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In re Hannah E.

September 28, 2007

IN RE HANNAH E., ALLEGED TO BE A PERSON SUBJECT TO INVOLUNTARY ADMISSION
(THE PEOPLE OF THE STATE OF ILLINOIS, PETITIONER-APPELLEE,
v.
HANNAH E., RESPONDENT-APPELLANT).



Appeal from the Circuit Court of Cook County. No. 06 CoMH 1424 The Honorable Marcia Maras, Judge Presiding.

The opinion of the court was delivered by: Presiding Justice Fitzgerald Smith

Published opinion

Respondent-appellant Hannah E. (respondent) appeals the trial court's grant of petitioner-appellee People of the State of Illinois' (State) petition for involuntary admission. Respondent contends that her hearing was not conducted in a timely manner, the certificate supporting the petition was invalid, the State did not prove harm by clear and convincing evidence, and the trial court erroneously failed to consider and use a least restrictive alternative disposition to commitment. Respondent asks that we reverse the trial court's order. For the following reasons, we affirm.

BACKGROUND

The underlying facts regarding this cause have been set forth adequately in the related case of In re Hannah E., 372 Ill. App. 3d 251 (2007), dealing with the first of three commitment orders involving respondent. We restate herein only what is necessary for the disposition of the instant cause.

An involuntary commitment order for respondent was issued on January 6, 2006, based upon a petition filed by the State and supported by a certificate from Mae Wormely, an employee of the City of Chicago's department of animal care and control, and a certificate from respondent's psychiatrist. Testimony at the ensuing hearing indicated that respondent, who had been keeping a multitude of living and deceased domesticated and nondomesticated animals in her Chicago home, had threatened Wormely after Wormely had entered her home to remove the animals; that she had threatened Rita Sattler, an aide to respondent's alderman, following court cases resulting in the removal of respondent from her home due to building code violations and its deplorable condition; and that she, upon her arrival at Chicago Read Mental Health Center (Chicago Read), suffered from mental illness. See Hannah E., 372 Ill. App. 3d 253-55. While in the care of doctors, respondent told them she owned three guns which she insisted she kept in the suburbs and not within city limits; however, upon investigation, two guns were found in respondent's Chicago home and the third was never recovered. See Hannah E., 372 Ill. App. 3d at 253-56. Further investigation revealed ammunition, holsters, handcuffs and mace in respondent's home as well. Respondent appealed her involuntary commitment, but we affirmed. See Hannah E., 372 Ill. App. 3d at 259-60.

When respondent's involuntary commitment expired on April 6, 2006, a second involuntary commitment petition was filed. This was later dismissed because respondent signed an application for voluntary admission, and she remained at Chicago Read. Following the expiration of this second order, respondent did not renew her voluntary admission and instead wanted to be released from Chicago Read. Adrienne Mazique, respondent's social worker, filed a third petition for involuntary commitment on behalf of the State, which is the basis of the current appeal. In the petition, Mazique stated that respondent was mentally ill and expected to inflict harm to herself or others. A hearing was held on this petition in June and July 2006.

In addition to Wormely and Mazique, David Zempich, a technician at Chicago Read, testified that on April 11, 2006, he saw respondent leave her room and approach the nurses' desk yelling that she had not received her medication. After the charge nurse explained to respondent that all medications had been dispensed, security was called to perform a room check. Zempich testified that he, the nurse and a security guard entered respondent's room and he asked respondent if she would cooperate with the room search; respondent ignored Zempich, and the nurse then ordered Zempich to search respondent. When Zempich attempted to remove a pen from respondent's hand so he could search her, she tried to bite his wrist. Zempich pulled away, but respondent grabbed Zempich's hand and scratched him three or four times, leaving scars.

Several doctors also testified at the hearing. Dr. Charles Stiava, respondent's treating psychologist at Chicago Read from January to May 2006, conducted several psychological tests and, in a report dated February 9, 2006, found that respondent suffered from major depression and had pronounced rebelliousness and belligerence consistent with a diagnosis of paranoid personality disorder. Though he did not indicate in the report that respondent had a desire to hurt herself or others, Dr. Stiava noted that her paranoid personality disorder could possibly lead to violence, particularly because respondent's third gun was still missing and because she had lied about the location of the guns that already had been found. Dr. Stiava also concluded that if respondent left Chicago Read and returned home, to where she was not allowed to go pursuant to court order, and if she were confronted there or told to leave, she could be a danger.

Dr. Evelyn Morales, respondent's psychiatrist from February to May 2006, was one of two doctors who filed a supporting certificate to Mazique's petition for respondent's involuntary commitment. Dr. Morales based her certificate on her observations of respondent, her examination of respondent's medical charts, and conversations she had with respondent's other physicians. Dr. Morales testified that she examined respondent and found her to be mentally ill and reasonably expected to inflict serious physical harm to herself or others in the near future. She based this on respondent's threat to Wormely and on respondent's behavior during the period in which Dr. Morales treated her.

