In re: ANGELA A., a Person Found Subject to the Administration of Psychotropic Medication and Involuntary Admission, THE PEOPLE OF THE STATE OF ILLINOIS, Petitioner-Appellee,
ANGELA A., Respondent-Appellant.
Appeal from Circuit Court of Sangamon County Nos. 12MH610 12MH645 Honorable April Troemper, Judge Presiding.
Justices Knecht and Turner concurred in the judgment and opinion.
¶ 1 Following an August 2012 hearing, the trial court found respondent, Angela A., subject to involuntary hospitalization (405 ILCS 5/3-700 (West 2010)) and involuntary administration of psychotropic medication (405 ILCS 5/2-107.1 (West 2010)). Respondent appeals, arguing (1) the trial court failed to comply with section 3-804 of the Mental Health and Developmental Disabilities Code (Mental Health Code) (405 ILCS 5/3-804 (West 2010)) when it denied respondent's request for an independent mental-health examination; (2) the trial court failed to comply with section 3-816 of the Mental Health Code (405 ILCS 5/3-816 (West 2010)) when it failed to make adequate oral or written findings of fact and conclusions of law in its orders; and (3) the State failed to prove by clear and convincing evidence that respondent lacked the requisite capacity to make a reasoned decision about her treatment (405 ILCS 5/2-107.1(a-5)(4)(E) (West 2010)). The State concedes error on respondent's first two grounds. We accept the State's concession and reverse the trial court's orders.
¶ 2 I. BACKGROUND
¶ 3 Respondent was admitted to St. John's Hospital in Springfield in March 2012 because she was experiencing psychotic episodes. She gave birth while in the hospital and the Illinois Department of Children and Family Services took the infant into protective custody. Respondent was discharged from the hospital in May with a prescription for Haldol. She reportedly failed to take her medication and was admitted to Memorial Medical Center in July 2012 after the police responded to her residence when she threatened to kill her roommate.
¶ 4 On July 26, 2012, a Sangamon County sheriff's deputy filed a petition for respondent's involuntary admission (Sangamon County case No. 12-MH-610). The petition alleged respondent suffered from a mental illness and (1) because of her illness, she was reasonably expected to engage in conduct placing her or another in physical harm or in the reasonable expectation of being harmed; (2) because of her illness, she was unable to provide for her basic physical needs without assistance so as to guard herself from serious harm; (3) she was refusing treatment and because of her illness, she was unable to understand her need for treatment and if untreated, she was expected to suffer mental or emotional deterioration. According to the petition, respondent was in need of immediate hospitalization for treatment and the prevention of harm. The petition was accompanied by two certificates completed by emergency room physician Dr. John Holland and McFarland Mental Health Center psychiatrist Dr. Arden D. Barnett. Both doctors opined that respondent was in need of immediate hospitalization to treat her mental illness.
¶ 5 On August 5, 2012, Dr. Aura Eberhardt, a psychiatrist at McFarland, filed a petition for the involuntary administration of psychotropic medication (Sangamon County case No. 12-MH-645). Dr. Eberhardt alleged respondent refused medication to treat her mental illness, and without treatment she would continue with her paranoia and psychotic state. According to Dr. Eberhardt, respondent lacked the capacity to make a reasoned decision about her treatment. The doctor sought to administer two medications (Zyprexa and Ativan) to relieve symptoms of psychosis and agitation, respectively, and Cogentin, as needed, to relieve any associated side effects. As alternatives, the doctor would try Haldol and risperidone. According to Dr. Eberhardt, the benefits of the drugs outweigh the potential harm.
¶ 6 On August 10, 2012, the trial court and the parties convened for a hearing on both petitions. However, respondent requested a continuance for the purpose of obtaining an independent psychiatric examination. The court allowed the continuance.
¶ 7 On August 17, 2012, the parties reconvened and the trial court proceeded with a hearing on both petitions, considering the involuntary-admission petition first. The prosecutor advised the court that psychiatrist Dr. Zhihong Zhang had filed a second-opinion report based upon his examination of respondent. (Dr. Zhang's report was not admitted into evidence.) Respondent and her counsel advised the court she wished to have an independent evaluation by a doctor of her choice, rather than a doctor of the State's choice. The court asked if respondent was requesting a continuance. Without answering the court's question, respondent's counsel said: "I don't think—in good faith, Your Honor, she has a right to an independent evaluation, but I don't think she has a right to pick the physician of her choice so—." The prosecutor clarified that respondent could choose her own physician if she paid for the examination. If respondent wanted the State to pay for it, then Dr. Zhang was the choice. Without resolving the issue, the court proceeded to consider evidence on the merits of the first petition.
¶ 8 On the petition for involuntary admission, the State called Dr. Aura Eberhardt, respondent's treating psychiatrist. She said respondent was diagnosed with schizoaffective disorder, bipolar type in 2000 and she currently suffers from paranoid delusions and grandiose delusions. Respondent believes physicians from SIU School of Medicine (SIU) had been stealing eggs from her ovaries, using them to create babies, and selling the babies on the black market. According to Dr. Eberhardt, respondent had been hospitalized for her mental illness on at least five occasions with the last hospitalization in March 2012. She remained hospitalized for two months and was treated with the psychotropic medication Haldol. She was released with a prescription for the same.
¶ 9 Dr. Eberhardt said she began treating respondent within a week of her admission to McFarland on July 26, 2012. Respondent informed the doctor she did not take her medication because she did not need it, she was not ill, and she did not need treatment. Based on respondent's position, the doctor opined it was clear respondent was unable to understand her need for treatment due to her mental illness. Further, if not treated on an inpatient basis, respondent was reasonably expected to suffer mental or emotional deterioration and be unable to provide for her basic physical needs.
¶ 10 At the time of respondent's recent admission to the hospital, she was residing with a friend, who had advised the social worker he could no longer allow respondent to reside in his home. When Dr. Eberhardt posed the question to respondent about where she would reside upon release, respondent would not "share with us any information." She suffered from paranoia and insisted she worked as a police informant and that the government spied on her through the use of her Link card. She claimed her husband (though she is not married) was very rich. Because of his wealth, she surrendered her section 8 housing. Other than this information, respondent refused to disclose where she would live or how she would provide for herself. Her hygiene and diet were satisfactory.
¶ 11 In Dr. Eberhardt's opinion, respondent was in need of hospitalization to protect herself and others from harm. She was unable to live on her own without treatment. A treatment plan was formulated for her. She was not a candidate for a group home or a nursing home at this time. In fact, the doctor testified hospitalization was the least restrictive treatment alternative for respondent. The State introduced as an exhibit a prepared social investigation, psychiatric history, ...