Title: Norskog v. Pfiel

State: illinois

Issuer: Illinois Supreme Court

Document:

Docket No. 89985-Agenda 26-March 2001.
MARSHA NORSKOG, Indiv. and as Adm'r of 
 the Estate of
Hillary Norskog, Appellant, v. ROGER PFIEL et al., Appellees.
Opinion filed July 26, 2001.
	JUSTICE McMORROW delivered the opinion of the court:
	On April 30, 1999, the circuit court of Cook County issued
contempt citations against Roger and Gayle Pfiel (the Pfiels) and
their son, Steven Pfiel (Steven) (collectively, the defendants), for
refusing to comply with discovery orders directing them to identify
mental health services providers seen by Steven and to disclose
information regarding Steven's diagnosis and treatment.
Defendants appealed and the appellate court reversed the orders of
contempt (314 Ill. App. 3d 877), finding that the trial court erred
when it compelled the disclosure of this information, which was
privileged pursuant to the Mental Health and Developmental
Disabilities Confidentiality Act (the Mental Health Act) (740 ILCS
110/1 et seq. (West 1998)). Plaintiff, Marsha Norskog, petitioned
this court for leave to appeal and the petition was granted. 177 Ill.
2d R. 315(a).
	We allowed amicus briefs in support of the defendants to be
filed by the Mental Health Association in Illinois and, collectively,
by Brazelton Center for Mental Health Law, Equip for Equality,
Inc., the Illinois Psychological Association, the National Alliance
for the Mentally Ill-Illinois Chapter, the National Depressive and
Manic Depressive Association, and the National Mental Health
Association.
	For reasons that follow, we now affirm the judgment of the
appellate court.

BACKGROUND
	On July 14, 1993, plaintiff's 13-year-old daughter, Hillary
Norskog, was stabbed to death. Seventeen-year-old Steven, who
had been dating Hillary, was charged with her murder. Initially,
Steven pleaded not guilty to the criminal charges and gave notice
that he would assert an insanity defense. The trial court appointed
a psychiatrist, Dr. Markos, to examine Steven to determine his
fitness to stand trial.
	On March 18, 1995, while Steven was free on bond, he killed
his brother and assaulted his sister. Thereafter, Steven entered into
a negotiated plea agreement. Steven pleaded guilty to the murders
of Hillary and his brother and was sentenced to life imprisonment
without the possibility of parole.
	In July 1995, plaintiff, individually and as the administrator
of Hillary's estate, filed a civil complaint against the defendants.
The complaint was amended on June 26, 1996, to allege 12 counts.
Some counts have been dismissed, but the remaining counts
include wrongful-death and survival actions against Steven
alleging intentional assault and battery of Hillary,(1) wrongful-death
and survival actions against the Pfiels for negligent supervision
and negligent entrustment, an action against Steven for reckless
infliction of emotional distress with respect to plaintiff, and an
action against the Pfiels brought under the Family Expenses Act.
See 750 ILCS 65/15 (West 2000).
	In the negligent supervision counts, plaintiff alleges that the
Pfiels knew or should have known of their minor son's "antisocial,
aggressive, hostile, and criminal behavior," but failed to properly
supervise and control him. The negligent entrustment counts are
premised on allegations that the Pfiels negligently entrusted
Steven with dangerous instrumentalities, namely, a hunting knife
with a 5¼-inch blade, which Steven used to kill Hillary, and an
automobile owned by Gayle Pfiel, which Steven drove on the
night of Hillary's murder.
	Plaintiff's amended complaint contained several factual
allegations which made reference to Steven being the recipient of
mental health services.(2) Both Steven and the Pfiels objected and
moved to strike these allegations. Defendants contended that all
mental health records and communications with mental health
providers, including information which identified Steven as the
recipient of mental health services, were privileged under the
Mental Health Act.
	Over defendants' claim of privilege, plaintiff persisted in her
efforts to obtain Steven's mental health information by
subpoenaing Steven's school records, submitting interrogatories
to the defendants, and by subpoenaing the defendants to appear for
deposition and directing them to produce documents and records
which would reveal when and for what purpose Steven may have
received mental health or psychiatric treatment prior to July 1993;
whether a diagnosis was made; and whether a treatment plan was
suggested to the Pfiels. Plaintiff also subpoenaed Dr. Markos, the
court-ordered psychiatrist who examined Steven to determine his
fitness to stand trial on the criminal charges. The subpoena
instructed Dr. Markos to provide copies of all records received and
used by him in conjunction with his court-ordered fitness
examinations of Steven.
