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In re James E.

May 22, 2003


The opinion of the court was delivered by: Justice Garman


Docket No. 93608-Agenda 8-November 2002.

The trial court found respondent to be subject to involuntary admission to a mental health facility and placed him in the custody of the Department of Human Services. The appellate court affirmed, holding that, under the Mental Health and Developmental Disabilities Code (Code) (405 ILCS 5/1-100 et seq. (West 2000)), an individual may be subject to involuntary commitment to a state mental health facility even though he had initially committed himself voluntarily to a private hospital and had not requested in writing a discharge. No. 5-00-0607 (unpublished order under Supreme Court Rule 23). We granted respondent's petition for leave to appeal (177 Ill. 2d R. 315) and now affirm.


On September 5, 2000, respondent, a 20-year-old male, was admitted as a voluntary patient to the inpatient psychiatric unit of St. Clare's Hospital (St. Clare's), a private hospital in Alton, Illinois. Respondent was diagnosed with substance-induced psychotic disorder. This was respondent's first hospitalization related to mental health services.

On September 8, 2000, respondent was transported to Alton Mental Health Center (Alton) after staff at St. Clare's executed a petition for involuntary admission by emergency certificate pursuant to section 3-600 of the Code (405 ILCS 5/3-600 (West 2000)). On September 11, 2000, the State filed a "Petition for Involuntary/Judicial Admission" (petition) seeking to admit respondent involuntarily. A second petition was filed the following day. In the second petition, it was alleged that respondent was mentally ill, that because of his mental illness he was reasonably expected to inflict serious physical harm upon himself or another in the near future, and that he was in need of immediate hospitalization to prevent such harm. The second petition stated that respondent had been suspicious, paranoid, and delusional and claimed to have been hearing the "Devil's voice." A knife, which he was going to use to "protect himself from his parents," had apparently been taken away from him. Respondent refused to eat or take his medication. The second petition also referred to a recent incident at a nearby college where respondent struck another student because he thought the student was a threat to him.

The second petition was accompanied by a certificate from a qualified mental health examiner, as required by section 3-602 of the Code (405 ILCS 5/3-602 (West 2000)), in which the examiner indicated that he had examined respondent on September 8, at St. Clare's, and had determined that respondent was mentally ill. The examiner concluded that because of his mental illness he was unable to provide for his basic needs so as to guard himself from serious harm. The examiner found that respondent exhibited signs of acute psychosis. He had paranoid delusions that his parents were going to kill him and was very preoccupied with religion, believing that he was fighting with the devil. Respondent refused to comply with his treatment or medication and was a threat to his parents.

A hearing on the State's petition was held on September 14, 2000. Respondent's attorney stated that respondent was discharged from St. Clare's because "he didn't want to take medication and because he would not have insurance coverage." Dr. Jim Belman, a licensed clinical psychologist at Alton, testified for the State. Dr. Belman testified that respondent had been diagnosed with substance-induced psychotic disorder. He reiterated the basic facts supporting the allegations contained in the second petition and accompanying certificate, including that respondent heard the voices of Satan and God talking in his head, refused medication, and refused to eat. Dr. Belman also testified regarding continuing problems respondent was experiencing since being moved to Alton.

Prior to the hearing, respondent filed a "Motion to Strike and Dismiss" the petition, arguing that the petition for involuntary admission was improper because it had not been preceded by respondent's making a written request for discharge pursuant to case law under section 3-403. After hearing the evidence, the trial court denied respondent's motion and found respondent to be a person subject to involuntary admission. The appellate court affirmed and rejected respondent's argument that he could not be involuntarily admitted because he did not request in writing to be discharged from St. Clare's.


