In re Christine R.

2019 IL App (3d) 180264Opinion filed September 10, 2019
____________________________________________________________________________
IN THE
APPELLATE COURT OF ILLINOIS
THIRD DISTRICT
2019
In re CHRISTINE R., a Person Found Subject
) Appeal from the Circuit Court
to Involuntary Medication, ) of the 10th Judicial Circuit,
) Peoria County, Illinois
(The People of the State of Illinois, )
)
Petitioner-Appellee, ) Appeal No. 3-18-0264
) Circuit No. 18-MH-99
v. )
)
Christine R. ) Honorable
) Alicia N. Washington
Respondent-Appellant). ) Judge, Presiding
____________________________________________________________________________
JUSTICE O’BRIEN delivered the judgment of the court, with opinion.
Justice Carter concurred in the judgment and opinion.
Presiding Justice Schmidt dissented, with opinion.
____________________________________________________________________________
OPINION
¶1 The State filed petitions for the involuntary commitment and administration of
psychotropic medication to respondent Christine R. At a hearing on the commitment petition,
Christine was removed due to disruptive behavior, and her attorney waived Christine’s
appearance and subsequent appearance at the medication hearing. The trial court granted both
petitions. Christine appealed. We reverse.
¶2 I. BACKGROUND
¶3 Christine R. is a 67-year-old woman with a long history of mental illness. She lived alone
in a trailer in a mobile home community and received home visits from the Human Service
Center, a behavioral healthcare organization. Christine also received psychiatric care at the
center. After she began to act erratically, her neighbor called Christine’s sister regarding her
mental health and behavior toward the neighbors. The sister called the Emergency Response
Service, which resulted in Christine being taken to the mental health unit at UnityPoint Proctor
Hospital on April 26, 2018. She would not agree to admission so the staff filed petitions for
Christine’s involuntary admission and administration of psychotropic medication.
¶4 Hearings took place on the petitions on May 1, 2018. At the commitment hearing,
Christine was present. As Christine walked into court, she threw a file of paperwork toward the
bench and was admonished by the court: “We don’t do that ***.” Christine explained that she
wanted to show the trial court the paperwork she had been provided. Christine asked to represent
herself, and the trial court questioned her about her education, employment history, and
computer usage. It denied Christine’s request and informed her the public defender would
represent her. Christine responded that the public defender did not know what was happening.
¶5 The hearing continued with one witness, Jayalakshmi Attaluri, Christine’s treating
psychiatrist, testifying. Christine disrupted the testimony. The court then explained to Christine:
“[T]he amazing thing about this process is, if there’s something that needs to be corrected, when
it is time, when it is time, you will have that opportunity to clarify that information for the
Court.” As Attaluri testified to the neighbors’ concerns about Christine’s behavior and threats
toward them, Christine interrupted and asked, “What?” and “Where is all this bullshit coming
from?” The court addressed Christine, as follows:
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“THE COURT: Here’s what’s amazing about this process.
[CHRISTINE]: Oh my God Almighty.
THE COURT: I recognize you have some concerns about the statements. We will
have the opportunity to hear them. This will be the last time that I ask you to stop
talking when the doctor talks, okay?”
¶6 The witness continued testifying, explaining that the police responded to Christine’s
trailer. Christine interjected, “And she busted in my door.” The trial court stopped the hearing
and the following exchange occurred.
“TRIAL COURT: This is where we’re gonna have to stop. We’re gonna—
[CHRISTINE]: We need for her to object.
THE COURT: No. No. At this point in time, the Court is going to direct this
particular process to stop. We’re going to take a recess. Then you, [Christine], are
going to have the opportunity to go to in the hallway and take a break. Okay?
We’re gonna give you a break.
Then you’re gonna come back. If you elect to come back in, you’re going to have
to be quiet throughout the testimony of the doctor. It makes it very difficult—
[CHRISTINE]: Excuse me.
THE COURT: You keep raising your voice. You understand I can hear you. You
have everyone in here to assist you if there’s any issues. I also want to give the
opportunity to each witness so I can hear their testimony.
I have someone who is recording every statement. It’s very difficult to record
while you’re yelling and making those outbursts. You understand that?
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[CHRISTINE]: She needs to object to what she’s saying. She should listen to her
client. That’s why I didn’t want an attorney. I want to object to some of the stuff she
says. I want it in the record and it’s put, being put down.
THE COURT: Unfortunately, [Christine], I have noticed you utilizing your finger
and—
[CHRISTINE]: I’m going like this. (Indicating.)
THE COURT: You’ve been pointing throughout this process as well.
