People v. Robert M. (In re Robert M.)
| Decision Date | 28 February 2020 |
| Docket Number | NO. 5-17-0015,5-17-0015 |
| Citation | 2020 IL App (5th) 170015,145 N.E.3d 767,438 Ill.Dec. 231 |
| Parties | IN RE ROBERT M., a Person Found Subject to Involuntary Medication (The People of the State of Illinois, Petitioner-Appellee, v. Robert M., Respondent-Appellant). |
| Court | United States Appellate Court of Illinois |
Veronique Baker and Laurel Spahn, of Illinois Guardianship & Advocacy Commission, of Hines, for appellant.
Thomas D. Gibbons, State's Attorney, of Edwardsville (Patrick Delfino, Patrick D. Daly, and Sharon Shanahan, of State's Attorneys Appellate Prosecutor's Office, of counsel), for the People.
¶ 1 The respondent, Robert M., raises two arguments in this appeal from an order finding him to be subject to the involuntary administration of psychotropic medication. First, he argues that there was insufficient evidence to prove by clear and convincing evidence that he was suffering, one of the statutory requirements for the involuntary administration of psychotropic medication. See 405 ILCS 5/2-107.1(a-5)(4)(B)(ii) (West 2016). Second, he argues that there was insufficient evidence to prove that less restrictive treatments were explored and found to be inappropriate, another statutory requirement. See id. § 2-107.1(a-5)(4)(F). In particular, he points out that there was evidence that he was willing to take an antianxiety medication, one of the types of medication his treating psychiatrist wanted to administer. He argues that there was no evidence that voluntarily administering an antianxiety medication would have been inappropriate. We affirm.
¶ 3 Robert was 32 years old at the time of the proceedings in this matter. He had a history of mental illness that dated back to when he was 10 years old, which required several previous admissions to psychiatric facilities.
¶ 4 On July 21, 2016, Robert was admitted to Alton Mental Health Center (Alton) after being found unfit to stand trial. His treating psychiatrist at Alton was Dr. Jagannath Patil. On August 12, 2016, the State filed a petition seeking to involuntarily administer psychotropic medication to Robert. In a supporting affidavit, Dr. Patil indicated that he wanted to administer medications to control anxiety and symptoms of psychosis
, including paranoid delusions.
¶ 5 At the time of his admission to Alton, Robert was experiencing pain from several infected teeth. He attributed his anxiety to his dental pain. While at Alton, Robert received dental care for his problem. He took two rounds of antibiotics for the infection and had two teeth filled. The dentist also recommended that five teeth be extracted. At the time of the hearing in this matter, Robert was still awaiting an appointment at Southern Illinois University School of Dental Medicine to have the teeth extracted.
¶ 6 On September 1, 2016, the court held a hearing on the petition for involuntary administration of psychotropic medication. Dr. Patil testified that he diagnosed Robert with schizoaffective disorder
, bipolar type. As a result of this disorder, Robert experienced paranoid delusions, anger, hostility, increased speech, and increased psychomotor activity. Dr. Patil stated that Robert also experienced somatic preoccupations. Asked to explain, he noted that Robert believed that taking antibiotics helped him to think more clearly because they "slow[ed] down his brain." He also noted that Robert told him that the fever from his infected teeth was interfering with his ability to think clearly.
¶ 7 Dr. Patil testified that Robert exhibited a deterioration in his ability to function. Asked to explain, he noted that Robert typically only slept four to five hours a night. He described Robert as being always "on guard" and frequently argumentative. Dr. Patil described some of the paranoid beliefs expressed by Robert. For example, he testified that Robert believed that staff members were "messing up with his locked toothbrushes." He further testified that Robert asked to shower alone due to paranoid fears. Dr. Patil testified that on one occasion, Robert refused to take Tylenol
for his tooth pain even though he had requested it. He testified that Robert spit out the tablet, insisting that it was not really Tylenol. When a staff member showed him the box, Robert continued to insist that the tablet was something other than Tylenol, and he accused staff members of conspiring against him to turn him into a "zombie."
¶ 8 Dr. Patil opined that Robert was suffering as a result of his symptoms. He noted that Robert reported to his treatment team that he was "in duress with anxiety." Dr. Patil testified that Robert complained that the staff was neglecting his pain, anxiety, and medical needs, but when staff members asked him what they could do to help, Robert accused them of being "too aggressive."
