In re Charles K. ( 2010 )

Filed 11/23/10 NO. 4-10-0203
IN THE APPELLATE COURT
OF ILLINOIS
FOURTH DISTRICT
In re: CHARLES K., a Person Found Subject to ) Appeal from
Involuntary Admission, ) Circuit Court of
THE PEOPLE OF THE STATE OF ILLINOIS, ) Macon County
Petitioner-Appellee, ) No. 10MH27
v. )
CHARLES K., ) Honorable
Respondent-Appellant. ) Lisa Holder White,
) Judge Presiding.
JUSTICE APPLETON delivered the opinion of the court:
In February 2010, a petition was filed for the emergency involuntary
admission of respondent, Charles K., alleging he was mentally ill, reasonably expected to
inflict serious physical harm upon himself or others, and unable to provide for his basic
physical needs. The trial court conducted a jury trial and, upon the jury's verdict finding
respondent was a person subject to involuntary admission, ordered respondent
hospitalized for no more than 90 days. On appeal, respondent claims the order must be
reversed because the jury was not instructed that the State was required to prove by clear
and convincing evidence that he was mentally ill. We affirm.
I. BACKGROUND
On February 4, 2010, Decatur police officer T. Tool filed a petition for
emergency involuntary admission as to respondent pursuant to section 3-601 of the Mental
Health and Developmental Disabilities Code (Code) (405 ILCS 5/3-601 (West 2008)). In
his factual basis, Tool stated respondent was found at the Holiday Inn in Decatur after
police were called because respondent was "barking at patrons who were entering and
exiting" the hotel. Tool spoke with respondent, "who was making no sense and stated 'they
are watching me.'" Tool asked respondent who was watching him and respondent "would
change the subject[,] again making no sense as he communicated."
The petition alleged respondent was (1) mentally ill, (2) reasonably expected
to inflict serious physical harm upon himself or another in the near future, (3) unable to
provide for his basic physical needs so as to guard himself from serious harm without the
assistance of family or outside help, and (4) in need of immediate hospitalization for the
prevention of such harm. Two medical certificates were also filed indicating respondent
was subject to involuntary admission and in need of immediate hospitalization.
Respondent elected to have his petition heard by a jury, and on February 16,
2010, the trial court conducted respondent's jury trial. Outside the presence of the jury,
the State introduced two exhibits. Exhibit No. 1 was a comprehensive examination and
social investigation report and treatment plan, which indicated that respondent had
"multiple past psychiatric hospitalizations for mental illness" and he was uncooperative
with treatment. Exhibit No. 2 was a typed one-page document identifying the
"Appropriateness and Availability of Alternative Treatment Settings," "Proposed Treatment
Methods," and "Timetable for Achievement of Treatment Goals." According to this exhibit,
respondent's refusal to take his medication had "consistently been an issue for him and the
major reason for his hospitalizations." His refusal, coupled with his resulting aggressive
behavior, made placement at his home or in a nursing home "impractical." It was
recommended that respondent be hospitalized at Andrew McFarland Mental Health Center
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(McFarland) . The exhibit further indicated that medication was the "essential" treatment
for controlling respondent's symptoms, but he would also be urged to participate in other
means of treatment such as individual, group, occupational, and recreational therapies.
Finally, "[g]iven the severity and chronicity of [respondent]'s condition[,] as well as his
history of noncompliance, a minimum of three months--and probably much longer--of
inpatient treatment will probably be required in order to have any real impact on his
functioning." Our review of the record indicates that the jury was never presented with, or
even aware of, these exhibits.
After the trial court admitted these exhibits into evidence, the court
summoned the jury, and the State presented the following testimony. Dr. Rohi Patil
testified he had worked as a psychiatrist at St. Mary's Hospital for 34 years. Based on his
examination of respondent, Dr. Patil diagnosed him with paranoid schizophrenia and
opined that respondent was experiencing "severe" psychotic episodes. Respondent was
"very psychotic," hostile, and angry. Dr. Patil described respondent's behavior and
statements as "bizarre." For example, Dr. Patil told respondent he did not understand what
respondent was saying, and respondent replied that only the Central Intelligence Agency
(CIA) could understand him. Dr. Patil said he had examined respondent every day since
his admission, and respondent remained paranoid and delusional and had refused his
medications. In Dr. Patil's opinion, respondent was unable to care for himself in his
current mental state.
