2024 IL App (5th) 230317-U NOTICE NOTICE Decision filed 07/24/24. The This order was filed under text of this decision may be NO. 5-23-0317 Supreme Court Rule 23 and is changed or corrected prior to the filing of a Petition for not precedent except in the
Rehearing or the disposition of IN THE limited circumstances allowed the same. under Rule 23(e)(1). APPELLATE COURT OF ILLINOIS
FIFTH DISTRICT ______________________________________________________________________________
In re PAMELA M., Alleged to Be a Person ) Appeal from the Circuit Court of Subject to Involuntary Treatment ) Union County. ) (The People of the State of Illinois, Petitioner- ) No. 22-MH-43 Appellee, v. Pamela M., Respondent-Appellant). ) ) Honorable Tyler R. Edmonds, ) Judge, presiding. ______________________________________________________________________________
JUSTICE BARBERIS delivered the judgment of the court. Justices Boie and McHaney concurred in the judgment.
ORDER
¶1 Held: Where the respondent’s appeal from a medication order is moot, and it does not fall into any of the exceptions to the mootness doctrine, this court grants the respondent’s appointed appellate counsel leave to withdraw, and it dismisses this appeal.
¶2 The respondent, Pamela M., appeals from an order authorizing the involuntary
administration of psychotropic medication, entered pursuant to the Mental Health and
Developmental Disabilities Code (Mental Health Code) (405 ILCS 5/1-100 et seq. (West 2022)).
(The respondent was not subject to an involuntary-commitment order.) Her appointed attorney on
appeal, the Legal Advocacy Service of the Illinois Guardianship and Advocacy Commission
(Legal Advocacy), has filed a motion to withdraw as counsel pursuant to Anders v. California, 386
U.S. 738 (1967). See In re Juswick, 237 Ill. App. 3d 102 (1992) (the Anders procedure is applicable
in an appeal from an involuntary-commitment order under the Mental Health Code). Legal
1 Advocacy contends that this appeal is moot. Furthermore, Legal Advocacy has concluded that
none of the exceptions to the mootness doctrine applies here. Legal Advocacy served the
respondent with proper notice of its Anders motion, and this court granted her time to file a pro se
response to the motion. However, the respondent has not filed with this court any type of response
to the Anders motion. This court agrees with Legal Advocacy as to the mootness of this appeal.
Accordingly, this court grants the Anders motion and dismisses the instant appeal.
¶3 BACKGROUND
¶4 In March 2021, the respondent was voluntarily admitted to the Choate Mental Health and
Developmental Center (Choate), a state-operated mental health facility in Anna, Illinois. On
December 16, 2022, Dr. Rakesh Chandra, a psychiatrist at Choate, filed a petition for an order
authorizing the administration of psychotropic medication, pursuant to section 2-107.1 of the
Mental Health Code (405 ILCS 5/2-107.1 (West 2022)).
¶5 The respondent thereafter filed a motion for substitution of judge as of right, which was
granted. The respondent also sought and received an independent psychiatric examination.
¶6 On March 22, 2023, the circuit court held a hearing on the petition for the administration
of psychotropic medication. Dr. Chandra was the sole witness for the State. He was qualified as
an expert in the field of psychiatry. According to Dr. Chandra, he treated the respondent at Choate.
He interacted with her regularly and had reviewed her records. Based on all that, he had diagnosed
her with “schizophrenia, paranoid type,” which he described as a serious mental illness. A person
with schizophrenia, paranoid type, does not trust anyone and believes that other people are trying
to harm him or her. Dr. Chandra had been working with the respondent for about two years. She
had shown great improvement as a result of being treated with a particular medication, Invega
Sustenna, and without experiencing side effects. In fact, she had improved to such an extent that
2 Dr. Chandra was preparing to discharge her from Choate, enabling her to “live in the community,”
without the severe limitations on liberty characteristic of life in a mental health facility. “And
suddenly, around June last year [i.e., in June 2022], she stopped taking her medication” and “went
on a downward spiral to the state she is in today.”
