Court of Appeals of Illinois, First District, Second Division
from the Circuit Court Of Cook County. No. 02 CR 28384 The
Honorable Earl Hoffenberg, Judge Presiding.
JUSTICE NEVILLE delivered the judgment of the court, with
opinion. Presiding Justice Hyman and Justice Pierce concurred
in the judgment and opinion.
1 In 2005, a court found Sean Gunderson, charged with
attempted murder, not guilty by reason of insanity. Gunderson
petitioned for discharge from the custody of the Department
of Human Services (DHS) in 2015. The trial court denied the
petition. On appeal, Gunderson argues that section 5-2-4(g)
of the Unified Code of Corrections (Code) (730 ILCS
5/5-2-4(g) (West 2014)) violates his right to due process,
because it requires him to prove by clear and convincing
evidence that he no longer suffers from a mental illness. We
find the statute constitutional. Accordingly, we affirm the
trial court's judgment.
3 In 2002, Gunderson cut the throats of his mother, his
father, and his grandmother. Prosecutors charged him with
attempted murder and aggravated battery. Following a bench
trial, the court found Gunderson not guilty by reason of
insanity. He has remained in the custody of DHS since the
4 In April 2015, Gunderson filed a motion for discharge from
DHS, or for on-grounds pass privileges. At the hearing on the
motion, Gunderson's mother testified that she spoke with
and visited Gunderson frequently throughout his confinement,
and she believed that he had recovered from his illness. She
believed that he did not present a threat of harm to anyone.
If DHS released Gunderson, Gunderson could live with his
5 Dr. Vikramjit Gill, who began treating Gunderson in July
2014, recommended the on- grounds pass privileges. According
to Dr. Gill, Gunderson no longer showed any symptoms of
mental illness. Dr. Gill had not prescribed any medication
for Gunderson. Dr. Gill described Gunderson as a
high-functioning patient, with schizophrenia in remission,
who had progressed well without medication since 2011.
6 Faye Edlund, a social worker who had served on
Gunderson's treatment team since February 2013, testified
that no one on the treatment team recommended discharge for
Gunderson. Edlund never saw Gunderson act aggressively, and
she saw no overt signs or symptoms of schizophrenia. She
signed onto the recommendation for on-grounds passes, so that
the treatment team could assess how well Gunderson could
handle increased freedom.
7 Martha Welch, a psychologist who reviewed the treatment
team's recommendation, agreed that Gunderson should have
on-grounds passes. She interviewed Gunderson and members of
the treatment team and concluded that Gunderson presented
little risk of violent behavior.
8 Dr. Mathew Markos, who examined Gunderson four times in
2003 and 2004, interviewed Gunderson briefly in April 2015 to
determine whether to support the treatment team's
recommendation. In Dr. Markos's opinion, schizophrenia is
always a lifelong illness that patients can control only with
antipsychotic medication. Dr. Markos found that Gunderson
showed several signs of continuing schizophrenia. First,
Gunderson spoke rapidly during the interview. Dr. Markos
asked Gunderson whether Gunderson had a mental illness. Dr.
Markos testified that Gunderson answered, "I have
disconnections with reality I tend to attribute to spiritual
reasons; when I was 17, I wasn't living healthy. There
was an unresolved spiritual crisis." Dr. Markos
characterized the response as "delusional." Dr.
Markos added, "He's not in touch with reality. He
lacks insight. He will not take his medication, and
that's just not the way to proceed with schizophrenia
illness." Dr. Markos could not understand why Dr. Gill
decided not to prescribe antipsychotic medication for
9 Dr. Markos did not know of any studies that support his
assertions, but he knew of no instance in which a
schizophrenic patient recovered without remaining on
antipsychotic medication for life. Because Dr. Gill did not
prescribe antipsychotic medication for Gunderson, Dr. Markos
opposed the request for on-grounds pass privileges.
10 Dr. Toby Watson, who has a degree in clinical psychology,
testified about long-term studies of schizophrenia. Dr.
Watson said that every controlled study of patients treated
for more than one year showed that schizophrenic patients
given minimal medication, or no medication at all, had much
better recovery rates than patients treated regularly with
antipsychotics. Dr. Watson explained that antipsychotic
medication blocks dopamine, and thereby produces the
immediate effect of reducing hallucinations and delusions.
But after extended dopamine deprivation, the brain
compensates by finding ways to produce more dopamine. To
continue controlling the brain, doctors usually need to
increase the dosage of antipsychotics. The antipsychotics
have side effects that damage the brain. Dr. Watson testified
that "outcome studies have been showing that people who
stay on medication can chronically become disabled and
mentally ill potentially for life."
11 Dr. Watson said that he found no studies showing that
treatment for more than one year with antipsychotics improved
results for schizophrenic patients. In response to a question
from Gunderson's attorney, Dr. Watson said, "What do
you call it if somebody believes something and all the
overwhelming evidence says contrary to that? *** I mean,
it's delusion." Dr. Watson then related the course
of his own beliefs on the issue. All of his professors taught
that one must use antipsychotic drugs to treat schizophrenia,
and he fully accepted the teaching. His opinion gradually
changed in light of the studies he read. The prosecutor,
claiming that Dr. Watson's testimony implied that Dr.
Markos suffered from delusions about the nature of
schizophrenia, asked Dr. Watson whether ...