[CHRISTINE]: What I want to—
THE COURT: Please take her outside. I think we have an issue right now. I want
to make sure we’re able to move forward. Thank you.
(Patient taken out of the courtroom.)
THE COURT: I want to make sure her agitation level is taken care of as well.
(A recess was taken.)
THE COURT: Back on the record. Based on the Court’s observation of
[Christine] and the proximity of [Christine] to the nurse, to the doctor, to the Court,
and how aggressive her mannerisms have been inside of this space, the Court has
asked [Christine] to be removed from the courtroom.”
¶7 Christine did not return to the hearing. The trial court asked Christine’s attorney whether
counsel could adequately represent Christine in her absence. When the attorney responded she
could, the State moved to proceed in Christine’s absence. The court agreed, finding that, based
on its observations and “being on the receiving end of [Christine’s] communications and
physical actions since the entry of the court,” it was in Christine’s best interests that she
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remained absent. The court stated it was difficult to proceed with Christine’s outbursts and
excused her presence from the hearing.
¶8 The hearing continued in Christine’s absence. Attaluri testified Christine has suffered
from mental illness since she was in her twenties and has had other hospitalizations. Christine
has schizoaffective disorder, bipolar type. Attaluri had treated Christine in the behavioral unit
from December 19, 2017, to February 16, 2018. Attaluri explained that Christine preferred a
particular antipsychotic and believed that everything will be fine if she takes it. Christine was not
interested in other medications. Attaluri considered alternative medications that come in an
injectable form during Christine’s prior hospitalization but opted against them because
Christine’s psychiatrist opined that Christine did well on Stelazine. According to Attaluri,
Christine’s conduct in the courtroom mirrored her daily behavior, which included yelling at staff,
making demanding remarks, becoming easily agitated, pounding on the table, and violating
personal space boundaries.
¶9 No other witnesses testified, and Christine’s counsel waived closing argument. Counsel
stated, “I believe my client’s behavior and statements when she was in here somewhat gave her
closing statement.” The trial court found Christine subject to involuntary admission and ordered
her committed for a 90-day period.
¶ 10 The court then recessed and when it reconvened it immediately proceeded to a hearing on
the petition for involuntary administration of medication. At the onset of the hearing, Christine’s
absence was discussed. The State asked the court to take judicial notice of the previous hearing
and the statements made concerning Christine’s removal from it. Christine’s counsel asked the
court to waive Christine’s presence, which the court did. The hearing took place in Christine’s
absence.
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¶ 11 Attaluri again testified. She requested administration of several medications and
explained Christine had been provided a list of the medications and information regarding their
side effects and benefits, and had previously refused to take two of the antipsychotic medications
Attaluri suggested. In Attaluri’s opinion, Christine lacked capacity and her illness prevented her
from understanding the need for medication. Medical records from 2004 show that Christine was
placed on different medications in the past but did not indicate whether she suffered side effects
from them.
¶ 12 Closing arguments were waived and the trial court granted the petition for administration
of medication. The court found Christine exhibited threatening and disruptive behavior and
deterioration in her ability to function due to lack of sleep and difficult relationships. The court
further found Christine lacked capacity and the medications’ benefits would outweigh any harm
from them. The trial court authorized the testing requested by Attaluri, including “clinically
indicated,” nonspecified testing. Christine timely appealed.
¶ 13 II. ANALYSIS
¶ 14 There are six issues on appeal: whether the case is moot, whether Christine was denied
her rights to be present at the commitment and medication hearings, whether the medication
order must be reversed if the commitment order is reversed, whether Christine was denied
effective assistance of counsel, and whether the State’s statutory and petitioning failures require
reversal if counsel’s representation was not ineffective.
¶ 15 We begin with a consideration of whether this case is moot. Christine argues that,
although the 90-day period for the commitment and medication orders expired, the cause is not
moot and should be considered under the public interest and capable of repetition yet evading
review exceptions to the mootness doctrine.
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¶ 16 Generally, Illinois courts will not decide moot questions, render advisory opinions, or
consider issues where the court’s decision will not affect the result. In re Mary Ann P., 202 Ill.
2d 393, 401 (2002). There are exceptions to the mootness doctrine, including the public interest
exception and the capable of repetition yet evading review exception. In re Atul R., 382 Ill. App.
3d 1164, 1167-68 (2008). Under the public interest exception, a moot case may be considered
when “(1) the question presented is of a public nature; (2) there is a need for an authoritative
determination for the future guidance of public officers; and (3) there is a likelihood of future
recurrence of the question.” In re Alfred H.H., 233 Ill. 2d 345, 355 (2009). The capable of
repetition yet avoiding review exception allows a moot case to be considered when (1) the
challenged action is of a duration too short to be fully litigated before it terminates, and (2)
“there must be a reasonable expectation that ‘the same complaining party would be subjected to
the same action again.’ ” Id. at 358 (quoting In re Barbara H., 183 Ill. 2d 482, 491 (1998)).
