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No. 3--01--0938 

IN THE

APPELLATE COURT OF ILLINOIS

THIRD DISTRICT

A.D., 2002

The State filed a petition seeking commitment of respondentto a hospital. The State also filed a separate petition in whichit sought the authority to involuntarily administer psychotropicmedication to respondent in the course of his treatment.

At the hearing, respondent stated he wanted to representhimself, claiming he was an attorney and Oxford graduate. Respondent further stated that he had been a "judge of the Tenth"and a physician. The court denied respondent's request torepresent himself.

Dr. Pratapkumar Attaluri testified he was respondent'streating psychiatrist. While living at a group home, respondenthad stopped taking his medications for treatment of schizophreniaand he was not regularly eating his meals or bathing. Respondentlater left the group home and was incarcerated in the county jailfor violating an order of protection.

While incarcerated, respondent made delusional statements,refused to eat and refused to take his prescribed medication. Respondent was then transferred from the county jail to ZellerMental Health Center (Zeller) for treatment of his condition. Dr. Attaluri testified respondent had been delusional since hewas transferred to Zeller, believing that he was the President ofthe United States, a judge and an attorney. Respondent agreedwith this testimony, stating "that's correct, exactly correct."

Dr. Attaluri had diagnosed respondent with schizophrenia,chronic paranoid type, and testified that respondent had beensuffering from that mental illness for at least the past 10years. Attaluri further testified that respondent did notbelieve he was mentally ill and he had refused to take hisprescribed medication. Respondent had also refused to take hismedication on several prior occasions over the past few years. When he stopped taking his medication, respondent had violatedorders of protection his family members had obtained restrainingrespondent from contact with them.

Since he was admitted to Zeller, respondent had bathed anddressed himself, eaten meals, spoken with his therapist andattended group sessions. However, respondent persisted in hisrefusal to take psychotropic medication because he did notbelieve he was mentally ill. Dr. Attaluri opined that respondentwas unable to provide for his basic physical needs and stated thetreatment plan involved stabilizing respondent on his medicationsand then transferring him to a group home.

Respondent testified he had bathed, dressed himself andeaten meals regularly while he was at the group home and atZeller. While in the county jail, respondent ate meals butshowered less frequently because he viewed the jail as ahazardous place. Respondent stated he would live at his familyfarm if he was released from Zeller. However, on cross-examination, respondent stated he could not live at the familyfarm because tenants lived there. Respondent then testified hewould live at his house on Park School Road if he was released.

The trial court found respondent was mentally ill and wasunable to provide for his basic physical needs. The courtentered an order involuntarily admitting respondent to theDepartment of Mental Health and Developmental Disabilities.

At the hearing on the petition for involuntary treatment,Dr. Attaluri testified he had prescribed Haldol to stabilize thesymptoms of respondent's mental illness and Ativan to treatanxiety and agitation. Dr. Attaluri testified such medicationswere the only effective treatment for respondent's condition. The potential side effects of these medications included tremors,rigidity and drowsiness, but respondent had not experienced anyside effects when he previously took these medications. Dr.Attaluri further testified respondent would be monitored whiletaking the medications and he believed the benefits of thistreatment outweighed any risks.

The court entered an order allowing involuntaryadministration of psychotropic medication and electro-convulsivetherapy. The order did not specify the medications to be used orthe dosages allowed to be administered to respondent.

Respondent does not contest his diagnosis of schizophrenia,but argues that the evidence presented at the hearing did notestablish that he is unable to provide for his basic physicalneeds. Respondent also contends the State did not establish thathospitalization was the least restrictive treatment alternative.

An individual may be involuntarily admitted if the Stateproves by clear and convincing evidence that (1) he is mentallyill; and (2) he is incapable of providing for his basic physicalneeds so as to guard himself from serious harm. 405 ILCS 5/1--119(2), 3--808 (West 2000). In determining whether a person canprovide for his basic physical needs, courts may consider hisability to obtain food, shelter and medical care, and whether hehas a place to live or family to support him. In re Winters, 255Ill. App. 3d 605, 627 N.E.2d 410 (1994). The circuit court'sdecision to involuntarily admit an individual will not bereversed on appeal unless it is manifestly erroneous. In reRovelstad, 281 Ill. App. 3d 956, 667 N.E.2d 720 (1996).

