FOURTH DIVISION
| THE PEOPLE OF THE STATE OF
ILLINOIS,
Plaintiff-Appellant, v. LEE ROBIN, Defendant-Appellee. |
Appeal from the Circuit Court of Cook
County.
Honorable James P. Flannery, Judge Presiding. |
JUSTICE SOUTH delivered the opinion of the court:
Defendant was charged for the August 1988, murders of his wife and daughter. He used an axe in the killing of his wife and drowned their daughter. Defendant was admitted to the Elgin Mental Health Center (Elgin) in November 1988, after a finding that he was unfit to stand trial. On April 21, 1989, defendant was found fit to stand trial. After a bench trial, he was adjudicated not guilty of the murders by reason of insanity (NGRI), and readmitted to Elgin.
On September 17, 1999, the trial court granted defendant's conditional release pursuant to a recommendation plan submitted by the Department of Human Services (DHS). The plan as presented was accepted by the court but modified to include, among other conditions, blood testing twice a month for lithium levels. The State's motion to reconsider was denied.
Previously, on March 26, 1992, a recommendation for release was submitted to the circuit court by DHS on defendant's behalf. This recommendation was amended to a request for unsupervised off-ground passes. A hearing on this matter was held and the circuit court heard extensive testimony from psychiatrists opposed to the recommendation as well as from psychiatrists in support of the recommendation. This court affirmed the circuit court's denial of the recommendation in People v. Robin, 264 Ill. App. 3d 936 (1994).
The following testimony was adduced at the hearing on the instant petition for conditional release:
The State called Dr. Linda Gruenberg, a board
certified psychiatrist, and Dr. Randi Zoot, a psychologist, as witnesses. Dr.
Gruenberg received numerous documents generated by various agencies which had
dealt with defendant in preparation for her interviews with him. She interviewed
defendant for a total of 7¼ hours. Based upon the interviews and her review of
the documents, Dr. Gruenberg formed an opinion within a reasonable degree of
psychiatric certainty that defendant suffers from Bipolar Disorder II. She
stated that such a mood disorder is characterized by periods of elation,
increased energy and feeling better than one would normally feel when feeling
good. Defendant's disorder is treatable but it is not curable. Defendant is
presently being treated with Sinequan, an anti-depressant, and Lithium, a mood
stabilizer, which Dr. Gruenberg said he must take if he is to avoid a relapse of
great severity. She also found defendant sensitive to stressful situations. Dr.
Gruenberg opined that defendant should be granted unsupervised off-site passes
as called for in the Transitional Plan(1)
but should not be conditionally released to an
off-site housing program. Dr. Zoot, after reviewing various records,
interviewed defendant for 3½ hours. She also conducted psychological testing of
defendant, which tests included the Minnesota Multi-Phasic Personality Inventory
(MMPI), the Million Clinical Multi-Axle Inventory 3 (MCI3), and the Rorschach
test. Dr. Zoot testified that the results of the MMPI test showed defendant to
be defensive, very unwilling to disclose personal information, guarded, showing
a lack of insight into what makes him tick, what motivates him. The MCI3 test
disclosed that defendant has a distinct tendency to avoid disclosing personal
information. The Rorschach test revealed dysphoric, depressed feelings, which
could result from a sense of loneliness. The test showed that defendant had
inadequate resources to deal with the everyday stresses of life. Based upon the
interviews with defendant and the results of the tests, Dr. Zoot testified that
she did not believe defendant should be conditionally released until his ability
to handle stress was better understood. Ronald Wedell, defendant's first witness, a
board certified clinical social worker, has worked at Elgin for a number of
years and known defendant since he came to the William White Cottage at Elgin in
January 1995. Wedell oversees defendant's day-to-day progress, evaluates
defendant's mental condition and coordinates with IRC and Northwest concerning
his treatment. The William White Cottage is considered a non-secured setting.
While residing at White Cottage, defendant travels to other locations at Elgin
for various activities using his unsupervised on-grounds pass privilege. There
have been no problems with his use of this privilege. Wedell testified that the patients at White
Cottage are given their medications at prescribed times. While defendant is not
forced to take his medications, if he refuses, the staff would meet with him in
order to find out the reason for his refusal. Wedell believes that defendant has received the
maximum amount of benefits from inpatient treatment and that he should now
receive treatment on an outpatient basis. Defendant has a mental illness but it
is in full remission. Wedell does not believe defendant is a danger, nor does he
believe that he will inflict harm upon himself or others because of his illness.
