The opinion of the court was delivered by: Justice South.
Appeal from the Circuit Court of Cook County. Honorable James P. Flannery, Judge Presiding.
Defendant was charged for the August 1988, murders of his wife and daughter. He used an axe in the killing of his wife and drowned their daughter. Defendant was admitted to the Elgin Mental Health Center (Elgin) in November 1988, after a finding that he was unfit to stand trial. On April 21, 1989, defendant was found fit to stand trial. After a bench trial, he was adjudicated not guilty of the murders by reason of insanity (NGRI), and readmitted to Elgin.
On September 17, 1999, the trial court granted defendant's conditional release pursuant to a recommendation plan submitted by the Department of Human Services (DHS). The plan as presented was accepted by the court but modified to include, among other conditions, blood testing twice a month for lithium levels. The State's motion to reconsider was denied.
Previously, on March 26, 1992, a recommendation for release was submitted to the circuit court by DHS on defendant's behalf. This recommendation was amended to a request for unsupervised off-ground passes. A hearing on this matter was held and the circuit court heard extensive testimony from psychiatrists opposed to the recommendation as well as from psychiatrists in support of the recommendation. This court affirmed the circuit court's denial of the recommendation in People v. Robin, 264 Ill. App. 3d 936 (1994).
The following testimony was adduced at the hearing on the instant petition for conditional release:
The State called Dr. Linda Gruenberg, a board certified psychiatrist, and Dr. Randi Zoot, a psychologist, as witnesses. Dr. Gruenberg received numerous documents generated by various agencies which had dealt with defendant in preparation for her interviews with him. She interviewed defendant for a total of 7-1/4 hours. Based upon the interviews and her review of the documents, Dr. Gruenberg formed an opinion within a reasonable degree of psychiatric certainty that defendant suffers from Bipolar Disorder II. She stated that such a mood disorder is characterized by periods of elation, increased energy and feeling better than one would normally feel when feeling good. Defendant's disorder is treatable but it is not curable. Defendant is presently being treated with Sinequan, an anti-depressant, and Lithium, a mood stabilizer, which Dr. Gruenberg said he must take if he is to avoid a relapse of great severity. She also found defendant sensitive to stressful situations. Dr. Gruenberg opined that defendant should be granted unsupervised off-site passes as called for in the Transitional Plan *fn1 but should not be conditionally released to an off-site housing program.
Dr. Zoot, after reviewing various records, interviewed defendant for 3½ hours. She also conducted psychological testing of defendant, which tests included the Minnesota Multi-Phasic Personality Inventory (MMPI), the Million Clinical Multi-Axle Inventory 3 (MCI3), and the Rorschach test. Dr. Zoot testified that the results of the MMPI test showed defendant to be defensive, very unwilling to disclose personal information, guarded, showing a lack of insight into what makes him tick, what motivates him. The MCI3 test disclosed that defendant has a distinct tendency to avoid disclosing personal information. The Rorschach test revealed dysphoric, depressed feelings, which could result from a sense of loneliness. The test showed that defendant had inadequate resources to deal with the everyday stresses of life. Based upon the interviews with defendant and the results of the tests, Dr. Zoot testified that she did not believe defendant should be conditionally released until his ability to handle stress was better understood.
Ronald Wedell, defendant's first witness, a board certified clinical social worker, has worked at Elgin for a number of years and known defendant since he came to the William White Cottage at Elgin in January 1995. Wedell oversees defendant's day-to-day progress, evaluates defendant's mental condition and coordinates with IRC and Northwest concerning his treatment. The William White Cottage is considered a non-secured setting. While residing at White Cottage, defendant travels to other locations at Elgin for various activities using his unsupervised on-grounds pass privilege. There have been no problems with his use of this privilege.
Wedell testified that the patients at White Cottage are given their medications at prescribed times. While defendant is not forced to take his medications, if he refuses, the staff would meet with him in order to find out the reason for his refusal.
Wedell believes that defendant has received the maximum amount of benefits from inpatient treatment and that he should now receive treatment on an outpatient basis. Defendant has a mental illness but it is in full remission. Wedell does not believe defendant is a danger, nor does he believe that he will inflict harm upon himself or others because of his illness. He also believes defendant can provide for his basic physical needs.
Dr. Jack Green, a psychologist and Director of Behavioral Studies and Group Therapy at Isaac Ray, has seen defendant in individual cognitive restructuring therapy since 1993. Since treatment began, Dr. Green has seen improvement in defendant in all areas. Dr. Green testified that defendant's sense of empathy has greatly improved as to how he deals with others. Dr. Green stated that Elgin itself is a stressful situation, so, in that regard, defendant has been dealing with stress for years. He testified that defendant is committed to his treatment and pointed out that at one time defendant asked for an increase in his medication because he felt his current dosage was inadequate. Dr. Green does not believe that defendant is a danger to himself or to others. He also believes defendant can provide for his own basic needs and that he will benefit more from treatment if his environment changes and there are new issues with which he can deal. He stressed that for defendant's illness to remain in remission, it is important that he remain in therapy and continue taking medication. Dr. Green stated that the conditional release plan will adequately regulate and oversee defendant's condition, and that the plan can be terminated at anytime if defendant's behavior warrants it. It is his professional opinion that defendant is ready for conditional release.
Dr. Jonathan Kelly, a psychiatrist and Medical Director at Isaac Ray, has seen defendant in individual therapy once a month since 1991. Dr. Kelly agreed that defendant has a bipolar II disorder that has been in full remission since 1992. Dr. Kelly makes medication recommendations to Elgin, although the medication is actually prescribed by Dr. Raftery and administered at Elgin. Dr. Kelly testified that defendant is not presently subject to involuntary admission but should be conditionally released pursuant to the 1997 plan and the 1999 transitional plan. Dr. Kelly believes that both plans have taken into account defendant's difficulties with transitional periods, but the Lithium helps defendant deal with these stressors which led to the crimes.
Stephen Fossing, a licensed clinical social worker at Northwest, has seen defendant in individual counseling for community integration on a biweekly basis since 1996. Fossing is the supervisor of the Psychosocial Rehabilitation Program. Fossing counsels defendant on concrete issues surrounding defendant's transition to living in the community, including employment, money and medication management, community perceptions, and family issues. Fossing stated that defendant has remained clinically stable over the three years that he has known him. Under the release plan he will see defendant every other week. He believes he would detect any decompensation on defendant's part since decompensation is a gradual process and symptoms would be manifested within two to three days. Since defendant will be seen by a variety of staff members, any decompensation will be identified. He also believes defendant can provide for his basic needs if released, and he recommended defendant's conditional release.
Dr. Orest Wasyliu, a psychologist and Director of Adult Clinical Psychology at Isaac Ray, has performed psychological assessments of defendant four times since 1990. He administered the MMPI, MCI3 and Rorschach tests and agreed with Dr. Zoot's finding that defendant's test results showed a tendency to avoid self-disclosure, which could be an indication of a lack of insight. However, the results of these and other tests showed no evidence of any psychotic disorder but rather substantial improvement in terms of personality functioning. Dr. Wasyliu stressed that defendant ...