Mootness is an issue of law this court reviews de novo. In re Rita P., 2014 IL 115798, ¶ 30.
¶ 17 It is undisputed this case is moot. The orders for involuntary commitment and
administration of medication were entered on May 1, 2018, and were in effect for 90 days. At
issue on appeal are the procedures the trial court should take when faced with a disruptive
respondent during mental health proceedings. The procedures to be followed in hearings
concerning involuntary treatment of mental health services are “matters of a public nature and of
substantial public concern.” Mary Ann P., 202 Ill. 2d at 402. Thus, this case falls under the
public interest exception. It also falls under the capable of repetition yet avoiding review
exception. Both the commitment and involuntary administration of medication orders were for
limited durations of 90 days, a period too short for litigation. The evidence established that
Christine has a long history of mental illness and has been hospitalized on numerous occasions;
7
thus, it is likely that she would face involuntary commitment and administration of psychotropic
medications in the future. Despite the moot nature of the case, we find review is appropriate
under either exception to the mootness doctrine as discussed.
¶ 18 We next consider whether Christine was denied her right to be present at the commitment
and medication hearings. Christine claims her right to be present at the hearings was violated on
both constitutional and statutory grounds. Because a nonconstitutional basis exists to resolve
Christine’s claims, we will not address her constitutional arguments. See In re E.H., 224 Ill. 2d
172, 178 (2006) (“cases should be decided on nonconstitutional grounds whenever possible,
reaching constitutional issues only as a last resort”). We thus begin with a review of Christine’s
argument that the trial court violated her statutory right to be present at the commitment and
medication hearings.
¶ 19 Section 3-806 of the Mental Health and Developmental Disabilities Code (Mental Health
Code) (405 ILCS 5/3-806 (West 2018)) affords a respondent the right to be present at any
proceedings. Under section 3-806, there are two exceptions to the requirement of the
respondent’s presence where: (1) respondent’s counsel waives his or her presence and there is a
clear showing to the court that the respondent’s presence would subject her to a “substantial risk
of serious physical or emotional harm” or (2) respondent’s attorney informs the court that the
respondent refuses to attend the hearing. 405 ILCS 5/3-806(a)-(b) (West 2018). A respondent
may lose her right to attend a commitment hearing if her conduct is so disruptive as to
necessitate that she be excluded. In re Barbara H., 288 Ill. App. 3d 360, 367 (1997). Although a
mental health respondent may waive her rights, the court should not allow waiver without
considering the respondent’s capacity to waive her rights and her understanding of the
consequences of waiver. In re Michael H., 392 Ill. App. 3d 965, 974 (2009). This court reviews
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de novo the determination of statutory requirements and whether a respondent’s statutory rights
have been violated. In re Amanda H., 2017 IL App (3d) 150164, ¶ 34.
¶ 20 In order to determine whether the trial court violated Christine’s right to be present at the
commitment hearing and subsequent medication hearing, it is necessary to determine whether
either of the statutory exceptions to the right to be present apply to this case. Neither party argues
and the record does not indicate that Christine refused to attend the hearing, so we review the
proceedings to determine whether the remaining statutory exception was invoked so as to waive
Christine’s right to be present. In order to do so, we must examine the transcript from the
proceedings. In reviewing the transcript, it is apparent from the outset that Christine intended to
fully participate in all the proceedings at issue before us. At the commencement of the
commitment hearing, Christine informed the court that she wanted to represent herself. She
represented to the court that she did not believe appointed counsel was prepared. The trial court
informed Christine that it would need to assess her ability to represent herself, and after asking
Christine a few questions about her education, her employment history, and the last date she used
a computer, the court informed Christine that it would not allow her to represent herself and that
appointed counsel would continue to represent her.
¶ 21 It is also apparent that Christine disrupted the proceedings by interrupting the court, the
prosecutor, and a witness. She further made hand and/or finger gestures and spoke loudly. This
behavior continued, despite the trial court’s warning to Christine about her behavior and the
court’s explanation that Christine would have the opportunity, through counsel, to present
evidence. After a series of interruptions, the trial court made the following statement:
“No. No. At this point in time, the Court is going to direct this particular process
to stop. We’re going to take a recess. Then you, [Christine], are going to have the
9
opportunity to go in the hallway and take a break. Okay? We’re gonna give you a
break.