¶7 Dr. Chandra further testified that the respondent, due to her mental illness, was
deteriorating in her ability to function, she was suffering, and she was engaging in threatening
behavior, and Dr. Chandra provided details illustrative of those effects. He specified that he was
seeking authorization to treat the respondent with just one drug, Invega Sustenna, which would be
given as a monthly injection. This drug, he said, was the same medication that he had been
administering to the respondent previously, on a voluntary basis, for a period of months, and which
had produced such great improvement for the respondent. Dr. Chandra thought that the benefits to
the respondent far outweighed the harm. During the time she was taking the drug previously, “she
tolerated [it] very well.” Dr. Chandra viewed Invega Sustenna as “the least restrictive” approach
possible, while the only real alternative was to have the respondent continue to deteriorate. He had
discussed with the respondent the nature of her illness, as well as the upsides and downsides of
Invega Sustenna and the availability of other therapies, including group therapy. In his opinion,
though, the respondent lacked the capacity to make a reasoned decision about medication, and she
could not even understand the seriousness of her illness. Dr. Chandra also sought permission to
perform simple tests, such as a blood panel, to make sure that the respondent’s reaction to treatment
was no different than it was previously.
¶8 As for the respondent, she testified on her own behalf at the hearing. Her testimony was
largely unfocused and unresponsive to questioning by her appointed attorney.
3 ¶9 After hearing argument, the circuit court concluded that the State had met its burden at the
hearing. The court then entered a written order determining by clear and convincing evidence,
inter alia, that the respondent was deteriorating in her ability to function, was suffering, and was
engaging in threatening behavior. The court authorized the involuntary administration of
psychotropic medication—specifically, Invega Sustenna—for a period not to exceed 90 days. The
court also directed that the respondent was to receive certain specified medical tests as the Choate
medical staff deemed necessary.
¶ 10 The respondent perfected this appeal.
¶ 11 ANALYSIS
¶ 12 The order authorizing the involuntary administration of psychotropic drugs to the
respondent (hereinafter, the medication order) went into effect on March 22, 2023. By its own
terms, it expired 90 days afterward. Since the 90-day period already has expired, this court cannot
grant effectual relief to the respondent, and therefore this appeal is moot. See In re J.T., 221 Ill. 2d
338, 349-50 (2006). “As a general rule, courts in Illinois do not decide moot questions, render
advisory opinions, or consider issues where the result will not be affected regardless of how those
issues are decided.” In re Alfred H.H., 233 Ill. 2d 345, 351 (2009).
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2024 IL App (5th) 230317-U NOTICE NOTICE Decision filed 07/24/24. The This order was filed under text of this decision may be NO. 5-23-0317 Supreme Court Rule 23 and is changed or corrected prior to the filing of a Petition for not precedent except in the
Rehearing or the disposition of IN THE limited circumstances allowed the same. under Rule 23(e)(1). APPELLATE COURT OF ILLINOIS
FIFTH DISTRICT ______________________________________________________________________________
In re PAMELA M., Alleged to Be a Person ) Appeal from the Circuit Court of Subject to Involuntary Treatment ) Union County. ) (The People of the State of Illinois, Petitioner- ) No. 22-MH-43 Appellee, v. Pamela M., Respondent-Appellant). ) ) Honorable Tyler R. Edmonds, ) Judge, presiding. ______________________________________________________________________________
JUSTICE BARBERIS delivered the judgment of the court. Justices Boie and McHaney concurred in the judgment.
ORDER
¶1 Held: Where the respondent’s appeal from a medication order is moot, and it does not fall into any of the exceptions to the mootness doctrine, this court grants the respondent’s appointed appellate counsel leave to withdraw, and it dismisses this appeal.
¶2 The respondent, Pamela M., appeals from an order authorizing the involuntary
administration of psychotropic medication, entered pursuant to the Mental Health and
Developmental Disabilities Code (Mental Health Code) (405 ILCS 5/1-100 et seq. (West 2022)).
