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In re Wilma T.

Court of Appeals of Illinois, Third District

April 24, 2018

In re WILMA T.,
Wilma T., Respondent-Appellant. The People of the State of Illinois, Petitioner-Appellee,

          Appeal from the Circuit Court of the 14th Judicial Circuit, Rock Island County, Illinois, Circuit Nos. 17-MH-3 and 17-MH-4 Honorable Frank R. Fuhr, Judge, Presiding.

          JUSTICE WRIGHT delivered the judgment of the court, with opinion. Presiding Justice Carter concurred in the judgment and opinion.



         ¶ 1 Respondent, Wilma T., appeals from the circuit court's orders for involuntary commitment and involuntary administration of psychotropic medication, arguing the court erred by granting (1) the order for involuntary commitment where she was a voluntarily admitted patient and did not file a written request for discharge, and (2) the order for involuntary administration of psychotropic medication where respondent was not presented written information about less restrictive alternatives to medication. We reverse.

         ¶ 2 FACTS

         ¶ 3 Respondent is a 62-year-old homeless woman. On January 26, 2017, respondent was brought to the emergency room at Trinity Hospital by the police after she was found in a home that was not her own. She voluntarily admitted herself to the Robert Young Mental Health Center (Robert Young) at the hospital.

         ¶ 4 On February 17, 2017, a nurse at Robert Young filed a petition for respondent's involuntary admission. The petition stated respondent had been a voluntary admittee, but had "submitted written notice of [her] desire to be discharged." The petition further stated respondent "threatens staff members, " "is non-compliant with medications, " "is in denial of her mental illness, " and "believes she is pregnant" and married to Barack Obama. Respondent's request for discharge was not signed by respondent, but stated, "[p]atient requesting discharge, but refusing to sign." It was signed by three nurses. Simultaneously, Dr. Rickey L. Wilson filed a petition for the administration of psychotropic medications requesting that respondent receive 25 to 100 milligrams of Risperdal Consta because respondent refused medication, presented as a potential harm to others, and could not provide for her own safety in a less restrictive environment.

         ¶ 5 A hearing was held on the petition on March 2, 2017. Wilson was accepted as an expert in the field of psychiatry and general medicine. Wilson stated he was employed at Robert Young as a psychiatric hospitalist. He provided inpatient care for respondent and had seen her Monday through Friday since January 30, 2017. He had the opportunity to examine respondent and diagnosed her with chronic schizophrenia paranoid subtype. Wilson did not believe respondent was able to understand her need for treatment. He stated she refused to take medication, and he believed respondent could cause herself or others to be put into harm's way. He noted that he had observed her in an agitated state where she was threatening one of the nurses with a metal fork. Wilson did not believe respondent could care for her needs based, in part, on her recent, prior admissions at Robert Young, stating:

"I feel that because of her lack of insight she needs to be stabilized and improved before discharge. And in her present untreated condition, I do not feel that she could keep herself safe and provide for basic needs, and I base that on the fact that those three very rapid admissions prior to my arrival here, but that's in her records, showing that she could not sustain herself on an outpatient basis."

         Wilson created a treatment plan for respondent, which included medication. He noted she was also attending groups, but they were "not making a difference in her mental state." When asked if he had considered alternative treatments for respondent, Wilson stated, "She has had community support services prescribed in the past. She never complied with that[.]" With the medication, Wilson hoped respondent would stabilize within six weeks to two months. He recommended she remain at an inpatient facility. He believed respondent's condition would deteriorate.

         ¶ 6 On cross-examination, Wilson was asked if respondent was in the facility voluntarily. Wilson stated, "She would not sign a five day notice for discharge. *** But she would say that she might want to leave but then she would change her mind, so it would be considered voluntary." He further stated, "She would not sign the form, but there were two witnesses to her request to leave." The court granted the petition.

         ¶ 7 The case then proceeded to a hearing on the petition for administration of psychotropic medication. Wilson again testified as an expert and stated respondent has shown poor judgment and disruptive behavior. Based on Wilson's review of respondent's medical records, her symptoms continue because she does not take medication. He stated, "I believe that medication is warranted. She does have a history of partially responding to medication in the past." Wilson recommended Risperdal Consta injections every two weeks. He stated respondent had been on the medication previously. The appropriate response time for each of the medications was three months. Wilson stated he discussed the medication with respondent and the nurses gave her a pharmacy printout of side-effects, benefits, and risks of the proposed medication. When asked if he considered less restrictive alternatives to the medications, Wilson stated, "She is attending group therapy. It is not effective. I have offered her oral medications, which she has refused." There was no indication respondent was given written information regarding alternatives to the treatment. The court granted the petition.

         ¶ 8 ANALYSIS

         ¶ 9 On appeal, respondent argues, inter alia, that the court erred by granting (1) the petition for involuntary commitment where respondent was a voluntary patient and did not present written notice of her desire to be discharged, and (2) the petition for involuntary administration of psychotropic medication where she was not given written information regarding alternatives to the proposed treatment. The State argues this appeal should be dismissed as moot. We agree the appeal is moot, but find that the capable of repetition yet evading review exception to the mootness doctrine applies. We further find the court erred by granting the petitions based on noncompliance ...

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