Patients Admitted for Treatment Charged With Crimes Instead

On a chilly November morning in 2019, Lutrice Williams, a patient at a state-run mental health center in southern Illinois, was surprised by a visit from a sheriff’s deputy. He served Williams a summons ordering her to report to criminal court on a felony battery charge.

Williams has been diagnosed with an intellectual disability, bipolar disorder, and post-traumatic stress disorder, and her personal story consists of one upheaval after another. At age 23, in a state of crisis, Williams had sought help at Choate Mental Health and Developmental Center. She’d never been charged with a crime before. But four months before the deputy showed up, a Choate employee who claimed Williams had forcefully shoved her asked her employer to pursue charges against the patient.

This story was originally published at ProPublica. Read the original article.

“You have a job to deal with people with mental health problems,” Williams said she thought at the time. “Why are you charging me?”

Williams, records show, is far from the only patient to have faced criminal charges.

By scouring courthouse and police records, reporters with Lee Enterprises Midwest, Capitol News Illinois, and ProPublica discovered at least 40 felony charges filed against 29 patients since 2015 in two of the four downstate counties where the state operates a residential facility. (Reporters did not identify any charges at two of the four facilities.)

Of the 29 patients charged, 22 were receiving care at Choate. The facility, which treats people with intellectual and developmental disabilities and mental illnesses, has been the subject of a monthslong investigation by the news organizations.

The charges against patients contrast sharply with the way the facility and police agencies have handled employees who are accused of mistreating and abusing patients. In some of those cases, staff who faced serious abuse allegations experienced few consequences because colleagues refused to cooperate in investigations — or actively worked to derail them.

At the same time, the institution and its employees sought charges against patients even as watchdogs say it failed to provide legally required services, such as individualized therapy for people with traumatic histories and poor coping mechanisms. What’s more, Choate carried out its own investigations against patients under its care, and prosecutors used those investigations to press charges even in cases when the patients denied the allegations against them and there were no other witnesses.

The charges in all but one of the 40 cases were elevated from misdemeanors to felonies based on legal technicalities allowed under Illinois law — that the altercations happened at a “public place” or that the victim was a medical professional — rather than the seriousness of the acts.

The accusations included hitting, pushing, hair pulling and, in one case, throwing soiled underwear at an employee. Some patients faced multiple charges over several years. Many of the patients who were charged had legal guardians, meaning that a court had previously found them unable to handle their own affairs. Among this group was one patient whose mental function was at the level of a preschooler, court records show. Some of the young adults who faced charges had experienced physical or sexual abuse as children and had only recently aged out of the foster care system, court records show.

Reporters spoke with seven legal experts and advocates for people with developmental disabilities and mental illness who said they were alarmed that so many patients had been charged at a single facility, especially one set up to help people with complex needs and behavioral issues. Except in extreme cases, they said, patients in crisis should not be charged.

Leigh Ann Davis, who oversees the National Center on Criminal Justice and Disability at The Arc, one of the nation’s largest advocacy organizations for people with disabilities, said she’d never heard of such a large number of patients at a single facility facing charges in her 26 years in the field. Although there’s a dearth of data on the subject, she said, the numbers are “deeply concerning.”

“This is such an invisible population in the criminal justice system and this situation really showcases that,” she said.

The Illinois Department of Human Services does not track patient arrests at its facilities. During an interview with reporters, one senior official said she hadn’t been aware of the volume of patients who had faced charges at Choate.

She also said she didn’t know the facility security staff had been conducting investigations and determining whether patients had committed felonies that were then referred to the state’s attorney. She called the practice “highly inappropriate.” In a statement, an IDHS spokesperson said that upon learning about this, the agency “acted immediately to ensure that this practice has stopped.” The statement said that Choate itself “does not pursue criminal charges against residents and instead works to provide them with the appropriate treatment.”

The statement also said that staff members who are injured on the job by a patient do have the right to pursue charges on their own by filing a complaint with a law enforcement agency or the state’s attorney and “IDHS cannot infringe on that right,” the statement said. “When staff chooses to exercise that right, it is then the decision of the local state’s attorney and law enforcement as to how investigations proceed and whether to pursue charges and IDHS fully cooperates in all cases.”

Tyler Edmonds, who was the state’s attorney when most of the patients were charged, is no longer in that role. He declined comment to a reporter, saying it would violate judicial ethics because he’s now a judge in Union County, where the courthouse continues to hear cases about Choate. Tyler Tripp, who was the defense attorney for many of the charged patients, including Williams, and who took over as state’s attorney in 2020, said that each charging decision he makes is dependent upon the unique facts of the case and strength of available evidence. With regards to Choate patients accused of crimes, Tripp said he does take into consideration the fact that individuals are already in a facility receiving treatment and how this could impact their criminal intent, among other considerations. Court records show he has filed charges against two patients.