The question presented in this appeal is one of law, which we review de novo. Woods v. Cole, 181 Ill. 2d 512, 516 (1998). We are asked to determine whether a hospital not owned and operated by the State of Illinois can initiate a petition for involuntary commitment against one of its voluntary mental health patients, who has not requested a discharge in writing, to facilitate transferring the patient to a state facility. This issue requires an examination of section 3-403 of the Code, which provides:

"A voluntary recipient shall be allowed to be discharged from the facility at the earliest appropriate time, not to exceed 5 business days, excluding Saturdays, Sundays and holidays, after he gives any treatment staff person written notice of his desire to be discharged unless he either withdraws the notice in writing or unless within the 5 day period a petition and 2 certificates conforming to the requirements of paragraph (b) of Section 3-601 and Section 3-602 are filed with the court. Upon receipt of the petition, the court shall order a hearing to be held within 5 days, excluding Saturdays, Sundays and holidays, and to be conducted pursuant to Article IX of this Chapter. Hospitalization of the recipient may continue pending further order of the court." 405 ILCS 5/3-403 (West 2000).

We have had prior occasions to review section 3-403. In In re Hays, 102 Ill. 2d 314 (1984), the 19-year-old respondent voluntarily admitted himself to the psychiatric unit of Mercy Hospital in Urbana. He had been voluntarily admitted there on nine previous occasions over the previous four years. On the day following his admission, he refused to take medication, threw a phone at security guards, and became physically resistive. After being physically restrained, he told a nurse that he wanted to die. He was given medication and did not cause any further disturbance. The hospital petitioned the trial court to have the respondent declared a person subject to involuntary admission under the Code (Ill. Rev. Stat. 1981, ch. 91½, par. 3-600 et seq.). The purpose of the petition was to permit transfer of the respondent to an institution with facilities better suited to treat him. On the evening after the incident, a physician executed the first certificate required for involuntary commitment. Ill. Rev. Stat. 1981, ch. 91½, par. 3-602. The respondent was transferred that night to Adolph Meyer Health Center in Decatur, a state facility. The second required certificate, which must be executed by a psychiatrist (Ill. Rev. Stat. 1981, ch. 91½, pars. 3-602, 3-610), was prepared the following day. The trial court declared the respondent to be a person subject to involuntary admission to a mental health facility under the Code. Hays, 102 Ill. 2d at 316-17. We affirmed the appellate court's reversal of the trial court. We determined that, under section 3-403, involuntary commitment proceedings may not be brought against a voluntarily admitted patient unless the patient has already submitted a request for discharge. We held that one of the purposes of the Code is to encourage voluntary admissions, and a patient who voluntarily undertakes therapy is more likely to be rehabilitated than one who is involuntarily required to undergo treatment. Hays, 102 Ill. 2d at 319-20. An important means of encouraging voluntary admission is to guarantee voluntary patients the right to request their discharge. Hays, 102 Ill. 2d at 320.

In In re Splett, 143 Ill. 2d 225 (1991), the respondent voluntarily admitted himself to Elgin Mental Health Center, a state facility. A month later, the State filed a petition seeking respondent's involuntary admission. At a hearing, experts for the State testified that the respondent suffered from a bipolar disorder with psychotic features and posed a threat to himself and others. The respondent raised no challenge to the validity of the proceedings. Splett, 143 Ill. 2d at 227-28. The trial court found that the evidence of the respondent's mental illness and potential to inflict harm upon himself and others had been established by clear and convincing evidence and that he was subject to involuntary admission. The appellate court reversed, holding that the commitment order was ineffective because the State had failed to comply with the notice requirements of the Code. Splett, 143 Ill. 2d at 228. We affirmed the appellate court but for reasons not discussed in the appellate opinion. We found that respondent was not eligible for involuntary admission because he had not submitted a written request seeking his discharge from the state mental health center to which he had been voluntarily admitted. Splett, 143 Ill. 2d at 235. The only reference in the record to a request by the respondent for discharge appeared in the certificate of one of the physicians, who stated that the respondent had "requested his discharge." Splett, 143 Ill. 2d at 234. We stated that because the ...

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