 Ariz.
594, 596 (App. 1986) (imminence implicit in concepts of danger and
expectation of harm).

¶9 Here, J.R. admitted to getting out of a slow-moving vehicle.
His mother testified that he had done it “a couple of times,” most recently
when she was driving three to five miles per hour in a parking lot. The only
other incident she described had occurred about nine months prior when
they were “coming down the street” to their house, approaching the
driveway and J.R. was upset. His mother stated, “If you start talking to
[J.R.] in a car and you get on something that he doesn’t want to hear about,
it is like the escape.” S.M. similarly testified that J.R. had jumped out of the
car the most recent time because “he was just mad.” By contrast, J.R.
testified that he had jumped out of the car that time because he was
“scared.” He explained that his mother was not paying attention and there
had been another vehicle backing up and a pedestrian walking close to the
car. J.R. did not think his behavior was “unsafe” because “people were
walking faster than the vehicle was moving.”

¶10 As a preliminary matter, we agree with the trial court that
getting out of a moving vehicle, even one going slowly, is a dangerous
behavior. The record lacks direct evidence that J.R.’s behavior in doing so
was the “result of a mental disorder.” § 36-501(9)(a); see also In re Maricopa
Cnty. Mental Health No. MH 94-00592, 182 Ariz. 440, 444 (App. 1995) (danger
to self focuses on “behavioral impairments” resulting from mental disorder
(emphasis omitted)). But Dr. Lee and Dr. Chaudhary both suggested that
J.R.’s “impulsive” behavior was indicative of mental illness.
Dr. Chaudhary, in particular, noted that J.R. “could not comprehend the
danger he has caused to himself due to his impulsive behaviors by getting
out of a moving vehicle.” To the extent such evidence conflicts with the
testimony that J.R. got out of the car because he was upset or scared, it was
for the trial court to resolve any such conflicts. In re Pima Cnty. Mental
Health No. MH-2010-0047, 228 Ariz. 94, ¶ 17 (App. 2011). We will not
reweigh the evidence on appeal. Id.

¶11 However, based on the undisputed evidence in this case that
the vehicle was traveling three to five miles per hour, we cannot agree with
the trial court that J.R. was a “danger to self” insofar as his behavior in
getting out of the vehicle (i) “constitutes a danger of inflicting serious
physical harm” to himself or (ii) “will result in serious physical harm or
serious illness” to him without hospitalization. § 36-501(9)(a). Resolution
of this issue requires us to interpret the meaning of “danger to self” in
§ 36-501(9)(a). See In re Maricopa Cnty. Mental Health No. MH 2006-000749,

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214 Ariz. 318, ¶ 13 (App. 2007) (we review issues of statutory interpretation
de novo). In doing so, we look to the language of the statute as the most
reliable indicator of its meaning. Maricopa Cnty. No. MH 2008-000097, 221
Ariz. 73, ¶ 8. If that language is plain and unambiguous, we apply it as
written without resorting to other methods of statutory interpretation. In
re Drummond, ___ Ariz. ___, ¶ 5, 543 P.3d 1022, 1025 (2024). In the absence
of statutory definitions, we give words their ordinary meaning and may
rely on respected dictionary definitions. Maricopa Cnty. No.
MH 2008-000097, 221 Ariz. 73, ¶ 8; see also Drummond, ___ Ariz. ___, ¶ 7, 543
P.3d 1022, 1025.

¶12 The mental-health statutes do not define “serious physical
harm,” as used in § 36-501(9)(a). Relying on the term’s ordinary meaning,
as well as dictionary definitions, we conclude “serious physical harm”
means harm that poses a substantial risk of death, permanent
disfigurement, or protracted impairment. See Physical harm, Black’s Law
Dictionary (12th ed. 2024) (“Any physical injury or impairment of . . . the
human body.”); Injury, Black’s Law Dictionary (12th ed. 2024) (“physical
injury” means “bodily injury,” and “serious bodily injury” means
“[s]erious physical impairment of the human body; esp., bodily injury that
creates a substantial risk of death or that causes serious, permanent
disfigurement or protracted loss or impairment of the function of any body
part or organ”); cf. A.R.S. § 13-105(39) (in criminal statutes, “serious
physical injury” means “physical injury that creates a reasonable risk of
death, or that causes serious and permanent disfigurement, serious
impairment of health or loss or protracted impairment of the function of
any bodily organ or limb”). And, as used in § 36-501(9)(a), “will result in”
means serious physical harm or illness will necessarily occur in the future.
See Maricopa Cnty. No. MH 2008-000097, 221 Ariz. 73, ¶ 8; see also Result in,
Merriam-Webster, https://merriam-webster.com (last visited Sept. 30,
2024) (“to cause (something) to happen” or “to produce (something) as a
result”); Will, Merriam-Webster, https://merriam-webster.com (last
visited Sept. 30, 2024) (“used to express futurity” or “used to express
inevitability”).