(The respondent was not subject to an involuntary-commitment order.) Her appointed attorney on
appeal, the Legal Advocacy Service of the Illinois Guardianship and Advocacy Commission
(Legal Advocacy), has filed a motion to withdraw as counsel pursuant to Anders v. California, 386
U.S. 738 (1967). See In re Juswick, 237 Ill. App. 3d 102 (1992) (the Anders procedure is applicable
in an appeal from an involuntary-commitment order under the Mental Health Code). Legal
1 Advocacy contends that this appeal is moot. Furthermore, Legal Advocacy has concluded that
none of the exceptions to the mootness doctrine applies here. Legal Advocacy served the
respondent with proper notice of its Anders motion, and this court granted her time to file a pro se
response to the motion. However, the respondent has not filed with this court any type of response
to the Anders motion. This court agrees with Legal Advocacy as to the mootness of this appeal.
Accordingly, this court grants the Anders motion and dismisses the instant appeal.
¶3 BACKGROUND
¶4 In March 2021, the respondent was voluntarily admitted to the Choate Mental Health and
Developmental Center (Choate), a state-operated mental health facility in Anna, Illinois. On
December 16, 2022, Dr. Rakesh Chandra, a psychiatrist at Choate, filed a petition for an order
authorizing the administration of psychotropic medication, pursuant to section 2-107.1 of the
Mental Health Code (405 ILCS 5/2-107.1 (West 2022)).
¶5 The respondent thereafter filed a motion for substitution of judge as of right, which was
granted. The respondent also sought and received an independent psychiatric examination.
¶6 On March 22, 2023, the circuit court held a hearing on the petition for the administration
of psychotropic medication. Dr. Chandra was the sole witness for the State. He was qualified as
an expert in the field of psychiatry. According to Dr. Chandra, he treated the respondent at Choate.
He interacted with her regularly and had reviewed her records. Based on all that, he had diagnosed
her with “schizophrenia, paranoid type,” which he described as a serious mental illness. A person
with schizophrenia, paranoid type, does not trust anyone and believes that other people are trying
to harm him or her. Dr. Chandra had been working with the respondent for about two years. She
had shown great improvement as a result of being treated with a particular medication, Invega
Sustenna, and without experiencing side effects. In fact, she had improved to such an extent that
2 Dr. Chandra was preparing to discharge her from Choate, enabling her to “live in the community,”
without the severe limitations on liberty characteristic of life in a mental health facility. “And
suddenly, around June last year [i.e., in June 2022], she stopped taking her medication” and “went
on a downward spiral to the state she is in today.”
¶7 Dr. Chandra further testified that the respondent, due to her mental illness, was
deteriorating in her ability to function, she was suffering, and she was engaging in threatening
behavior, and Dr. Chandra provided details illustrative of those effects. He specified that he was
seeking authorization to treat the respondent with just one drug, Invega Sustenna, which would be
given as a monthly injection. This drug, he said, was the same medication that he had been
administering to the respondent previously, on a voluntary basis, for a period of months, and which
had produced such great improvement for the respondent. Dr. Chandra thought that the benefits to
the respondent far outweighed the harm. During the time she was taking the drug previously, “she
tolerated [it] very well.” Dr. Chandra viewed Invega Sustenna as “the least restrictive” approach
possible, while the only real alternative was to have the respondent continue to deteriorate. He had
discussed with the respondent the nature of her illness, as well as the upsides and downsides of
Invega Sustenna and the availability of other therapies, including group therapy. In his opinion,
though, the respondent lacked the capacity to make a reasoned decision about medication, and she
could not even understand the seriousness of her illness. Dr. Chandra also sought permission to
perform simple tests, such as a blood panel, to make sure that the respondent’s reaction to treatment
was no different than it was previously.
¶8 As for the respondent, she testified on her own behalf at the hearing. Her testimony was
largely unfocused and unresponsive to questioning by her appointed attorney.