Dr. Patil testified that he had reviewed respondent's mental-health records
and discovered that respondent had suffered from paranoid schizophrenia for "a number
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of years." Respondent was most recently hospitalized for treatment for six months last year
at McFarland in Springfield. According to Dr. Patil, respondent's current prognosis with
treatment was good, but without treatment, it was "poor." Without treatment, there was
"a high likelihood" that respondent "may hurt somebody." Dr. Patil recommended that
respondent be treated at McFarland in order to "protect him and protect other people."
On cross-examination, Dr. Patil described respondent as follows: "He's a very
sick gentleman, really sick. Needing the help. Has no insight into his problems."
Shelly Perry, a registered nurse at St. Mary's, testified next for the State. She
described respondent as "threatening [and] aggressive." She described a recent incident
where she had knocked on respondent's door, announcing that she had his oral medication.
Respondent jumped out of bed, "was in [her] face in a very intimidating manner[,]" and
threatened her with violence if she did not leave. She left respondent's room, but he chased
after her to the nurses' station. Perry said respondent was frequently very agitated and
intimidating and has invaded her "personal space." On another occasion, four or five days
after the first incident, Perry said she had to request the services of hospital security due
to respondent's threatening, intimidating and impulsive behavior. He had approached the
nurses' station, asking to leave the unit. When his request was denied, he initially became
agitated, but his behavior escalated until he threatened to assault the staff. Security had
to physically restrain respondent until the staff could inject him with a sedative. Perry said
respondent has told her that he was "the Archbishop to the Pope" and a CIA agent.
Perry also testified that respondent was not taking care of his personal
hygiene on his own. She said the staff had to order him to take a shower, brush his teeth,
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and comb his hair. Perry had observed respondent threaten other nurses and behave in
what Perry described as a sexually inappropriate manner with other staff members.
Respondent was in a housekeeper's "personal space, kind of looming over her" when he
asked her for her telephone number. According to Perry, the housekeeper felt
uncomfortable. Perry redirected respondent without incident, informing him he was acting
inappropriately. Perry said on every shift she worked, she observed respondent "looming
over" people, entering into their personal space. He was not always redirected easily. In
those two or three instances where they were unable to redirect him, the staff would use the
gathering of "silent speed teams" or a "show of force," which indicated to respondent that
he was outnumbered.
Laterrika Bradford, a front-desk employee at the Decatur Holiday Inn,
testified that respondent was a guest at the hotel on February 3, 2010. During Bradford's
3 p.m. to 11 p.m. shift, she saw respondent in the lobby. He approached her at the front
desk and said something to her, but Bradford did not understand what he was saying. She
shook her head and he walked away. She saw respondent approach a male guest who was
walking through the lobby. Respondent grabbed the man's arm. Bradford said the man
looked afraid, but walked away from respondent. Respondent approached Bradford at the
front desk multiple times. Each time he began approaching, Bradford picked up the
telephone and simulated a conversation. Bradford said respondent was scaring her. Each
time respondent saw Bradford on the telephone, he would approach someone else in the
lobby. Bradford estimated that respondent approached approximately 20 different people.
She also saw respondent talking to a wall, but she could not understand anything he said.
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One guest told Bradford that he did not feel comfortable at the hotel with respondent there.
Another guest told respondent to go to his room, but he ignored her, so she called the
police. When the police arrived, respondent refused to go to his room and was generally
uncooperative with their requests.
Bradford said respondent did not make any aggressive gestures toward her
or the other guests, but she was still afraid of him due to his odd behavior. She admitted
that in terms of physical contact, respondent did nothing more than grab another person's
arm and try to initiate a conversation.
Stephen J. Rathnow, a licensed clinical professional counselor, testified that
he worked at St. Mary's with the involuntarily admitted patients. Rathnow had difficulty
speaking with respondent because respondent would either refuse to talk to him or would
mutter, ramble, or speak unintelligibly. Rathnow had not seen respondent become
aggressive but had seen him talking and arguing with himself in the hallway. He would
frequently shake his finger at the wall, which Rathnow described as a response to internal
stimuli, such as auditory or visual hallucinations--symptoms that individuals with a
"serious mental illness" often experience. He said initially, respondent refused to shower,
but lately he had complied when directed. However, respondent continued to be
noncompliant with his treatment. In Rathnow's opinion, if respondent did not remain
hospitalized, his prognosis was "[v]ery poor" and his condition would deteriorate, resulting
in activity that would put himself and others at "great risk."
