In re Michelle L. ( 2007 )

NO. 4-06-0599 Filed 4/13/07
IN THE APPELLATE COURT
OF ILLINOIS
FOURTH DISTRICT
In re: MICHELLE L., a Person Found ) Appeal from
Subject to Involuntary Admission, ) Circuit Court of
THE PEOPLE OF THE STATE OF ILLINOIS, ) Sangamon County
Petitioner-Appellee, ) No. 06MH422
v. )
MICHELLE L., ) Honorable
Respondent-Appellant. ) George H. Ray,
) Judge Presiding.
JUSTICE APPLETON delivered the opinion of the court:
The trial court ordered the involuntary admission of
respondent, Michelle L., to a mental-health facility. She
appeals on two grounds: (1) the court should have allowed her to
be a voluntary patient; and (2) the State failed to prove, by
clear and convincing evidence, that she was a "person subject to
involuntary admission" (405 ILCS 5/1-119 (West 2004)). We
disagree with both contentions and affirm the judgment.
I. BACKGROUND
According to the petition for involuntary admission,
respondent needed immediate hospitalization for two reasons.
First, she had a mental illness because of which she was "reason-
ably expected" to inflict serious physical harm upon herself or
someone else. See 405 ILCS 5/1-119(1) (West 2004). Second, this
illness incapacitated her from providing for her own basic
physical needs and guarding herself from serious harm. See 405
ILCS 5/1-119(2) (West 2004).
In the hearing on the petition, respondent’s attorney
told the trial court:
"MR. CONROY: *** Your Honor, last week
we had this hearing, and [respondent] ex-
pressed [a] desire to sign a voluntary appli-
cation form, and the case was continued until
today in the hope[] that that would occur.
She would still like to sign a voluntary
admission form, but[,] apparently, there is
an objection from the State[.] [U]nder
[s]ection 3-801 [of the Mental Health and
Developmental Disabilities Code (Code) (420
ILCS 5/3-801 (West 2004))], [r]espondent may
request admission as an informal or voluntary
recipient, and she is doing that at this
time.
THE COURT: Response, Miss Carey?
MRS. CAREY-RYAN [(assistant State’s
Attorney)]: The State would object. Her
treating physicians at this time do not feel
that she could sign a voluntary admission.
MR. CONROY: Why could that be?
MRS. CAREY-RYAN: They feel that she
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would sign it and then ask to be released,
which would be her right.
MR. CONROY: Well, it would not be her
right to be released, and think the facility
here knows what the procedure--
THE COURT: What is the section that you
mentioned, Mr. Conroy?
MR. CONROY: [Section] 3-801.
THE RESPONDENT: May I speak?
THE COURT: The facility director will
not approve of her being a voluntary patient?
MR. CONROY: Well, apparently, I guess
that’s the position. I’m not sure. But the
reasoning, as I understand it, is that she
might sign a five-day notice in the future,
and, of course, this is--I mean, it’s
just--to the degree that that’s a valid ob-
jection, it just doesn’t seem to ever happen.
We just never see any five-day notice cases.
At any rate, even if it did happen, that
would be her right, and when Miss Carey
states that it would be her right to ***
leave the facility, that, of course, is not
true. She would not have to be allowed to
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leave the facility, and if the facility felt
that a petition for involuntary admission was
factually supportable, then they would go
ahead and file that.
THE RESPONDENT: I need time to find
another doctor. The one I have right now--
THE COURT: Find another doctor where?
THE RESPONDENT: Here. He is giving me
medication that[,] I find[,] is giving me
troubled and jumbled thoughts, and I would
not--I had a doctor, but I would not jump to
conclusions and do as you expect.
THE COURT: Dr. Myers, you are the agent
of the facility director, I take it, today,
so--
DR. MYERS: Yes.
THE COURT: And the facility director
will not approve her being a voluntary pa-
tient?
DR. MYERS: Well, I think that she’s
indicating here that she really isn’t satis-
fied with the treatment she's receiving, and
that indicates to me that, you know, that if
she doesn't get exactly what she wants, she
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would sign a five-day notice and we’d be
doing this again, so I think that--I mean,
we'd be doing the court proceedings again
very shortly, so I think that we need to
proceed with the hearing.
THE COURT: You may proceed, [Prosecu-
tor]."