Then you’re going to come back. If you elect to come back in, you’re going to
have to be quiet throughout the testimony of the doctor. It makes it very difficult—”
At this point, Christine says, “[e]xcuse me,” and the trial court again tells Christine her loud
voice makes it hard for the recording equipment to pick up all the witness’s testimony. The court
also tells Christine it has noticed her utilizing her finger and then says: “Please take her outside. I
think we have an issue right now.”
¶ 22 Christine proposes that courts use the following procedure when faced with a disruptive
respondent in civil commitment hearings. First, the court must notify the respondent that certain
behavior is disruptive or objectionable. Second, the court must warn the respondent that
continued disruptive conduct will result in her removal. Third, the court must offer opportunities
for the respondent to return. As described above, the procedure that Christine advocates was
used, in part, by the trial court in removing Christine. The court warned Christine that her
behavior was disruptive and offered her opportunities to align her behavior with courtroom
decorum, to no avail. We find the court’s removal of Christine was not improper. Her behavior
disrupted the proceedings, interrupted the witness, and ignored the court’s directives to remain
quiet. See Illinois v. Allen, 397 U.S. 337, 343 (1970) (a disruptive criminal defendant may be
removed from the proceedings after the trial court warns of removal and the defendant continues
to disrupt the proceedings with his behavior; defendant is allowed to return once he is able to
behave).
¶ 23 Although the court acted properly in removing Christine, it erred when it failed to allow
Christine the chance to return to the proceedings or to make a record with the mandatory findings
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as to why her return did not take place. When Christine was removed, the court recessed the
proceedings. When the hearing resumed, Christine was not present. The court provided for the
record that it asked for Christine’s removal based on its observation of Christine and her
proximity to the nurse, doctor and court, “and how aggressive her mannerisms have been inside
of this space.” Counsel for Christine informed the court she could adequately represent Christine
in her absence. The court concluded it was in Christine’s best interest that she remain absent
from the hearing, based on its observations and “being on the receiving end of [Christine’s]
communications and physical actions.” The court also found that “it can become a safety issue
for her.” The court added that Christine’s outbursts made it difficult to conduct the hearing
before excusing her presence.
¶ 24 The Mental Health Code requires that a respondent’s absence at a civil commitment
hearing is proper when the respondent’s attorney waives her right to be present and the trial court
finds by “a clear showing” that the respondent’s presence would cause her a “substantial risk of
serious physical or emotional harm.” 405 ILCS 5/3-806(a) (West 2018). Here, Christine’s
attorney did not expressly waive her client’s presence; rather, she stated counsel could
adequately represent Christine in her absence. Moreover, we cannot assume or infer from the
circumstances that Christine was offered the chance to return as the record is silent regarding
what transpired between Christine’s removal and the resumption of the commitment proceeding.
See People v. Carlson, 221 Ill. App. 3d 445, 447 (1991) (court cannot make presumptions
regarding defendant’s absence from commitment hearing).
¶ 25 The record does not demonstrate a clear showing that Christine would be subjected to
serious physical or emotion harm if she attended the hearing. Rather, the court noted her
proximity to others in the courtroom and her aggressive behavior, its own observations of
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Christine’s behavior, and that the court itself was subjected to Christine’s “communications and
physical actions.”These findings are not the statutorily required findings of substantial physical
or emotional harm. The trial court made no such mandated findings. The court’s observations
and speculations regarding Christine’s conduct do not equate to findings of substantial physical
and emotional harm. Moreover, the record indicates removal was due to Christine’s outbursts,
not because of a substantial risk of harm to her. The court mentioned more than once the
difficulty in recording the proceedings caused by Christine’s outbursts. The court noted the
presence of a nurse and two guards in the courtroom but it never suggested any courtroom
personnel expressed concern about their safety or any concern that Christine would harm herself.
The record does not establish that there was any risk of harm to Christine or to the court or others
in the courtroom because of Christine’s presence.
¶ 26 Moreover, we have no information about what happened when Christine was removed
from the commitment hearing. Per the trial court’s comments, the plan was to recess for
Christine to take a break and collect herself, with the opportunity to return but it segued into her
involuntary removal and continued absence without explanation. The court’s admonishments
regarding Christine’s behavior never informed her that her conduct could result in permanent
removal from the hearing. To the contrary, the court told Christine that she would be provided
the opportunities to tell her story and clarify the evidence presented by the State, so long as she
could remain quiet upon her return to the courtroom. Because the record is devoid of any
explanation or chronology of what happened to Christine after her removal from the commitment
hearing, we do not know if she was afforded a chance to return, as the trial court promised, or
even if she wanted or was able to return.