He also believes defendant can provide for his basic physical needs. Dr. Jack Green, a psychologist and Director of
Behavioral Studies and Group Therapy at Isaac Ray, has seen defendant in
individual cognitive restructuring therapy since 1993. Since treatment began,
Dr. Green has seen improvement in defendant in all areas. Dr. Green testified
that defendant's sense of empathy has greatly improved as to how he deals with
others. Dr. Green stated that Elgin itself is a stressful situation, so, in that
regard, defendant has been dealing with stress for years. He testified that
defendant is committed to his treatment and pointed out that at one time
defendant asked for an increase in his medication because he felt his current
dosage was inadequate. Dr. Green does not believe that defendant is a danger to
himself or to others. He also believes defendant can provide for his own basic
needs and that he will benefit more from treatment if his environment changes
and there are new issues with which he can deal. He stressed that for
defendant's illness to remain in remission, it is important that he remain in
therapy and continue taking medication. Dr. Green stated that the conditional
release plan will adequately regulate and oversee defendant's condition, and
that the plan can be terminated at anytime if defendant's behavior warrants it.
It is his professional opinion that defendant is ready for conditional
release. Dr. Jonathan Kelly, a psychiatrist and Medical
Director at Isaac Ray, has seen defendant in individual therapy once a month
since 1991. Dr. Kelly agreed that defendant has a bipolar II disorder that has
been in full remission since 1992. Dr. Kelly makes medication recommendations to
Elgin, although the medication is actually prescribed by Dr. Raftery and
administered at Elgin. Dr. Kelly testified that defendant is not presently
subject to involuntary admission but should be conditionally released pursuant
to the 1997 plan and the 1999 transitional plan. Dr. Kelly believes that both
plans have taken into account defendant's difficulties with transitional
periods, but the Lithium helps defendant deal with these stressors which led to
the crimes. Stephen Fossing, a licensed clinical social
worker at Northwest, has seen defendant in individual counseling for community
integration on a biweekly basis since 1996. Fossing is the supervisor of the
Psychosocial Rehabilitation Program. Fossing counsels defendant on concrete
issues surrounding defendant's transition to living in the community, including
employment, money and medication management, community perceptions, and family
issues. Fossing stated that defendant has remained clinically stable over the
three years that he has known him. Under the release plan he will see defendant
every other week. He believes he would detect any decompensation on defendant's
part since decompensation is a gradual process and symptoms would be manifested
within two to three days. Since defendant will be seen by a variety of staff
members, any decompensation will be identified. He also believes defendant can
provide for his basic needs if released, and he recommended defendant's
conditional release. Dr. Orest Wasyliu, a psychologist and Director
of Adult Clinical Psychology at Isaac Ray, has performed psychological
assessments of defendant four times since 1990. He administered the MMPI, MCI3
and Rorschach tests and agreed with Dr. Zoot's finding that defendant's test
results showed a tendency to avoid self-disclosure, which could be an indication
of a lack of insight. However, the results of these and other tests showed no
evidence of any psychotic disorder but rather substantial improvement in terms
of personality functioning. Dr. Wasyliu stressed that defendant must continue in
treatment and understands this. He believes the release plan adequately
addresses the concerns expressed by Drs. Zoot and Gruenberg. Dr. William Raftery, chief of psychiatry at
Elgin's William White cottage where defendant currently resides, stated that
defendant suffers from Bipolar Disorder II, which is in full remission. He is
concerned that defendant's present medication may be insufficient to control his
illness once he is subjected to the additional stresses he will encounter upon
conditional release. Therefore, his medication may need to be reassessed
subsequent to his release. Dr. Raftery testified that defendant's history shows
that should he severely decompensate, he would likely be a danger to himself or
others. In spite of these concerns, he is comfortable with the conditional
release plan prepared by DHS and does not believe it is likely that defendant
will decompensate if released. The court granted DHS' recommendation after
concluding that defendant was no longer subject to involuntary admission or in
need of mental health services on an inpatient basis. The State moved for
reconsideration which was denied. The trial court entered a final order granting
defendant's conditional release. The order incorporated the terms of the
Transitional Plan, and added the following six conditions: In addition, the circuit court specified that
defendant must comply with the rules and requirements of Elgin, Isaac Ray, and
Northwest. The State argues that the circuit court abused
its discretion in granting DHS' petition to conditionally release defendant when
the State proved by clear and convincing evidence that defendant was in need of
mental treatment. Defendant responds that the State failed to prove by clear and
convincing evidence that he was either subject to involuntary admission or in
need of mental health services on an inpatient basis. 730 ILCS 5/5-2-4(h) (West
1999). The State is incorrect in stating that the
standard of review is abuse of discretion. The burden is upon the State to prove
by clear and convincing evidence that defendant is subject to involuntary
commitment based on his mental condition. People v. Williams, 140 Ill.