3 ¶9 After hearing argument, the circuit court concluded that the State had met its burden at the
hearing. The court then entered a written order determining by clear and convincing evidence,
inter alia, that the respondent was deteriorating in her ability to function, was suffering, and was
engaging in threatening behavior. The court authorized the involuntary administration of
psychotropic medication—specifically, Invega Sustenna—for a period not to exceed 90 days. The
court also directed that the respondent was to receive certain specified medical tests as the Choate
medical staff deemed necessary.
¶ 10 The respondent perfected this appeal.
¶ 11 ANALYSIS
¶ 12 The order authorizing the involuntary administration of psychotropic drugs to the
respondent (hereinafter, the medication order) went into effect on March 22, 2023. By its own
terms, it expired 90 days afterward. Since the 90-day period already has expired, this court cannot
grant effectual relief to the respondent, and therefore this appeal is moot. See In re J.T., 221 Ill. 2d
338, 349-50 (2006). “As a general rule, courts in Illinois do not decide moot questions, render
advisory opinions, or consider issues where the result will not be affected regardless of how those
issues are decided.” In re Alfred H.H., 233 Ill. 2d 345, 351 (2009). However, where an otherwise
moot case falls under a recognized exception, this court will consider the appeal. Illinois recognizes
these exceptions to the mootness doctrine: (1) the collateral-consequences exception, (2) the
capable-of-repetition-yet-evading-review exception, or (3) the public-interest exception. See id.
Courts consider these exceptions on a case-by-case basis. Id. at 354. All exceptions to the mootness
doctrine are “to be construed narrowly and require a clear showing of each criterion to bring the
case within the terms.” In re J.T., 221 Ill. 2d at 350.
4 ¶ 13 The Collateral-Consequences Exception
¶ 14 The collateral-consequences exception to the mootness doctrine applies where the
respondent has suffered, or is threatened with, an actual injury that is traceable to the medication
order, and the injury is likely to be redressed by a favorable judicial decision. Alfred H.H., 233 Ill.
2d at 361. Here, the record does not reveal any specific collateral consequence stemming from the
medication order. This court finds that this exception does not allow for a review of the merits of
this appeal.
¶ 15 The Capable-of-Repetition-Yet-Evading-Review Exception
¶ 16 Where a case involves an event of short duration that is capable of repetition, yet evading
review, it may qualify for review even if it would otherwise be moot. In re Barbara H., 183 Ill. 2d
482, 491 (1998). In order for this exception to apply, “the complaining party must demonstrate
that: (1) the challenged action is in its duration too short to 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.” Id.
¶ 17 The first criterion for this exception certainly applies here. By statute, the right to
administer psychotropic medication to a person against his or her will is subject to tight time
constraints. Psychotropic medication cannot be administered involuntarily for more than 90 days
without additional hearings. 405 ILCS 5/2-107.1(a-5)(5) (West 2022). Without doubt, such a
duration is too short to allow for appellate review. While the first criterion applies, the second
criterion does not apply. The record on appeal does not reveal any particular reason to expect that
the respondent would be subjected, again, to the same type of medication order.
5 ¶ 18 The Public-Interest Exception
¶ 19 “Application of the public interest exception requires (1) the existence of a question of
public importance; (2) the desirability of an authoritative determination for the purpose of guiding
public officers in the performance of their duties; and (3) the likelihood that the question will
recur.” J.T., 221 Ill. 2d at 350. The instant appeal does not raise a question of public importance,
and a decision on the merits of this appeal would not guide public officers in the performance of
their duties. The fact-specific nature of this case does not allow for the use of the public-interest
exception to the mootness doctrine. See Alfred H.H., 233 Ill. 2d at 356-57.
¶ 20 CONCLUSION
¶ 21 For the reasons stated above, this appeal is moot, and none of the exceptions to the
mootness doctrine applies. Therefore, Legal Advocacy’s motion to withdraw as appellate counsel
is granted, and this appeal is dismissed.
¶ 22 Motion granted; appeal dismissed.