In re Beverly B.
2017 IL App (2d) 160327
Ill. App. Ct.2017Background
- Beverly B. was involuntarily committed to Elgin Mental Health Center after an adjudication of unfitness to stand trial and the State petitioned to administer psychotropic medication involuntarily under 405 ILCS 5/2-107.1.
- The court allowed Beverly to represent herself with standby counsel; hearings included testimony from social worker Danille Fossie and psychiatrist Dr. Mohammed Ali.
- Dr. Ali diagnosed psychosis NOS, testified Beverly had longstanding delusions, opined she lacked capacity to make a reasoned decision about medication, and said written materials about medication risks/benefits and general group schedules were provided on admission.
- The State relied on (i) alleged deterioration in Beverly’s functioning, (ii) her suffering, and (iii) instances of threatening behavior as statutory bases for involuntary medication; the court found serious mental illness, deterioration, and suffering (but not threatening behavior).
- Beverly appealed, arguing (a) denial of standby counsel’s intervention, (b) failure to satisfy section 2-102(a-5)’s written-advice requirement regarding alternatives to medication, and (c) insufficient evidence tying deterioration or suffering to her mental illness.
Issues
| Issue | Plaintiff's Argument (State) | Defendant's Argument (Beverly) | Held |
|---|---|---|---|
| Whether court erred denying standby counsel’s request to take over mid-hearing | No error; Beverly had invoked self-representation and court properly required her to request counsel | Court should have permitted standby counsel to step in when requested to protect Beverly’s rights | Moot on appeal; court declined to reach merits (not addressed under mootness exceptions) |
| Whether written advisement of alternatives under 405 ILCS 5/2-102(a-5) was satisfied | General written materials (group schedules, expectations) and offers of groups/therapy satisfied the statute | Materials were generic and did not explain how specific, realistic alternatives could substitute for medication; thus statute not satisfied | Reversed: general schedules insufficient; section 2-102(a-5) requires information enabling a reasoned choice about realistic alternatives |
| Whether evidence showed deterioration in ability to function attributable to her mental illness | Lengthy commitment and history permit inference of unemployment/homelessness and deterioration tied to illness | Evidence did not adequately connect losses or functional decline to symptoms treatable by antipsychotic medication | Reversed: State failed to prove deterioration was linked to the mental illness or that medication would address the deterioration |
| Whether evidence showed suffering attributable to her mental illness | Observed sadness, displeasure with confinement, and delusional symptoms support finding of suffering | Suffering mostly stemmed from dislike of confinement/economic/social consequences; no clear link showing medication would alleviate the alleged suffering | Reversed: suffering was not shown by clear-and-convincing evidence to be caused by symptoms that medication would treat |
Key Cases Cited
- In re Alfred H.H., 233 Ill. 2d 345 (Ill. 2009) (mootness exceptions and standards for addressing expired involuntary-treatment orders)
- In re Laura H., 404 Ill. App. 3d 286 (Ill. App. Ct. 2010) (review for compliance with section 2-102(a-5) is de novo)
- Moon v. Rhode, 2016 IL 119572 (Ill. 2016) (statutory interpretation is reviewed de novo)
- In re Nicholas L., 407 Ill. App. 3d 1061 (Ill. App. Ct. 2011) (section 2-102(a-5) protects due process and requires strict compliance)
- In re John R., 339 Ill. App. 3d 778 (Ill. App. Ct. 2003) (section 2-102(a-5) ensures respondents are fully informed)
- In re Israel, 278 Ill. App. 3d 24 (Ill. App. Ct. 1996) (definition of capacity to consent/refuse treatment based on conveyed information about risks, benefits, and reasonable alternatives)
- In re C.E., 161 Ill. 2d 200 (Ill. 1994) (interpretation of deterioration/suffering/threatening behavior in context of the mental illness being treated)
- Washington v. Harper, 494 U.S. 210 (U.S. 1990) (noting significant liberty interests implicated by involuntary administration of antipsychotic medication)
- Johnson v. Tinwalla, 855 F.3d 747 (7th Cir. 2017) (discussing liberty concerns and intrusive nature of forcible psychotropic treatment)