Appeal from the Circuit Court of Madison County. No. 02-MH-16 Honorable Ralph J. Mendelsohn, Judge, presiding.
Justices: Honorable Gordon E. Maag, J.
Honorable Melissa A. Chapman, J., and
Honorable James K. Donovan, J.,
The opinion of the court was delivered by: Justice Maag
The respondent, Christopher P., appeals the circuit court's order finding him to be a person subject to the involuntary administration of psychotropic medication. We reverse.
On February 8, 2002, Dr. Jagannath Patil filed a petition for the involuntary administration of non-emergency psychotropic medication for the respondent. Dr. Patil sought an authorization to involuntarily administer four psychotropic medications (Risperidone, Ativan, and the alternative medications Haldol and injectable Haldol decanoate) to the respondent on a non-emergency basis. The petition stated, "[The respondent] suffers from a major psychiatric illness manifested by delusional beliefs, disorganized thinking, aggressive behaviors, etc.[,] and refuses to take any psychotropic medications." Dr. Patil's diagnosis for the respondent's illness was "Schizophrenia, Paranoid Type."
Dr. Kanwal Mahmood, a psychiatrist at Alton Mental Health Center, testified that the respondent had been admitted to Alton Mental Health Center on February 5, 2002. Dr. Mahmood had reviewed the respondent's records and discussed the case with his treating psychiatrist, Dr. Patil. Dr. Mahmood attempted to meet with the respondent the day before the hearing, but he refused to speak to her since she was a female. Dr. Mahmood explained that the respondent had refused treatment from any female and refused to talk to females. Dr. Mahmood claimed that the respondent had not eaten for at least three or four days because he believed that his food was poisoned. He refused to eat anything at Alton Mental Health Center because he thought he was in the "enemy house." Dr. Mahmood stated that the respondent wanted to be released and claimed that he was going to sue Alton Mental Health Center because it was his "enemy." Dr. Mahmood described the respondent as "isolative," explaining that he refuses to talk with the treatment team, with the exception of a few males, and that he stays in his room. Dr. Mahmood stated that the respondent had been charged with the crimes of disorderly conduct and aggravated battery to a police officer arising from an incident when he wanted to photograph a woman and placed his arm in front of her face. When the police attempted to arrest him, he pulled away and struck a police officer.
Dr. Mahmood testified that the respondent had been on psychotropic medication in the past but that the records were unclear about what medications he had taken. The treatment team determined that the respondent should take Risperidone and Ativan. The treatment team decided that if Risperidone proved to be ineffective, Haldol or Haldol decanoate should be used as a backup. Dr. Mahmood stated that Risperidone and Haldol would render the respondent fit to stand trial.
She said that these medications would enable the respondent to have reality-based thinking and that his delusions would not interfere with his functioning. Dr. Mahmood also testified regarding the expected benefits of the medications and the dosage ranges. Dr. Mahmood opined that the benefits of taking the medication outweighed the risks of harm. When Dr. Mahmood was asked whether less restrictive treatment services such as counseling, education, or therapy would be adequate without medication to properly treat the respondent, she stated "No." She was not asked if other alternatives had been explored.
Dr. Mahmood stated that the respondent was suffering due to the fact that he had not eaten much since his arrest. She claimed that he had exhibited threatening behavior prior to his arrest and that he was unfit to stand trial. She opined that, without medication, the respondent's ability to function would continue to deteriorate or he would remain in a deteriorated condition. Dr. Mahmood stated that she did not think that the respondent had the capacity to make a reasoned and informed decision about whether he should or should not take the prescribed medication.
On cross-examination, Dr. Mahmood admitted that the respondent had not engaged in any threatening behavior since his arrest, but she stated that he had shown agitation over the unit's rules. Dr. Mahmood explained that even if the respondent had been out on bond since his arrest in September until February (when he was brought to the Alton Mental Health Center) and had not been in any trouble with the law for engaging in threatening behaviors, she would not change her opinion that the respondent was in need of psychotropic medications. Dr. Mahmood also indicated that the respondent had not been in any fights since his admission.
Although Dr. Mahmood did not personally discuss the benefits and risks of the proposed medications with the respondent, she read Dr. Patil's initial treatment recommendations from the respondent's chart, which stated as follows:
"I've explained the benefits and risks of Resperidone [sic] and Haldol to this patient. He's thoroughly psychotic. And based on his delusion[al] beliefs of a persecuted nature and refuses [sic] to take any medication, he states that he will not take any medication, and whenever we give him a shot[,] he will take it, but *** he would like to have a return paper about his refusal."
Dr. Mahmood admitted that there was no documentation indicating that the respondent had been told about the benefits and risks of Ativan.
The respondent moved for a directed finding based upon this court's opinion in In re Edward S., 298 Ill. App. 3d 162, 698 N.E.2d 186 (1998), that the only basis for believing that information about the benefits and risks of the proposed medications had been given to the respondent was a reference to an "out-of-court statement being offered for the truth of the matter asserted" rather than the basis for an opinion that the benefits and risks of the two medications had been explained to the respondent. Additionally, the record shows that no risk information or benefit information regarding Ativan had ever been given to the respondent. The State responded by suggesting that it was sufficient that the respondent was present in open court when Dr. Mahmood discussed the benefits and risks of the medications. Also, the State claimed that because In re Edward S. was an Appellate Court, Second District, decision, it should not control this court's decision. The circuit court did not agree ...