In re Robert R.
Case Date: 03/26/2003
Court: 5th District Appellate
Docket No: 5-01-0814 Rel
JUSTICE CHAPMAN delivered the opinion of the court: This is an appeal from two separate orders of the circuit court for the involuntaryadministration of psychotropic medications to Robert R. (respondent). Respondent filed atimely pro se notice of appeal after each of the court's orders, and we have consolidated theappeals for the purposes of this decision. The issues for review are (1) whether the circuitcourt erred in proceeding in respondent's absence at the first hearing and (2) whether thecourt erred in ordering the involuntary administration of psychotropic medication requestedin the second petition, when a predispositional report had not been filed. We affirm. On August 23, 2001, respondent was transferred to the Alton Mental Health Centerfrom the Peoria County jail after being found unfit to stand trial for aggravated battery. OnSeptember 4, 2001, Dr. Jagannath Patil of the Alton Mental Health Center filed a petitionwith the court. The petition alleged that respondent was a person subject to the involuntaryadministration of psychotropic medication pursuant to section 2-107.1 of the Mental Healthand Developmental Disabilities Code (Code) (405 ILCS 5/2-107.1 (West Supp. 2001)). Inthe petition, Dr. Patil alleged that respondent had refused to take psychotropic medicationswhile he was in jail and continued to refuse such medication while at the mental health centerbecause of illogical or irrational reasoning and delusional beliefs. On September 6, 2001, a hearing on the petition was held in a courtroom within theAlton Mental Health Center. However, respondent, a patient at the mental health center, didnot appear in the courtroom. Respondent's attorney advised the court that, though respondentwanted to attend the hearing, he did not wish to be placed in restraints to be moved from thebuilding where he was housed to the building in which the hearing was to be held. Respondent's attorney, relying upon section 3-806 of the Code (405 ILCS 5/3-806 (West2000)), requested that the proceedings be moved to a courtroom located within the unit whererespondent was located. The court denied the request and found that the holding ofproceedings at the mental health center was sufficient to accommodate respondent. Thehearing then began, without counsel waiving respondent's presence. The court foundrespondent to be a person subject to the involuntary administration of psychotropicmedication. Respondent filed a timely pro se appeal. On November 26, 2001, Dr. Patil filed another petition seeking the involuntaryadministration of psychotropic medication. On November 29, 2001, a hearing attended byrespondent and his counsel was held. Dr. Patil testified as the State's only witness. Dr. Patil testified that he was respondent's treating psychiatrist and that he haddiagnosed him as suffering from schizoaffective disorder, bipolar type. Dr. Patil testifiedthat, as a result of this diagnosis, respondent exhibits delusional, disorganized thinking andaggressive behaviors. Dr. Patil testified that at the time of the testimony respondent was onmedication and that some of his symptoms had improved. However, respondent continuedto exhibit delusional paranoia and bizarre thinking. Dr. Patil stated that psychotropicmedication is a necessary part of respondent's treatment, and he asked that the court approvespecific dosages of risperidone and Depakote with alternating medications of Clozaril,Haldol, and Ativan. These medications, he testified, would help rid respondent of hisdelusional beliefs and stabilize his psychiatric condition, improving his ability to interactwith others and to benefit from counseling, leading to his possible fitness to stand trial. Inassessing whether respondent had any conditions that would put him at an extraordinary,serious risk of harm from any of the recommended medications, Dr. Patil noted thatrespondent had previously suffered a myocardial infarct that would require a work-up EKGby a cardiologist before Clozaril could be administered to respondent. At the close of the evidence, respondent's attorney argued that the State had notproven that less restrictive treatment options had been explored and found inappropriate. Respondent's attorney contended that, in the absence of a predispositional report pursuant tosection 3-810 of the Code (405 ILCS 5/3-810 (West 2000)), it was impossible for the Stateto have proven that less restrictive treatment options had been explored and foundinappropriate. The State responded by noting that there had been specific testimony elicitedon the issue of less restrictive treatment services and no contrary evidence. The Stateconceded that there had not been a predispositional report prepared. The court found that respondent was a person subject to the involuntary administrationof