For many patients, Choate is an option of last resort when family or supervised community homes are no longer able to provide the level of care they need.

That’s how it was for Williams, who grew up on Chicago’s South Side. She was born with fetal alcohol syndrome; her father was seldom in the picture, and her mother lost custody of her when she was a baby. Her adopted mom died unexpectedly when Williams was 16.

Overwhelmed by the loss, she began acting out and skipping school. She tried living with other family members, but they found her behaviors too difficult to manage. Then she reentered the foster care system, according to medical records she provided to a reporter.

After she aged out, Williams spent five years at a supervised community home for adults with intellectual and developmental disabilities in Chicago. She wanted nothing more than to live a normal life, and she experienced some successes. She graduated from high school at 21 and held an office job, answering phones, filing paperwork, and cleaning.

Williams, who recently turned 30, has kind eyes that turn up at the edges when she smiles, and she can be exceedingly sweet. But her feelings, she said, are like a layer of raw skin — and the slightest bump against it can send her flying into fits of rage.

“It’s like I black out until I calm down again,” she said.

In the year before she arrived at Choate, she’d been hospitalized for psychiatric treatment on four occasions for aggression and homicidal threats to staff at her community home. She had refused to take her medications and attempted to run away on multiple occasions, her medical records show.

After an incident in November 2015, staff said she couldn’t return. She spent nearly four months at the hospital while her treatment team looked for places for her to live.

Eventually, they suggested she try Choate — located at the opposite end of the state in rural southern Illinois. Williams was skeptical, but when she spoke with Choate staff by phone, they sounded nice and told her she’d get the help she needed there, Williams recalled.

She arrived on the grounds of the wooded campus in March 2016, having traveled some 350 miles in the back of an ambulance.

“When I got there, it was a whole different story,” she said.

Williams said she felt she didn’t receive the level of talk therapy she needed to address the trauma she’d endured in her life. She said some staff members were dismissive and rude, and that she was physically abused.

She is named as the victim in a felony case against an employee accused of whipping her with a belt in 2020, court records show; two colleagues reported the alleged abuse to authorities. The employee, whose employment with Choate ended after he was charged, has pleaded not guilty, and his jury trial is scheduled for early next year.

Williams said there wasn’t much to do at Choate, and residents spent much of their days watching TV.

“It’s a lot of downtime,” she said. “That’s where I think a lot of the behaviors came from. Everybody was always fighting everybody. Residents, staff, everybody.”

Williams’ criticisms of the institution’s shortcomings are echoed by oversight entities and advocacy organizations. In a 2009 report, the U.S. Department of Justice’s Civil Rights Division found “many instances where individuals were receiving inappropriate or insufficient behavioral interventions” at Choate.

These shortcomings, the report concluded, led to an overreliance on the use of restraints by Choate staff to control patients, contributed to an unsafe environment, and ultimately resulted in patients staying at Choate far longer than they should have, in violation of their constitutional rights.

More than a decade later, staff with a legal advocacy organization, Equip for Equality, conducted a review of programming at Choate and again found the facility falling short. Numerous residents at Choate and other similar state-run institutions “have significant trauma histories that do not appear to be adequately addressed,” the organization wrote in a September 2021 report to the Illinois Department of Human Services obtained under the Freedom of Information Act.

Stacey Aschemann, an Equip for Equality vice president, said in an interview that Choate residents aren’t offered the individualized therapy many of them need. And monitors with the organization have observed residents sitting around for much of the day with little to do. Aschemann said that this lack of effective treatment “negatively impacts an individual’s progress and personal safety” and that it contributes to a “chaotic and sometimes unsafe environment.”

Heidi Dalenberg, an attorney with the American Civil Liberties Union of Illinois, said Choate and its staff have responded to the “consequences of its own failure of care” by arresting patients in need of help. “The end result is the person went in as someone with an illness needing treatment and exits as a ‘criminal,’” she said. “That is an abusive system.”

In previous reporting, IDHS acknowledged ongoing problems at Choate in patient care and safety and said that the shortcomings are the result of “longstanding, entrenched issues dating back decades.” The department said that the current administration, under Gov. J.B. Pritzker, has taken aggressive measures to resolve these issues. In a new statement, the department said its focus at Choate is on “providing quality care to residents and keeping staff and residents safe,” which includes working individually with residents to ensure they receive the appropriate treatment.

By the time Williams was charged, she had been a patient at Choate for more than three years. Displays of impulsive behavior were part of her history.

