Appeal from the Circuit Court of Cook County; the Hon. Romie
J. Palmer, Judge, presiding.
JUSTICE GOLDBERG DELIVERED THE OPINION OF THE COURT:
Michael Smith (defendant) was charged with arson. On September 27, 1982, he was found not guilty by reason of insanity. He has since remained confined at Manteno Mental Health Center (Manteno). After a hearing concluded on May 20, 1983, the trial court ordered defendant to undergo inpatient care and treatment under the direction of the Illinois Department of Mental Health and Development Disabilities. The order of the trial court did not specify a determinate duration for the commitment. Defendant appeals.
Dr. Robert Wettstein, a fully qualified consulting psychiatrist for the Illinois Department of Mental Health, testified he examined defendant four times and observed defendant interact with other individuals on numerous occasions at Manteno. The witness knew that defendant "had a history of psychotic symptoms" including making sexual advances to siblings and urinating on the floor. Defendant denied the incidents to the witness. The witness was also aware of defendant's "history of drug abuse." The witness stated that defendant's expression of personal feelings was infantile, and he showed little insight into his past or current mental problems. Although the witness concluded defendant has "shown very little motivation for outpatient treatment," the witness recommended that defendant be treated on an outpatient basis at a facility other than Manteno. Manteno has neither a drug abuse program nor drug abuse counselors. Defendant has not received any medication there. The clinic at Loretto Hospital, which has a drug abuse program, has accepted defendant for outpatient treatment.
The witness further testified he has not heard of any instances in which defendant has threatened, hurt, or made sexual advances to any person at Manteno for the four months defendant was there. In the expert opinion of the witness, defendant "does not need and would not benefit from further hospital treatment," and is "not currently suffering from mental illness." Defendant's condition is, "atypical psychosis in remission." Defendant's drug abuse has contributed to his previous psychotic episodes. The doctor also believed defendant had a "mixed personality disorder" which is categorized by a number of antisocial features and difficulty in dealing with some of his feelings, including anger. The witness did not know defendant's mental disorder to exhibit itself in violence. The fire defendant started was the result of "his atypical psychosis as a result of drug abuse and not as a result of his personality problem." The witness concluded that it was certainly possible that if defendant again used drugs his atypical psychosis could re-emerge.
David Das, a qualified expert psychologist at Manteno, testified he interviewed defendant on several occasions. In his expert opinion defendant did not meet the statutory requirements for involuntary commitment. He "certainly" agreed with Dr. Wettstein that defendant should not be hospitalized but should instead be treated on an outpatient basis. The witness also testified "if there were excessive use of drugs, [defendant's] past mental condition, psychotic condition, is likely to recur."
On examination by the court, the witness stated the cause of defendant's psychosis is not exactly known but, in the opinion of the witness, "drugs and alcohol can cause an exacerbation of psychosis." Furthermore, the stresses of life outside Manteno could disturb defendant. However, outpatient counseling could help defendant through his difficulties. Also, defendant does not meet the statutory requirement for involuntary admission. At present, he is not a danger to himself or others, but he should be released only with "close monitoring." In addition, the witness knew that defendant had previously been treated at Loretto Hospital.
Patricia Perry, a social worker at Manteno, testified she planned the discharge of defendant should he be released for outpatient treatment. Defendant would live with his family and receive outpatient treatment at Loretto Hospital. She believed defendant was a proper candidate for outpatient treatment from the time he was first admitted to Manteno. She believed strict supervision by defendant's family is the only way to monitor defendant's use of alcohol and drugs, should defendant be released.
The witness never personally observed any behavioral problems with defendant. The only problem of which she was aware during defendant's stay at Manteno was an instance of gambling with other residents. The witness did not believe defendant should reside at a "halfway house" because the residents there are generally older than defendant and subject to chronic mental illness.
Connie Pokalsey, a psychologist at Manteno, testified she has interviewed defendant. She led the treatment team for defendant. She concurs with the recommendation of Dr. Wettstein that defendant should be treated on an outpatient basis.
Alice Smith, defendant's mother, testified she was aware of defendant's previous mental and behavioral problems. Nevertheless, she was willing for defendant to live with her and four of her other children. She is employed and is generally away from home from 10 a.m. to 8:30 or 9 p.m.
The trial judge entered an order remanding defendant to the custody of the Department of Mental Health. The order specified that defendant was not subject to involuntary commitment but that defendant was in need of mental health services on an inpatient basis.
The controlling statute provides in pertinent part (Ill. Rev. Stat. 1983, ch. 38, par. 1005-2-4(a)(1)(B),(g):
"(B) `In need of mental health services on an inpatient basis' means: a defendant who has been found not guilty by reason of insanity who is not subject to involuntary admission but who is reasonably expected to inflict physical harm upon himself or another and who would benefit from inpatient care or is in need of inpatient care.
(g) The findings of the court shall be established by clear and convincing evidence. The burden of proof and the burden of going forth with the evidence rest with the State when a hearing is held to review the determination of the facility director ...