In re Rita P.
No. 115798
Supreme Court of Illinois
May 22, 2014
2014 IL 115798
JUSTICE THEIS delivered the judgment of the court, with opinion. Chief Justice Garman and Justices Freeman, Thomas, Kilbride, Karmeier, and Burke concurred in the judgment and opinion.
Illinois Official Reports
Docket No. 115798
Filed May 22, 2014
Held (Note: This syllabus constitutes no part of the opinion of the court but has been prepared by the Reporter of Decisions for the convenience of the reader.)
The Mental Health Code provision for findings of fact on the record in granting a 90-day involuntary medication order is directory rather than mandatory, and a circuit court‘s expression only of its legal conclusion that the evidence was overwhelming did not call for reversal where there were no claims of evidentiary insufficiency or compromised due process—mootness exception.
Decision Under Review: Appeal from the Appellate Court for the First District; heard in that court on appeal from the Circuit Court of Cook County, the Hon. Paul A. Karkula, Judge, presiding.
Judgment: Appellate court judgment reversed. Circuit court judgment affirmed.
Lisa Madigan, Attorney General, of Springfield, and Anita Alvarez, State‘s Attorney, of Chicago (Alan J. Spellberg, Assistant State‘s Attorney, of counsel), for the People.
Ann Krasuski, Veronique Baker and Laurel Spahn, of the Legal Advocacy Service of the Guardianship and Advocacy Commission, of Hines, for appellee.
Mark J. Heyrman, of Chicago, for amicus curiae Mental Health America of Illinois.
Justices: JUSTICE THEIS delivered the judgment of the court, with opinion. Chief Justice Garman and Justices Freeman, Thomas, Kilbride, Karmeier, and Burke concurred in the judgment and opinion.
OPINION
¶ 1 On September 2, 2011, the Cook County circuit court entered an order authorizing the involuntary treatment of respondent, Rita P., with psychotropic medication. On appeal, respondent argued that the treatment order must be reversed because the trial court failed to comply with
¶ 2 For the reasons that follow, we reverse the judgment of the appellate court and affirm the judgment of the trial court.
¶ 3 BACKGROUND
¶ 4 On August 18, 2011, Dr. He Yuan, a psychiatrist at Chicago-Read Mental Health Center (Chicago-Read), filed a petition seeking a court order authorizing involuntary treatment of respondent. In the petition, Dr. Yuan described, inter alia, respondent‘s symptoms, the deterioration in her ability to function, the behaviors in which she engaged that were dangerous to herself and others, and the therapies that had been tried without success. Dr. Yuan stated that respondent met the criteria for a diagnosis of “schizophrenia paranoid type,” and requested authorization to administer specific medications, including Risperidone, for a period of up to 90 days.
¶ 5 A hearing on the petition was held on September 2, 2011. The State called two witnesses: respondent‘s son, Mayjourio, and Dr. Yuan. Mayjourio testified that he was 24 years old and had lived with respondent in her Evanston home for the past six to seven years. In January 2008, respondent was operating a daycare business in her home. At that time, Mayjourio noticed that respondent was very agitated and angry, and spoke about harming the people that had wronged her. For two months she spoke about “going out there and getting herself some street justice.” In March 2009, Mayjourio observed that respondent had begun talking to herself. She would go into the bedroom or the laundry room, close the door, and have a one-sided conversation. “[S]he would talk, and then she would be quiet, and then she would talk some more, and then be quiet. It was as if she was talking, listening, talking, listening.” Mayjourio further testified that at the same time respondent began talking to herself, her sleep habits changed. Respondent, who had been a heavy sleeper, was now up in the middle of the night talking to herself in her bedroom.
¶ 7 Mayjourio described an incident in September 2010, in which respondent had “one of her moments,” i.e., a “conversation between her[self] and several of her voices,” and left a pot of water on the stove too long, causing the pot to be blackened. Mayjourio testified that these conversations were time-consuming and took her attention away from other matters. Because respondent was still operating her daycare business, Mayjourio and his sister made sure that one of them was always present so that none of the children were hurt if respondent had one of her “moments.”