If a person is found subject to involuntary admission, thecourt must consider various treatment alternatives which areavailable to the respondent, including hospitalization,outpatient treatment or placement with a relative. 405 ILCS 5/3--811 (West 2000); In re Luttrell, 261 Ill. App. 3d 221, 633N.E.2d 74 (1994). The court must order the least restrictivetreatment alternative which is appropriate. 405 ILCS 5/3--811(West 2000).

In this case, the evidence established that respondent hadbeen consistently diagnosed with schizophrenia over the past 10years and he was suffering from that mental illness at the timeof the hearing. Respondent did not provide care for himselfduring the relevant time period, but was cared for at the grouphome, jail and hospital.

Respondent was delusional as shown by the testimony and byhis own statements at the hearing. The testimony also indicatedthat respondent had refused to voluntarily take his medicationsand he could not expect an improvement in his condition withoutthat treatment. Moreover, respondent's testimony was uncertainwith regard to where he would live if he was released. We cannotconclude from respondent's testimony that he had a place to liveif he was released. Further, there was no indication thatrespondent had someone willing to assist him in his care. Inthis regard, we note that respondent's family members hadapparently obtained orders of protection against him. Thisevidence supports a finding that respondent was mentally ill andthat he was unable to provide for his basic physical needs.

Respondent also argues he could have been placed in a grouphome as a less restrictive alternative to hospitalization.

Dr. Attaluri testified that the only effective method oftreating respondent's mental illness was to administerpsychotropic medication. However, respondent had refused to takehis medications while in the group home. Therefore, a group homewould not be a viable alternative to ensure respondent's symptomswere stabilized on his medication. Based on these facts, weconclude there was no less restrictive alternative tohospitalization. In sum, we find the trial court's decision toorder involuntary hospitalization was not against the manifestweight of the evidence.

Respondent also contends the order allowing involuntarytreatment should be reversed because it was not specific as tothe authorized treatment, medications or dosages.

An order authorizing involuntary treatment must designatethe people allowed to administer the treatment and must specifythe authorized medications and anticipated range of dosages. 405ILCS 5/2--107.1(a)(6) (West 2000).

In this case, the court used a form order. The order simplystated that the clinical staff was authorized to involuntarilyadminister psychotropic medication and electro-convulsivetherapy. The order did not specify the medications or dosagesthat could be administered. Therefore, the order was not incompliance with the statute requiring specificity in themedications and dosages to be administered. Further, the court'soral ruling did not provide the information necessary to complywith the statutory requirements.

In a recent case, the Fourth District Appellate Court heldthat the lack of specificity in a trial court order authorizinginvoluntary treatment resulted in a failure to ensure proper useof psychotropic medication. In re Gwendolyn N., 326 Ill. App. 3d427, 760 N.E.2d 575 (2001). The court reversed the orderauthorizing involuntary treatment, concluding that therespondent's liberty interests were violated due to the lack ofspecificity in the order. Gwendolyn N., 326 Ill. App. 3d 427,760 N.E.2d 575.

Likewise, in this case the lack of specificity in the trialcourt's order resulted in a failure to ensure that respondentwould receive only the involuntary treatment specificallyauthorized by the court. Under the terms of the order,respondent could be administered any psychotropic medication inany dosage. Respondent could also be administered electro-convulsive therapy. In its oral ruling, the court acknowledgedthat the State was not seeking authority to administer electro-convulsive therapy, and it seemed to be understood that suchtreatment would not be administered. Nonetheless, the court'swritten order authorized such treatment.

As in Gwendolyn N., we do not question that the trial courtand clinical staff have the best of intentions for treatingrespondent. However, the statute requires specificity as asafeguard against potential abuses of involuntary administrationof such treatment. See In re C.E., 161 Ill. 2d 200, 641 N.E.2d345 (1994); Gwendolyn N., 326 Ill. App. 3d 427, 760 N.E.2d 575. We conclude respondent was prejudiced by the failure to specifythe authorized involuntary treatment, medications or anticipateddosages. Accordingly, the order authorizing involuntarytreatment must be reversed.

Because we find the order authorizing involuntary treatmentwas not in compliance with the statutory requirements, we willnot consider respondent's other arguments challenging that order.

For the foregoing reasons, the judgment of the circuit courtof Peoria County is affirmed in part and reversed in part.

Affirmed in part and reversed in part.

LYTTON, P.J., and HOMER, J., concur.