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People v. Markwart

December 28, 2001


The opinion of the court was delivered by: Justice Gordon


Appeal from the Circuit Court of Cook County. The Honorable Stuart Palmer, Judge Presiding.

In 1996, John Markwart (defendant) was found not guilty by reason of insanity of aggravated arson in a bench trial before the circuit court of Cook County. He was then committed to the custody of the Illinois Department of Human Services pursuant to section 5-2-4 of the Unified Code of Corrections. 730 ILCS 5/5-2-4 (West 2000). In April 2000, defendant sought review of the treatment plan report filed by the mental health facility housing him, alleging that the plan did not comply with governing statutes. Defendant also sought review of his treatment at that facility, alleging that it was not adequate. The circuit court held that the existing plan complied with the statute and denied defendant's request for a hearing to review his actual treatment. Defendant appeals the circuit court's rulings, claiming that the finding that the plan was adequate is against the manifest weight of the evidence and that the hearing requested is mandatory and not within the discretion of the circuit court to deny. For the reasons discussed below, we affirm.


In August 1995, defendant was charged with aggravated arson for setting on fire a desk at Cook County Hospital. According to testimony given during defendant's bench trial, defendant approached the desk of a hospital employee, poured liquid on it from a jar and then lit the desk on fire. At trial, the parties stipulated that if a detective from the Chicago Police Department Bomb and Arson Unit were to have testified, he would have stated that the fire in question caused structural damage and was intentionally set. The detective would also have testified that defendant told him that he set the fire because he was dissatisfied with the psychiatric treatment he was receiving at Cook County Hospital. The defense presented the testimony of Dr. Stafford Henry, a forensic psychologist, who performed a psychiatric evaluation of defendant and concluded that defendant was suffering from schizophrenia and was legally insane at the time the fire was set. The trial court found that the State proved all the elements of the crime beyond a reasonable doubt but further found that the defense proved, by clear and convincing evidence, that defendant was legally insane at the time of the crime. The court then found defendant not guilty by reason of insanity.

From his acquittal in December 1996, until the present, defendant has been in the custody of the Department of Human Services at the Elgin Mental Health Center. During this period, Cora Markwart was appointed legal guardian of her son, defendant, pursuant to section 11a-1 et seq. of the Probate Act and pursued these proceedings on his behalf. 755 ILCS 5/11a-1 (West 2000).

Under section 5-2-4 of the Unified Code of Corrections, the facility housing a defendant acquitted by reason of insanity must file a treatment plan report with the court every 60 days during the defendant's confinement. 730 ILCS 5/5-2-4(b) (West 2000). The report Elgin filed in February 2000, is at issue in this case. According to the contents of this report, defendant suffers from delusions, including the notion that he has an increased sensitivity to pain. These delusions led defendant to demand that Cook County Hospital perform "$3,000" worth of tests on him and their refusal to accede to this apparently psychotic demand led defendant to set the fire at that location. According to the treatment plan report, in February 2000, defendant was still actively delusional. In 1999, the report states that defendant experienced a period of anorexia, his weigh dropping to 127 pounds, during which he claimed that starving himself would get him out of Elgin "sooner than later." Through the administration of medication and court approved electroconvulsive therapy (ECT), defendant's weight was raised to 179 pounds, but Elgin staff apparently still strictly monitored defendant's eating and his efforts to sell his food. The report also indicates that defendant manifested significant problems with social skills and personal hygiene. The report reveals that defendant's primary form of treatment is anti-psychotic medications. Apparently, the treating psychiatrist has tried a number of different medications, the one in use in February 2000, offering only moderate success in limiting defendant's delusion.

In addition, the June 2000, treatment plan report, submitted during the course of this litigation, indicates that defendant followed a nurse into a restricted area, would not leave, and when set on by another patient coming to the nurse's aid, bit the other patient, drawing blood. Defendant then went on a medications strike which was eventually resolved.

In April 2000, defendant filed a petition for review of treatment alleging that his February 2000, treatment plan did not conform to the statutory requirements set out in sections 3-209 and 3-814 of the Mental Health and Developmental Disabilities Code (Mental Health Code). 405 ILCS 5/3-209 and 5/3-814 (West 2000). Defendant asked that the court enter an order requiring Elgin to submit a revised treatment plan. Defendant also requested a hearing to determine whether he was receiving adequate and humane care and services under his treatment plan as defined in section 1-101.2 of the Mental Health Code. 405 ILCS 5/1-101.2 (West 2000). On defendant's first request, the trial court reviewed the treatment plan and concluded that it was adequate and necessary for defendant's condition. Upon the trial judge's ruling, defendant reiterated his request for a hearing on the adequacy of his treatment and requested that an independent psychiatric exam be performed as part of that review. The trial court denied defendant's petition, stating "[a]t its discretion the Court denies that request." This appeal followed.


By his first issue, defendant argues that the trial court erred in finding that the treatment plan submitted by the Elgin Mental Health Center was adequate. Defendant contends that the plan failed to articulate several of the statutorily mandated elements and those it did include were facially inadequate. Although no case directly addresses the standard of review of a trial court's holdings on a treatment plan, defendant and the State agree that the applicable standard of review is whether the finding was against the manifest weight of the evidence. See, e.g., Whyte v. Estate of Whyte, 244 Ill. App. 3d 746, 748, 614 N.E.2d 372, 373 (1993) (trial court's ruling that previously void marriage became lawful would only be disturbed if it were against the manifest weight of the evidence).

Defendant's right to challenge the facial adequacy of his treatment plan is outlined in the inter-referential subsections of the two statutes governing his confinement: section 5-2-4 of the Unified Code of Corrections and section 3-814 of the Mental Health Code. 730 ILCS 5/5-2-4 (West 2000); 405 ILCS 5/3-814 (West 2000). Defendant was committed to Elgin, after being found not guilty by reason of insanity (NGRI), under section 5-2-4 of the Unified Code of Corrections. 730 ILCS 5/5-2-4(a) (West 1996). This section provides detailed directions about the process of commitment in such cases, the reporting requirements of the treatment facility, and the rights to and procedures for review of certain aspects of a defendant's confinement. Part (b) of this section also provides that

"[i]f the Court finds the defendant subject to involuntary admission or in need of mental health services on an inpatient basis, the admission, detention, care, treatment or review of treatment and treatment plans, and discharge of the defendant after such order shall be under the Mental Health and Developmental Disabilities Code." 730 ILCS 5/5-2-4(b) (West 2000).

Under that code, section 3-814(c) states that "[o]n request of the recipient or an interested person on his behalf, or on the court's own discretion, the court shall review the current treatment plan to determine whether its contents comply with the requirements * * *. If the court determines that any of the information required by this Section * * * to be included in the treatment plan is not in the treatment plan * * * the court shall indicate what is lacking and order the facility director to revise the current treatment plan to comply with this Section." 405 ILCS 5/3-814(c) (West 2000). Thus section 5-2-4(b), by ...

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