¶ 8 Mayjourio also described three incidents, the first of which occurred in September 2010, in which he found respondent with her hands around her own neck choking herself. Respondent denied that she choked herself, telling Mayjourio that it was “the church” or “the voices.” In October 2010, respondent told Mayjourio that she was going to get a gun and kill the members of the church who attacked her. Respondent attempted to get a gun license, and asked Mayjourio to take her to a gun range to practice. Mayjourio testified that during this period, as he had for the past two years, he talked to respondent about seeing a doctor. Every time he brought up the subject, he was met with anger and opposition.
¶ 9 Mayjourio additionally testified regarding an incident in February 2011, in which he came home and discovered an open container of gasoline in the living room. Respondent was still operating her home daycare business at this time. Respondent initially told Mayjourio that she was using the gasoline as a cleaner, but later told him that she was doing experiments. Mayjourio moved the gasoline to the garage, but the following month he found the open gasoline container in the basement, along with turpentine and lighter fluid. Respondent again stated that she was doing experiments.
¶ 10 Mayjourio testified that respondent‘s condition worsened in the following months:
“She [would] be up at night outside in the front yard, outside in the back yard having screaming matches with the lamp post, and the ground, and the air.
And all the while all the voices are manifesting themselves. She will be in the room screaming, yelling. You will be woke[n] up at 2:00 in the morning to her having one of her fits with herself.
*** [B]efore the voices wouldn‘t confront you, but now the voices confront you.
***
If you look at her and say, ‘Mom, what‘s going on,’ Rita doesn‘t reply. One of the voices replies, ‘My name ain‘t Rita.’ ”
¶ 12 Dr. Yuan testified that he first saw respondent on August 5, 2011 at Chicago-Read, and had seen her almost daily thereafter. He opined that respondent has a mental illness—schizophrenia paranoid type—in which she has significant delusions regarding church people embodied spiritually and physically inside her. Respondent admitted to Dr. Yuan that she tried to choke herself to kill the people inside her. As of the day before the hearing, respondent still believed she was embodied by church members, but she had not tried to choke herself in the hospital. Dr. Yuan further testified that respondent‘s functioning had deteriorated due to her preoccupation with the delusions, and that the delusions could be dangerous because respondent may act on them. Respondent, however, had not threatened anyone at Chicago-Read, and no cause existed to place her in restraints or administer emergency medication. Although generally cooperative, respondent refused to attend group therapy, and could not be convinced to take medication. Dr. Yuan deemed group therapy without medication to be inappropriate at this point.
¶ 13 Dr. Yuan additionally testified regarding the primary medications he sought to administer, potential side effects, dosing, and the tests necessary for safe administration of the medication. Dr. Yuan opined that respondent lacked the capacity to make a reasoned decision about the treatment, and that the benefits of the treatment outweighed the harm.
¶ 15 Respondent testified on her own behalf. At the time of the hearing, she was 51 years old and for the last 15 years had operated a daycare center in her home. Due to the economy and a loss of clientele, respondent closed her business in April 2011 and filed for bankruptcy. She sought general assistance through Evanston Township, became a member of Illinois WorkNet, and joined several community boards. The Community Economic Development Board nominated her as its treasurer in 2011.
¶ 16 Respondent also testified that she had problems with her memory, so she initiated a sequence of events that, in January 2011, led her to Dr. Singleton, a neurologist at Stroger Hospital. Respondent last saw Dr. Singleton in July 2011, and testified that she would like to be under his care.
¶ 17 Respondent further testified that beginning in October 2010, she had filed nine reports against 125 members of her church with the Illinois Attorney General, the Chicago police department, the Federal Bureau of Investigation, and the Evanston police department. In the reports she alleged assault, harassment, and stalking by church members.
¶ 18 When questioned about the gun she had tried to obtain, respondent explained that she had initiated, but had not completed, the process of obtaining firearm training and a gun license. Respondent testified that she was aware that it is illegal in this state to have a gun on the street. Her intention was to have a gun in her home, securely locked away. She “wasn‘t thinking of taking matters into her own hands.”
¶ 19 With respect to the gasoline and turpentine that Mayjourio testified he found in her home, respondent explained that the driveway had been resurfaced and a technician from Home Depot told her that the tar-based material could only be cleaned off of utensils with gasoline, which is what she used.