When she arrived, an evaluation of Williams identified verbal and physical aggression and the provoking of others as “areas of primary concern.” Her medical records stated she was admitted to Choate specifically to receive treatment to “stabilize her behavior” and moods.

The IDHS spokesperson said the agency could not disclose individual treatment plans, but said that both one-on-one and group therapy are available to Choate residents. Therapy needs, IDHS said, are “determined on a case-by-case basis.”

Other residents who faced charges while at Choate also had sought treatment because of their traumatic pasts or behaviors that stemmed from their disabilities. In March 2019, an employee accused a patient of pulling out a chunk of her hair when she told the patient that she couldn’t attend activities due to “staff shortages.” Nine months later, the patient was charged with felony battery. In a court-ordered fitness evaluation, an IDHS social worker wrote that the resident’s “maladaptive behavior” was driven by elements of her intellectual disability, including poor coping skills, lack of impulse control and low tolerance for frustration.

Another young woman who was charged while receiving care at Choate had been hospitalized dozens of times for unstable moods and psychosis while growing up in the foster care system. In November 2016, the patient told a nurse she didn’t feel well. When the nurse told her to wait to be seen while the nurse finished other work, the patient attacked her, though she wasn’t seriously injured, internal records obtained by reporters show. In August 2017, the patient pleaded guilty to felony aggravated battery.

A year later, staff found the patient dead in her room. An autopsy determined that she died by suicide while in Choate’s care, according to a coroner’s report obtained under the Freedem of Information Act.

Decisions on whether to pursue charges against patients for misconduct during the course of their treatment are largely left up to local officials. Reporters examined how these decisions were handled at four state-run facilities in southern Illinois.

Chester Mental Health Center, a maximum-security, state-run psychiatric hospital located about 55 miles northwest of Choate, serves the largest number of patients of the four — about 450 people annually. It primarily houses men with mental illnesses who were ordered by a court to receive treatment, including some who were accused of violent crimes. Reporters did not find any felony charges filed against patients since 2015 in Randolph County, where Chester is located.

Jeremy Walker, who was the state’s attorney in that county until late last year when he became a judge, said he didn’t pursue charges because patients would most likely be found unfit to stand trial. With a few exceptions, he said in an interview in October, it would be a “waste of time and resources” to bring them into criminal court when they were already confined to a secure facility for mental health treatment.

Alton Mental Health Center, located outside of St. Louis, serves a similar population to the one at Chester, but the smaller, medium-security hospital mostly houses women. Since 2015, prosecutors have filed 11 felony charges against seven patients at Alton. Most of these charges were filed in the past three years, though court hearings have been suspended so that patients’ treatment at Alton isn’t interrupted, a spokesperson for Madison County State’s Attorney Tom Haine said. IDHS, which also runs Alton, said the facility did not conduct the investigations against the patients there.

Reporters found no felony charges against patients at Murray Developmental Center, which serves patients with developmental disabilities. (The state’s attorney in Clinton County, where Murray is located in south-central Illinois, declined an interview).

But at Choate, it wasn’t only the number of residents taken to criminal court that alarmed advocates. The facility’s handling of residents’ alleged misconduct may have violated their civil rights, experts said.

When employees at Choate faced abuse allegations, Illinois State Police investigators were called to the scene. They notified the accused workers of their Miranda rights as well as their Garrity rights, which prohibit public employees from being compelled to incriminate themselves during an investigation by their employer.

When patients were accused, on the other hand, Choate handled the investigations internally. A Choate security officer questioned the patient and any witnesses. The accused patients were not read Miranda warnings and their guardians were not contacted.

In an interview, Steve Hartline, the longtime security chief at Choate who retired at the end of 2019, said his staff didn’t need to read Miranda warnings to patients because Choate’s security officers are civilian employees — not sworn law enforcement officers. The staff’s role, he said, was to conduct a “neutral” investigation and forward the interview reports to the state’s attorney’s office.

“We had no control over who was charged or who wasn’t charged,” Hartline said. “Everything was sent to the state’s attorney, and the state’s attorney made his discretionary call.” Hartline, who is also the longtime mayor of Anna, the town where Choate is located, stressed that he was not acting as a police officer, a job he held prior to coming to Choate. “We are not a criminal law enforcement entity. We don’t recommend any criminal charges or anything.”

But internal investigative records show that, in some cases, security officers’ reports sent to the state’s attorney’s office included their conclusions that the patients had committed felony battery. That’s what happened in Williams’ case.

