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In Re Bobby F., Alleged To Be A Person of Subject To Involuntary Treatment With Psychotropic Medication v. the People of the State of Illinois

June 1, 2012


Appeal from the Circuit Court Randolph County. No. 11-MH-39 Honorable Richard A. Brown, Judge, presiding.

The opinion of the court was delivered by: Justice Wexstten

Rule 23 order filed 2012 IL App (5th) 110214 April 16, 2012;Motion to publish granted

JUSTICE WEXSTTEN delivered the judgment of the court, with opinion. Presiding Justice Donovan and Justice Goldenhersh concurred in the judgment and opinion.


¶ 1 The respondent, Bobby F., appeals from an order of the circuit court of Randolph County granting the State's petition to involuntarily administer psychotropic medication to him. On appeal, the respondent argues that the court's decision should be reversed because, inter alia, the circuit court's order violated the respondent's due process rights and failed to specify the dosage for all the medications authorized. We reverse.


¶ 3 The respondent is a 31-year-old male who was admitted to Chester Mental Health Center on January 8, 2011, after transferring from Singer Mental Health Center. The respondent has 12 times been admitted to the Department of Human Services, including 6 admissions to Chester Mental Health Center.

¶ 4 On April 4, 2011, Dr. Terrence Casey, a Chester Mental Health Center psychiatrist, filed a petition alleging that the respondent was a person subject to the involuntary administration of psychotropic medication pursuant to section 2-107.1 of the Mental Health and Developmental Disabilities Code (the Code) (405 ILCS 5/2-107.1 (West 2010)). In the form petition, Dr. Casey alleged, inter alia, that the respondent was given a written list of side effects. Dr. Casey added the following information to the petition:

"Antipsychotic medications are used to decrease and remit psychotic symptoms such as delusions as well as alleviate disorganized and confused thought process. They also reduce the possibility of hostile behaviors and control[ ] his aggressive and violent acting out behaviors. They can cause shakes and muscle spasms, sedation, and occasionally they can cause serious complications such as Neuroleptic Malignant Syndrome and Tardive Dyskinesia[;] however these can be detected and monitored to prevent serious dysfunction or discomfort, with the administration of medications to alleviate side effects, as well as using the least effective doses of the medication.

Mood stabilizers are used to stabilize mood, alleviate impulsivity as well as control[ ] aggressive behaviors. They also augment the effects of antipsychotic medications. Side effects include sedation, dizziness, upset stomach, blood cell suppression, effects on liver function and thyroid function but this can be offset by observation, regular laboratory work-up including blood levels to guide the best dose and to discontinue them if necessary.

Anxiolytic medications are used to alleviate anxiety, tension, restlessness, and agitation. They could cause sedation, incoordination, memory difficulties and dependence but this can be assessed by ongoing monitoring, and alleviated by using the minimum effective doses and discontinuing if side effects are intolerable."

¶ 5 On April 13, 2011, at the hearing on the petition, Dr. Casey testified that the respondent suffered from "bipolar one disorder, most recent episode manic, severe with psychotic features." Dr. Casey testified that the respondent exhibited severe mania, grandiose delusions, very rapid pressured speech, and tangential flight of ideas. Dr. Casey testified that since being admitted to the hospital, the respondent had deteriorated, had verbally threatened staff or peers, and had caused the staff to impose seclusion and restraints.

¶ 6 Dr. Casey testified that he had recommended the medications Zyprexa and Depakote to the respondent, but the respondent had refused to sign a consent for Zyprexa, stating that he preferred Abilify. Dr. Casey testified, however, that he had previously prescribed the maximum dose of Abilify, and the respondent continued to deteriorate. Dr. Casey testified that the respondent had, in the past, made significant improvement when prescribed Zyprexa and, while on a Zyprexa regimen, had twice been discharged. Dr. Casey testified that most recently he had administered Zyprexa as an emergency-enforced medication for the respondent and had noticed that the respondent's speech became less pressured and less rapid, and the staff had reported his improvement.

¶ 7 Dr. Casey testified that the respondent lacked the mental capability to understand his need for medication. Dr. Casey testified that he had given the respondent a written list of any side effects. Dr. Casey testified that the benefits of the respondent taking his medication outweighed the possible side effects. Dr. Casey testified that less restrictive services were provided to the respondent but were determined to be inappropriate because of his aggressive behavior.

¶ 8 When asked the exact medications he was seeking the court to enforce, Dr. Casey replied:

"Well, his current medications, he's on valproic acid, the Depakote. He gets 1500 milligrams in the morning--I'm sorry--2,000 milligrams in the morning and 1500 milligrams at night. His blood level is therapeutic. It's 93.6 on that medication. He's on Clonazepam 2 milligrams t.i.d., three times a day. We have his p.r.n. of Haldol and Ativan, five Haldol, two Ativan. And he's on Zyprexa. And right now that's being titrated up. He's--right now he gets ten in the morning, five at night, and ten at--ten in the morning, five in the afternoon, and ten at night."

Dr. Casey testified that although the respondent complained of photophobia, an extreme aversion to light, as a side effect of Zyprexa, Dr. Casey did not witness any ...

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