¶13 Here, J.R. jumped out of a slow-moving vehicle twice,
approximately nine months apart, and there was no evidence of any harm
to J.R., let alone a substantial risk of death, permanent disfigurement, or
protracted impairment. At least with regard to the most recent incident,
there was evidence that people were walking faster than the vehicle was

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Opinion of the Court

moving. And there was no evidence of suicidal ideations by J.R. 4 See In re
Pima Cnty. Mental Health No. MH-1375-2-85, 146 Ariz. 488, 489 (App. 1985)
(patient’s multiple suicide attempts and statements supported “danger to
self” finding). J.R.’s behavior thus stands in stark contrast to other
behaviors—such as walking into heavy traffic, driving the wrong way on
the freeway, or laying beneath a jet preparing for takeoff—that this court
has determined sufficient to constitute a danger to self. See Pima Cnty. No.
MH-674-5-88, 159 Ariz. at 548; Kaplan, 124 Ariz. at 512.

¶14 Notably, although both doctors indicated in their reports that
J.R. was a danger to self, neither seemed particularly concerned with that
conclusion at the hearing. When asked whether J.R. was a danger to
himself, Dr. Lee testified that “it was more PAD than anything else.”
Dr. Chaudhary somewhat similarly testified that he was concerned
“predominately [with] the safety of other[s],” not J.R.

¶15 Although we defer to the trial court’s ability to weigh the
evidence, observe the parties, and judge the credibility of witnesses, Pima
Cnty. No. MH-2010-0047, 228 Ariz. 94, ¶ 7, “the bare assertion that the
statutory criterion was met, without any explication of the facts that show
it was met, does not constitute clear and convincing evidence,” In re
Maricopa Cnty. Mental Health No. MH2011-000914, 229 Ariz. 312, ¶ 13 (App.
2012) (quoting Maricopa Cnty. No. MH 94-00592, 182 Ariz. at 447 n.4). On
this record, the possibility that J.R.’s behavior might have resulted in
serious physical harm was speculative. See City of Tucson v. Citizens Utils.
Water Co., 17 Ariz. App. 477, 481 (1972) (mere speculation not substantial
evidence). Because there is insufficient evidence to establish J.R. met the
statutory definition of being a danger to self, we vacate the involuntary
treatment order.5

4At the hearing, J.R.’s mother testified that J.R. had “talk[ed] about

using his gun” about nine months prior, but there was no follow-up or
clarification of what this meant. And the trial court found “a lot of
inconsistencies” in her testimony. See Pima Cnty. No. MH-2010-0047, 228
Ariz. 94, ¶ 17 (trial court determines witness credibility).
5Although we vacate the trial court’s order for insufficient evidence,

we nevertheless address J.R.’s remaining arguments because of the liberty
interests at stake and because the issues would potentially evade our
review. See In re Pima Cnty. Mental Health No. MH20130801, 237 Ariz. 152,
¶ 27 (App. 2015).

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Treatment Alternatives

I. The physician’s discussion of the treatment alternatives

¶16 J.R. also argues that the trial court erred in ordering
involuntary treatment because the statutory scheme, specifically A.R.S.
§ 36-533(A)(2), “requires evaluating physicians to discuss the alternatives
to treatment, including the disadvantages and advantages of treatment
alternatives with those individuals subject to a petition for court-ordered
treatment.” Because Dr. Lee and Dr. Chaudhary failed to discuss any
alternatives with him, J.R. maintains that the order must be vacated.