¶ 20 As to the incident immediately preceding her hospitalization, respondent testified: “They [the voices] told him [Mayjourio] that they killed me.” Respondent also indicated that she hit Mayjourio that day because he hurt her when he restrained her.
¶ 21 Respondent further testified that she had never been hospitalized at a mental health facility, and had never taken any of the medications Dr. Yuan sought to administer. According to respondent, Dr. Yuan had seen her only three or four times during the month preceding the hearing. On cross-examination, when asked whether the church members had spiritually raped her, respondent answered: “Exactly.”
¶ 22 After closing arguments, the trial court granted the petition for involuntary medication of respondent. The court stated: “The testimony is overwhelming[ly] in support of the State‘s petition. All three witnesses and all the observations of the Court made in open court today so I am going to grant the petition.”
¶ 23 The trial court‘s written order tracked
¶ 24 Respondent did not ask the trial court to make specific findings of fact on the record, and did not seek clarification of the trial court‘s oral or written ruling. Respondent, however, did file a notice of appeal, seeking reversal of the trial court‘s treatment order. Respondent argued that
¶ 25 The appellate court reviewed the case under the collateral consequences exception to the mootness doctrine, and agreed with respondent that because
¶ 26 We allowed the State‘s petition for leave to appeal (
¶ 27 ANALYSIS
¶ 28 I. Mootness
¶ 29 No dispute exists that respondent‘s appeal to the appellate court was rendered moot by the expiration of the 90-day treatment period. See In re Robert S., 213 Ill. 2d 30, 45 (2004). The appellate court, however, noted that respondent had not been previously subject to involuntary treatment, and that the collateral consequences exception to the mootness doctrine “applies to a first involuntary-treatment order.” 2013 IL App (1st) 112837, ¶ 10 (citing In re Linda K., 407 Ill. App. 3d 1146, 1150 (2011)).
¶ 30 The State argues that, contrary to the appellate court‘s opinion, no per se exception to the mootness doctrine applies to first involuntary treatment orders, or mental health cases generally, and that the appellate court should have dismissed respondent‘s appeal as moot. The State requests that we vacate the appellate court‘s judgment. See In re Commitment of Hernandez, 239 Ill. 2d 195, 205 (2010) (vacating appellate court judgment where the appeal
¶ 31 In Alfred H.H., we held that the collateral consequences exception to the mootness doctrine is applicable in mental health cases. Id. at 362. Under this exception, where collateral consequences survive the expiration or cessation of a court order that are likely to be redressed by a favorable judicial determination, appellate review is permissible. Id. at 361. Although we recognized that reversal of a mental health admission or treatment order could provide a “host of potential legal benefits,” we concluded that application of the collateral consequences exception “is still decided on a case-by-case basis.” Id. at 362. When we considered the facts of the specific case before us, in which the respondent challenged an involuntary commitment order, we determined that no collateral consequences existed that would warrant application of this mootness exception. We explained:
“[R]espondent has had multiple involuntary commitments prior to the present case. In addition, respondent is a felon who has served a sentence for murder. Simply stated, there is no collateral consequence that can be identified that could stem solely from the present adjudication. Every collateral consequence that can be identified already existed as a result of respondent‘s previous adjudications and felony conviction.” Id. at 363.
¶ 32 In Alfred H.H. we also rejected the respondent‘s invitation to adopt a new exception to the mootness doctrine applicable to all civil commitment proceedings. Id. We stressed that “the evaluation of the established mootness exceptions must be conducted on a case-by-case basis,” and that “[t]his evaluation must consider all the applicable exceptions in light of the relevant facts and legal claims raised in the appeal.” Id. at 364.