Robert K., respondent's brother, testified next for the State. Robert said
respondent has had mental-health issues for "quite a few years." After respondent's
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hospitalization at St. Mary's, Robert visited respondent's home and described it as follows:
"A water hose was stuck in a washing machine in the
basement. It flooded out his basement. His stove in the
kitchen was burnt black. They had to take it out and put it in
the back yard. It's a wonder he didn't burn the house down.
His wiring, he's got the plates off the wall, and the wire's
sticking out, and the receptacle is sticking out. There's water
dripping from the *** first floor ceiling in the kitchen down in
onto the floor and on the walls. Scum on the walls. He threw
his clothes out in the street. He threw his clothes in the front
yard. He threw his clothes on the roof.
***
Electricity right now is shut off. They're trying to get it
on so they can clean his walls and everything and get it
straightened up for him."
Robert testified that respondent had been hospitalized at McFarland twice and once at a
facility in Elgin. He said when respondent took his medication, he was fine. When he
refused to take his medication, "he gets in trouble." Robert said respondent "needs help"
and needs to be hospitalized.
Robert said he and his family tried to watch over respondent at home. Their
mother could see respondent's house from her house, and Robert's daughter and son-in-
law stopped by regularly to check on him. He said respondent's home was usually in
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disarray, but since his hospitalization, it had been condemned by the fire department.
Robert's children were working on the house to get it liveable again.
At the conclusion of Robert's testimony, the State rested. The trial court
continued the trial until the next day. On February 17, 2010, the trial resumed with
respondent testifying on his own behalf. He said, before staying at the Holiday Inn in
Decatur for two days, he lived in his own home in Lincoln. He explained in detail, but in
rambling fashion, the electrical and plumbing problems at his home. When asked about
his stove, respondent explained that he had unplugged the "self-starter" and the pilot light
"melted," starting a fire. He said the blackness observed on the stove was the "fire
extinguishing material."
Respondent said he met a "very good friend" and "business people" at the
Holiday Inn. He said he might have grabbed them by the arm to shake their hand in an
attempt to be "real friendly and courteous." The following exchange occurred:
"Q. So, everybody you talked to at the hotel, did you
know them?
A. Pretty much or knew where they were from because
I could tell by their language. I speak many languages. Also--
(inaudible)--that's beside the point.
Q. Okay.
A. (Unintelligible utterance) (Unintelligible utterance)
Q. Now, with regards to you're being brought into the
hospital, there was testimony with regards to interaction that
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you had with the doctor.
A. Interaction with the doctor?
Q. Dr. Patil. You know?
A. Like you had just then? Interaction. What would
you say, I should continue or leave? Such as a gesture I used.
Q. Okay.
A. Not warding him off or anything. Speaking good.
Q. Were you--uh--willing--did you willingly go to St.
Mary's?
A. No, I did not. As a matter of fact, the officers were
there, and someone had called an ambulance in the meanwhile.
The officers were merely very, very ready, I feel, to just fuse the
factor. They had my records, my license, all my material. I
didn't read it. Debit card. Whole nine yards. They knew I was
able to take care of myself. So, the--uh--attendants came.
They started questioning me such as, 'Do you know red?' You
know, the old saying, red fire engine, white, whatever they call
it. Psychology tests. They'd ask me the same questions back
and forth between the two. I said, [']well, they're watching me
too closely. Can't answer.['] You know, I--I just don't answer."
Respondent continued with a rambling narrative of his ride in the ambulance to the
hospital. Respondent explained that, once he arrived at the hospital, the staff "demanded
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[he] take a shot. The shot they g[a]ve [him] was with one of these apparatus like--uh--
transfusions. You never give a shot like that. What it was, probably sodium. After [he]
c[a]me to, [he] blacked out." He explained that he had five "bypasses" in the past, but was
otherwise "very healthy." He denied chasing Perry from his room but admitted he had
followed her to the nurses' desk because he "was little upset and wanted to get some activity
anyhow for whatever reason."