App. 3d 216, 227, 488 N.E.2d 649, 660 (1986). However, it is the province of the
trier of fact, not the psychiatrists, to weigh all the evidence presented.
Williams, 140 Ill. App. 3d at 226, 488 N.E.2d at 659. The trial court's
determination will be reversed only if it is manifestly erroneous. People v.
Hager, 253 Ill. App. 3d 37, 42, 625 N.E.2d 232, 236 (1993); People v.
Cross, 301 Ill. App. 3d 901, 912, 704, N.E.2d 766, 773 (1998). A defendant who has been found not guilty by
reason of insanity is subject to involuntary admission only if he is mentally
ill and because of his mental illness is unable to provide for his basic
physical needs so as to guard himself from serious harm. 730 ILCS
5/5-2-4(a)(1)(A) (West 1999); Hager, 253 Ill. App. 3d at 41, 625 N.E.2d
at 236; People v. Grant, 295 Ill. App. 3d 750, 758, 692 N.E.2d 1295,
1300 (1998). An NGRI acquittee is in need of mental health services on an
inpatient basis only if he is not subject to involuntary admission but is
reasonably expected to inflict serious physical harm upon himself or another and
would benefit from inpatient care or is in need of inpatient care. 730 ILCS
5/5-2-4(a)(1)(B); Hager, 253 Ill. App. 3d at 41, 625 N.E.2d at 236;
Grant, 295 Ill. App. 3d at 758, 692 N.E.2d at 1300. Once a criminal defendant is involuntarily
admitted, he may be held only as long as he is both mentally ill and dangerous.
Hager, 253 Ill. App. 3d at 41, 625 N.E.2d at 236. As a matter of due
process, it is unconstitutional for a State to confine a harmless, mentally ill
person. Hager, 253 Ill. App. 3d at 41, 625 N.E.2d at 236. A
finding that an insanity acquittee is subject to involuntary admission or is in
need of services must be based upon explicit medical opinion regarding the
insanity acquittee's future conduct and cannot be based upon a mere finding of
mental illness. Grant, 295 Ill. App. 3d at 758, 692 N.E.2d at 1300-01.
The possibility that an insanity acquittee might have difficulty adjusting to
the stresses of noninstitutional life is insufficient to sustain the denial of
conditional discharge. Grant, 295 Ill. App. 3d at 761, 692 N.E.2d at
1302. A careful review of the record, and the
testimony of both defendant's and the State's witnesses, clearly showed that
defendant was not a danger to himself or to others. Dr. Kelly opined that he did
not believe defendant was subject to involuntary admission or in need of mental
health services on an inpatient basis. He did not believe that defendant was a
danger to himself or others nor, as an outpatient, would defendant be dangerous
to himself or others as long as he complies with treatment. Dr. Green did not believe that defendant was
dangerous to himself or others, nor did he envision defendant becoming dangerous
during his transition from Elgin. Ron Wedell testified that defendant would no
longer benefit from inpatient treatment. He also did not believe that defendant
would inflict physical harm upon himself or others. Steve Fossing testified that he did not observe
any evidence of dangerousness in defendant since the start of therapy with him
in 1996. He believed that defendant had obtained maximum benefit from inpatient
care, and that defendant was now able to provide for his basic needs. Dr.
Wasyliu testified that he did not identify any dangerousness on defendant's part
and that there was no reason to expect such dangerousness as long as defendant
follows his treatment plan. He also stated that defendant can provide for his
basic needs and protect himself from serious harm. In general, defendant's treatment team found
that he has not engaged in a single physical or inappropriate verbal
confrontation with another patient or staff member since his transfer to White
Cottage. In addition, defendant has not had any problems in using his on-site or
off-site privileges. All of defendant's witnesses stated that he was ready for
conditional release, including Dr. Raftery who does not believe that it is
likely that defendant would decompensate if released. Dr. Gruenberg testified that she felt it would
be appropriate to allow defendant unsupervised off-ground passes for therapy and
treatment purposes only, which is Phase I of the Transitional Plan. She felt
that if defendant were to decompensate it is possible that he would be a danger
to himself or others. She did not testify that he was presently a danger to
himself or others. Dr. Zoot's opinion was that if depression recurred in
defendant and he decompensated and became fairly psychotic, there is a
probability that he would be a harm to himself and others. Based upon the foregoing, we do not find that
the trial court's determination was manifestly erroneous. The State argues, however, that the stresses of
noninstitutional life would be difficult for defendant, and that he would
decompensate, which would lead to psychosis, and a risk of dangerousness.