Dr. Flora Baetiong, respondent's current attending psychiatrist as of May 2006 and the second doctor who filed a supporting certificate to Mazique's petition for involuntary commitment, testified that she first diagnosed respondent with major depression and paranoid personality disorder and it was her opinion that respondent still suffered from these. She based this on respondent's previous medical records, her medical history, and Dr. Baetiong's direct observations and conversations with respondent. Dr. Baetiong testified that respondent was currently refusing medication, was very upset and depressed that she had been ordered to vacate her home, and believed that the City of Chicago was out to ruin her life. Considering respondent's previous threat to Wormely and the fact that the third gun was still missing, Dr. Baetiong stated that she was concerned about discharging respondent from Chicago Read because there was a reasonable probability that respondent would harm others. Dr. Baetiong further testified that it was her recommendation that respondent remain hospitalized, as less restrictive alternatives were considered and presented to respondent (including going to live with a friend in the suburbs) but respondent refused them and wanted only a complete discharge so she could return to her own home.

On respondent's behalf, Dr. Robert Sharpe testified that he conducted an independent examination of her in February 2006 and again in June 2006. In his initial exam, he concluded that respondent did not have a personality disorder but, rather, was bipolar. His later exam noted that respondent did not have a propensity to violence, was not experiencing hallucinations or delusions, and there was no indication of risk of harm to herself or others. It was Dr. Sharpe's opinion that respondent should not be subject to involuntary hospitalization at this time. However, Dr. Sharpe admitted that he never spoke to or consulted with any of respondent's former or current treating psychiatrists and that his evaluations of her resulted from only "nominally" observing her for 45 minutes. Dr. Sharpe also noted that respondent had made only limited progress in terms of her hospitalization and that she was continuing to refuse any medications.

On July 17, 2006, at the close of the hearing, the trial court ordered respondent subject to involuntary commitment. In its lengthy colloquy, the court explained that from all the evidence, it was clear that respondent suffers from a mental illness. It commented that while the doctors could not all agree on one exact diagnosis, Drs. Baetiong, Stiava and even Sharpe agreed in one way or another that respondent had a character trait of paranoid personality disorder. Regarding the existence of a risk of harm to herself or others, the court noted that Dr. Baetiong had testified that the object of respondent's paranoia was the City of Chicago and any of its employees who would attempt to enforce the current court orders removing her from her home; the court remarked that several witness had testified to respondent's insistence that upon her discharge, she would undoubtedly return to live there even though this was prohibited. The court further discussed the fact that respondent had lied about the location of her guns and that only two had been found, as well as the fact that she had threatened Wormely and Sattler, had hurt Zempich, and was diagnosed by Dr. Stiava as having a pronounced rebelliousness to authority. In reviewing Dr. Sharpe's opinion, the court stated that he spent only 45 minutes with her during 2 examinations and had admitted on cross-examination that he had not spoken to any of respondent's psychiatrists and did not know anything about the incidents in which she was involved. Accordingly, the court held that the State had "met its burden and shown by clear and convincing evidence that Respondent suffers from a mental illness *** [and] is reasonably expected to cause harm to others."

The court then examined whether a "least restrictive alternative" to continued hospitalization was viable in this case. The court recalled the testimony of several witnesses discussing Dr. Baetiong's offer of a care and custody order which would have allowed respondent to live with a friend in the suburbs and complete aftercare there, and respondent's rejection of it in favor of returning to her home in Chicago. This, along with the opinions of Dr. Baetiong, Dr. Stiava and social worker Mazique that respondent should not return home, and the court orders prohibiting such a return, comprised the basis of the court's holding that, "at this time a locked facility is the most appropriate place for Respondent and [the] least restrictive alterative."

ANALYSIS

As a threshold matter, just as it did in the related appeal involving respondent's first involuntary commitment order, the State argues here that this appeal is moot because the July 17, 2006, order involuntarily committing respondent has expired. See Hannah E., 372 Ill. App. 3d at 257. However, we recall the proposition we cited in our prior decision in response to this: " 'although the order under review is expired, review of an involuntary admission order is nevertheless appropriate because "the collateral consequences related to the stigma of an involuntary admission may confront respondent in the future." ' " Hannah E., 372 Ill. App. 3d at 257, quoting In re Gail F., 365 Ill. App. 3d 439, 444 (2006), quoting In re Splett, 143 Ill. 2d 225, 228 (1991). Accordingly, having taken into consideration the arguments presented by both parties regarding mootness, we choose to exercise our review over the instant cause. See, e.g., In re Louis S., 361 Ill. App. 3d 763, 767-68 (2005) (even though involuntary commitment order expired, case would be reviewed on appeal as the respondent had history of mental illness and history of prior involuntary hospitalizations).

I. Timeliness

Addressing the merits of the case, respondent first contends that the commitment order must be reversed since her hearing was not completed in a timely manner pursuant to section 3-800(b) of the Mental Health and Developmental Disabilities Code (Code) (405 ILCS 5/3-800(b) (West 2004)), as there were continuances granted beyond the mandated 15 days that she had not requested. According to respondent, apart from two continuances that were attributable to her, her cause should have been resolved no later than June 30, 2006, and the trial court violated her strict procedural protections by extending this to July 17, 2006. For its part, the State maintains that respondent has waived this issue for review since she failed to raise it in the trial court; the State further argues that, based on the facts and circumstances of this case, the continuances were necessary and attributable to respondent.

We note that the State is correct that respondent has waived this issue for review. See In re Nau, 153 Ill. 2d 406, 417 (1992) (involuntary admittee waived untimeliness of petition when failed to raise timeliness objection at ...


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