In re ROBERT F., a Person Found Subject to Involuntary Admission (The People of the State of Illinois, Petitioner-Appellee, v. Robert F., Respondent-Appellant)
Fourth District No. 4-08-0810
Fourth District
November 9, 2009
396 Ill. App. 3d 304
Argued September 16, 2009.
John P. Schmidt, State‘s Attorney, of Springfield (Patrick Delfino, Robert J. Biderman, and Anastacia R. Brooks (argued), all of State‘s Attorneys Appellate Prosecutor‘s Office, of counsel), for the People.
Cheryl R. Jansen, Deborah Kennedy, and Melissa O. Picciola, all of Equip for Equality, Inc., of Chicago, amicus curiae.
Respondent, Robert F., appeals from the trial court‘s order finding that he was a person subject to involuntary admission and ordering him to be treated for his mental illness for a period not to exceed 90 days at Springfield Terrace Nursing Home pursuant to an agreement for alternative treatment. Because the court‘s order complied with neither the statute governing involuntary admissions (
I. BACKGROUND
Respondent, a 56-year-old man, has had a long history of mental illness and has been the subject of prior orders of involuntary admission. On October 10, 2008, respondent‘s case coordinator filed a petition for continued involuntary admission at McFarland Mental Health Center (McFarland) pursuant to section 3—813 of the Mental Health and Developmental Disabilities Code (Mental Health Code) (
On October 17, 2008, the trial court conducted a hearing on the petition for involuntary admission. The State moved to amend the petition to include the allegations that respondent was a person subject to involuntary admission because (1) due to his mental illness, he was unable to provide for his basic physical needs so as to guard himself from serious harm without the assistance of family or outside help and (2) he was in need of immediate hospitalization for the prevention of such harm. Without objection, the court allowed the amendment.
Respondent‘s treating psychiatrist at McFarland, Dr. Kasturi Kripakran, testified as the State‘s expert witness. She said respondent was diagnosed with schizophrenia and has suffered from delusions and paranoia. Although respondent has demonstrated some improvement with treatment, he recently reverted to threatening Dr. Kripakran. According to Dr. Kripakran, respondent does not believe he has a mental illness or that he needs medication. But, in her opinion, continuing respondent‘s treatment would be in his best interest.
The State posed the following question to the doctor:
“Q. Doctor, do you have an opinion within a reasonable degree of psychiatric certainty whether because of his mental illness he is reasonably expected to engage in dangerous conduct, which may include threatening behavior or conduct that places that person or another individual in reasonable expectation of being harmed? Do you have an opinion as to that?
A. Yes, I do.
Q. And what is your opinion?
A. I do believe that he is a danger if he does not continue treatment.
Q. And what factual basis do you have for your opinion?
A. Based on his past history and his past repeated hospitalizations for similar other episodes of aggression.
Q. When you describe his past history, does he have a long history of violence?
A. Yes.”
Dr. Kripakran testified that on September 19, 2008, respondent told her “he had a KPO order against [her], which means kill to protect order.” He also told the doctor he had “people who could carry out his order.” In her opinion, respondent‘s mental illness prevented him from caring for his basic physical needs without assistance. She said in the last several years, respondent has resided only in nursing homes or McFarland. She said, to a reasonable degree of psychiatric certainty, she believes respondent is unable to understand his need for treatment and without treatment, he will suffer or continue to suffer mental or emotional deterioration. If he deteriorates, he will be reasonably expected to engage in dangerous conduct. Dr. Kripakran said she considers respondent in need of continued treatment for the prevention of harm to himself or others.
The prosecutor introduced the written agreement for alternative treatment, which was marked and introduced into evidence as exhibit No. 1. Dr. Kripakran described Springfield Terrace as the least-restrictive environment for respondent‘s treatment.
On cross-examination, Dr. Kripakran said respondent had lived in an apartment on his own several years ago, but that “failed because of his delusional beliefs.” He had collected feces and urine in the apartment and was evicted.
Dr. Kripakran recommended for respondent a nursing home rather than McFarland because “he has not shown any dangerous behavior, and he has been able to take care of his ADLs [(activities of daily living)] with supervision.” She opined that if he did well in the nursing home and continued his treatment and medication, he had a good chance of succeeding in an independent environment in the community.
