*1 (The M., Subject Involuntary In re LILLIE a Person Found Admission People Illinois, of Petitioner-Appellee, M., Respondent- the State of v. Lillie
Appellant). Fourth District No. 4 - 06-0947 Argued May 16, Opinion September 5, filed 2007. 2007. KNECHT, J., dissenting. Cynthia Tracy (argued), Guardianship Advocacy Commission, Z. of & of
Peoria, Baker, Veronique Advocacy Guardianship Commission, of & Chicago, appellant. (Norbert Schmidt, Attorney, John P. Springfield Goetten, State’s J. Biderman, Timothy J. Londrigan (argued),
Robert J. all of State’s At- torneys Appellate Office, counsel), People. Prosecutor’s for the
JUSTICE COOK delivered the court: M., Respondent, age 43, appeals from the trial court’s order subject Hospital admission at St. John’s (St. John’s). At issue is presented whether the State sufficient evidence was unable to needs (405 119(2) (West so as to herself from serious harm ILCS 5/1 — 2006)) whether the ordered the least-restrictive treatment (West 2006)). alternative ILCS We affirm. 5/3 —811
I. BACKGROUND According history report, to Lillie’s examination Lil- prior report also indicated This lie has a illness. by case, Lillie had been seen instant rise gave the facts point At Bland, recently as physician, doing well. time, taking her medication and retarded, mildly report noted that is also questions appropriately. inability to answer may contribute to brought Lillie to the On October members *2 in and dif- change Lillie a behavior emergency room after exhibited began Lillie had cut her hair and ficulty functioning. Specifically, away emergency Lillie room burning it in the then ran sink. in herself the bathroom apartment. and returned to her locked it in the putting time pair with a and cut more this scissors toilet. apartment at Lillie’s Agans-Dominguez officer C. arrived
Police Lillie was Lillie with and the toilet full of hair. find a bizarre haircut ques- did pacing apartment respond Agans-Dominguez’s not well-being and family expressed tions. Lillie’s a concern for Lillie’s “people put that stuff Agans-Dominguez told that Lillie earlier stated Agans-Dominguez petition in her house.” then filed a for he Lillie’s reporting just what had seen at residence. petition alleged expected to harm reasonably that could be un- appeared illness and that herself or others due to physical take her own basic needs. able to care of hearing petition On October the trial court held a on the hearing only for admission. The issue at the was whether Lillie and Lillie would be unable to care for her basic Shea, psychiatrist, Dr. Laura were the two witnesses. psychiatrist years Dr. Shea testified that admittance, morning first met and examined Lillie the after her had examined Lillie’s chart. Dr. Shea also medical diagnosed paranoid had chronic Shea noted that Lillie been with schizophrenia schizophrenia. chronic undifferentiated Dr. Shea history indicated that she had been stated that Lillie’s medical that, during by schizophrenia past. in the Dr. Shea stated “disabled” “nothing interview, Lillie had been “too determined” that hard and Lillie stared wrong.” very Lillie’s facial expression hair-cutting that at Dr. Shea. Dr. Shea recounted the incident records. petition described in the and was contained been Lillie’s out how Dr. Shea stated that was not assertive stated faring in Lillie’s absence. Dr. Shea seven-year-old daughter was that though not certain showering daily, Lillie had she was been food, telling initially refused was due Lillie’s own initiative. two something to it.” On at least Dr. Shea that the had “done occasions, but Lillie asked for food then would refuse to eat it. However, Dr. eating Shea stated that Lillie had pretty been well over the last days. several degree psychiatric Shea stated she believed with reasonable Lillie,
