Appeal from the Circuit Court of Cook County, the Hon. Earl E.
Strayhorn, Judge, presiding.
MR. CHIEF JUSTICE GOLDENHERSH DELIVERED THE OPINION OF THE COURT:
Rehearing denied March 28, 1980.
On May 3, 1978, following a bench trial in the circuit court of Cook County, defendant, Miguel Valdez, was acquitted by reason of insanity (Ill. Rev. Stat. 1977, ch. 38, par. 115-3) of the murders of Lecia Agsaoay on April 3, 1977, and Dr. Jesus Lim on April 4, 1977. On May 11, 1978, in a hearing held pursuant to section 5-2-4(a) of the Unified Code of Corrections (Ill. Rev. Stat. 1977, ch. 38, par. 1005-2-4(a)) defendant was found in need of mental treatment and remanded to the Department of Mental Health and Developmental Disabilities (hereafter the Department). The Department placed defendant for care and treatment at the John J. Madden Mental Health Center. Apparently in response to a notice dated November 1, 1978, that the Department was "considering granting [Valdez] off-grounds privileges to start December 15, 1978, in the company of his wife," the State's Attorney of Cook County, pursuant to section 5-2-4(d) (Ill. Rev. Stat. 1977, ch. 38, par. 1005-2-4(d)), requested a hearing. Defendant filed a "Petition for Discharge or Release to Isaac Ray Center." On November 29, 1978, the Department notified the court that it had decided against recommending off-grounds privileges. We note parenthetically that neither of the notices given by the Department is contained in the record.
The circuit court overruled defendant's objection that by reason of the notice of November 29, 1978, the matter was moot, and conducted an evidentiary hearing. Following the hearing the court entered an order in which it found that housing defendant with patients who receive only short-term treatment whereas he was in need of long-term care involving extensive psychiatric treatment was of "possible detrimental effect to [defendant's] treatment." The court ordered that the Department establish a treatment plan for defendant to provide individual treatment from a qualified psychiatrist for at least two sessions per week, each session to be not less than 45 minutes in length; counseling by a psychologist mental-health specialist, familiar with his case, for a period of not less than 30 minutes each day, three times each week; and family and group therapy. The court also ordered that within 90 days of the entry of the order, the Department publish a memorandum directed to all of its units setting forth procedures and regulations to be followed in all cases in which the Department receives into its custody, care and control a patient committed under section 5-2-4 of the Unified Code of Corrections. Defendant and the Department appealed. We allowed direct appeal (73 Ill.2d R. 302(b)) and consolidated the appeals for argument and opinion.
The testimony showed that defendant was assigned to one of eight pavilions at Madden, each of which provided residence for 28 persons. The pavilion to which he was assigned was staffed by one psychiatrist, a staff nurse (one nurse on each of three shifts), a social worker and an activity therapist. The individual involved in the therapy testified that although defendant, because of his acquittal, was considered "a special case," he was seen by the psychiatrist only once each week for approximately 15 minutes and by the mental health specialist social worker only once each week for 15 to 30 minutes. During the 11-month period of his residence in that pavilion, it had been headed by three different psychiatrists, none of whom had established an active treatment program for defendant. Although he attended group therapy sessions, defendant did not participate in discussion. The testimony indicated that the effect of the group therapy was lessened because the pavilion to which defendant was assigned had a rapid rate of patient turnover and defendant was the only long-term-care patient residing in the pavilion.
The transcript contains conflicting professional opinions as to whether defendant had improved during his period of residence at Madden. Apparently he was continued on drug therapy to reduce the effects of his paranoia. Although his wife visited often, no family group therapy was instituted for him.
Dr. Robert A. Reifman, a psychiatrist and director of the Psychiatric Institute of the circuit court of Cook County, testified that defendant should be treated "on a deep therapy basis" which would involve seeing a psychiatrist once or twice each week.
Dr. James L. Cavanaugh, clinical director of the Department of Psychiatry at Rush-Presbyterian Hospital, testified that defendant's treatment program should include "ongoing psychopharmacological treatment," group therapy, and family psychotherapy, and that if he were under the care of the Isaac Ray Center at Rush-Presbyterian Hospital "we would start out by seeing him two times a week, definitely."
At the time of the murders of which defendant was acquitted by reason of insanity, section 5-2-4(b) of the Unified Code of Corrections (Ill. Rev. Stat. 1975, ch. 38, par. 1005-2-4(b)) provided that in the event of such acquittal the circuit court "shall enter an order finding the defendant to be in need of mental treatment and hospitalizing the defendant in the custody of the Department of Mental Health and Developmental Disabilities for an initial period not to exceed 12 months from the date of such order. The order of the court shall be in the form of and shall produce the same effects and subsequent review proceedings as an order of hospitalization under the Mental Health Code of 1967 * * *." Release from such commitment was governed by the Mental Health Code of 1967 (Ill. Rev. Stat. 1975, ch. 91 1/2, par. 1-1 et seq.), which provided for discharge upon the order of the superintendent of the hospital where the acquitted was placed. Ill. Rev. Stat. 1975, ch. 91 1/2, par. 10-4.
Effective August 1, 1977, section 5-2-4 was amended to provide that in the event of such acquittal a hearing was to be held under the Mental Health Code of 1967 (Ill. Rev. Stat. 1977, ch. 91 1/2, par. 1-1 et seq.) to determine whether the defendant was in need of mental treatment. If found to be in need of mental treatment the court was to enter an order so specifying. The initial order for admission is for an indefinite period of time subject to the provision that such period of commitment shall not exceed "the maximum length of time that the defendant would have been required to serve, less credit for good behavior, before becoming eligible for parole had he been convicted of and received the maximum sentence for the most serious crime for which he has been acquitted by reason of insanity." (Ill. Rev. Stat. 1977, ch. 38, par. 1005-2-4(b).) The statute provides that when the defendant is no longer in need of mental treatment, or in the event that he continues to be in need of mental treatment, release or discharge is appropriate, under specified conditions, the superintendent must give written notice not less than 30 days prior to such release to the State's Attorney of the county where the criminal proceeding took place and to the court which found the defendant mentally ill and in need of mental treatment. (Ill. Rev. Stat. 1977, ch. 38, par. 1005-2-4(d).) The statute further provides:
"(h) If the court finds that the defendant is no longer in need of mental treatment it shall order the superintendent to discharge or release the defendant.
(i) If the court does not so find, it may order the superintendent not to discharge or release the defendant, or may order discharge or release under such conditions * * * which reasonably assure the defendant's satisfactory progress * * *.
(j) The court may subsequently modify the conditions for release or discharge of a defendant who continues to be in need of mental treatment, including remanding him to a facility, when in its judgment such modification is appropriate to reasonably assure either the defendant's satisfactory progress in treatment or his safety and ...