¶17 Involuntary treatment proceedings may result in serious
deprivations of a defendant’s liberty interests. In re Maricopa Cnty. Mental
Health No. 2003-000058, 207 Ariz. 224, ¶ 12 (App. 2004). We thus require
“complete compliance” with the statutory scheme. In re Pima Cnty. Mental
Health No. 20200860221, 255 Ariz. 519, ¶ 11 (2023) (explaining that
compliance may be “technically different from what the statute requires”).
Whether there has been sufficient compliance is a question of law we
review de novo. Pima Cnty. No. MH-2010-0047, 228 Ariz. 94, ¶ 7. “But to
the extent the trial court’s decisions in this regard require it to assess the
credibility of witnesses and weigh the relative strength of their testimony
in order to reach fact-based conclusions, we defer to the court.” Id.

¶18 Section 36-533(A) provides the requirements for a petition for
court-ordered treatment. The petition must allege: (1) “[t]hat the patient is
in need of a period of treatment because the patient, as a result of mental
disorder, is a danger to self or to others or has a persistent or acute disability
or a grave disability,” (2) “[t]he treatment alternatives that are appropriate
or available,” and (3) “[t]hat the patient is unwilling to accept or incapable
of accepting treatment voluntarily.”

¶19 Contrary to J.R.’s argument, this statute does not require the
physicians to discuss treatment alternatives with the patient. It merely
requires that the alternatives be listed on the petition for court-ordered
treatment. That requirement was met here. The petition listed three
treatment alternatives—“court-ordered outpatient treatment,”
“court-ordered combined inpatient and outpatient treatment,” and
“court-ordered inpatient treatment”—with a checkbox next to each. Dr. Lee
checked the second option for “court-ordered, combined inpatient and
outpatient treatment.”

¶20 J.R. nevertheless relies on In re Pima County Mental Health No.
MH20130801, 237 Ariz. 152 (App. 2015). He argues that “[t]he purpose of

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the requirement for evaluating physicians to discuss treatment alternatives
with the person being evaluated is to provide a basis for the evaluator and
the court to assess whether the patient has the ability to make an informed
decision about treatment.” But Pima County No. MH20130801 is
inapplicable here.

¶21 In that case, we vacated the trial court’s order continuing
S.A.’s involuntary mental health treatment. Pima Cnty. No. MH20130801,
237 Ariz. 152, ¶ 36. We determined, in part, that the petitioner had failed
to prove S.A. was PAD. Id. ¶ 35. Pointing to the definition of “persistent or
acute disability,” we explained that to establish S.A. was PAD, the
petitioner was required to prove he had a severe mental disorder that
“causes [him] to be incapable of understanding and expressing an
understanding of the advantages and disadvantages of accepting treatment
and understanding and expressing an understanding of the alternatives to
the particular treatment offered after the advantages, disadvantages and
alternatives are explained to [him].” Id. ¶ 28 (quoting A.R.S.
§ 36-501(31)(b)).6 Thus, before the trial court could make a PAD finding, we
observed that the doctors must explain to the patient “the advantages and
disadvantages of accepting treatment[] and . . . the alternatives to such
treatment and the advantages and disadvantages of such alternatives.” Id.
¶ 29 (quoting In re Alleged Mentally Disordered Person MH 91-00558, 175 Ariz.
221, 225 (App. 1993)). We recognized a narrow exception for when it is
impracticable, “such as when a patient engages in ‘excessive verbal abuse,
physical abuse, repeatedly walking away when the physicians attempt to
discuss the matters, or nonresponsiveness.’” Id. ¶ 30 (quoting Maricopa
Cnty. No. MH 94-00592, 182 Ariz. at 446). However, because no discussion
occurred in that case, we concluded the petitioner had failed to establish
S.A. remained PAD. Id. ¶ 35.

¶22 Unlike Pima County No. MH20130801—and the cases on
which it is based—this case does not involve a PAD finding. Although
Dr. Lee and Dr. Chaudhary both opined that J.R. was PAD, the trial court
rejected those opinions, instead finding that J.R. was a danger to self. As
discussed above, to establish that a patient is a danger to self, the petitioner
is required to show behavior that, as a result of a mental disorder,
(i) constitutes a danger of inflicting serious physical harm on oneself or
(ii) will result in serious physical harm or illness without hospitalization.
§ 36-501(9). Thus, a danger-to-self finding does not require the patient to

6 Section 36-501 has since been amended, and the definition of
persistent or acute disability is now located in subsection (33).