certainty that due to her mental would be unable to needs so herself from serious 119(2) (West 2006). physical harm. ILCS Shea aware 5/1 — petition originally alleged reasonably Lillie could be (West 119(1) expected 2006)), to harm herself or others ILCS 5/1 — certify allegation. but Dr. did recommended Dr. Shea period that commitment St. John’s for a days to exceed 90 was the treatment least-restrictive Specifically, Dr. Shea testified that she supported plan the treatment prepared that, St. John’s. That prior stated to Lil- lie’s emergency room, admittance to the Lillie had living her adult sister and had been “current with the Mental Health Center” discharge had seen Dr. Bland. The plan’s strategy included referral back to the “Mental Health Center” and treatment once an ability Lillie demonstrated to care for herself. The length stay at hearing, estimated St. John’s was week. At the one Dr. Shea further stated: stay [Lillie St. John’s]
“Could have but have leave to transfer discharged [Lillie] her McFarland we need to? I’d like to see *3 [St. John’s] if we can since she’s taken her medicine for two days. I’m not how sure to handle that.” petition, In addition appeared to the stated it Lillie did not family take care herself and mentioned members’ concern for Lil- well-being, lie’s based Shea her conclusion that Lillie needed to be on paranoia.” admitted Lillie’s “basic if Shea worried Lillie did not trust her care providers, other Lillie not would food, medicine, shelter, able get or other necessary care. Lillie’s paranoia would like to see evidence that had cleared before Lil- lie left St. John’s. seven-year-old
Lillie testified that she lived alone her daughter. However, emergency-room indicate Lillie records lives with her adult has sister. Lillie also told staff that she her cut lives with mother. Lillie stated that she wanted to her hair a change, toilet, short for she had flushed her hair down why and she had not burned her hair in the sink. When asked she put answered, her “I toilet, hair in Lillie didn’t have else to nowhere put nobody it. I didn’t it.” doing nothing want that, John’s,
Lillie stated since admission into has been she showering brushing daily. and asked frequently teeth When how on, well, might you stated, “Off and eating, Lillie she has but— felt she asked on cross-examination day.” every When as well answered, food, Lillie trying poison someone these statements Lillie contradicted to trust.” later “I don’t who know thought that she time,” denying and my “I food all the saying, eat by stated that she took poison her. Lillie also trying anyone like needed it. did not feel she and medication “sometimes” once home. taking did on her medication indicated that she responded questions that Lillie often transcripts The reflect instance, For asked what inappropriate an odd or manner. when I stated, “Yeah, I flushed it down the toilet. did with my asked whether she cooked meals swore bible.” When Cook, wash, “Yeah, clean, mop. I Go daughter, answered, cook. times interrupted spoke and out of turn three for walk.” Lillie also Further, and examination during proceedings. “completely that Lillie often unreliable” report indicated providing information. by and argument,
After the trial stated it found clear closing illness as a convincing that Lillie from mental evidence suffered illness could not take care of her basic needs. The court result further, explain did its but it ordered to remain hospitalized Hospital period days. for a not to exceed 90 at St. John’s trial The court found this to the least-restrictive alternative. The court’s written order mentioned commitment at St. On Lil- possibility
did not mention the transfer. appeal. objec- lie filed instant On November over Lillie’s tion, judge signed transferring the trial an order Lillie to McFarland section of Mental Mental Health Center under 3—908 Health (West 2006)). Developmental Disabilities Code ILCS 5/3—908 order, record further Aside from the trial court’s contains no regarding information the transfer.