Respondent testified on his own behalf as follows:
“Q. There‘s a proposal today to have you live at Springfield Terrace Nursing Home—
A. Uh-huh.
Q. —for a period of not to exceed 90 days.
A. Uh-huh.
Q. What do you think about that?
A. Well, the ADLs that they spoke of, I can take care of myself. I take showers on my own, and I can eat on my own. I can cook for myself. I have done it before.
The—evidently, I was in the apartment in 2004, and I was having fun walking across the street. I was acting like (indicating), you know, a little curtsy, having fun and going across the street, and somebody saw me doing that. I was just having a good time.
Q. So is it your belief that—
A. I wasn‘t doing anything.
Q. —you could live in an apartment right now?
A. Yes. But somebody saw me doing it, and they didn‘t like it, so they filed a petition to admit me. That‘s how I ended up here in ‘04. And I have been going in and out of nursing homes since October ‘04.
Q. Has that been helpful to you?
A. No, not at all. It‘s a strain. It‘s stressful. I give other people freedom. I don‘t understand why people don‘t give me freedom.
Q. Do you have an apartment you would go live in if you left here today?
A. Not that I know of, not right now. It would have to be arranged.
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Q. Bob, if you were to be in the nursing home and did well, would you—do you think it would be possible for you to live in the community?
A. Well, what—what the doctor said was—and Scott said was about mental deterioration. That happens with the Haldol over a period of time when someone doesn‘t need it. And the stress and the brain, I want my own freedom. Plus the Haldol Decanoate, it can cause a little bit of deterioration. Yes, it can.
Q. So you believe the medications are harming you at this particular time?
A. Yes, I do. Right now they are. I have my—I don‘t have anything in the city—
Q. Would you agree to live at Springfield Terrace—
A. Yeah.
Q. —for a little while?
A. Yeah. I can go for a little while. They need to correct what they did to me because they filed a wrong complaint against me and put me in here.”
Both parties rested. After considering the evidence and arguments of counsel, the trial court found as follows:
“The [c]ourt finds that the petition has been proved by clear and convincing evidence.
In particular, the [c]ourt finds that [respondent] is a person who is suffering from mental illness, and as a result of his illness, he is unable to provide for his basic physical needs so as to guard himself
from serious harm without the assistance of his family or outside help.
Moreover, I find that he—as a result of his illness, he‘s unable to understand the need for treatment as testified. He doesn‘t believe that he needs medication. And if not treated, he‘s reasonably expected to suffer or continue to suffer mental deterioration or emotional deterioration or both to the point that he is reasonably expected to engage in dangerous conduct.
In light of the doctor‘s testimony that he has not been dangerous in the recent weeks, I find that as of today there is insufficient evidence to establish by clear and convincing evidence that he is expected to engage in dangerous conduct at the present time.
I find that he‘s subject to hospitalization or to treatment at a facility. In this particular case, I‘m going to honor that agreement of all the parties and order that he be hospitalized in the care of Springfield Terrace here in Springfield, Illinois, under the agreement. And the agreement is incorporated as part of this order, and that that stay at Springfield Terrace shall not exceed 90 days.”
The court entered a written order consistent with his oral pronouncement. This appeal followed.
II. ANALYSIS
Respondent claims section 1—119(3) of the amended Mental Health Code (
We note this case, like the majority of involuntary-admission cases where the orders extend for only 90 days, is moot. Ordinarily, we
For the reasons that follow, we find the trial court lacked the statutory authority to enter the type of order entered in this case. In its order, the trial court (1) found respondent subject to involuntary admission, and (2) incorporated an agreement for alternative treatment. These two remedies are mutually exclusive and possess their own procedural requirements within the Mental Health Code. We will review the procedural requirements for each remedy below, keeping in mind the following:
“The procedural safeguards enacted by the legislature are not mere technicalities. Rather, they are intended to safeguard the important liberty interests of the respondent which are involved in mental[-]health cases. * * *
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* * * The total disregard for the legislatively established procedures is contrary to the balancing of interests established by the [Mental Health] Code and should not be condoned.” In re Luttrell, 261 Ill. App. 3d 221, 230, 633 N.E.2d 74, 81-82 (1994).