	In support of her claim to this information, plaintiff argued
that Steven waived the confidentiality privilege to all of his mental
health records by raising the insanity defense at his criminal trial,
by disclosing mental health information and records to Dr. Markos
at his fitness examinations, and by providing mental health
information to school officials, his probation officer, and others.
Plaintiff claimed that Steven's mental health treatment was a
matter of public record, having been publicly disclosed in an
article in the Chicago Magazine. A copy of the article was attached
to papers plaintiff filed in the circuit court.
	In the alternative, plaintiff claimed that, pursuant to this
court's opinion in D.C. v. S.A., 178 Ill. 2d 551 (1997), even if the
confidentiality privilege had not been waived, fundamental
fairness demanded that the mental health information be made
available in the pending civil proceeding.
	Defendants objected to the release of Steven's school records,
arguing that the information was privileged under the Illinois
School Students Records Act (105 ILCS 10/1 et seq. (West 2000)),
as well as the Mental Health Act. Defendants also denied that the
Mental Health Act confidentiality privilege had been waived and
moved to quash all subpoenas and refused to answer any
interrogatories which would reveal whether Steven was the
recipient of mental health services.
	In resolving these matters, the trial court ruled that Steven's
mental health information was privileged under the Mental Health
Act. The trial court reviewed in camera Steven's school records
and deleted all material which would be confidential under the
Mental Health Act. However, before deciding whether Steven
waived the confidentiality privilege when he was examined by Dr.
Markos, the trial court allowed plaintiff to depose Dr. Markos
concerning the nature and scope of confidentiality admonitions
given to Steven during his fitness examinations. Based on Dr.
Markos' deposition testimony, the trial court, in an order dated
March 16, 1999, ruled as follows:
		"That Steven Pfiel's motion to quash the subpoena for
deposition of Dr. Markos is granted. For reasons stated in
open court, including findings that Pfiel has not waived
his privilege under the Mental Health and Development
[sic] Disabilities Confidentiality Act and that admonitions
given to him by Dr. Markos were insufficient to constitute
waiver of confidentiality or privilege, the plaintiff may not
depose Dr. Markos or obtain his records pertaining to
Pfiel's fitness-for-trial examinations.
* * *
			*** [T]his court finds per D.C. v. S.A., 178 Ill. 2d 551
(1997), Roger Pfiel and Gayle Pfiel should produce the
identities of any mental health provider seen by Steven
Pfiel and the dates on which each provider saw him.
Plaintiff may depose Roger Pfiel and Gayle Pfiel as to any
communications made to them by a mental health
provider but such questions shall be limited to Steven's
diagnosis and any recommendation or admonition given
to them by a mental health provider as to what they
should or should not do concerning Steven's mental
health. Plaintiff may depose any mental health provider
limited to the above areas. Pursuant to 740 ILCS 110/10,
this court shall conduct an in camera inspection of
testimony or other evidence concerning the discovery
information permitted above to determine that it is
relevant, probative, not unduly prejudicial or
inflammatory, and otherwise admissible."
	On March 17, 1999, a second order was entered, directing all
parties to answer Rule 213(f) interrogatories; granting plaintiff
permission to depose Steven; ordering the Pfiels to disclose
Steven's mental health providers by March 31, 1999; and allowing
plaintiff to subpoena Steven's mental health records from
providers identified, with such records being returnable to the
court for examination.
	In a motion dated April 14, 1999, the Pfiels "respectfully
decline[d] to comply with the courts [sic] orders of March 16 and
March 17, 1999 as they pertain to identifying any mental health
therapists who provided services to Steven Pfiel." The Pfiels
requested that the trial court "issue a contempt citation against
them for the purpose of seeking appellate review of the legal issue
about which there is a good faith dispute." Steven also sought a
contempt citation after giving notice that he would refuse to
comply with these and other orders directing him to identify
mental health providers who had treated him prior to July 14,
1993.
