Madison - St. Clair Record

Monday, September 16, 2019

Fifth District reverses trial court's ruling on involuntary psychotropic drug administration

By Angela Underwood | Feb 22, 2018

MOUNT VERNON – The Fifth District Appellate Court has reversed a trial court’s judgment over the involuntary administration of psychotropic drugs.

Based on the Mental Health and Developmental Disabilities Code and the public-interest exception to the mootness doctrine, on Jan. 29 Justices Thomas Welch, Richard Goldenhersh and James Moore reversed a trial court's 2014 decision regarding the involuntary administration of psychotropic medication to Roger S. because of a failure to provide written information to the respondent about nonmedical alternatives to his treatment.

The case of People v. Roger S. was presided over by Madison County Associate Judge Thomas Chapman.

The complaint stems from Alton Mental Health Center (AHMC) psychiatrist Dr. Sanghee Kim-Ansbro’s petition to continue the involuntary administration of psychotropic medication to Roger S., whose behavior met Mental Health and Developmental Disabilities Code criteria specifically for a schizoaffective and bipolar disorder that the patient suffered from since he was a teenager.

According to the doctor and the staff, though Roger S. refused the medication, “he was ‘not in touch with reality and unable to converse in a rational manner,’” according to the decision. Kim-Ansbro testified an example of said behavior was Roger’s belief that he was being poisoned by the AHMC and a biological weapon and since the administration of the psychotropic drug, Roger S. became less tormented by his irrational beliefs, specifically showing less aggressive behavior towards the staff.

“Dr. Kim-Ansbro testified that, prior to the psychotropic medication, he had threatened to hit a physician with a brick, threw a bowl of cereal at the staff, pushed a door shut and hit a physician's foot, threatened to slit the throat of another patient, hit a member of the staff with coffee he threw across the dining room, spit on the floor and banged a nightlight cover with his fist, and asked for a gun,” according to the decision.

She concluded in her testimony Roger S. in fact showed less-aggressive behavior after the administration of the drug in question “however, she was not asked, nor did she testify, that the respondent was provided with written materials regarding nonmedical alternatives to treatment as required by the Code,” according to the appeal.

After Roger S. testified on behalf of himself, noting that the prescribed medication caused physical problems including dizziness, blurred vision, headaches and stinging in his hands and feet, he failed to acknowledge his aggressive behavior while also testifying that Kim-Ansbro was a liar. After hearing all testimony, the trial court ruled that “the benefits of the medication would outweigh the harm,” and Roger S. needed the medication despite his refusal.

“Though the state has already admitted to the error, it has failed to provide all statutorily required written materials at least twice to this respondent alone, and therefore, it seems that instruction or guidance is needed,” Welch wrote in the ruling, adding the “Third, the circumstances are likely to recur because under the Code the state is required to prove a person lacks the ability to make a reasoned decision about his treatment in all involuntary-treatment and involuntary-medication cases. Therefore, we find that the public-interest exception to the mootness doctrine applies in this case.

“The state concedes that it did not prove that the respondent received written information about nonmedical alternatives to treatment prior to the entry of the involuntary medication order and thus did not comply with the Code,” Welch wrote. “Therefore, we reverse.”

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