Respondent said he was able to care for his own basic needs. He said:
"[S]ome people do not realize this, but if you do not feel that mental health is curable, then
you should not be in the business of doctoring. You do not have direction or attempt to
cure adults. That's the way I feel, and that's the way I have to designate my feelings."
On cross-examination, respondent said he had a mortgage loan on his home
from the United States Department of Agriculture in St. Louis or Jacksonville. His account
number was 52. He said the people he spoke with at the Holiday Inn were all "comfortable"
with him. He said: "The lady did not realize the language we were speaking or the actions
we were taking as being friendly." Counsel posed the following questions:
"Q. Okay. All right. Mr. K., what is your own business?
You say–
A. Own business?
Q. What is it?
A. Uh--manufacturing consultant.
Q. All right.
A. And auto merchandising and merchandising.
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Q. All right. Now, you also said you have a lot of
overseas contacts?
A. I did there, for instance. These people were from
overseas mostly.
Q. All right. And that was when you worked at
Caterpillar?
A. No, that was just the--uh--motel. I don't want to get
into my business at Caterpillar. This is strictly not your
concern at this time."
Respondent presented no further evidence. After closing arguments, the
matter was submitted to the jury on instructions submitted by the State, without objection.
Respondent did not tender any proposed instructions. The jury subsequently returned a
verdict, finding respondent was a person subject to involuntary admission. The court
entered a written order on the jury's verdict, ordering respondent hospitalized in the
Department of Human Services for a period not to exceed 90 days. This appeal followed.
II. ANALYSIS
A. Mootness
Initially, we note this case is moot. The trial court entered an order on
February 17, 2010, and limited the enforceability of the order to a period not to exceed 90
days. The 90-day duration has long passed. Thus, we must determine whether this court
is able to grant any meaningful relief to respondent if we addressed the merits of his claims.
See In re Robert F., 396 Ill. App. 3d 304, 310-11, 917 N.E.2d 1201, 1206 (2009). In other
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words, we must determine whether any exception to the mootness doctrine applies here.
In his brief, respondent asserts that all three established exceptions apply to justify our
consideration of an otherwise moot issue. In contrast, the State claims that no exception
applies.
The supreme court's decision in In re Alfred H.H., 233 Ill. 2d 345, 364, 910
N.E.2d 74, 85 (2009), provides guidance by discussing the applicability of the three
established mootness exceptions to cases of involuntary admissions. Those exceptions are
(1) the collateral-consequences exception, (2) the public-interest exception, and (3) the
capable-of-repetition-yet-avoiding-review exception. Alfred H.H., 233 Ill. 2d at 355-63, 910
N.E.2d at 80-84. Whether a particular case falls within one of the exceptions must be
examined case by case. Alfred H.H., 233 Ill. 2d at 355, 910 N.E.2d at 80. "This evaluation
must consider all the applicable exceptions in light of the relevant facts and legal claims
raised in the appeal." Alfred H.H., 233 Ill. 2d at 364, 910 N.E.2d at 85.
First, the collateral-consequences exception does not apply. This exception
is applied in mental-health cases where the respondent could be plagued in the future by
the adjudication at issue. See Alfred H.H., 233 Ill. 2d at 361, 910 N.E.2d at 83. When the
respondent, like respondent here, has been previously committed, there are no obvious
collateral consequences that can be traced exclusively to the adjudication at issue. Alfred
H.H., 233 Ill. 2d at 363, 910 N.E.2d at 84 (the court could not identify any collateral
consequence that could stem solely from the adjudication at issue because the respondent
had previously been committed involuntarily multiple times and had been convicted of
murder). Any collateral consequence that would result from the trial court's involuntary-
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commitment order at issue in this appeal has already attached to respondent due to his
prior hospitalizations.
