In Re: Richard A. Hopkins, Jr.

may not be cited except as provided by

Minn. Stat. § 480 A. 08, subd. 3 (1996).

 STATE OF MINNESOTA

 IN COURT OF APPEALS

 C5-97-1931

In Re: Richard A. Hopkins, Jr.

 Filed February 24, 1998

 Affirmed

 Davies, Judge

Itasca County District Court

File No. P7971559

John P. Dimich, 16 Northeast Third St., Grand Rapids, MN 55744 (for appellant)

John J. Muhar, Itasca County Attorney, W. James Mason, Assistant County Attorney, Itasca County Courthouse, 123 Northeast Fourth St., Grand Rapids, MN 55744 (for respondent)

Considered and decided by Davies, Presiding Judge, Peterson, Judge, and Foley, Judge.*

*

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

 U N P U B L I S H E D O P I N I O N

 DAVIES, Judge

Appellant challenges the district court's judgment finding him to be mentally ill and committing him jointly to the University Medical Center-Mesabi and the Brainerd Regional Human Services Center. We affirm.

 FACTS

In September 1997, the Itasca County Human Services Department petitioned for the commitment of appellant Richard A. Hopkins, Jr. Following a commitment hearing, the district court found that appellant suffers from a psychotic condition of paranoia and that his condition makes him dangerous to others. The court ordered commitment jointly to the University Medical Center-Mesabi and the Brainerd Regional Human Services Center. The court also authorized administration of neuroleptic medication. Appellant appeals on the grounds that (1) there is insufficient evidence that he is mentally ill and (2) the court failed to place him in the least restrictive setting.

 D E C I S I O N

On appeal from a judicial commitment, this court's review is limited to whether the district court complied with the Minnesota Commitment and Treatment Act and whether the commitment was "justified by findings based upon evidence" submitted at the hearing. In re Knops, 536 N.W.2d 616, 620 (Minn. 1995). The district court's factual findings must be affirmed unless clearly erroneous. In re Schauer, 450 N.W.2d 194, 196 (Minn. App. 1990).

 I. Clear and Convincing Evidence

To commit a person as mentally ill, the district court must find by clear and convincing evidence that the person is mentally ill. Minn. Stat. § 253B.09, subd. 1 (Supp. 1997). A mentally ill person is

any person who has an organic disorder of the brain or a substantial psychiatric disorder of thought, mood, perception, orientation, or memory which grossly impairs judgment, behavior, capacity to recognize reality, or to reason or understand, which is manifested by instances of grossly disturbed behavior or faulty perceptions and poses a substantial likelihood of physical harm to self or others as demonstrated by:

(1) a failure to obtain necessary food, clothing, shelter, or medical care as a result of the impairment; or

(2) a recent attempt or threat to physically harm self or others.

Minn. Stat. § 253B.02, subd. 13(a) (Supp. 1997).

At the commitment hearing, the court-appointed psychiatrist testified that appellant's diagnosis was paranoid psychotic disorder, that he was in need of antipsychotic medication to treat this disorder, and that commitment was needed so that treatment could proceed. The court-appointed psychologist confirmed the psychiatrist's diagnosis and the need for commitment. Appellant's wife and a nurse from the psychiatric unit where appellant was being held both testified as to appellant's paranoid delusions. That appellant had faulty perceptions of reality could also be seen from his own testimony.

As to the substantial likelihood that appellant may harm others, both court-appointed examiners testified that psychotic paranoia can be dangerous. Appellant's wife testified that appellant had told her he would shoot her if he found out that she or her family were involved with those who were allegedly watching him. According to the petition for commitment and appellant's own testimony, appellant struck his wife. She then took their three children and moved into "safe housing." Appellant's assault of his wife and his threat to shoot her is sufficient to show a substantial likelihood that he will physically harm others. See In re Martin, 458 N.W.2d 700, 704-05 (Minn. App. 1990) (assault threats by psychotic person provided sufficient evidence of substantial likelihood of harm to self or others); In re Anderson, 367 N.W.2d 107, 109 (Minn. App. 1985) (when danger of patient's condition is evident, court is not compelled to wait until irreparable harm is suffered). The district court's finding that appellant is mentally ill is not clearly erroneous.

 II. Least Restrictive Alternative

A mentally ill person determined to be in need of commitment must be committed to the least restrictive, yet adequate, treatment program. Minn. Stat. § 253B.09, subd. 1. The treatment decision is to be made only after the district court has considered reasonable alternative dispositions, including voluntary treatment. Id.; In re Butler, 379 N.W.2d 233, 235 (Minn. App. 1985).

The district court considered alternatives to commitment but rejected voluntary treatment because appellant "makes it clear that he does not intend to cooperate" with any treatment plans. The court also considered alternative treatment programs before ordering joint commitment, first to the University Medical Center-Mesabi in Hibbing (a 45-day community-based residential treatment program) and then, if appellant's condition deteriorated, to the Brainerd Human Services Center (a regional treatment center).

Both the court-appointed psychiatrist and psychologist felt commitment was necessary for treatment. The psychologist recommended inpatient treatment as the least restrictive alternative. The psychiatric nurse confirmed that appellant would not take his prescribed medication. Appellant testified that he was not mentally ill and not in need of any psychiatric treatment or medication. This evidence supports the district court's finding that voluntary programs were not likely to work.

Community-based nonresidential treatment, a less restrictive alternative, was not appropriate because of appellant's lack of willingness to participate in a treatment plan. Placement at the Itasca Medical Center was not possible because it no longer has a 45-day treatment program. The record supports the district court's determination that dual commitment to the University Medical Center-Mesabi and the Brainerd Regional Human Services Center is the least restrictive alternative.

  Affirmed.