¶ 33 Despite our clear statements in Alfred H.H. that application of the collateral consequences exception is decided on a case-by-case basis, even in cases arising under the Mental Health Code, some appellate court opinions have adopted the view that a first involuntary admission order or, as in this case, a first involuntary treatment order, is automatically reviewable under the collateral consequences exception. E.g., Linda K., 407 Ill. App. 3d at 1150 (” ‘collateral-consequences exception applies to a first involuntary-treatment order’ ” (quoting In re Joseph P., 406 Ill. App. 3d 341, 346 (2010))); In re Wendy T., 406 Ill. App. 3d 185, 189 (2010) (applying collateral consequences exception where the “record does not indicate that respondent has ever before been subject to an order for the involuntary administration of medication,” and “[t]hus, there are collateral consequences that might plague respondent in the future“); In re Val Q., 396 Ill. App. 3d 155, 159-60 (2009) (“this being respondent‘s first involuntary treatment order, there are collateral consequences that may plague respondent in the future“); In re Gloria C., 401 Ill. App. 3d 271, 275 (2010) (“this being the respondent‘s first involuntary admission order, there are collateral consequences that may plague the respondent in the future“).
¶ 34 Application of the collateral consequences exception cannot rest upon the lone fact that no prior involuntary admission or treatment order was entered, or upon a vague, unsupported statement that collateral consequences might plague the respondent in the future. Rather, a reviewing court must consider all the relevant facts and legal issues raised in the appeal before- 7 -
¶ 35 The State maintains that respondent here cannot identify any collateral consequences that stem solely from the trial court‘s involuntary treatment order. We need not consider this issue because we agree with respondent that even if the collateral consequences exception does not apply, review was nonetheless appropriate under the public interest exception.
¶ 36 Review of an otherwise moot issue under the public interest exception requires a clear showing of each of the following criteria: “(1) the question presented is of a public nature; (2) an authoritative determination of the question is desirable for the future guidance of public officers; and (3) the question is likely to recur.” In re Shelby R., 2013 IL 114994, ¶ 16. With respect to the first criterion, case-specific inquiries, such as sufficiency of the evidence, do not present the kinds of broad public issues required for review under the public interest exception. Alfred H.H., 233 Ill. 2d at 356-57. Here, however, the issue before the appellate court was not case-specific. Rather, the issue was one of general applicability to mental health cases, involving the proper construction of
¶ 37 With respect to the second criterion, the need for an authoritative determination of the question, we consider the state of the law as it relates to the moot question. See Shelby R., 2013 IL 114994, ¶ 19. Research discloses that at the time respondent filed her notice of appeal, this court had not spoken on
¶ 38 The desirability of an authoritative determination of this issue is also demonstrated by the inconsistent positions adopted by the State‘s Attorney of Randolph County in Lance H., and the State‘s Attorney of Cook County in the instant case. In Lance H., the State conceded that the trial court‘s failure to follow
¶ 39 Finally, with respect to the third criterion, no doubt exists that the question is likely to recur because
¶ 40 We conclude that the appellate court could have properly reviewed this case pursuant to the public interest exception to the mootness doctrine. Accordingly, we decline the State‘s invitation to vacate the appellate court opinion, and will consider the case on the merits. See Shelby R., 2013 IL 114994, ¶ 23 (“For the same reasons that review by the appellate court was appropriate, review by this court is also appropriate.“).
¶ 41 II. Mandatory Versus Directory
¶ 42
¶ 43 “Whether a statutory command is mandatory or directory is a question of statutory construction, which we review de novo.” People v. Robinson, 217 Ill. 2d 43, 54 (2005). The answer to this question is a matter of legislative intent. Id. As this court has explained:
“[S]tatutes are mandatory if the intent of the legislature dictates a particular consequence for failure to comply with the provision. [Citation.] However, in the absence of such legislative intent the statute is directory and no particular consequence flows from noncompliance. [Citation.] There are consequences to a directory reading, but a directory reading acknowledges only that no specific consequence is triggered by- 9 -
the failure to comply with the statute. [Citation.] In other words, the mandatory/directory question simply denotes whether the failure to comply with a particular procedural step will or will not have the effect of invalidating the governmental action to which the procedural requirement relates. [Citation.]” (Emphasis in original.) (Internal quotation marks omitted.) In re M.I., 2013 IL 113776, ¶ 16.
¶ 44 The law presumes that statutory language that issues a procedural command to a government official indicates an intent that the statute is directory. Id. ¶ 17. This presumption may be overcome, and the provision will be read as mandatory, under either of two conditions: (1) when the statute contains language prohibiting further action, or indicating a specific consequence, in the case of noncompliance, or (2) when the right or rights the statute was designed to protect would generally be injured by a directory reading. Id. ¶¶ 17-18.
