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In Re Dawn H., Alleged To Be A Person Subject To Involuntary Treatment v. Dawn H

August 20, 2012


Appeal from the Circuit Court of Kane County. No. 11-MH-118 Honorable Susan Clancy Boles Judge, Presiding.

The opinion of the court was delivered by: Presiding Justice Jorgensen

PRESIDING JUSTICE JORGENSEN delivered the judgment of the court, with opinion. Justices Hutchinson and Schostok concurred in the judgment and opinion.


¶ 1 In September 2011, the trial court authorized the involuntary administration of psychotropic medication to respondent, Dawn H., for a period of 90 days. 405 ILCS 5/2-107.1 (West 2010). We decline to dismiss this appeal as moot, but we affirm the trial court's order.


¶ 3 Respondent, age 30, has a 12-year history of mental illness. Specifically, respondent has been diagnosed with bipolar disorder with psychosis. Respondent first became symptomatic following the birth of her first child (respondent's two children are now in the custody of respondent's mother). According to respondent's mother, respondent has had "revolving door type hospitalizations" throughout the past decade and has been consistently noncompliant with treatment recommendations.

¶ 4 The instant episode can be traced back to April 2011, when respondent was jailed for scratching two male victims in the face. While in jail, respondent exhibited a state of psychosis and was placed in the jail medical unit. There, she went 30 days without showering, was unable to interact with others, and talked to herself. In the middle of her jail stay, she was taken to a custody hearing concerning her children. There, she got into a verbal altercation with officers of the court and spit in the faces of three officers, leading to her removal from the courtroom.

¶ 5 Respondent was subsequently placed in the Elgin Mental Health Center, and in September 2011, her treating psychiatrist, Dr. Donna Luchetta, petitioned for the involuntary administration of psychotropic medication. Luchetta averred in the petition that, for two weeks, she had observed respondent on a daily basis during group and individual interviews. Luchetta collected information about respondent's behavior from health center staff and from jail progress notes.

¶ 6 Luchetta requested the court's permission to administer the following medications with specified alternatives should the proposed medications prove ineffective or difficult to administer:

(1) lithium (or divalproex or carbamazepine) for mood stabilization; (2) olanzepine (or risperidone or haloperidol or fluphenazine) for treatment of psychosis; (3) lorazepam for agitation; (4) fluvoxamine for anxiety; (5) aripiprazole for depression; and (6) diphenhydramime, i.e., Benadryl (or benztropine), to prevent side effects (not a psychotropic medication). Additionally, Luchetta requested authorization to perform procedures to monitor for side effects; these procedures included urinalysis, EKGs (electrocardiogram tests), and blood tests.

¶ 7 At the hearing on the petition, Luchetta testified that she observed respondent's bipolar disorder with psychosis manifested in respondent's loud, argumentative behavior; monopolizing and hyperverbal speech; hypergraphia (writing unprompted five- and six-page letters to judges, requesting that they help her find a home, even though she was housed in the health center at the time); delusions (reporting to others that the health center staff were, in effect, killing her because they did not allow her food when, in fact, she received three meals per day plus snacks); grandiose delusions (repeatedly stating that she is perfect); and impaired judgment (previously having been unable to secure housing despite receipt of a $700-per-month social security check). Additionally, while at the health center, respondent called the Will County courthouse and told the person who answered the phone that she had a gun to her head and was going to kill herself.

¶ 8 Luchetta further testified to an incident where health center staff administered three medications under a "restriction of rights" policy. On that occasion, respondent threatened others and exhibited loud, hostile behavior. The medications were: (1) haloperidol for psychosis; (2) lorazepam for agitation; and (3) diphenhydramime to prevent side effects. The medications treated the targeted conditions without side effect. However, following that incident, respondent has refused medication, hence the instant petition. Luchetta stated that, due to respondent's paranoia, respondent was unable to make reasonable decisions concerning her own treatment.

¶ 9 Finally, in 12 transcript pages of direct testimony and 5 transcript pages of cross-examination, Luchetta testified to the purpose, dosage, and potential risks and side effects of each drug listed in the petition. As to the purpose, Luchetta testified as stated in the petition and as set forth above as to each drug (i.e., for mood stabilization, for treatment of psychosis, for agitation, for anxiety, and for depression). Luchetta testified extensively concerning risks, much of which was elicited during cross-examination. At one point, Luchetta testified to which specific drugs within a certain class were preferred based on the likelihood of fewer or less severe side effects: "The reason why carbamazepine is such an effective mood stabilizer is because it doesn't have many of the side effects that you might have with either lithium or divalproex sodium, yet you do have very significant mood-stabilizing benefits."

ΒΆ 10 In closing, respondent's attorney argued: "The benefits may be somewhat apparent, but it is very clear that the [negative] effects of this medication, contrary to [Luchetta's] minimizing it, *** are enough to give this court some pause in ordering them." In other words, respondent virtually conceded the benefits of treatment and did not question the amount of testimony concerning risks; rather, respondent thought the risks so grave as to preclude treatment. The court rejected respondent's argument and found that the statutory factors for the involuntary administration of psychotropic medication were met by clear and convincing ...

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