II. ANALYSIS (1) convincing did clear and evidence not war admission did not involuntary rant 405 ILCS constitute the least-restrictive treatment alternative. 5/3— (West 2006). proving has the the need State burden convincing Schu clear and evidence. *4 (1994). maker, 723, 727, 169, App. 260 Ill. 3d 172 Because 633 N.E.2d position weigh in the evidence and trial court is the best credibility determine the of the witnesses admis “ proceeding, ‘will not be set aside sions trial court’s decision court, level, the clear appellate reviewing applying even if the after 856 convincing standard, differently’ [citation], would have ruled un against weight Bennett,
less it is the manifest of the evidence.” In re App. 888, 251 887, 942, (1993), 3d 623 N.E.2d quoting In re (1988). Orr, 498, 64, App. 505, 3d 531 N.E.2d ill, mentally that even she were the State did not A physical was unable to care basic own person against ill cannot be confined because will she suffers from a if she safely mental illness can live in freedom. In re (1994). Turnan, 110, App. 106, 54, 268 Ill. 3d person is, however, subject with a mental illness she, where because of her mental is unable provide basic physical needs so as to herself from harm serious without 119(2) (West family help. assistance of or outside 405 ILCS 5/1 — 2006). must prevent caring “[The] illness her from for her basic physi by substantially thought cal impairing process, needs perception reality, judgment, behavior, of emotional stability, ability cope or ordinary 364, with life’s In re Ingersoll, App. demands.” 188 Ill. 3d (1989). 409, 412 In determining person 544 N.E.2d whether can 119(2), physical needs under section the court 1— food, shelter, should person look to whether the can obtain her own care, person place medical has a whether live her, assist whether she can function in society, person whether money has an of In understanding as means of sustenance. re Rovel (1996) (Second stad, App. 3d 667 N.E.2d District). The person’s repeated court look to evidence past pattern specific person’s behavior and actions related to ill (West 2004). ness. 405 ILCS Similarly, the is not 5/1 —119 required to wait until actual harm before results Manis, warranted. In re 3d 572 N.E.2d (1991). Here, the State’s evidence that Lillie take largely needs consisted of Dr. Shea’s and Dr. observations interpretation petition Shea’s of the facts contained and medi cal report. underlying support testifying While the factual of the not, law, expert’s substantively matter of opinion need as a admis sible, expert’s opinion supported by must be a sufficient factual Turnan, convincing. basis to render it clear and 110-11, Cutsinger, see (medical opinion not clear and basis, merely any convincing expert, without reference to factual gave could not care for patient basic needs). balance, “[diagnosis are and treatment we mindful highly specialized disorder] is a area medicine is bet- *5 contrary, a reason to the In the experts ter to the ***. absence left and treatment diagnosis [the] physician’s App. 3d at Ingersoll, 188 Ill. and followed.” given should credence be C.E., at see (different issue). 345, 358 N.E.2d are prior to the instant occurrence Lillie’s medical records
Though history of be- record, Lillie had a part the Dr. Shea testified that Lillie and schizophrenia. observing After ing by her “disabled” Lillie would did not believe witnessing paranoia,” her “basic help to secure her to ask for the she needed able others paranoia. clear Dr. Shea testi- well-being. It is that suffered “something [the had been to food fied that Lillie had stated that done hearing, anybody at At when asked at the hospital].” food, Lillie “I to poison to answered don’t know who trying put toilet, explained in the why trust.” When asked she hair nobody doing nothing that “didn’t to it.” want recognize that, Rovelstad, the court found that evidence We paranoid thoughts that has or absent evidence person delusional likely thoughts that is to on those to her own person reasonably act involuntary admission. Rovel detriment is insufficient to warrant an stad, However, at 3d at N.E.2d 728-29. Rovelstad, distinguishable instant case is from Rovelstad. In him respondent testified he heard told run around that voices that to Rovelstad, naked, stop sleeping, commit eating to and to suicide. 281 App. suggested 3d at 667 N.E.2d at Evidence that the 728. instance, respondent past. acted on odd beliefs in the For respondent doorways had marked and household items with mineral oil he mineral be blessed. “protection” for because believed oil to However, Rovelstad, 3d at N.E.2d at 722. attempted respondent court held that because the had never acted or naked, response telling stop act in the voices him to run around suicide, against eating sleeping, and commit it was the manifest weight respondent find of the evidence for the trial court to that the Rovelstad, to care was unable for his basic at 728-29. contrast, upon paranoid potentially Lillie did act harmful tampering thoughts. that staff believed food, least two occasions where Lillie Shea testified held Similarly, food and then refused eat it. ordered something” “do to her unrealistic belief “someone” would danger- potentially of it in an odd and by disposing Lillie acted so True, ous extreme in the sense that manner. these actions are not above, as they guaranteed to cause harm. stated were Moreover, court does not need to until actual harm wait results. to the extent District in implied Second Rovelstad that the facts must the respondent upon dangerous show acted beliefs delusions (a suicide), voice tells person to commit opposed harmless (mineral beliefs or delusions provides protection), oil simply disagree. hold as would give expert To much the medical the abil ity properly diagnose treat and symptoms nuanced and “abstract” they Ingersoll, those believe to dangerously afflicted. See App. 3d at
Here,
Shea,
years
experience,
believed that Lillie
herself,
physically
would be unable to
agreed,
the trial court
opposite finding
apparent.
and we cannot
that an
clearly
Finally,
that the State
failed to
admission to
If person
least-restrictive alternative.