¶ 45 With respect to the first condition,
¶ 46 With respect to the second condition, the parties have identified three rights which one or both of them claim
¶ 47 III. Appeal Rights
¶ 48 The Mental Health Code provides that “[a]n appeal from a final order may be taken in the same manner as in other civil cases.”
¶ 49 Respondent makes no claim that the trial court‘s noncompliance with
¶ 50 Although a clear recitation of the trial court‘s findings of fact would be helpful to a reviewing court (see In re Madison H., 215 Ill. 2d 364, 374 (2005)), we agree with the State- 10 -
¶ 51 Our conclusion that a lack of factual findings does not preclude appellate review also finds support in the principle that it is the “judgment” of the lower court that is reviewed, and “not what else may have been said.” In re Estate of Funk, 221 Ill. 2d 30, 86 (2006). Thus, although factual findings may provide an explanation or reason for the trial court‘s decision, it is the correctness of the court‘s ruling, and not the correctness of its reasoning, that is under review. People v. Johnson, 208 Ill. 2d 118, 128 (2003).
¶ 52 Because no reason has been identified from which we may conclude that an injury to respondent‘s appeal rights would generally result from a directory reading of the statute, the presumption that
¶ 53 IV. Liberty Interest
¶ 54 Respondent argues that
¶ 55 The State does not directly challenge respondent‘s assertion that
¶ 56 Our task is to determine whether a directory reading of
¶ 57 This court has recognized that persons who are mentally ill have a federal constitutionally protected liberty interest to refuse the administration of psychotropic medication. In re C.E., 161 Ill. 2d 200, 214 (1994). The State, however, has a legitimate parens patriae interest, embodied in
¶ 58 Pursuant to
¶ 59 At the judicial hearing on the petition, which is separate from the hearing to determine if the respondent is subject to involuntary admission (
“(A) That the recipient has a serious mental illness or developmental disability.
(B) That because of said mental illness or developmental disability, the recipient currently exhibits any one of the following: (i) deterioration of his or her ability to function, as compared to the recipient‘s ability to function prior to the current onset of symptoms of the mental illness or disability for which treatment is presently sought, (ii) suffering, or (iii) threatening behavior.
(C) That the illness or disability has existed for a period marked by the continuing presence of the symptoms set forth in item (B) *** or the repeated episodic occurrence of these symptoms.
(D) That the benefits of the treatment outweigh the harm.
(E) That the recipient lacks the capacity to make a reasoned decision about the treatment.
(F) That other less restrictive services have been explored and found inappropriate.
(G) If the petition seeks authorization for testing and other procedures, that such testing and procedures are essential for the safe and effective administration of the treatment.”
405 ILCS 5/2-107.1(a-5)(4) (West 2010) .
¶ 60 A directory reading of
¶ 61 V. Right to Notice of the Trial Court‘s Reasoning
¶ 62 Respondent also argues that a directory reading of
¶ 63 We first consider the source of respondent‘s claimed “right to notice of the trial court‘s reasoning.” Respondent does not argue that such right flows from
¶ 64 Madison H. involved an appeal following a dispositional hearing under the Juvenile Court Act, in which guardianship of the minor child was placed in the Department of Children and Family Services. At issue was a provision of the Juvenile Court Act, stating that “[i]f the trial court determines and puts in writing” its factual basis for finding the parents unable to care for the child, and that the child‘s best interests will be jeopardized if the child remains with the parents, the court may commit the minor to the Department of Children and Family Services.
¶ 66 Respondent identifies no other source of her right to such notice. Instead, respondent generally maintains that notice of the trial court‘s reasoning will protect her liberty interest in not being medicated involuntarily, just as statutory notice of the medication and its side effects will protect her liberty interest. Thus, respondent‘s right-to-notice argument devolves into a liberty-interest argument. As already discussed, however, we rejected respondent‘s argument that a directory reading of
¶ 67 CONCLUSION
¶ 68 Having found no reason to conclude that a respondent‘s appeal rights or liberty interests will generally be injured through a directory reading of
¶ 69 Appellate court judgment reversed.
¶ 70 Circuit court judgment affirmed.