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be incapable of understanding the advantages and disadvantages of
treatment, which in turn does not require the doctors to discuss those
advantages and disadvantages with the patient.

¶23 We recognize that § 36-533(A)(3) requires the petition to
allege that “the patient is unwilling to accept or incapable of accepting
treatment voluntarily.” This seems to imply that the physician will have
some sort of discussion with the patient about treatment—at least in cases
where the patient is capable of accepting treatment. But we fail to see how
the statute requires a granular discussion of “the disadvantages and
advantages of treatment alternatives,” as J.R. contends. Indeed, at oral
argument, J.R. recognized that requiring physicians to discuss treatment
alternatives with a PAD patient as opposed to a danger-to-self patient
“makes sense” because of the severity of the behavior involved with a
danger-to-self finding.

II. The trial court’s consideration of the treatment alternatives

¶24 In a related argument, J.R. contends the trial court “failed to
consider alternatives and erred by not imposing the least intrusive
treatment plan.” He maintains the court “immediately sought out the most
severe deprivation of liberty it could order by determining the longest
period it could order in-patient treatment and did not even consider
whether there should be limits on the use of psychotropic medication.”

¶25 The trial court must “consider all available and appropriate
alternatives for the treatment and care of the patient” and “shall order the
least restrictive treatment alternative available.” A.R.S. § 36-540(B). “‘Least
restrictive treatment alternative’ means the treatment plan and setting that
infringe in the least possible degree with the patient’s right to liberty and
that are consistent with providing needed treatment in a safe and humane
manner.” § 36-501(22).

¶26 Here, the trial court ordered a combination of inpatient and
outpatient treatment, consistent with Dr. Lee’s request on the petition. The
order was consistent with the statutory scheme. The court ordered J.R. to
receive treatment “for a period of time not to exceed a total of 365 days,”
with the inpatient treatment “not to exceed” ninety days, allowing for a
shorter treatment period as appropriate. See § 36-540(D) (order to receive
treatment shall not exceed 365 days), (F)(1) (maximum period of inpatient
treatment is ninety days for person found to be danger to self).

¶27 J.R. nevertheless argues that the trial court committed
fundamental error by subjecting him to forced psychotropic medication.

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See Pima Cnty. No. 20200860221, 255 Ariz. 519, ¶ 20 (although we apply
fundamental error review sparingly in civil cases, it is appropriate where
patient’s liberty interests at stake). He maintains that, under § 36-540(B),
“all available and appropriate alternatives for the treatment and care of the
patient” includes a patient’s medication regimen, which the court failed to
consider in this case. He further contends that Dr. Lee and Dr. Chaudhary
“merely opined” that “inpatient treatment with the forcible use of
psychotropic medication” was necessary without explaining why. J.R.
bases this argument on his right to privacy under article II, § 8 of the
Arizona Constitution and the due process clause of the federal constitution.

¶28 The right to be free from the involuntary administration of
psychotropic drugs is constitutionally protected. Rasmussen by Mitchell v.
Fleming, 154 Ariz. 207, 215 (1987) (right to refuse medical treatment
protected by both state and federal constitutions); see also Large v. Superior
Court, 148 Ariz. 229, 235-36 (1986) (federal constitution provides
“benchmark of minimum constitutional protection”). However, that right
may be infringed if the state “has legal reason to do so and when the
procedures are proper.” Large, 148 Ariz. at 236; see also Fleming, 154 Ariz. at
216-17. The question here is whether the trial court followed the proper
procedures—a question that requires us to interpret § 36-540(B). See Pima
Cnty. No. MH-2010-0047, 228 Ariz. 94, ¶ 7.

¶29 When interpreting a statute, we must consider the context and
read related statutes together to maintain harmony. In re Maricopa Cnty.
Mental Health No. MH 2007-000937, 218 Ariz. 517, ¶ 12 (App. 2008). Here,
reading the relevant statutes together shows that the “alternatives” the
court must consider under § 36-540(B) are inpatient treatment, outpatient
treatment, and combined inpatient and outpatient treatment, not the
specifics of the treatment plan, including medication, as J.R. maintains.