Involuntary admission into a mental-health facility involves a ” ‘massive curtailment of liberty.’ ” In re Barbara H., 183 Ill. 2d 482, 496, 702 N.E.2d 555, 561 (1998), quoting Vitek v. Jones, 445 U.S. 480, 491, 63 L. Ed. 2d 552, 564, 100 S. Ct. 1254, 1263 (1980). In this vein, the legislature enacted the Mental Health Code, which sets forth specific procedures that will serve to protect the respondent‘s interests in order to “ensure that Illinois citizens are not subjected to such services improperly.” Barbara H., 183 Ill. 2d at 496, 702 N.E.2d at 561-62. A petition for involuntary admission must assert that the respondent is suffering from a condition that requires immediate hospitalization in order to protect himself or others from harm.
An initial order for involuntary admission is of short duration; it is valid for only 90 days.
B. Procedural Requirements for Agreed Orders for Treatment
On the other hand, a respondent who agrees to admission at an outpatient-alternative-treatment facility cannot be subject to involuntary admission. See
As a limited exception to the no-hospitalization requirement set forth above, the statute does provide that a custodian may have the authority to admit a respondent to a hospital if he fails to comply with the conditions of the agreed order.
C. Trial Court‘s Order
The order in this case found respondent subject to involuntary commitment and, at the same time, incorporated an agreement for voluntary treatment at an alternative treatment facility. The Mental Health Code does not authorize such an order. In fact, the order “flies in the face of this entire statutory scheme.” Michael H., 392 Ill. App. 3d at 979, 912 N.E.2d at 714. “If the respondent agrees to be admitted, he must be admitted on a voluntary basis.” Michael H., 392 Ill. App. 3d at 979, 912 N.E.2d at 714. A trial court cannot find respondent subject to involuntary admission while, at the same time, setting forth conditions pursuant to an agreement for alternative treatment, conditions that are statutorily prohibited in involuntary-admission proceedings.
The only provision in the Mental Health Code that addresses both an involuntary and voluntary status is section 3—801 (
The trial court‘s order did not satisfy the statutory requirements for involuntary-admission orders. For example, one of the conditions set forth in the agreement incorporated into the order required respondent to “take all his medications as prescribed.” This condition is strictly prohibited in involuntary-admission orders. See
Likewise, the trial court‘s order incorporating an agreement for alternative treatment did not satisfy the statutory requirements for agreed orders. Nothing in the record suggests that respondent agreed to comply with, or was even aware of, the conditions set forth in the order. See
Because the trial court‘s order did not comply with the statutory requirements for either an involuntary-admission order or an agreed order, the order is void for want of statutory authority. In re Weimer, 219 Ill. App. 3d 1005, 1009, 580 N.E.2d 182, 184 (1991). The Mental Health Code makes clear that a respondent cannot be treated as both an involuntary and voluntary patient in the same proceedings. The State argues that this court should simply strike the portions of the agreement that do not comply with orders for involuntary admission. Due to the fundamental liberty interests at stake in involuntary-admission proceedings, we will not pick and choose which of the trial court‘s requirements implicate respondent‘s due-process rights and which do not. For the reasons stated, we reverse the order finding respondent to be subject to both involuntary admission and the conditions of the agreement for alternative treatment. In light of this conclusion, we need not consider respondent‘s additional arguments.
For the foregoing reasons, we vacate the trial court‘s judgment as void.
Vacated.
POPE, J., concurs.
MYERSCOUGH, J., specially concurring in part and dissenting in part:
I specially concur in part and respectfully dissent in part. I agree the trial court should not have adopted the “agreed” order for alternative treatment because the court had ordered involuntary commitment and respondent had not agreed to or been advised of a voluntary commitment and the terms set forth in that “agreed” order. However, the court‘s order is not void in full. The court‘s involuntary commitment was correct and should stand. This matter should, therefore, be remanded for further hearing on placement.