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In re Lillie M.

September 5, 2007


Appeal from Circuit Court of Sangamon County No. 06MH687 Honorable George H. Ray, Judge Presiding.

The opinion of the court was delivered by: Justice Cook

Published opinion

Respondent, Lillie M., aged 43, appeals from the trial court's order finding Lillie subject to involuntary admission at St. John's Hospital (St. John's). At issue is whether the State presented sufficient evidence to prove that Lillie was unable to provide for her basic physical needs so as to guard herself from serious harm (405 ILCS 5/1-119(2) (West 2006)) and whether the court ordered the least-restrictive treatment alternative (405 ILCS 5/3-811 (West 2006)). We affirm.


According to Lillie's history and physical examination report, Lillie has a history of mental illness. This report also indicated that prior to the facts that gave rise to the instant case, Lillie had been seen by a physician, Dr. Bland, as recently as October 2, 2006. At that point in time, Lillie had been taking her medication and had been doing well. The report noted that Lillie is also mildly mentally retarded, which may contribute to her inability to answer questions appropriately.

On October 23, 2006, family members brought Lillie to the emergency room after Lillie exhibited a change in behavior and difficulty functioning. Specifically, Lillie had cut her hair and began burning it in the sink. Lillie then ran away from the emergency room and returned to her apartment. Lillie locked herself in the bathroom with a pair of scissors and cut more hair, this time putting it in the toilet.

Police officer C. Agans-Dominguez arrived at Lillie's apartment to find Lillie with a bizarre haircut and the toilet full of hair. Lillie was pacing the apartment and did not respond to Agans-Dominguez's questions. Lillie's family expressed a concern for Lillie's well-being and told AgansDominguez that Lillie earlier stated that "people put stuff in her house." Agans-Dominguez then filed a petition for involuntary admission, reporting what he had just seen at Lillie's residence. The petition alleged that Lillie could be reasonably expected to harm herself or others due to her mental illness and that Lillie appeared unable to take care of her own basic physical needs.

On October 27, 2006, the trial court held a hearing on the petition for involuntary admission. The only issue at the hearing was whether Lillie would be unable to care for her basic physical needs. Lillie and Dr. Laura Shea, a psychiatrist, were the only two witnesses.

Dr. Shea testified that she had been a psychiatrist for 16 years and had first met and examined Lillie the morning after her admittance, October 24, 2006. Dr. Shea also examined Lillie's medical chart. Dr. Shea noted that Lillie had been diagnosed with chronic paranoid schizophrenia or chronic undifferentiated schizophrenia. Dr. Shea stated that Lillie's medical history indicated that she had been "disabled" by schizophrenia in the past. Dr. Shea stated that, during the interview, Lillie had been "too determined" to say that "nothing was wrong." Lillie's facial expression was very hard and Lillie stared at Dr. Shea. Dr. Shea recounted the hair-cutting incident that had been described in the petition and was contained in hospital records. Dr. Shea stated that Lillie was not assertive in finding out how Lillie's seven-year-old daughter was faring in Lillie's absence. Dr. Shea stated that Lillie had been showering daily, though she was not certain that was due to Lillie's own initiative. Lillie initially refused food, telling Dr. Shea that the hospital had "done something to it." On at least two occasions, Lillie asked for food but then would refuse to eat it. However, Dr. Shea stated that Lillie had been eating pretty well over the last several days.

Dr. Shea stated she believed with a reasonable degree of psychiatric certainty that Lillie, due to her mental illness, would be unable to provide for her physical needs so as to guard herself from serious physical harm. 405 ILCS 5/1-119(2) (West 2006). Dr. Shea was aware that the petition originally alleged that Lillie could be reasonably expected to harm herself or others (405 ILCS 5/1-119(1) (West 2006)), but Dr. Shea did not certify that allegation.

Dr. Shea recommended that commitment at St. John's for a period not to exceed 90 days was the least-restrictive treatment alternative. Specifically, Dr. Shea testified that she supported the treatment plan prepared by St. John's. That treatment plan stated that, prior to Lillie's admittance to the emergency room, Lillie had been living with her adult sister and had been "current with the Mental Health Center" and had seen Dr. Bland. The plan's discharge strategy included a referral back to the "Mental Health Center" and outpatient treatment once Lillie demonstrated an ability to care for herself. The estimated length of stay at St. John's was one week. At the hearing, Dr. Shea further stated:

"Could we have [Lillie stay at St. John's] but have leave to transfer her to McFarland if we need to? I'd like to see [Lillie] discharged from [St. John's] if we can since she's taken her medicine for two days. I'm not sure how to handle that."

In addition to the petition, which stated it appeared Lillie did not take care of herself and mentioned family members' concern for Lillie's well-being, Dr. Shea based her conclusion that Lillie needed to be admitted on Lillie's "basic paranoia." Dr. Shea worried that if Lillie did not trust her family or other care providers, Lillie would not be able to get shelter, food, medicine, or other necessary care. Dr. Shea would like to see evidence that Lillie's paranoia had cleared before Lillie left St. John's.

Lillie testified that she lived alone with her seven-year-old daughter. However, emergency-room records indicate that Lillie also lives with her adult sister. Lillie has also told hospital staff that she lives with her mother. Lillie stated that she wanted to cut her hair short for a change, she had merely flushed her hair down the toilet, and she had not burned her hair in the sink. When asked why she put her hair in ...

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