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¶ 27 In In re Daryll C., 401 Ill. App. 3d 748, 750 (2010), this court took no issue with a civil
commitment hearing taking place in the respondent’s absence, where the respondent was in the
courthouse washroom taking a nap, he had been informed that the hearing would proceed
without him and that he could return at any time and the court was aware that the respondent had
been so informed. Respondent’s counsel waived the respondent’s presence by informing the
court the hearing could proceed in the respondent’s absence and the respondent’s absence was
not an issue for the reviewing court. Id. Significantly, the record indicated that the respondent
was aware the hearing would proceed without him and that he was free to attend at any time. Id.Contrary to the facts in Daryll C., no information was presented regarding Christine’s
whereabouts or whether she wanted or was able to return to the proceeding. From the trial
court’s comments, we find it unlikely Christine was free to attend the hearings after her removal.
The only certainty is that the hearing continued in Christine’s absence, contrary to the statutory
dictates which mandate a clear showing of substantial harm. See In re James, 67 Ill. App. 3d 49,
51 (1978) (respondent denied statutory right to be present where trial court removed her from a
portion of commitment hearing without making required finding of harm). We find Christine was
denied her right to be present at the commitment hearing and reverse the trial court’s involuntary
commitment order.
¶ 28 Our reversal of the commitment order also vacates the medication order. See In re
John N., 364 Ill. App. 3d 996, 998 (2006) (a respondent who is not ordered to receive or
receiving mental health treatment is not a recipient of services, and the trial court cannot order
the administration of psychotropic medication). However, we address Christine’s argument to
clarify the statutory requirements of a respondent’s right to be present. At the medication
proceeding, Christine was never provided the opportunity to be present at the hearing at any
13
time. Rather, at the beginning of the hearing, the court sought statements regarding Christine’s
absence. The State asked the court to take judicial notice of the commitment hearing and
“statements that were made in regards to her removal from the hearing.” Christine’s attorney
asked that Christine’s presence be waived “given the last hearing.” The trial court accepted the
waiver, and the parties proceeded on the merits of the petition in Christine’s absence.
¶ 29 As noted above, the record lacks any information regarding Christine’s whereabouts after
her removal or about whether Christine wanted to be present at the medication hearing. Although
Christine’s attorney sought waiver of her presence, she did not indicate whether Christine wished
to be present, whether she became less agitated during the recess between proceedings, or
whether she was willing for the medication hearing to proceed in her absence. Her attorney did
not expressly waive her right to be present at either hearing, and the court’s findings did not
establish that Christine was at risk of physical or emotional harm. As occurred with the
commitment hearing, the trial court permitted Christine’s absence in violation of the statutory
requirement that she be present. We find that her statutory right to be present at each hearing was
violated.
¶ 30 Because we find Christine was denied her statutory right to be present at the commitment
and medication hearings, we reverse on those grounds and need not consider the other issues she
raises on appeal.
¶ 31 III. CONCLUSION
¶ 32 For the foregoing reasons, the judgment of the circuit court of Peoria County is reversed.
¶ 33 Reversed.
¶ 34 PRESIDING JUSTICE SCHMIDT, dissenting:
¶ 35 It is undisputed that this case is moot. I would dismiss it as such.
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¶ 36 The majority finds that the public interest and capable of repetition exceptions to
mootness apply. These exceptions are to be narrowly construed. Alfred H.H., 233 Ill. 2d at 355-
56; In re A.W., 381 Ill. App. 3d 950, 954 (2008). The majority does not boldly go where no court
of review has gone before. Because it breaks no new ground, the public interest exception does
not apply. See In re Adoption of Walgreen, 186 Ill. 2d 362, 365 (1999) (public interest exception
requires a “need to make an authoritative determination for future guidance of public officers”).
This exception is also proper “where the law is in disarray or there is conflicting precedent.”
(Internal quotation marks omitted.) Alfred H.H., 233 Ill. 2d at 358. This opinion says nothing that
has not been said before and does not resolve a conflict in our precedent. See James, 67 Ill. App.
3d at 51 (“Unless there is a specific finding that emotional or physical harm would result from a
respondent’s presence in the courtroom, that individual should be permitted to be present ***.”).
¶ 37 Further, the fact that respondent may face involuntary admission and involuntary
medication in the future is an insufficient basis to apply the capable of repetition exception.
Alfred H.H., 233 Ill. 2d at 358-60. There is no clear indication that the issue the majority chooses
to address could be of use to respondent in future litigation. Id. at 360.
¶ 38 Under the majority’s analysis, virtually every case involving involuntary
admission/administration of drugs would fall within a mootness exception. I respectfully dissent.
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