the psychotropic medications requested, with the exception of Clozaril. Respondent fileda timely pro se appeal. Respondent first argues that he was denied an opportunity to be heard when the court refused to accommodate his attorney's request to move the location of the hearing and thenproceeded in respondent's absence. We disagree. At the onset of the hearing on September 6, 2001, respondent's attorney informed thecourt that respondent originally wanted to come to court but had not understood that hewould have to be restrained. Further, respondent had apparently misunderstood that thehearing was to be held in a building different from the one in which he was being housed. Respondent's attorney then requested that the hearing be moved to the forensic unit of theAlton Mental Health Center, where respondent was housed. In support of this request,respondent's attorney cited to section 3-806(b) of the Code, which states in part, "The courtshall make reasonable accommodation of any request by the recipient's attorney concerningthe location of the hearing" (405 ILCS 5/3-806(b) (West 2000)). The court, however, denied the request, pointing out that it had already madereasonable accommodations and noting further that a move to the forensic unit would raisesecurity concerns involving court and hospital personnel. The court further emphasized theimpracticality of holding a hearing wherever a patient wished it to be held. After the courthad denied the request to move the hearing, respondent's attorney informed the court that hedid not have authority to waive respondent's right to be present at the hearing. The courtasked the State whether it wanted to lay a foundation to explain why respondent was notpresent. The State called Theresa Mitchell, a licensed clinical social worker employed at theAlton Mental Health Center. Mitchell testified that she worked in the forensic unit where respondent was a patient.On the morning of the hearing, the nursing staff informed her that respondent had stated thathe wanted to go to court but was agitated because he did not want to have any securitydevices on. Mitchell testified that, as a forensic patient at the Alton Mental Health Center,respondent was required to be secured with shackles before he could move from building tobuilding. She testified that when she discussed the matter with him, respondent became veryagitated, telling Mitchell that he did not want to go to court if he had to wear restrainingdevices. Mitchell said she believed that respondent would have become even more agitated,possibly to the point of becoming a danger to himself and others, if he were physicallyrestrained and brought to court under protest. On the cross-examination of Mitchell, respondent's attorney inquired about theexistence of a courtroom in the unit in which respondent was being held: "Q. All right. And is there a state seal and courtroom type area in the forensicunit in the front? A. We have a conference room, but it's never been used as a courtroom to myknowledge. Q. In the visitors' area in the front where the state seal is above the bench? Doyou know where I'm talking about? Is there a visitors' room? A. Yeah, we have a visitors' room. Q. And do people have to wear restraints when they go there? A. Well, no, but they have to be-we have to believe they're behaviorally stablebefore we'll let them off the treatment unit, and in my opinion [respondent] was notbehaviorally stable this morning." After hearing testimony from Mitchell, the court found that there was a substantialrisk of physical harm to respondent if he were brought to court against his will. The courtfound that there was a need for orderly proceedings and that respondent's case had been setfor that day. The court then proceeded on the petition. Section 3-806 provides as follows: "(a) The respondent shall be present at any hearing held under this Act unlesshis attorney waives his right to be present and the court is satisfied by a clear showingthat the respondent's attendance would subject him to substantial risk of seriousphysical or emotional harm. (b) The court shall make reasonable accommodation of any request by therecipient's attorney concerning the location of the hearing. If the recipient's attorneyadvises the court that the recipient refuses to attend, the hearing may proceed in hisor her absence. (c) No inference may be drawn from the recipient's non[]attendance pursuantto either subsection (a) or (b) of this Section." 