The State called the clinical psychologist whom the
trial court addressed earlier, James E. Myers. He testified he
had examined respondent and reviewed her medical records and, in
his opinion, she was suffering from a bipolar disorder. He
further opined that because of this illness, she was "reasonably
expected to inflict serious physical harm on herself."
Carey-Ryan asked him:
"Q. What is the factual basis for this
opinion [that respondent was reasonably ex-
pected to harm herself]?
A. [S]ince [respondent] has been hospi-
talized, she's exhibited multiple examples of
self-injurious behavior, including throwing
*** herself into a sink in the wall, and as
recently as two days ago, *** she was banging
her head on the floor, and these examples of
self-injurious behavior have occurred on
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other occasions as well, but[,] also, she's
exhibiting other symptoms of mental illness
on the treatment unit."
Myers had drafted a treatment plan, admitted into evidence as
People's exhibit A. He recommended an initial period of commit-
ment of 90 days, which, in his view, was the least-restrictive
alternative.
Respondent then took the stand in her own behalf. She
testified that the medicine she was presently taking was "very
different from [her] previous doctor's selection": it made her
groggy and unable to order her thoughts. These side effects put
her "under tremendous duress" and made her frightened and angry.
She "need[ed] to be back on the medications [she] was taking
before" so that she could pursue her dream of "start[ing] a small
business in textiles." She denied having any present inclination
to harm herself; she "loved [herself]." Because the new medicine
had turned her mind into a blur, she could not remember jumping
into a sink in the wall. If she did so, she was only "trying to
get free" of the medicine and her environment: "[i]t was experi-
mental because [she was] so bored and pent up [t]here. It was
brought on by stress and boredom and feeling confined."
Conroy asked respondent:
"Q. If you were allowed to leave today,
where would you go?
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A. I would work with my caseworker and
the mental health facility in
Champaign-Urbana [with which] I've worked ***
for many, many years and get back going to
classes, get back with my psychiatrist, Dr.
Sue, and the pills I was taking and get my
mind cleared."
The trial court found, by clear and convincing evi-
dence, that respondent suffered from a mental illness that could
cause her to harm herself and that hospitalization for up to 90
days was the least-restrictive alternative.
This appeal followed.
II. ANALYSIS
A. The Request for Voluntary Admission
Respondent claims it was error to proceed with the
hearing on the petition for involuntary admission after she
offered to sign a voluntary-admission form. Section 3-801 of the
Code provides as follows:
"A respondent may request admission as
an informal or voluntary recipient at any
time prior to an adjudication that he is
subject to involuntary admission. The facil-
ity director shall approve such a request
unless the facility director determines that
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the respondent lacks the capacity to consent
to informal or voluntary admission or that
informal or voluntary admission is clinically
inappropriate. The director shall not find
that voluntary admission is clinically inap-
propriate in the absence of a documented
history of the respondent's illness and
treatment demonstrating that the respondent
is unlikely to continue to receive needed
treatment following release from informal or
voluntary admission and that an order for
alternative treatment or for care and custody
is necessary in order to ensure continuity of
treatment outside a mental[-]health facility.
If the facility director approves such a
request, the court may dismiss the pending
proceedings but may require proof that such
dismissal is in the best interest of the
respondent and of the public." 405 ILCS
5/3-801 (West Supp. 2005).
Respondent does not dispute that the facility director denied her
request for voluntary admission. Nor does she complain, specifi-
cally, of a lack of documentation (an oral history as opposed to
a "documented history"). Instead, she complains of a lack of
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evidence to support the denial. According to her, the facility
director had no evidence that she lacked the capacity to consent
to voluntary admission or that voluntary admission was "clini-
cally inappropriate."
Speaking for the facility director, Myers deemed
voluntary admission to be "clinically inappropriate" for respon-
dent (although he did not use that terminology). Because respon-
dent was dissatisfied with the treatment she was receiving at the
facility, he foresaw that if her request to be a voluntary
patient were allowed, she would forthwith submit a request for
discharge, necessitating the filing of another petition for
involuntary admission within five days thereafter. See 405 ILCS
5/3-403 (West 2004). Thus, respondent was "unlikely to continue
to receive [the] needed treatment following release from informal
or voluntary admission and *** an order *** for care and custody
[was] necessary to ensure continuity of treatment." 405 ILCS
5/3-801 (West Supp. 2005). The hearing tended to show that Myers
was correct, for when respondent took the stand, all she could
speak of was "get[ting] free" of her medication and environment.