*6
is subject
court
required
the
is
to order the
least-restrictive
appropriate.
treatment
is
405 ILCS 5/3 —811
(West 2006). In
hospitalization,
addition
the
also consider
outpatient
placement
treatment or
in the care
relative.
statu
tory preference exists for treatment other than hospitalization, and
therefore
court may
hospitalization only
the
order
it
where
has been
A.,
shown
the
to be
least-restrictive treatment
In re Nancy
(2003).
540,
565,
344
3d
App.
556,
Ill.
801 N.E.2d
580
split
is
exactly
Case law somewhat
is
how much evidence
support
required
given
that a
treatment
is the least-
1, 7,
Devine,
re
214 Ill. App.
restrictive alternative.
3d
572 N.E.2d
1238,
(1991),
1242
the Second District held that the trial court’s failure
its
specify in
order of commitment that the
constituted
least-restrictive means
treatment
not fatal
State’s
primary
responded affirmatively
witness
when asked
whether
confinement constituted the
But
least-restrictive treatment.
see In re
(1992) (Second
Long,
105, 112,
1259,
App.
3d
606 N.E.2d
1264
District, stating
that Devine
for the proposition
stands
that the
required
explicit finding
court is not
make
that the treatment
is
the least-restrictive
alternative and not that
the least-restrictive
requirement
expert
opines
met
alternative
such).
is
when an
that it is
required
expert’s
Other courts have
than an
statement at
more
hearing
proposed
that the
treatment
least-restrictive alterna
tive,
expert’s
requiring
opinion
supported
further
112,
explanation. See
Ill.
at
Long,
App.
3d
Further, the evidence this case Lilhe to ordering family. supportive have a apparently does treatment does undergoing while reside with appears alternative because like reasonable treatment seem her to family brought receiving before her the treatment Lilhe was 30, 34, D., In David emergency room. See to care for aunt’s offer (respondent’s 1248-49 alternative where not a reasonable respondent was respondent until caring respondent respondent’s aunt had been *7 in for treat brought respondent aunt later away respondent’s ran Accordingly, respondent). manage ment because she felt she could involuntary admission to sufficient evidence presented the State John’s the least-restrictive St.
III. CONCLUSION court’s order. reasons, affirm the trial For the aforementioned Affirmed. EJ.,
STEIGMANN, concurs. KNECHT, dissenting:
JUSTICE to evidence present sufficient The State failed unable to respondent was ill needs so as to herself serious There likely harm. more evidence that have been State presented, but the took the oft- used having only shortcut of the psychiatrist testify. haircut, degree odd and a
paranoia enough suggest respondent would benefit from treatment, prove by but it does not a clear-and-convincing standard that she needs be involuntarily committed.
Some staff at St. John’s discharged believed would be to her follow-up home psychiatrist treatment. Even stay believed she would at St. for no than more one week. Yet just days hearing, respondent after the was ordered transferred Mc- Farland Health though Mental Center trial court even order of found John’s was the least-restrictive curious, alternative. The transfer is but that is not issue before us. This court has some frequency procedural commented with deficiencies in mental-health cases. Those deficiencies and mistakes require sometimes they suggest do not reversal. a lack of at- case, tention I process. lacking, This contend the evidence is suggests quality a failure to understand the quantity of evidence required high of proof meet burden in such cases. ILLINOIS, THE THE Plaintiff-Appellee, PEOPLE OF STATE OF v. JOHN IV, Defendant-Appellant. H. ERBY Fifth No. District 5 - 06-0217 August 24, Opinion filed