However, the second and third exceptions do apply. The capable-of-
repetition-yet-avoiding-review exception applies when (1) the challenged action is of such
a duration that it may not be fully litigated prior to its cessation, and (2) there is a
reasonable expectation that "'the same complaining party would be subjected to the same
action again.'" Alfred H.H., 233 Ill. 2d at 358, 910 N.E.2d at 82, quoting In re Barbara H.,
183 Ill. 2d 482, 491, 702 N.E.2d 555, 559 (1998). Although the limited duration of the 90-
day commitment order prevents the case from being fully litigated within the applicable
time frame, the issue presented in this appeal is capable of repetition in a subsequent
action. Because this is not a case merely challenging the sufficiency of the particular
evidence presented, it is possible that the issue of whether the jury was properly instructed
on the State's burden of proof could arise in a subsequent mental-health case brought
against respondent. Cf. Alfred H.H., 233 Ill. 2d at 360, 910 N.E.2d at 83 (there was no
"clear indication of how a resolution of [the sufficiency-of-the-evidence] issue," based on
the specific facts presented in that particular specific adjudication, could be of use to the
respondent in future litigation).
The public-interest exception also applies for reasons similar to those
explained above. This exception "allows a court to consider an otherwise moot case when
(1) the question presented is of a public nature; (2) there is a need for an authoritative
determination for future guidance of public officers; and (3) there is a likelihood of future
recurrence of the question." Alfred H.H., 233 Ill. 2d at 355, 910 N.E.2d at 80. First,
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whether a jury is properly instructed on the law, which would include an instruction on the
State's burden of proof at trial, is a question of a public nature. See In re Mary Ann P., 202
Ill. 2d 393, 402, 781 N.E.2d 237, 243 (2002) ("the procedures which must be followed and
the proofs that must be made before a court may authorize involuntary treatment to
recipients of mental health services are matters of a public nature and of substantial public
concern"). Second, there does not appear to be any authoritative determination within
Illinois case law specifically requiring the trial court to instruct the jury in the manner
suggested by respondent in this appeal. Third, it is possible that in the future respondent
himself, or another respondent, will be the subject of a petition for involuntary admission
and demand a trial by jury. In such an instance, the issue of what instructions should be
given may arise. The issue presented in this appeal is not fact driven like a challenge to the
sufficiency of the evidence. Instead, resolution of the issue could be helpful in similar cases
in the future. Thus, we find the question on appeal presents a matter of public importance
and is crucial to the conduct of fair proceedings in the future. See In re Stephenson, 67 Ill.
2d 544, 550, 367 N.E.2d 1273, 1274 (1977) (determining the State's burden of proof in
involuntary-admission proceedings would "contribute to the efficient operation of our
system of justice").
B. Forfeiture
Because we find this case falls within two recognized exceptions to the
mootness doctrine, we will address this appeal on the merits. As we have stated,
respondent argues here that the order directing him to be involuntarily committed for
treatment must be reversed because the jury was not instructed that the State had to prove
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by clear and convincing evidence that respondent suffered from a mental illness.
We note that respondent raises this issue for the first time on appeal. His
counsel did not raise the issue in the trial court proceedings, nor did he propose an
instruction that he now argues should have been presented. Generally, an issue not
presented to or considered by the trial court cannot be raised for the first time on review.
In re Barnard, 247 Ill. App. 3d 234, 252, 616 N.E.2d 714, 727 (1993). Specifically, with
regard to a putative jury-instruction error, a respondent forfeits review if he did not object
to the instruction or offer an alternative instruction. People v. Mohr, 228 Ill. 2d 53, 64-65,
885 N.E.2d 1019, 1025 (2008).
Respondent acknowledges his procedural default, but argues that, "in the
interests of justice," this court should review his claim due to the implication of the
substantial liberty interests involved. In other words, respondent urges our review under
a doctrine analogous to the plain-error doctrine. The plain-error doctrine set forth in
Supreme Court Rule 615(a) (134 Ill. 2d R. 615(a)) applies to appeals in criminal cases, not
civil cases.
In the past, this court has addressed issues raised for the first time on appeal.