405 ILCS 5/3-806 (West 2000). On appeal, respondent argues that strict compliance with the Code's proceduralsafeguards are required to ensure that the mental health system does not become a tool tooppress, rather than to serve, society and that the circuit court did not have discretion to denyhis counsel's reasonable request. While we agree with respondent that the clear language ofsection 3-806(b) mandates that the court make a reasonable accommodation of any requestconcerning the location of the hearing, it does not follow that every accommodationrequested is reasonable. Accordingly, the circuit court is charged with determining thereasonableness of any such requests made under this provision. In making the determination, one factor the court considered was whether the securityof court and hospital personnel would be compromised if the proceedings were to be movedfrom the customary courtroom to a room characterized as a "visiting room" in a nearbybuilding. The court further expressed concern that such an accommodation would result infuture requests to move hearings from building to building and room to room within thefacility, thereby burdening the court. We find these concerns reasonable and agree with thecourt's finding that it had already reasonably accommodated respondent. We find that thecourt did not abuse its discretion by denying his further request. In arguing that the court improperly waived his presence at the hearing, respondentrelies upon section 3-806(a)'s requirement that a "respondent shall be present at any hearing*** unless his attorney waives his right to be present and the court is satisfied by a clearshowing that the respondent's attendance would subject him to substantial risk of seriousphysical or emotional harm." 405 ILCS 5/3-806(a) (West 2000). Respondent pointed outthat, although the court found that his attendance at the hearing would have causedsubstantial risk of harm, his attorney did not waive his right to be present as required underthis provision. However, an express waiver of respondent's presence at the hearing by his attorneywas not necessary in this case, because counsel for respondent had already informed the courtthat respondent refused to attend the hearing at the noticed location, allowing the hearing toproceed in respondent's absence pursuant to section 3-806(b). Theresa Mitchell's testimonyverified respondent's refusal to attend and indicated that respondent's refusal was voluntaryand knowing. The satisfaction of the requirements of section 3-806(a), upon whichrespondent now relies, was unnecessary for the court to proceed in respondent's absence inthis case. Thus, the court's decision to proceed on the petition without respondent presentwas not error. Next, respondent argues that the court erred in finding that he was a person subjectto the involuntary administration of psychotropic medication because the State failed tosubmit a predispositional report pursuant to section 3-810 of the Code. Section 3-810 of theCode provides as follows: "Before disposition is determined, the facility director or such other person asthe court may direct shall prepare a written report including information on theappropriateness and availability of alternative treatment settings, a social investigationof the respondent, a preliminary treatment plan, and any other information which thecourt may order. The treatment plan shall describe the respondent's problems andneeds, the treatment goals, the proposed treatment methods, and a projected timetablefor their attainment. If the respondent is found subject to involuntary admission, thecourt shall consider the report in determining an appropriate disposition." 405 ILCS5/3-810 (West 2000). Respondent notes that section 2-107.1 of the Code outlines the standards by whichinvoluntary treatment may be administered. 405 ILCS 5/2-107.1 (West Supp. 2001). Section2-107.1(a-5)(3) requires the following: "Unless otherwise provided herein, the proceduresset forth in Article VIII of Chapter 3 of [the Code], including the provisions regardingappointment of counsel, shall govern hearings held under this subsection (a-5)." 405 ILCS5/2-107.1(a-5)(3) (West Supp. 2001). Respondent relies upon this language as support forhis contention that the predispositional-report requirement of section 3-810 must be satisfiedin any proceedings seeking court-authorized involuntary administration of psychotropicmedication. The State argues that a predispositional report is intended to be used only in draftingorders related to involuntary commitment proceedings and is not applicable to proceedingsfor the involuntary administration of psychotropic medication. The State points out thatproceedings for involuntary commitment involve two separate hearings, one to determine ifthe respondent is subject to involuntary admission and another to determine how and wherethe respondent will be treated. The State asserts that the function of a predispositional reportis to enable the circuit court to decide where a respondent will be confined and treated onceit has found that the individual is a person subject to involuntary commitment. The Statefurther contends that a predispositional report serves no purpose in proceedings for theinvoluntary administration of