¶30 Section 36-539(B) requires the witnesses at an
involuntary-treatment hearing to testify as to “placement alternatives
appropriate and available for the care and treatment of the patient.” Using
that evidence, § 36-540(B) then requires the trial court to consider “all
available and appropriate alternatives for the treatment and care of the
patient” and to order “the least restrictive treatment alternative available.”
The mental-health statutes do not define “alternatives.” See § 36-501. They
do, however, define “least restrictive treatment alternative” as “the
treatment plan and setting that infringe in the least possible degree with the
patient’s right to liberty.” § 36-501(22). The statutes also do not define the
terms “treatment plan” or “setting.” See § 36-501. However, “outpatient
treatment plan” is defined as a “treatment plan that does not require

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continuous inpatient hospitalization,” suggesting that “treatment plan”
focuses on the environment in which treatment is administered and not the
specific course of treatment. 7 See § 36-501(30). We also understand
“setting” to carry its common meaning of place or location, like the
mental-health agency providing a certain treatment plan. See Setting,
Merriam-Webster, https://merriam-webster.com (last visited Nov. 13,
2024) (“the time, place, and circumstances in which something occurs or
develops”).

¶31 Our conclusion that “alternatives” refers to inpatient
treatment, outpatient treatment, or combined inpatient and outpatient
treatment is further supported by the common meaning of “alternative.”
“Alternative” generally means “one of two or more things, courses, or
propositions to be chosen.” Alternative, Merriam-Webster,
https://merriam-webster.com (last visited Nov. 14, 2024). Section
36-540(A) provides three “options”—a synonym for “alternatives”—for the
trial court’s order: inpatient treatment, outpatient treatment, and combined
inpatient and outpatient treatment.

¶32 We recognize that the contents of a given treatment plan will
be more detailed, perhaps including medication recommendations. See
§ 36-540.01(B) (contents of outpatient treatment plan). But the plain
language of § 36-540(B) does not require the trial court to consider those
details when ordering treatment. See Drummond, ___ Ariz. ___, ¶ 5, 543 P.3d
1022, 1025. Instead, the statute requires the court to consider the placement
“alternatives.”8 See In re Maricopa Cnty. Mental Health No. MH 2006-000490,
214 Ariz. 485, ¶ 12 (App. 2007) (“[W]e do not ‘inflate, expand, stretch or
extend a statute to matters not falling within its expressed provisions.’”
(quoting City of Phoenix v. Donofrio, 99 Ariz. 130, 133 (1965))). We thus do

7This court granted the state’s request to expand the record, to which

J.R. did not object, to include his “Outpatient Treatment Plan.” That plan
makes no specific medication recommendations.
8J.R. further contends that the trial court failed to find that he was

“unwilling or unable to accept voluntary treatment,” as required by
§ 36-540(A). But the involuntary treatment order contains that finding. We
do not construe the court’s statement, “I don’t know that [J.R.] can’t make
an informed decision,” as negating that finding. An individual may
simultaneously be unwilling to accept voluntary treatment and be capable
of making informed decisions.

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not agree with J.R. that the trial court erred by failing to consider the
medication regimen when ordering treatment.

¶33 That said, we agree with J.R. that neither doctor testified as to
any placement alternatives for J.R. The trial court took judicial notice of the
doctors’ affidavits and reports, but those also did not meaningfully discuss
the placement alternatives. Dr. Lee recommended a combination of
inpatient and outpatient treatment, but he did not explain why, stating only
that J.R. “would benefit from medication stabilization and safety planning.”
Dr. Chaudhary generally noted, “It is considered appropriate to treat
mental illness in inpatient and outpatient settings.” But he did not draw
any specific conclusions or make recommendations as to this case. There
was also no discussion of treatment centers other than CBI. Without such
testimony or evidence, we fail to see how the trial court could have
considered all available and appropriate treatment alternatives. This
further supports our decision to vacate the involuntary treatment order. See
§ 36-540(B); Pima Cnty. No. 20200860221, 255 Ariz. 519, ¶ 11.

Disposition

¶34 For the foregoing reasons, we vacate the trial court’s order for
involuntary treatment.

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