See In re James, 191 Ill. App. 3d 352, 357, 547 N.E.2d 759, 762 (1989); In re Franklin, 186
Ill. App. 3d 245, 248, 541 N.E.2d 168, 170 (1989); In re Satterlee, 148 Ill. App. 3d 84, 86,
499 N.E.2d 101, 102-03 (1986); In re Whittenberg, 143 Ill. App. 3d 836, 838-39, 493 N.E.2d
662, 663 (1986). However, in each of those cases, this court was asked to search the record
for error upon allegations of a failure to strictly comply with statutory procedural
requirements. In this case, the contention of error does not relate to noncompliance with
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any relevant statutory provision. At issue is respondent's right to a fair trial and whether
the jury was properly instructed regarding the State's burden of proof. Given that the Code
affords a respondent the right to a jury trial, we find the issue presented here of sufficient
importance to justify our review despite respondent's forfeiture. See People v. Burson, 11
Ill. 2d 360, 370-71, 143 N.E.2d 239, 245 (1957), quoting 3 Am. Jur. §248, at 33 ("'The court
may, as a matter of grace, in a case involving deprivation of life or liberty, take notice of
errors appearing upon the record which deprived the accused of substantial means of
enjoying a fair and impartial trial, although no exceptions were preserved or the question
is imperfectly presented'"). As in a plain-error analysis where a criminal defendant fails to
object in the trial court to the claimed error raised for the first time on appeal, we will
determine first whether any error occurred, and if so, whether respondent suffered
prejudice from the error. See People v. Davis, 233 Ill. 2d 244, 274, 909 N.E.2d 766, 782
(2009).
1. Did Any Error Occur?
In order to prove that respondent was a person subject to involuntary
commitment, the jury must have been presented with clear and convincing evidence that
(1) respondent was suffering from a mental illness, and (2) due to the mental illness, he
may injure himself or others, or is unable to care for himself. In re James, 199 Ill. App. 3d
316, 319, 556 N.E.2d 839, 841 (1990). "'Proof of mental illness alone is not sufficient to
support involuntary admission.'" In re Robin C., 385 Ill. App. 3d 523, 529, 898 N.E.2d 689,
694 (2008), quoting In re Nancy A., 344 Ill. App. 3d 540, 555, 801 N.E.2d 565, 580 (2003).
But, proof of mental illness is most certainly a prerequisite to a respondent's involuntary
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admission.
The jury must be instructed on the applicable legal rules so as to guide the
deliberations toward a proper verdict. Mohr, 228 Ill. 2d at 65, 885 N.E.2d at 1025. In
addition to giving pattern jury instructions that apply to the particular case, the trial court
should, sua sponte, issue any other instruction that, in the court's discretion, is necessary
to instruct the jury on any element of the case or the State's burden of proof, for it is these
issues that are imperative to a fair trial. See People v. Turner, 128 Ill. 2d 540, 562-63, 539
N.E.2d 1196, 1205 (1989). "The task of a reviewing court is to determine whether the
instructions, considered together, fully and fairly announce the law applicable to the
theories of the State and the defense. [Citations.] The proper standard of review is whether
the trial court abused its discretion." Mohr, 228 Ill. 2d at 65-66, 885 N.E.2d at 1026. "A
trial court abuses its discretion if jury instructions are not clear enough to avoid misleading
the jury or if the jury instructions do not accurately state the law." In re Timothy H., 301
Ill. App. 3d 1008, 1015, 704 N.E.2d 943, 948 (1998).
In accordance with the definitions of "mental illness" and "person subject to
involuntary admission" set forth in sections 1-129 and 1-119 of the Code (405 ILCS 5/1-129,
1-119 (West 2008)), respectively, the jury was instructed as follows:
"Mental illness means a mental or emotional disorder
that substantially impairs a person's thought, perception of
reality, emotional process, judgment, behavior, or ability to
cope with the ordinary demands of life but does not include a
developmental disability, dementia, or Alzheimer's disease
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absent psychosis, a substance[-]abuse disorder, or an
abnormality manifested only by repeated criminal or otherwise
antisocial conduct.
The respondent will be subject to involuntary admission
if because of his mental illness, he is unable to provide for his
basic physical needs so as to guard himself from serious harm
without the assistance of family or outside help.
The respondent will be subject to involuntary admission
if because of his mental illness, he is reasonably expected to
inflict serious physical harm upon himself or another in the
near future which may include threatening behavior or
conduct that places another individual in reasonable
expectation of being harmed.
