False imprisonment under the mental health code

In a recent appellate opinion, the fifth district appellate court held that a hospital may be held liable for false imprisonment if it does not comply with the requirements and procedures of the Mental Health and Developmental Disabilities Code (Mental Health Code), 405 ILCS 5/1-100 et seq.¹

In this case, the plaintiff drove herself to an emergency room operated by the defendant, Southern Illinois Healthcare, and sought treatment for pain and swelling in her leg.² At some point, her primary care physician informed the attending emergency room physician that plaintiff recently “made suicide ideations.”³ After two to four hours there, plaintiff walked out of the hospital.⁴ According to the defendant, the plaintiff was told that she was being detained for a mental health evaluation before she walked out of the hospital.⁵ However, according to the plaintiff, she was never told why she was not allowed to leave.⁶ She was approached in the parking lot by a nurse, who told her that she could not leave.⁷ When the plaintiff refused to accompany the nurse back into the hospital, the nurse called security.⁸ At some point, the police were also called.⁹ The plaintiff was escorted back into the hospital with the two security guards and the nurse at about the same time the police arrived.

The plaintiff was then detained in an exam room by two security guards, a nurse, and three police officers.¹⁰ While being detained there, she was required to get undressed, put on a paper hospital gown, provide blood and urine samples, and turn in her purse before emergency room personnel would request a mental health counselor come to the room to evaluate her.¹¹ The plaintiff refused to do so and sat on her purse so it could not be taken from her.¹² A struggle ensued for possession of the purse involving the plaintiff, one of the police officers, and one of the security guards.¹³ Although plaintiff denied biting the police officer during this struggle, she was subsequently convicted on one count of battery for doing so.¹⁴ The plaintiff was then shackled to a bed until she was transported to a jail on the battery charge.¹⁵ The appellate court noted that although plaintiff had to be medically cleared before she could be taken to jail, once she was shackled to the bed, no further medical or psychiatric evaluation took place.¹⁶

The plaintiff subsequently filed a lawsuit for false imprisonment.¹⁷ The defendant filed a motion for summary judgment, arguing that the plaintiff could not prove that her detention was unlawful or unreasonable, one of the elements necessary to support a claim of false imprisonment.¹⁸ The trial court granted summary judgment in favor of the defendant.¹⁹

Plaintiff appealed, arguing that summary judgment was inappropriate because there were genuine issues of material fact concerning the lawfulness of her detention.²⁰ The appellate court held that false imprisonment has two elements.²¹ To prevail, a plaintiff must prove both that (1) her personal freedom was curtailed against her wishes and (2) her detention was unreasonable or unlawful.²² The parties agreed that the plaintiff was detained against her wishes by the defendant.²³ As such, only the second element – the lawfulness of her detention was at issue.²⁴

The appellate court found that there were genuine issues of fact on the questions of the lawfulness of plaintiff’s detention.²⁵ First, the appellate court found that there were genuine questions of fact concerning whether the defendant’s emergency room personnel made any efforts to persuade the plaintiff to submit to a mental health evaluation voluntarily before deciding to detain her.²⁶ This fact was material because before a patient may be detained for an evaluation, the detaining party must be able to attest that a diligent effort was made to convince the patient to submit to the evaluation willingly.²⁷ Second, the appellate court found that it was not clear from the record that the defendant complied with the requirement of presenting a petition to the director of a mental health facility to have the plaintiff detained for examination.²⁸ Thus, the record presented genuine questions of fact on the material issue of the defendant’s compliance with the requirement of a petition.²⁹ Third, the appellate court found that there was some evidence in the record suggesting that the plaintiff may have reluctantly agreed to speak with a counselor as long as she could do so without additional delay.³⁰ The appellate court held that while the Mental Health Code authorizes the detention of a patient in a mental health facility, it does not authorize the detention of a patient in an emergency room to comply with the hospital’s internal policy of imposing prerequisites on a patient’s access to the mental health services.³¹ If the plaintiff’s presence in the emergency room became an unwilling detention only for the purpose of obtaining a urine sample and forcing her to change into a paper gown and surrender possession of her purse, it was not authorized by the Mental Health Code.³² Fourth, the appellate court held that the detention of a patient for a mental health evaluation is only authorized if the petitioner believed that the patient is or may be subject to involuntary admission and that immediate hospitalization was necessary to prevent harm to the patient or others.³³ The appellate court found that it was not clear from the record what information plaintiff’s primary physician gave to the emergency room physician who made the decision to detain the plaintiff.³⁴

The appellate court held that in the face of these disputed questions of material fact, the defendant was not entitled to judgment as a matter of law.³⁵ As such the trial court erred in granting summary judgment.³⁶ The appellate court remanded for further proceedings consistent with its opinion.³⁷

The opinion in Irvin underscores the importance for a hospital to properly instruct its personnel about the requirements and procedures of the Mental Health Code if it seeks to involuntarily confine a patient for mental health treatment. The Mental Health Code includes provisions that govern precisely the circumstances involved and procedures necessary to conduct an evaluation of an unwilling patient who may be subject to involuntary admission on an emergency basis.³⁸ If a hospital does not follow the Mental Health Code, it may readily be held liable for false imprisonment.

Andreas Liewald is a staff attorney with the Illinois Guardianship and Advocacy Commission, West Suburban (Hines) Office.