In re Tommy B.

CourtAppellate Court of Illinois
DecidedApril 18, 2007
Docket4-06-0690 Rel
StatusPublished

This text of In re Tommy B. (In re Tommy B.) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In re Tommy B., (Ill. Ct. App. 2007).

Opinion

NO. 4-06-0690 Filed 4/18/07

IN THE APPELLATE COURT

OF ILLINOIS

FOURTH DISTRICT

In re: TOMMY B., a Person Found ) Appeal from Subject to Involuntary Admission, ) Circuit Court of THE PEOPLE OF THE STATE OF ILLINOIS, ) Sangamon County Petitioner-Appellee, ) No. 06MH474 v. ) TOMMY B., ) Honorable Respondent-Appellant. ) George H. Ray, ) Judge Presiding.

JUSTICE MYERSCOUGH delivered the opinion of the court:

In July 2006, the trial court found respondent, Tommy

B., subject to involuntary admission to a mental-health facility

(405 ILCS 5/1-119(1), (2) (West 2004)). Respondent appeals,

arguing reversal is warranted because (1) the petition was

defective, (2) no clear and convincing evidence supported respon-

dent's involuntary commitment, and (3) hospitalization was not

the least-restrictive treatment alternative. We affirm.

I. BACKGROUND

On July 17, 2006, a licensed practical nurse at Memo-

rial Medical Center (Memorial), Jolynne A. Ralston, filed a

petition for the involuntary admission of respondent, a voluntary

admittee who had filed a written notice requesting discharge.

The petition alleged respondent was mentally ill and by reason of

his mental illness (1) was reasonably expected to inflict serious physical harm upon himself or another in the near future, or (2)

was unable to provide for his basic physical needs so as to guard

himself from serious harm. In support of those allegations,

Ralston provided the following factual basis:

"[Respondent] has a chronic mental ill-

ness and is noncompliant with medication and

mental[-]health services. He has threatened

staff. He threatened to 'beat the shit[']

out of a staff member. He also attempted to

hit staff[']s hand with phone receiver."

Ralston left the following portion of the petition blank:

"Listed below are the names and

addresses of the spouse, parent, guardian, or

surrogate decision maker, if any, and close

relative or, if none, a friend of the respon-

dent whom I have reason to believe may know

or have any of the other names and addresses.

If names and addresses are not listed below,

the following describes my efforts to iden-

tify and locate these individuals."

The petition was accompanied by the certificates of two psychia-

trists.

The trial court set a hearing on the petition for July

21, 2006. On respondent's motion, and over the State's objec-

- 2 - tion, the hearing was continued until July 28, 2006.

At the hearing on June 28, 2006, psychiatrist James

Black testified he was board certified and currently respondent's

treating physician. Dr. Black examined respondent on July 27,

2006. During the examination, respondent exhibited signs of

mental illness, including delusions, pressured speech,

grandiosity, increased energy, and difficulty with sleep.

Respondent did not threaten anyone during that conversation.

However, Dr. Black testified that during the hospital stay

respondent had been threatening and insulting to others.

Dr. Black diagnosed respondent with bipolar disorder

with mania and psychosis. Dr. Black believed, within a reason-

able degree of medical certainty, that because of his mental

illness, respondent was unable to provide for his basic physical

needs so as to guard himself from serious harm. Dr. Black

testified that respondent had a number of potentially life-

threatening medical disorders, including recurrent renal cell

carcinoma, right periaortic mass of cancer, severe papillary

thyroid disease, and chronic renal failure (hereinafter referred

to as "nonpsychiatric medical disorders"). Respondent could not

understand his medical risks, the treatments offered, and risks

if he does not get treatment for his nonpsychiatric medical

disorders.

Dr. Black also believed, within a reasonable degree of

- 3 - medical certainty, that respondent was reasonably expected to

inflict serious physical harm upon himself or another within the

immediate future. Dr. Black testified that if respondent left

his supervised setting, he would "fairly quickly decompensate and

be dangerous to himself or others quickly." He based this

conclusion on the fact that respondent had done so on an almost

daily basis at the hospital (presumably during his voluntary

admission). On a number of occasions, almost every day, respon-

dent had threatened others, causing respondent to require re-

straints and medications to stabilize him.

In light of his opinions, Dr. Black believed respondent

needed treatment. A treatment plan had been formulated and was

admitted into evidence without objection for the limited purpose

of the dispositional hearing. According to Dr. Black, the

treatment plan was the least-restrictive alternative. Based on

the treatment plan, Dr. Black recommended respondent be treated

at Memorial for a period not to exceed 90 days.

Dr. Black did not testify in detail regarding the

treatment plan. However, an examination of the treatment plan

reveals that respondent's plan of care had been revised to

require restriction to his room with supervision to be evaluated

daily. The July 24, 2006, progress report indicates that due to

respondent's threatening behavior, inability to comply with limit

setting, and actual staff assaults, respondent was restricted to

- 4 - his room or under staff supervision outside of his room. No one

was permitted to enter respondent's room alone. Any threats of

harm to others would result in seclusion or restraints.

On cross-examination, Dr. Black admitted that in some

cases psychosis could be caused by thyroid disease. However, Dr.

Black did not believe thyroid disease caused respondent's psycho-

sis.

The delusions respondent suffered from included respon-

dent's belief that he had been a pharaoh and that bullets could

pass through him. When asked what delusion would place respon-

dent or another in serious physical harm, Dr. Black responded

that respondent refused treatment for his cancer. Dr. Black

later explained, however, that respondent had not been offered

treatment for his cancer at this point but had only been offered

diagnostic studies.

According to Dr. Black, respondent had interfered with

treatment for his thyroid disease by pulling out his IV (intrave-

nous) and heart-rhythm monitor. Other examples of delusional

beliefs that placed respondent or another in serious harm in-

cluded respondent's belief that he was going to live forever and

delusions that caused respondent to attack other patients and

threaten to kill staff.

Dr. Black testified respondent currently received

treatment from physicians and other personnel in oncology, renal,

- 5 - endocrinology, and nutrition. Respondent could not be discharged

to a medical floor to obtain that treatment because he was too

mentally ill. If respondent were on a medical floor, his behav-

ior would be too much for them to manage, and respondent would be

unsafe.

Respondent took his psychiatric medication some of the

time. Respondent's last incident of assaultive behavior occurred

the previous weekend. After that, Dr.

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