The State has the burden of proving by clear and
convincing evidence that the respondent, because of his mental
illness, is unable to provide for his basic physical needs so as to
guard himself from serious harm without the assistance of
family or outside help, or that the respondent, because of his
mental illness, is reasonably expected to inflict serious physical
harm upon himself or another in the near future which may
include threatening behavior or conduct that places another
individual in reasonable expectation of being harmed.
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In order to find the respondent subject to involuntary
admission, the State must prove either one or both of the
following propositions:
First proposition: That the respondent, because of his
mental illness, is unable to provide for his basic physical needs
so as to guard himself from serious harm, without the
assistance of family or outside help; or
Second proposition: That the respondent, because of
his mental illness, is reasonably expected to inflict serious
physical harm upon himself or another in the near future,
which may include threatening behavior or conduct that places
another individual in reasonable expectation of being harmed.
If you find from your consideration of all the evidence
that either one or both of these propositions has been proved
by clear and convincing evidence, you should find the
respondent subject to involuntary admission.
If you find from your consideration of all the evidence
that neither one of these propositions has been proved by clear
and convincing evidence, you should find the respondent not
subject to involuntary admission."
Indeed, the instructions given to the jury did not explicitly convey that the
State had the burden of proving by clear and convincing evidence that respondent suffered
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from a mental illness. There exists no pattern jury instruction addressing the issue nor was
a nonpattern jury instruction tendered. Though it could be argued that such a proposition
was implicit in the instructions tendered, the jury could have, given the language of the
instructions, reasonably assumed that respondent's mental illness was a given, or an
element it need not resolve, and that it was only a matter of determining whether
respondent's mental illness would result in harm to himself or another, or in him not being
able to care for his basic needs without assistance. Because the instructions did not make
clear a necessary element of the issues involved, namely, the extent of the State's burden
of proof, we find it was error to not include an instruction explicitly conveying each and
every factor that the State was required to prove in order to support a finding that
respondent was a person subject to involuntary admission. See Timothy H., 301 Ill. App.
3d at 1016, 704 N.E.2d at 948 (to ensure a fair trial in an involuntary-treatment case, the
jury should be instructed on the elements ultimately authorizing the involuntary treatment
and the applicable burden of proof).
2. Was Respondent Prejudiced by the Error?
However, our analysis cannot end with a determination of error given
respondent's failure to properly preserve the error for review. We must also determine
whether the error justifies reversal. "'An error in a jury instruction is harmless if it is
demonstrated that the result of the trial would not have been different had the jury been
properly instructed.'" Mohr, 228 Ill. 2d at 69, 885 N.E.2d at 1028, quoting People v.
Pomykala, 203 Ill. 2d 198, 210, 784 N.E.2d 784, 791 (2003). We cannot say that the trial
court's failure to explicitly instruct the jury in the manner argued here by respondent
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denied him his due-process right to a fair trial.
The evidence presented at trial clearly demonstrated that respondent suffered
from a mental illness. Dr. Patil testified that he diagnosed respondent with paranoid
schizophrenia. Supporting the doctor's diagnosis were the facts that Dr. Patil had (1) met
with respondent every day during his hospitalization, (2) observed and recounted
respondent's symptoms, which were consistent with the diagnosis, and (3) reviewed
respondent's medical records, which indicated that respondent had suffered from the
illness for "a number of years," including prior hospitalizations. A medical opinion as to
the existence of a mental illness is clear and convincing if the expert "indicates the basis of
his diagnosis by having directly observed a respondent on several occasions." In re Tuman,
268 Ill. App. 3d 106, 111, 644 N.E.2d 56, 59-60 (1994).
Dr. Patil's expert testimony, coupled with (1) the testimony of the remaining
witnesses regarding respondent's behavior and (2) the lack of any evidence to the contrary,
was sufficient for the jury to find that respondent suffered from a mental disorder which
substantially impaired respondent's perception of reality, satisfying the definition of a
mental illness. We find that, given the weight of the evidence presented at trial that
respondent suffered from a mental illness, the fact that the jury was not specifically
instructed that the State was required to prove the existence of a mental illness by clear and
convincing evidence was harmless error. Given the record before us, we find the result of
the trial would not have been any different had the jury been properly instructed.
III. CONCLUSION
For the foregoing reasons, we affirm the trial court's judgment.
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Affirmed.
KNECHT and TURNER, JJ., concur.
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