¶ 9 When asked if Robert exhibited threatening behavior, Dr. Patil described three incidents. In one incident, Robert threw a chair against the wall during an argument with a nurse. The following night, he was awake most of the night slamming doors and talking loudly. During this incident, Robert threatened to "write up" staff members so they would be fired. Another time, Robert could be heard yelling and cursing angrily while he took a shower. Dr. Patil testified, however, that it was not necessary to medicate Robert on an emergency basis during any of these incidents or at any other time.
¶ 10 Dr. Patil testified that Robert reported suffering from depression and posttraumatic stress. Robert indicated to Dr. Patil that he "might" need to take Klonopin
, an antianxiety medication he had taken prior to his admission to Alton. Dr. Patil testified, however, that Robert felt he did not need to take antipsychotic medications because he was " ‘in control of [his] own paranoia.’ "
¶ 11 Dr. Patil did not have access to all of Robert's medical records. Instead, he elicited information from Robert on what medications he had taken in the past, although he testified that he did not know whether Robert was an "accurate historian." Robert told Dr. Patil that he previously took risperidone
, haloperidol (Haldol ), Invega, Thorazine, and Seroquel. Robert reported that he had "bad experiences" with risperidone, Haldol, and Invega. When asked what kind of bad experiences Robert had with these medications, Dr. Patil replied, "I mean, he did not elaborate, but I'm sure he may have experienced some side effects."
¶ 12 Dr. Patil was asked whether less restrictive treatments had been explored. In response, he noted that Robert participated in classes and therapy sessions. However, he opined that these alternatives were not adequate to treat Robert's symptoms unless used in conjunction with medication.
¶ 13 On cross-examination, Dr. Patil acknowledged that Robert was eating and taking showers and that his hygiene had improved. He further acknowledged that Robert's progress reports included entries indicating that he was interacting with others and cooperating with unit expectations. Dr. Patil testified that although Robert indicated that he might need to take Klonopin
, he did not sign a consent form. We note that Dr. Patil did not indicate whether Robert was ever asked to sign a consent form.
¶ 14 Robert testified in his own behalf. Asked which medications he has taken in the past, Robert replied, "I've been on a whole variety of medications that there was no success because * * * there has been no solid proof of any of the illnesses that they've accused me of having." He testified that he has taken Ativan
, Invega, Risperdal, Thorazine, Zyprexa, Haldol, and Robert was asked what side effects he experienced while taking these medications. He testified that Thorazine and Invega caused fever and rashes and that he experienced swelling in his throat after receiving injections. However, he could not remember which medications caused the swelling because they were administered a long time ago. He also testified that he blacked out and experienced redness in his eyes, but he did not specify which medications caused these side effects.
¶ 15 Robert acknowledged that he banged on the window to the nurses' station in order to get the attention of the nurses so he could request Tylenol
. He explained that he was "desperate for Tylenol" because he was running a fever, which he believed was "cooking [his] brain." He further testified that the infection from his teeth was spreading though his blood and that no one had "thoroughly checked" for infection throughout his system.
¶ 16 Robert testified that he was currently willing to take an antianxiety medication because the pain from his teeth was making him irritable. He indicated, however, that he did not believe he would need to take an antianxiety medication once his dental treatment was complete. Finally, Robert accused staff members of threatening to tell the doctors to medicate him against his will.
¶ 17 The last witness to testify was Anne Crane, Robert's mother. She testified that Robert lived with her prior to his admission to Alton. Crane described her son as being able to function reasonably well at home. She testified that he was able to take care of himself with no assistance and that he was also able to assist her due to her physical disability. She noted that he also worked on the family's vehicles. Crane did not believe that Robert should be medicated with antipsychotic medications, but she did believe he needed an antianxiety medication. She testified that there were several recent stressors in Robert's life. She explained that a year earlier, she was on life support in the emergency room, and emergency room personnel recommended that her husband execute a do not resuscitate order. In addition, she testified that Robert's father and brother both died and that his dental problems had been going on for a few years because he had no insurance to pay for the necessary care.
¶ 18...
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