psychotropic medication because, in conducting thoseproceedings, the court is required to find only whether the administration of psychotropicmedication or other forms of involuntary treatment should or should not be administered. These proceedings are therefore complete as soon as a finding has been entered, leavingnothing else to be considered. The issue before us is one of statutory construction-whether section 3-810 of the Codeapplies to proceedings on petitions for the involuntary administration of psychotropicmedication. "The primary rule of statutory construction is to ascertain and give effect to thelegislature's intent." People v. Ellis, 199 Ill. 2d 28, 39, 765 N.E.2d 991, 997 (2002). Indetermining legislative intent, we must first look to the statute's language, giving thelanguage its plain and commonly understood meaning. Ellis, 199 Ill. 2d at 39, 765 N.E.2dat 997. Additionally, we consider the reason and necessity of the statute, the problems soughtto be remedied, and the purpose to be achieved. In re Detention of Lieberman, 201 Ill. 2d300, 308, 776 N.E.2d 218, 223 (2002). Ordinarily, we will not depart from a statute's plain language by reading into itexceptions, limitations, or conditions not expressed by our legislature (Ellis, 199 Ill. 2d at 39,765 N.E.2d at 997); however, we will presume that in enacting the statute the GeneralAssembly did not intend absurdity, inconvenience, or injustice. In re Detention ofLieberman, 201 Ill. 2d at 309, 776 N.E.2d at 224. "Where the spirit and intent of the GeneralAssembly in adopting an act are clearly expressed and its objects and purposes are clearly setforth, courts are not bound by the literal language of a particular clause which would defeatthe obvious intent of the legislature." In re Detention of Lieberman, 201 Ill. 2d at 312, 776N.E.2d at 225-26. In circumstances where adhering to the literal language of the statutewould yield a result that is "clearly and demonstrably at odds with the obvious intent of theGeneral Assembly," we may disregard, modify, or supply language to give effect to thelegislative design. In re Detention of Lieberman, 201 Ill. 2d at 320, 776 N.E.2d at 230. The involuntary administration of psychotropic medications to an individual allegedto be mentally ill implicates substantial liberty interests. In re C.E., 161 Ill. 2d 200, 213-17,641 N.E.2d 345, 350-53 (1994). However, these liberty interests must be balanced againstthe State's legitimate interests in furthering the treatment of mentally ill individuals byforcibly administering psychotropic medication where an individual lacks the capacity tomake reasoned decisions concerning his or her need for such medication. In re C.E., 161 Ill.2d at 217, 641 N.E.2d at 353. In 1991, the General Assembly enacted section 2-107.1 as amechanism for determining when psychotropic medications may be administered over anindividual's objections. In re C.E., 161 Ill. 2d at 217, 641 N.E.2d at 353. Section 2-107.1serves as a guide for balancing the liberty of the individual and the State's interest in treatingits mentally ill citizens. In re C.E., 161 Ill. 2d at 217, 641 N.E.2d at 353. Section 2-107.1provides as follows: "(4) Authorized involuntary treatment shall not be administered to the recipientunless it has been determined by clear and convincing evidence that all of thefollowing factors are present: (A) That the recipient has a serious mental illness or developmentaldisability. (B) That because of said mental illness or developmental disability, therecipient exhibits any one of the following: (i) deterioration of his or her abilityto function, (ii) suffering, or (iii) threatening behavior. (C) That the illness or disability has existed for a period marked by thecontinuing presence of the symptoms set forth in item (B) of this subdivision(4) or the repeated episodic occurrence of these symptoms. (D) That the benefits of the treatment outweigh the harm. (E) That the recipient lacks the capacity to make a reasoned decisionabout the treatment. (F) That other less restrictive services have been explored and foundinappropriate. (G) If the petition seeks authorization for testing and other procedures,that such testing and procedures are essential for the safe and effectiveadministration of the treatment." 405 ILCS 5/2-107.1(a-5)(4) (West Supp.2001). As respondent has noted, section 2-107.1 also provides that the procedures set forthin article VIII of chapter 3 of the Code govern court hearings on petitions for the involuntaryadministration of psychotropic medication. 405 ILCS 5/2-107.1(a-5)(3) (West Supp. 2001). However, when first enacted in 1979, article VIII of chapter 3 addressed proceedingsconcerning the involuntary admission, transfer, or discharge of mentally ill individuals anddid not address the involuntary administration of psychotropic medications. Ill. Rev. Stat.1979, ch. 91 |