Appeal from the Circuit Court of Cook County. No. 01 CM 2568 Honorable Raymond L. Jagielski, Judge Presiding.
The opinion of the court was delivered by: Justice O'malley
This case involves a petition that alleges respondent, Tyrone S., to be a person subject to involuntary admission for mental health treatment. Under the Mental Health and Developmental Disabilities Code (Code), a person is subject to involuntary admission if he or she has a mental illness and because of that illness is either "reasonably expected to inflict serious physical harm on himself or herself or another in the near future" or is "unable to provide for his or her basic physical needs so as to guard himself or herself from serious harm." 405 ILCS 5/1-119 (1), (2) (West 2000).
Respondent appeals from the circuit court's order finding that he is a person subject to involuntary admission and ordering that he be hospitalized in the Department of Human Services. Respondent contends that the circuit court erred in committing him because the State did not prove by clear and convincing evidence that he reasonably could be expected to inflict serious harm upon himself or another in the near future.
On August 8, 2001, respondent was admitted to the Tinley Park Mental Health Center (TPMHC) following his release from the county jail. Respondent had been incarcerated pursuant to a guilty plea to a charge of public indecency. Soon after he arrived at the facility, respondent signed a voluntary admission form. He submitted notice of his desire to be discharged on September 12, 2001. In response, the State filed a petition for involuntary admission, alleging that respondent was a person who was mentally ill and because of his illness was reasonably expected to inflict serious physical harm on himself or another and that he was unable to provide for his physical needs. The State later withdrew the physical needs portion of its petition and proceeded to hearing alleging that respondent was reasonably expected to inflict serious harm on himself or another due to his mental illness.
A hearing was held on the State's petition on October 16, 2001. The State called two witnesses on direct examination, mental health technician Maurice Stegall and psychiatrist Dr. Phyu-Mar Hla, both of whom were assigned to TPMHC at the time of respondent's stay.
Stegall testified that on September 4, 2001, he observed respondent openly masturbating while situated in the doorway of another patient's bedroom. Stegall conveyed to respondent that such behavior was inappropriate and then sought to consult the nurse on duty as to what was to be done in response to respondent's actions. The nurse, Terry Thompson, directed that respondent be given an injection in order to quell his actions. Stegall and two other technicians approached respondent to assist Thompson in administering the injection, at which point respondent began cursing loudly, refusing to take the shot, and striking out at Stegall and the other technicians. Stegall and the other staff members had to wrestle respondent to the floor, where respondent attempted to kick and scratch those restraining him. Stegall stated that four or five other staff members were summoned to assist and ultimately placed respondent in full leather restraints.
On cross-examination, Stegall testified that at least two other staff members, including Dr. Hla, observed respondent masturbating in the doorway of the other patient's room. He also stated that respondent ceased this behavior when Stegall admonished him to stop, and that, to his knowledge, respondent had not attempted to strike anyone other than on that date.
On redirect examination and in response to questions posed directly by the court, Stegall testified that on September 4, he only consulted the nurses' station to report respondent's behavior, and that the decision to administer an injection was made by the nurse on duty, not by Stegall.
The State then called Dr. Hla. Respondent stipulated that Dr. Hla was an expert qualified to render an opinion in psychiatry and mental illness. Dr. Hla testified that, as the psychiatrist in charge of respondent's care, she had multiple opportunities to observe and evaluate respondent. She had diagnosed respondent as having a delusional disorder, manifested by respondent's belief that all women (fellow patients, staff, and Dr. Hla herself) desired him sexually. Respondent would act out on this belief by talking about it aloud with other patients, openly masturbating, exposing himself, and writing letters to staff members alleging their desire for him. Respondent often reacted in a hostile manner when given verbal redirection and would not participate in meetings regarding his prescribed behavioral plan.
Dr. Hla related that respondent had been admitted to TPMHC and other mental health facilities on prior occasions and had been ruled unfit to stand trial for the crime of stalking. She had consulted with other professionals and staff involved in respondent's care and examined his medical records in formulating her diagnosis of respondent's mental illness as a delusional disorder exhibited by his constant preoccupation with sex. She stated that respondent's condition impaired his judgment and substantially affected his ability to cope with the ordinary demands of life in that he would often become verbally abusive and combative when his delusions were challenged.
Dr. Hla's opinion was that respondent, because of his mental illness and the agitation resulting from his inability to deal with his delusions in a rational manner, was reasonably expected to inflict harm on himself or others in the near future. In support of this opinion, Dr. Hla cited the incident of September 4, related by Stegall. Another incident took place in the early morning of August 26, 2001, when respondent consistently followed one of the female nurses and repeatedly told her she was beautiful. Another time, respondent, naked at the time, wheeled himself into the day area and began openly masturbating. On both occasions, respondent refused verbal redirection and ultimately had to be medicated and restrained. Finally, on September 23, 2001, respondent became loud and combative in the TPMHC dining room, again refused verbal redirection, and threatened to "get" the nurse who ultimately injected him and had him restrained.
Dr. Hla testified that it was her opinion that hospitalization was the least restrictive treatment option available to respondent at the time of the hearing. She and her staff had explored other options for respondent, such as nursing homes and community placements, but none of the facilities contacted would accept respondent because of the behavior he had exhibited and because none of them had the capability to monitor respondent adequately. Respondent had a history of exposing himself in public before entering TPMHC and had been found in the bed of a quite debilitated female patient during his stay at a ...