	On April 29, 1999, plaintiff filed a motion, asking the trial
court to certify two questions for appellate review pursuant to
Supreme Court Rule 308(a):
			(1) "Does a defendant's raising and pursuing an insanity
defense in a criminal case constitute a waiver of the
defendant's mental health privilege arising under the
Mental Health and Development Disabilities
Confidentiality Act in a subsequent civil case?"
			(2) "Does a defendant's disclosure of his mental health
treatment and/or condition in a criminal case after a court-appointed psychiatrist informs the defendant that
information provided to the court-appointed psychiatrist
is not confidential, result in a waiver of any mental health
privilege in a subsequent civil case?"
	The trial court refused to certify these questions and, instead,
entered an order on April 30, 1999, holding defendants in
contempt of court for refusing to comply with the court's
discovery orders. A fine of $25 was imposed on each defendant.
The court noted in the order that defendants were acting in good
faith, for the purpose of seeking appellate review.
	On May 14, 1999, defendants appealed their contempt
citations in the appellate court pursuant to Supreme Court Rule
304(b)(5). The appellate court, when ruling on the appeal, refused
to consider whether Steven "placed his mental health at issue
under the terms of section 10(a)(1) or otherwise waived his
privilege." These matters, the appellate court held, were "not at
issue in this appeal." Rather, the appellate court considered only
whether Steven's mental health information, though confidential
and privileged under the Act, was discoverable pursuant to D.C.
v. S.A., 178 Ill. 2d 551 (1997).
	Finding that the D.C. exception did not apply in this case, the
appellate court ruled that defendants could not be compelled to
disclose Steven's mental health information. For that reason, the
appellate court reversed the orders holding defendants in contempt
of court for refusing to comply with the trial court's orders.
	Plaintiff petitioned this court for leave to appeal and the
petition was granted. 177 Ill. 2d R. 315(a).
ANALYSIS
Scope and Standard of Review
	As a preliminary matter, we address defendants' contention
that this court's jurisdiction extends only to review, as the
appellate court did, the question of whether the judicially
constructed fundamental fairness exception to the Mental Health
Act confidentiality privilege, announced in D.C. v. S.A., applies to
this case. We find no such limitation on this court's jurisdiction.
	As noted above, an interlocutory appeal was initiated in the
appellate court, pursuant to Supreme Court Rule 304(b)(5) (155
Ill. 2d R. 304(b)(5)), after defendants refused to comply with the
trial court's discovery orders, were held in contempt, and were
sanctioned. Because discovery orders are not final orders, they are
not ordinarily appealable. People ex rel. Scott v. Silverstein, 87 Ill. 2d 167, 171 (1981); Lewis v. Family Planning Management, Inc.,
306 Ill. App. 3d 918, 921 (1999). However, it is well settled that
the correctness of a discovery order may be tested through
contempt proceedings. Eskandani v. Phillips, 61 Ill. 2d 183, 194
(1975). When an individual appeals contempt sanctions imposed
for violating, or threatening to violate, a pretrial discovery order,
the discovery order is subject to review. See Almgren v.
Rush-Presbyterian-St. Luke's Medical Center, 162 Ill. 2d 205, 216
(1994). Review of the contempt finding necessarily requires
review of the order upon which it is based. Waste Management,
Inc. v. International Surplus Lines Insurance Co., 144 Ill. 2d 178,
189 (1991).
	In the case at bar, although the trial court found that the
statutory confidentiality privilege applied and had not been
waived, it then allowed discovery based on its finding that an
exception to the confidentiality privilege existed. It would be
incongruous for us to review the trial court's application of the
exception without first considering whether the trial court was
correct in its initial application of statutory privilege. It is the order
of discovery, not merely the grounds upon which it was based, that
is subject to review. This is especially so since a contrary
determination on the issues of waiver would be equally
determinative to the question of whether discovery was available.
As a general rule, courts of review may sustain orders on any
grounds which are called for by the record, regardless of the
grounds relied on when the order was entered. Gunthorp v. Golan,
184 Ill. 2d 432, 438 (1998); Messenger v. Edgar, 157 Ill. 2d 162
(1993); Bell v. Louisville & Nashville R.R. Co., 106 Ill. 2d 135
(1985). Consequently, in the appeal before this court, before
deciding whether, pursuant to D.C. v. S.A., fundamental fairness
requires the disclosure of information which is otherwise
privileged, we will consider whether the information is, in fact,
privileged under the Mental Health Act or whether, as plaintiff
claims, the privilege has been waived.
