HomeNews & EventsPublicationsMind Matters - Summer 2020In re Julie M., 2019 IL App (4th) 180753

In re Julie M., 2019 IL App (4th) 180753



Summer 2020  |  Issue 44

In re Julie M., 2019 IL App (4th) 180753
By: Meryl Sosa, Esq.

In this case, the Illinois Appellate Court considered whether the Circuit Court properly found respondent to be subject to involuntary admission for psychiatric treatment after she had already been voluntarily admitted for medical treatment, and whether the Circuit Court properly denied respondent’s motion to dismiss the State’s petition for involuntary admission. In re Linda B., 2017 IL 119392, an Illinois Supreme Court case involving a similar respondent, was central to the decision-making in this case.

On September 14, 2018, respondent Julie M, who had a history of medical and psychiatric admission for swallowing batteries just a few days prior, presented to Carle Hospital’s Emergency Department after another suicide attempt by swallowing batteries. Patient subsequently underwent an endoscopy procedure and was admitted to a medical floor. Dr. Gersh, a consult-liaison psychiatrist at Carle Hospital, testified that the psychiatry department consulted with respondent on September 17, 2018 and saw her regularly on “9/19, 9/26, 10/1, 10/2, 10/4 and 10/5.”  During her admission, respondent tried to hurt herself multiple times in her room and required “2 sitters.” Dr. Alcaraz, Jr., a hospitalist at Carle, said that respondent was medically cleared for discharge on September 28. A nurse contacted 7 or 8 psychiatric facilities. However, the local psychiatric facilities were not comfortable accepting “medically complicated people,” and Dr. Gersh stated that it was inappropriate to discharge respondent until October 4, 2018. He stated that respondent’s previous supportive living facility would not accept her, and respondent’s “going to a homeless shelter [was] unacceptable.” Dr. Gersh completed the involuntary certificate on October 4, 2018. A petition for the respondent’s involuntary admission was filed on October 5, 2018.

On October 16, 2018, respondent moved to dismiss the petition. She argued that, since she was medically cleared on September 28, she was held for more than 24 hours without proper documentation, and that Carle detained her involuntarily. At the hearing, the Circuit Court held that it was the respondent’s burden to show that she was in the hospital involuntarily, and that her physical presence in a hospital while not wanting to be there did not mean she was there involuntarily. Her admission would only become involuntary after being discharged from the hospital. In this case, the Circuit Court held that respondent was not medically discharged until October 3rd, and therefore the certificate on October 4th was filed in a timely manner. The Circuit Court granted the State’s petition for involuntary admission. The respondent appealed this order, contending that:

“the facility in which she received both medical treatment and psychiatric treatment was a “mental health facility” that failed to comply with the admission requirement of the Mental Health Code and, as a result, held and treated her involuntarily for longer than the 24 hour period in which a petition for involuntary admission should have been filed.”

The respondent claimed that her admission to the “mental health facility” was when she came to the hospital on September 14, 2018 for her suicide attempt. On December 20, 2019, the Appellate Court held that respondent was in a mental health facility from the moment Carle began giving her mental health treatment, even though she was also getting medical treatment at Carle. As a mental health facility, Carle would be required to comply with the admission procedures outlined in the Mental Health Code.

“The exception suggested by the State would result in the unusual scenario where psychiatric patients with no medical conditions are entitled to the protections of the Mental Health Code, while psychiatric patients for whom the severity of their mental illness results in self-harming or suicide attempts are not entitled to the same protections when being treated for physical. A mental health facility cannot hide behind a “medical care” shield to permit it to provide mental health services without the protections of the Mental Health Code and deny protections of the Mental Health Code to those patients who most need it.”

The Appellate Court’s decision reflects the Supreme Court’s judgment in Linda B., where the respondent Linda B arrived at a hospital with interrelated psychiatric and medical problems. She was admitted on April 22, 2013 to a medical floor and received both psychiatric and medical treatments. On May 9, 2013, a petition was filed for involuntary admission. In Linda B., Supreme Court held that a facility that provides psychiatric treatment is a mental health facility, even when it also provides medical treatment, and must comply with the Mental Health Code.

Julie M. lost the case because it was unclear when her treatment at Carle became involuntary and the court held that she had the burden of proving that her treatment was involuntary prior to the filling of the petition. Nevertheless, Julie M clearly was held at the hospital illegally and could sue for illegal (but not involuntary) confinement.
 
A link to this case is available here:
https://courts.illinois.gov/Opinions/AppellateCourt/2019/4thDistrict/4180753.pdf

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