Natalie Barnes, the employee who said she was assaulted, returned to work about two weeks after the incident and filed a statement with Choate security. She said Williams had caused a “cervical strain” in her neck that had to be treated in an emergency room. “This writer would like Chief Hartline to move forward and press charges against Lutrice Williams,” she wrote.

The next day, a security officer visited Williams’ unit and questioned her about the incident, though the officer didn’t tell her it was because an employee wanted her to be charged. Williams told the security officer that Barnes had gotten into her personal space and ordered her to stop knocking on a fellow patient’s door, so she put her hand on Barnes’ chest and pushed her backwards.

Both Barnes and Williams told the security staff that no one else was present during the altercation.

Security ultimately sent the report, complete with Williams’ statements, to the state’s attorney with a finding that she had committed aggravated battery. Four months later, Williams was charged with that crime, which carries a possible sentence of up to five years in prison and a $25,000 fine. Barnes declined comment.

Williams was one of seven patients charged at Choate in 2019. In other years, from 2015 to the present, between one and eight patients were charged per year. The last patient was charged in early 2022.

When Barry Smoot took over as security chief in early 2020, he said he was surprised to learn that patients were being charged with felonies for what he said were relatively minor assaults on staff.

He was further alarmed to discover that Choate had been taking statements from patients that became the basis for criminal charges against them.

“This isn’t right. Why isn’t law enforcement doing these investigations?” Smoot recalled thinking at the time. “We shouldn’t be interviewing people when we are providing them with services. We shouldn’t be taking those cases for charges.”

Smoot, who has since retired, initiated a change in policy that now dictates that an employee who wants to press charges must take their case to a law enforcement agency, rather than internal Choate security staff.

Most of the Choate patients who faced charges were initially found unfit to stand trial because they were unable to articulate the basics of court proceedings or participate in their own defense, which are minimal competency requirements under the law. They were ordered to undergo treatment to ready them to stand trial. But in numerous cases, IDHS mental health professionals determined that they were unlikely to gain fitness because of the severity of their disabilities.

That doesn’t mean the charges didn’t come with consequences.

Through a variety of legal mechanisms, patients were ordered into the custody of IDHS for treatment in a state facility, where some remained for years, even when the criminal charges against them were dismissed.

Among those who were able to meet the fitness benchmark to face the charges against them, two were found not guilty by reason of insanity.

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Findings of unfitness or not guilty by reason of insanity usually meant a transfer to a more secure hospital. Female patients at Choate with this status were typically transferred to Alton Mental Health’s forensic treatment program, located about 140 miles northwest of Choate. One of the patients who was charged with a felony at Choate was transferred to Alton, where she later faced four additional felony charges. The patient, according to court records, had a history of physical and sexual abuse as a child.

Williams, whose intellectual disability is in the mild range, was also initially found unfit to stand trial.

She was ordered into the state’s care at Choate, where she was already a patient. “They wanted to get rid of me,” she said; Williams would have gone to Alton, but transfers were halted during the pandemic, records show. Williams said she was given printouts to read about court terminology and tested again. Eventually, she was found fit to stand trial and her defense attorney urged her to accept a plea deal for misdemeanor battery.

Tripp, who was then Williams’ defense attorney and is now the state’s attorney, said he did raise questions about the investigation when he was arguing to reduce the charge against her. Tripp said that it is typical to see defendants plead to a lower-level offense to avoid the risk of felony conviction. “There’s an additional built-in credibility hurdle to clear in most cases that rely heavily on statements by those with mental health concerns,” Tripp said, which may make a jury less apt to believe a defendant’s version of events.

In August 2020, she was sentenced to 12 months of conditional discharge, which is a less restrictive alternative to court supervision.

She’s among four patients who were convicted. Three others received felony convictions.

Of all of the problems she said she faced at Choate, Williams is most frustrated by the fact that she was charged. If she could go back, Williams said, she wouldn’t accept the plea deal.

“This ain’t right and they shouldn’t be doing this,” Williams said. “At first, I didn’t know. I’d be more educated.”

Williams was discharged from Choate in November 2020 and is trying to stabilize her life. She has enrolled in college classes and is applying for jobs. But with every application she sends out, she worries that her criminal record will give the hiring manager pause.

And in some cases, it has. She provided the news organizations with a rejection letter from a temporary hiring agency showing she’d been disqualified for jobs because of the misdemeanor battery conviction. “Based on the enclosed background report,” said the letter from PeopleReady, “we have reservations about hiring you for the initial position offered.” The letter cited her Union County conviction from her time at Choate.

Williams said she called the clerk in Union County asking if she could get help having the conviction removed from her record. Expunging or sealing a case would require her to hire a private lawyer, Williams said they told her.

“I can’t afford a lawyer,” she said.