We recognize the policy of encouraging voluntary
admissions. In re Byrd, 68 Ill. App. 3d 849, 854, 386 N.E.2d
385, 388 (1979). This policy "is based on psychiatric evidence
indicating that a patient who recognizes his [or her] condition
and voluntarily undertakes treatment can more likely be rehabili-
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tated than one upon whom therapy is forced." In re Bennett, 251
Ill. App. 3d 887, 889, 623 N.E.2d 942, 944 (1993). Because
respondent, by her own admission, wished to quit taking her
medication and leave the facility immediately, this rationale was
inapplicable to her, and she was not a viable candidate for
voluntary admission. See In re Hall, 92 Ill. App. 3d 1136,
1137-38, 416 N.E.2d 731, 732 (1981). Signing a five-day notice
appeared to be more than a theoretical possibility in her case.
Cf. Byrd, 68 Ill. App. 3d at 855, 386 N.E.2d at 389 ("even if
Byrd as a voluntary admittee could seek his release by filing a
five-day notice, we believe that fact alone should not prevent
him from exercising his right *** to seek a voluntary admis-
sion").
B. Evidence That Respondent Was a "Person Subject
to Involuntary Admission"
To order respondent's involuntary admission to a
mental-health facility, the trial court had to find, by clear and
convincing evidence, that she was a "[p]erson subject to involun-
tary admission" as defined in section 1-119 of the Code (405 ILCS
5/1-119, 3-700, 3-808 (West 2004)) and that involuntary admission
was "the least[-]restrictive alternative" (405 ILCS 5/3-811 (West
2004)). We review the court's factual findings with deference,
asking whether they are against the manifest weight of the
evidence. In re Nancy A., 344 Ill. App. 3d 540, 554, 801 N.E.2d
565, 579 (2003), appeal denied, 207 Ill. 2d 604, 807 N.E.2d 975
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(2004). A finding is against the manifest weight of the evidence
only if the opposite conclusion is apparent or the finding is
unreasonable, arbitrary, or not based on evidence. Nancy A., 344
Ill. App. 3d at 554, 801 N.E.2d at 579.
Section 1-119(1) of the Code defines a "[p]erson
subject to involuntary admission" to include "[a] person with
mental illness and who because of *** her illness is reasonably
expected to inflict serious physical harm upon *** herself *** in
the near future." 405 ILCS 5/1-119(1) (West 2004). Respondent
argues that "absent direct evidence of dangerous or threatening
occurrences from any witnesses, Dr. Myers failed to clearly and
convincingly establish that the respondent was reasonably ex-
pected to soon threaten or inflict serious physical harm upon
herself due to her mental illness." We find such evidence in the
record. "In determining whether a person meets the criteria
specified in [section 1-119(1)], the court may consider evidence
of the person's repeated past pattern of specific behavior and
actions related to the person's illness." 405 ILCS 5/1-119 (West
2004). Myers testified that respondent threw herself into a sink
and beat her head on the floor. Respondent thereby repeatedly
put herself in serious physical danger. According to respondent,
she did these things only because of her medication and involun-
tary commitment, but the trial court did not have to believe her;
it could have concluded that she did these things because she was
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suffering from bipolar disorder.
In the hearing, respondent left no doubt what she would
do if she were an outpatient: stop taking the medication that
Myers had prescribed to treat her mental illness. See In re
Emmett J., 333 Ill. App. 3d 69, 73, 775 N.E.2d 193, 196 (2002)
("[The] respondent had refused to take his medications while in
the group home. Therefore, a group home would not be a viable
alternative to ensure [the] respondent's symptoms were stabilized
on his medication"). The record does not reveal who, outside the
facility, would persuade respondent to take her medication or
prevent her from engaging in self-destructive behavior. Cf. In
re Luttrell, 261 Ill. App. 3d 221, 226, 633 N.E.2d 74, 78 (1994)
("The evidence established placement with a relative was a viable
option, and Luttrell’s uncontroverted testimony was that his
brother had agreed to allow Luttrell to reside with him"), with
Emmett J., 333 Ill. App. 3d at 73, 775 N.E.2d at 196 ("there was
no indication that [the] respondent had someone willing to assist
him in his care"). The trial court could have reasonably found
that involuntary admission for up to 90 days was the least-
restrictive alternative.
III. CONCLUSION
For the foregoing reasons, we affirm the trial court’s
judgment.
Affirmed.
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STEIGMANN, P.J., and KNECHT, J., concur.
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