People v. James E.

CHIEF JUSTICE McMORROW

dissenting:

In the case at bar, the majority holds that a private mental health facility can initiate a petition for involuntary commitment against a voluntarily admitted patient even though the patient has not requested discharge in writing. The majority claims that it is carving out an exception to the rule prohibiting such action as set forth by this court in In re Hays, 102 Ill. 2d 314 (1984), and affirmed in In re Splett, 143 Ill. 2d 225 (1991). However, I believe, as the specially concurring opinion points out, that the purported exception swallows the rule and, consequently, the majority has implicitly overruled this court’s decision in In re Hays. Because I am not inclined to so easily discard the doctrine of stare decisis, especially when the prior opinion of this court was grounded on sound public policy, I respectfully dissent.

Article IV of chapter III of the Mental Health and Developmental Disabilities Code (405 ILCS 5/3 — 400 (West 2000)) addresses the “Voluntary Admission of Adults” to mental health facilities. Section 3 — 403 within this article provides:

“A voluntary recipient shall be allowed to be discharged from the facility at the earliest appropriate time, not to exceed 5 days, excluding Saturdays, Sundays and holidays, after he gives any treatment staff person written notice of his desire to be discharged unless he either withdraws the notice in writing or unless within the 5 day period a petition [for involuntary commitment is] filed with the court.” 405 ILCS 5/3 — 403 (West 2000).

This paragraph was interpreted by this court in In re Hays, under circumstances nearly identical to the facts of our present case. In Hays, we held that “in the case of a voluntarily admitted patient, involuntary-commitment proceedings must be preceded by a voluntary patient’s request for discharge.” (Emphasis added.) In re Hays, 102 Ill. 2d at 319. We reasoned that the rights given voluntarily admitted patients under the Code evinced a legislative intent to encourage voluntary admissions. Further, we found that persons needing treatment would be more likely to seek voluntary admission if they did not have to fear that they would be subjected to involuntary commitment unless there was a “ ‘significant change in their condition, the perception of their condition, or their willingness to be hospitalized.’ ” In re Hays, 102 Ill. 2d at 320, quoting Appeal of Niccoli, 472 Pa. 389, 399, 372 A.2d 749, 754 (1977).

In dicta, the Hays court suggested that an exception to the rule that involuntary proceedings may not be brought unless the patient has submitted a written request for discharge might be recognized if the patient had deteriorated to such a point that he or she was unable to request a discharge and the private facility could no longer provide adequate care for the patient. In such cases, the Hays court suggested that it would be appropriate for the private facility to “notify public health authorities and release the patient into their custody to permit the instituting of an involuntary-commitment proceeding.” In re Hays, 102 Ill. 2d at 321.

In the case at bar, there is no evidence that the patient had deteriorated to a point that he could not request discharge. Nor did the private facility attempt to show that it was unable to provide adequate services. Rather, it appears that the voluntarily admitted patient was unable to pay for treatment at the private facility.

The majority correctly notes that the Code fails to address the situation where a nonstate hospital, either for clinical or other reasons, cannot continue to treat a voluntary patient already admitted to the facility. The majority concludes that, in such circumstances, the non-state hospital has only two options: to discharge the patient altogether or to continue to provide inadequate care or care for which they will not be reimbursed. However, the majority wholly disregards an argument advanced by the respondent, i.e., that the nonstate hospital has a third option: to give the patient the opportunity to apply for voluntary admission to a state facility.

I find nothing in the Code or in Hays which would prevent us from embracing such an option. A private facility which finds itself in a position where it cannot provide its voluntarily admitted patient with adequate treatment, for clinical or other reasons, could advise the voluntarily admitted patient that the private facility can no longer provide adequate care to the patient and assist the patient in applying for voluntary admission to a public facility or initiate such application on the patient’s behalf, pursuant to section 3 — 400 of the Code (405 ILCS 5/3 — 400 (West 2000)). In this way, the voluntarily admitted patient could be transferred from the private facility to the public facility without losing his status as a voluntary patient. At the same time, the private facility would have the means to ensure that its voluntarily admitted patient receives needed services, while preserving the strong public policy concerns that animated the Hays and Splett decisions. Of course, if the voluntarily admitted patient refused to apply for voluntary admission to a public facility and if, in the professional opinion of the doctors at the private facility, the patient would be eligible for involuntary commitment, the patient could be so advised. See 405 ILCS 5/3 — 402 (West 2000).

Nearly 20 years ago, the Hays court, when confronted with circumstances nearly identical to those in the case at bar, ruled that it was a violation of a voluntarily admitted patient’s statutory rights to institute involuntary commitment proceedings unless the voluntary patient submitted a written request for discharge. The Hays court arrived at this conclusion based on its interpretation of the Code, grounded in the belief that the Code evinced a legislative intent to make needed services available to mental health patients under the least restrictive means. Thus, where, as in the present case, a patient recognizes the need for inpatient care or hospitalization and voluntarily admits himself for such care, he should not have to fear that his voluntary admission will be converted into an involuntary commitment unless he requests discharge or his mental condition has deteriorated to such a point that he is no longer capable of making an informed decision regarding his treatment. Since Hays issued, the legislature has not amended the Code and, accordingly, this court’s interpretation of the statute should be considered part of the statute itself. Henrich v. Libertyville High School, 186 Ill. 2d 381, 387 (1998); Miller v. Lockett, 98 Ill. 2d 478, 483 (1983).

The majority’s resolution is to allow the private facility to institute involuntary commitment proceedings against a voluntarily admitted patient even though he has not made a written request for discharge and there has been no significant change in the patient’s condition. This resolution implicitly overrules Hays and subordinates the rights of the patient to those of the private facility.

Principals of stare decisis compel adherence to established precedent absent compelling reasons for a departure. In the case at bar, no compelling reasons have been provided for overturning Hays. Consequently, I would hold, consistent with Hays, that a private mental health facility may not institute involuntary commitment proceedings against a voluntarily admitted patient unless the patient has requested discharge or, because of a deterioration in the patient’s condition, is unable to do so. Where, as here, a private facility is unable to continue to provide adequate care to a voluntarily admitted patient for clinical or other reasons, the facility may assist the patient in applying for voluntary admission to a public facility. In this way, the private facility ensures that the voluntarily admitted patient’s treatment needs are appropriately met, while at the same time, preserves the patient’s right to maintain his voluntary status.

It is disheartening to see this court show so little regard for the doctrine of stare decisis, particularly when the prior decision of this court, Hays, has, through legislative acquiescence, become incorporated into the statute. Further, I am troubled because a moderate, workable alternative to overruling Hays was presented to this court by respondent. The majority, instead of embracing this alternative or explaining why it should not be adopted, simply chooses to ignore it. This is unfortunate. At a minimum, the respondent’s argument deserves to be addressed by a majority of this court.

For the foregoing reasons, I would reverse the appellate court’s judgment and find that here, as in Hays, the respondent’s statutory rights were violated when the trial court found him to be a person subject to involuntary admission.

JUSTICE FREEMAN joins in this dissent.