Appeal from the Circuit Court of the 13th Judicial Circuit, La Salle County, Illinois. Circuit No. 13-MH-13. Honorable Daniel J. Bute, Judge, Presiding.
Penelope Smith, of Guardianship and Advocacy Commission, of Anna, for Appellant.
Brian Towne, State's Attorney, of Ottawa (Laura E. DeMichael, of State's Attorneys Appellate Prosecutor's Office, of counsel), for the People.
JUSTICE SCHMIDT delivered the judgment of the court, with opinion. Justices McDade and O'Brien concurred in the judgment and opinion.
[¶1] The State filed both a petition seeking to involuntarily commit respondent, E.F., to a treatment facility for inpatient mental health treatment and a petition for the administration of psychotropic medication. In a single order, the circuit court of La Salle County granted both petitions. Respondent appeals from the order, claiming, inter alia, that the trial court failed to conduct the necessary hearings as prescribed by statute prior to ordering the administration of psychotropic medication. Respondent further claims the State failed to provide him proper written notice of the risks and benefits of medications it sought to administer to him or alternatives to such treatment. Respondent also argues the court's order fails to properly identify which medications, and their corresponding dosages the State is authorized to administer to him.
[¶3] The State filed its petition seeking involuntary commitment of respondent on October 16, 2013. The petition specifically alleges that respondent was being detained at Illinois Valley Community Hospital pursuant to an emergency admission certificate.
[¶4] The petition continued, claiming that respondent is a person with mental illness who, due to that illness, is reasonably expected to engage in conduct likely to cause harm to him or others. Respondent refused treatment or was not adequately adhering to previously prescribed treatment. As such, the State alleged through the petition that it was necessary to involuntarily commit respondent for treatment so that he would not cause harm to him or others.
[¶5] The petition identified three witnesses who would testify that respondent " stated someone is out to get him. Wife states demons are talking to him and are in the walls trying to get him. They are telling him to take his life. Convinced wife is in danger."
[¶6] While the petition states there was only one certificate of examination attached, it appears from the record on appeal that there were actually two certificates of examination attached. One examination was conducted by Serge
Golber, M.D., and the other by Atul Sheth, M.D. Both were conducted on October 14, 2013.
[¶7] The certificates note that respondent is in need of immediate hospitalization to prevent harm to him. The certificates indicate that respondent is delusional, experienced ideas of persecution and was responding to " internal stimuli." The certificates further indicate that the respondent is " extremely paranoid" and " thinks people are out to get him." One physician described respondent's behavior as " bizarre" and noted that respondent was " responding defensively to this paranoia."
[¶8] After the State filed its original petition on October 16, 2013, the trial court entered an order appointing the public defender to represent respondent, continued the matter until October 21, 2013, for a mental health hearing, and directed the sheriff to transport respondent to and from the Illinois Valley Community Hospital as needed.
[¶9] At the October 21 hearing, the State noted that it filed a separate petition that morning seeking to allow doctors to administer psychotropic medication. The new petition included a treatment program. The hearing began and the State called Dr. Atul Sheth as its first witness.
[¶10] Dr. Sheth testified that he is a board-certified psychiatrist who examined respondent at least four or five times in the month prior to his testimony, as respondent had been visiting " several of the different emergency rooms in this area." Dr. Sheth had not seen respondent before that time.
[¶11] Respondent presented at the emergency room " feeling very paranoid about people following him and trying to attack him." During these visits, Sheth thought that respondent was cooperative. Respondent was given " prescriptions that he never filled." Sheth observed that respondent's behavior escalated as the visits continued. Respondent had been given Haldol and lorazepam in the emergency room and prescriptions for Geodon in an attempt to treat him on an outpatient basis.
[¶12] On one occasion at the emergency room, respondent grabbed a knife from his wife's purse and barricaded himself in a room, refusing any help at that time. Respondent claimed that the emergency room was bugged and felt people were watching and recording him.
[¶13] Dr. Sheth stated that during the last emergency room visit, he concluded that respondent's aggression and impulsivity had escalated to a point to where respondent was a danger to himself or others. Respondent lacked the ability to reason. Dr. Sheth ultimately diagnosed respondent with paranoid schizophrenia.
[¶14] Dr. Sheth testified that he did not believe continued attempts at outpatient treatment would be successful given the attempts in the past. He did not believe respondent to be capable of following through on any outpatient recommendations. Dr. Sheth recommended a period of commitment of 30 to 60 days. After that period, Dr. Sheth was hopeful that respondent would be " insightful enough to be treated on outpatient."
[¶15] The State rested after Dr. Sheth's testimony. The defense then called respondent's wife, Z.F., to testify. Z.F. stated that she had been married to the respondent for nine years. She believed a cause of her husband's current condition revolved around his significant struggle with alcohol for the past four or five years. He tried to " detox on his own," which led to him seeking treatment at various emergency rooms.
[¶16] Z.F. observed symptoms of jaundice, sweats, rapid heart rate, blood pressure issues, swelling of the legs, and " GI" problems in her husband. She attributed all these to his attempts to " detox" from his alcohol addiction. She indicated that her husband would routinely start to drink again, then abruptly stop. Each attempt to stop drinking resulted in his paranoia progressing.
[¶17] Z.F. described the paranoia as an expression of not feeling " safe at home or anywhere really in general." She admitted respondent went to the emergency room to deal with feelings of paranoia, but denied that Dr. Sheth ever sent respondent home with any prescriptions.
[¶18] Z.F. was at the hospital during one of respondent's visits. Respondent was in the intensive care unit " having some paranoia issues" when he grabbed her pocket knife from her purse. Respondent then backed up against the wall and " said please, I got to get out of this room. Put me in a different room." Eventually the staff and Z.F. obtained the knife from respondent and he was transferred to another room.
[¶19] Z.F. stated she believed her husband would adhere to an outpatient therapy plan. By the time she testified at the hearing, he had been hospitalized for approximately one week and she could " see him already changing." She claimed all his mental problems were caused by his attempts to stop drinking " and now that he has had a week and a half to sober up, I see a change in him."
[¶20] Following closing arguments the court informed the parties that it did not believe respondent could " handle this by" himself. It then issued a written order, dated October 21, 2013, which states:
" Following hearing on petition for involuntary mental health treatment, the court hereby finds that the respondent is in need of inpatient mental health treatment. Defendant is remanded to the care and custody of OSF St. Elizabeth for transfer to DHS. Petition for psychotropic medication as outlined ...