However, this is speculation on the State's part. In addition, under People
v. Blumenshine, 72 Ill. App. 3d 949, 391 N.E.2d 232 (1979), to deny
conditional release on this basis would result in a "self-fulfilling predicament
or catch-22" for defendant because of the sterility of the hospital environment,
the defendant's behavior in the real world remains uncertain and because of this
uncertainty he must remain hospitalized. Blumenshine, 72 Ill. App. 3d
at 955, 391 N.E.2d at 236. We reject this argument. The State contends next that if defendant fails
to take his medication, he could decompensate and become dangerous. We reject
this argument as well since the possibility that defendant may not comply with
the prescribed treatment is not sufficient to sustain the State's opposition to
conditional release. People v. Smith, 126 Ill. App. 3d 5, 9, 466 N.E.2d
1226, 1228 (1984). Finally, the State claims that the circuit court
did not consider all relevant factors in determining conditional release. Under
these factors the State includes the failure to consider the murders, whether
defendant failed to take his medication in the past, whether he has a support
system, any "guarded impulses" which defendant may have, and whether defendant
committed any bad acts while in a controlled setting. Section 5-2-4 states the relevant factors for
involuntary admission, namely, mentally ill and dangerous, or mentally ill and
unable to care for basic physical needs. Relevant factors in determining a
person's dangerousness include evidence of (1) prior hospitalization with the
underlying facts of that hospitalization and (2) defendant not taking his
medication in the past and still not perceiving the value of continued medical
treatment. Washington, 167 Ill. App. 3d at 80, 520 N.E.2d at 1163.
Factors that are not sufficient to sustain a finding of involuntary commitment
include violations of conditions of release and the possibility that defendant
may not comply with the prescribed treatment. Hager, 253 Ill. App. 3d
at 42, 625 N.E.2d at 236. In rendering its order, the court stated
that: Furthermore, in the
State's motion to reconsider, the court stated: There is nothing in
the record which indicates the court excluded any evidence in arriving at its
determination. Clearly some evidence was assigned greater weight and had greater
significance in the court's determination than other evidence; however, this the
court, as the trier of fact, may do. As a final point, at oral argument, the State
argued that the circuit court in ordering defendant's conditional release,
stated that it would not consider any evidence relating to defendant's murder of
his wife and daughter. However, this court has made a thorough perusal of the
record and, other than the statements of the court quoted above, we have found
no evidence that the court refused to consider the murders at all. For the foregoing reasons, the judgment of the
circuit court is affirmed. Affirmed. HOFFMAN, P.J, and HALL, J., concur. 1. 0The Transitional Plan was developed by DHS to
reintegrate defendant into society. Phase I called for defendant's use of
unsupervised off grounds passes to travel by train from Elgin to the Issac Ray
Center(IRC) for individual and group therapy. The purpose of this step was to
test potential stressful experiences in the community for defendant and to
evaluate his responses to them. Phase II was to begin three months later and
involved a series of progressive home visits at the Alexian Brothers Northwest
Mental Health Center (NWMHC) scattered site housing program. Throughout the home
visit process which would take approximately two months, ongoing assessment and
communication would be maintained. Upon successful completion of this
transitional plan, defendant would be discharged pursuant to the DHS
recommendation for conditional release.
"The Court has considered all of the evidence in the case, the
witnesses, the testimony, the exhibits and the stipulations.
The Court is going to mention some of
the evidence, but the Court will stress that the issue in the case is whether
the defendant is mentally ill and because of his mental illness he is
reasonably expected to inflict harm on himself or others.
***
Initially, People versus Csyz, ***,
says that the decision to commit must be based on the defendant's present
conduct and state of mind. *** Conduct in the distant past, the Court does not
feel is relevant. Conduct in the recent past, the Court feels is relevant. And
that's what the case law provides."
"The Court has considered the Petitioner's history in this case,
the mental history, or the history of mental problems before the day in
question, the acts on the day in question, as well as defendant's acts since
he has been in the Department of Mental Health."