In re H.P., 2019 IL App (5th) 150302
Spring 2020 | Issue 43
In re H.P., 2019 IL App (5th) 150302: Order for involuntary administration of psychotropic medication reversed.
By: Meryl Sosa
In this case, the Illinois Appellate court considered whether the State should present the evidence of known interactions between multiple medications so as to satisfy the statutory burden of showing that the benefits of the treatment outweigh the harm.
On June 11, 2015, H.P. was admitted to Chester Mental Health Center (Chester) after being found unfit to stand trial on multiple criminal charges. On July 22, 2015, the State filed a petition for involuntary administration of psychotropic medication. The petition was signed by a Chester psychiatrist, Dr. Muddasani Reddy. H.P. had 11 prior admissions to facilities and had been diagnosed with schizoaffective disorder, depressive type. H.P. experienced auditory hallucinations, grandiose delusions, mood swings between depression and elation. Dr. Reddy alleged that H.P. exhibited aggressive behavior as a result of his illness. Dr. Reddy also alleged that H.P. signed a consent to take medications but refused to do so. Dr. Reddy requested permission to administer six medications including olanzapine and haloperidol, specified a range of dosages for each, and alleged that “testing and procedures are essential for the safe and effective administration of treatment.”
The Illinois Supreme Court has held that mentally ill patients have a constitutionally protected right to refuse to be treated with psychotropic medications. The statute authorizing the involuntary administration of psychotropic medications provides important procedural safeguards that protect the right of patients while balancing the benefits of treatment.
The law requires the state to prove by clear and convincing evidence that the benefits of the proposed treatment outweighs the risk of harm from the treatment. The court must consider not only the type of harm that can results from a medication, but also interactions between medications can cause serious harm. In this case, H.P. claimed that Dr. Reddy did not testify about the benefits of using two antipsychotics simultaneously. Dr. Reddy did not testify about the interactions between the medications.
The law also requires the State to provide clear and convincing evidence that tests or procedures are “essential for the safe and effective administration of treatment.” To meet this standard, it is not enough to have the State’s expert to simply opine that the testing is essential; the State must also present evidence specifying what tests and procedures are required, and how often they are to be performed. In this case, Dr. Reddy testified that H.P. would be “[p]eriodically monitored” and that the blood tests would show any “metabolic changes in the parameters,” but did not testify the tests were essential, and he did not specify which tests. Thus, the court found that the State did not meet the requirements from the statute and reversed the order authorizing the involuntary administration of psychotropic medication and other tests and procedures to H.P.
The following is taken directly from the court reports:
“The statute provides that, before a patient may be medicated against his will, the State must prove by clear and convincing evidence that (1) the patient has a serious mental illness; (2) he currently exhibits a deterioration in his ability to function, suffering, or threatening behavior; (3) his illness has been marked by the continuing presence or repeated episodic occurrence of at least one of these three symptoms; (4) the benefits of the proposed treatment outweigh the harm; (5) the patient lacks the capacity to make a reasoned decision about his treatment; and (6) less restrictive alternatives have been considered and found to be inappropriate. 405 ILCS 5/2-107.1(a-5) (4)(A) -(F) (West 2014). If the State requests authorization for testing or other procedures, as it did here, it must also prove by clear and convincing evidence that those tests or procedures are “essential for the safe and effective administration of the treatment.” Id. § 2- 107.1(a-5) (4)(G). The court may only authorize the involuntary administration of psychotropic medication if it finds that the State has met its burden of proving all of these factors. In re Louis S., 361 Ill. App. 3d 774, 779 (2005).”
A link to this case is available here: https://courts.illinois.gov/Opinions/AppellateCourt/2019/5thDistrict/5150302.pdf.