Spring 2020 | Issue 43
In re Robert M., 2020 IL App (5th) 170015: Order for involuntary administration of psychotropic medication affirmed
By: Meryl Sosa
In this case, the Illinois Appellate court affirmed the order of the involuntary administration of psychotropic medication to Robert M
On July 21, 2016, Robert was admitted to Alton Mental Health Center (Alton) after being found unfit to stand trial. On August 12, 2016, the State filed a petition for involuntary administration of psychotropic medications, including medications to control anxiety and psychosis. Robert agreed to take an anti-anxiety medication, Klonopin, but he had these arguments against taking antipsychotics:
There was insufficient evidence to provide clear and convincing evidence that he was suffering, which is one of the statutory requirements of involuntary administration of psychotropic medication.
There was insufficient evidence to prove that less restrictive treatments were explored and found to be inappropriate, which is another statutory requirement, as Robert was willing to take Klonopin for his anxiety.
Regarding the first argument: Robert’s psychiatrist testified that Robert felt anxiety that was “not just ordinary daily anxiety” but an intense type and [he] was actually under duress. At the time of his admission, Robert was experiencing pain from several infected teeth. Robert received dental care for his problem and refused pain medication. The court noted that Robert’s paranoid delusions caused him to refuse pain medication which would have alleviated his physical pain, which added to his suffering. Therefore, the Appellate Court affirmed that Robert’s severe anxiety and paranoid delusions was sufficient to prove that he exhibited suffering.
Regarding the second argument: In the context of admission to a facility, Illinois courts have repeatedly held that voluntary mental health services are preferred to involuntary treatment if possible. The Court, in Torry G, 2014 IL APP (1st) 130709, held “that any treatment to which a mental health patient is willing to consent should be considered a less restrictive service [] than forced treatment under section 2-107.1” ID. Paragraph 35. If a patient is willing to take some medications voluntarily, treatment with those medications should be explored and found to be inappropriate before involuntary medication is authorized. In this case, the patient was willing to take anti-anxiety medication which he claimed that the only he needed. However, there was evidence that anti-anxiety medication was inappropriate to treat the patient’s symptoms of anger, hostility, paranoid delusions, and somatic preoccupations. Because the patient was not willing to take antipsychotics voluntarily, the Appellate Court affirmed the order for the involuntary administration of psychotropic medication.
The Appellate Court held that:
“Here, there was evidence that, in addition to severe anxiety, Robert experienced anger, hostility, paranoid delusions, and somatic preoccupations that caused him to believe that a dental infection had spread throughout his body through his bloodstream. Like the psychiatrist in Israel, Dr. Patil testified that these symptoms could only be treated with antipsychotic medications. Thus, while an antianxiety medication like Klonopin was appropriate for Robert to treat his anxiety, the record in this case establishes that it was not appropriate to administer only an antianxiety medication without also administering antipsychotic medication to treat Robert’s other symptoms. We therefore conclude that the evidence was sufficient to prove that less restrictive services were explored and found to be inappropriate.
A link to this case is available here:
https://courts.illinois.gov/Opinions/AppellateCourt/2020/5thDistrict/5170015.pdf.