	Our jurisdiction over the waiver issues is unaffected by the
trial court's denial of plaintiff's request to have these issues
certified for review pursuant to Supreme Court Rule 308. Granting
plaintiff appeal by certification would have been improper under
the circumstances. See Material Service Corp. v. Department of
Revenue, 98 Ill. 2d 382 (1983) (one who has obtained all that has
been asked for in the trial court cannot appeal from the judgment,
appeal should not be afforded to successful parties who may not
agree with the reasons, conclusion or findings below).
Furthermore, certification of the issues was unnecessary since, as
we have already shown, defendant's appeal of the contempt order
called into question the correctness of the discovery order and
allowed review of all the trial court's rulings on the application of
the Mental Health Act's confidentiality privilege.
	Although a trial court's discovery order is ordinarily reviewed
for a manifest abuse of discretion (Maxwell v. Hobart Corp., 216
Ill. App. 3d 108, 110 (1991)), the proper standard of review
depends on the question that was answered in the trial court
(Chicago Trust Co. v. Cook County Hospital, 298 Ill. App. 3d 396
(1998)). If the facts are uncontroverted and the issue is the trial
court's application of the law to the facts, a court of review may
determine the correctness of the ruling independently of the trial
court's judgment. In re Marriage of Bonneau, 294 Ill. App. 3d
720, 723-24 (1998).
	In this appeal, we are deciding whether disclosure of mental
health information is prohibited by a statutory discovery privilege
and whether any exception to the privilege applies. These are
matters of law subject to de novo review. D.C. v. S.A., 178 Ill. 2d 551, 559 (1997).

The Mental Health Act Confidentiality Privilege
	The Mental Health and Developmental Disabilities
Confidentiality Act provides that "any record kept by a therapist
or by an agency in the course of providing mental health or
developmental disabilities service to a recipient" and "any
communication made by a recipient or other person to a therapist
or to or in the presence of other persons during or in connection
with providing mental health or developmental disability services
to a recipient," including "information which indicates that a
person is a recipient," "shall be confidential and shall not be
disclosed except as provided in this Act." 740 ILCS 110/2, 3(a)
(West 2000). Subsequent sections of the Act identify the persons
entitled to inspect and copy a recipient's mental health record and
delineate when and how disclosure to other persons or agencies
may be accomplished.
	"The Confidentiality Act is carefully drawn to maintain the
confidentiality of mental health records except in the specific
circumstances explicitly enumerated." Sassali v. Rockford
Memorial Hospital, 296 Ill. App. 3d 80, 84-85 (1998). In each
instance where disclosure is allowed under the Act, the legislature
has been careful to restrict disclosure to that which is necessary to
accomplish a particular purpose. Exceptions to the Act are
narrowly crafted. Pritchard v. SwedishAmerican Hospital, 191 Ill.
App. 3d 388, 402 (1989). When viewed as a whole, the Act
constitutes a "strong statement" by the General Assembly about
the importance of keeping mental health records confidential.
Mandziara v. Canulli, 299 Ill. App. 3d 593, 599 (1998). That a
high value is placed on privacy is evidenced by the fact that the
privilege afforded a recipient of mental health treatment continues
even after the recipient's death. See 740 ILCS 110/5(e) (West
2000).
	The statutory scheme regulating the disclosure of mental
health information is appropriately rigorous. As the United States
Supreme Court noted:
		"Effective psychotherapy *** depends upon an
atmosphere of confidence and trust in which the patient
is willing to make a frank and complete disclosure of
facts, emotions, memories, and fears. Because of the
sensitive nature of the problems for which individuals
consult psychotherapists, disclosure of confidential
communications made during counseling sessions may
cause embarrassment or disgrace. For this reason, the
mere possibility of disclosure may impede development
of the confidential relationship necessary for successful
treatment." Jaffee v. Redmond, 518 U.S. 1, 10, 135 L. Ed. 2d 337, 345, 116 S. Ct. 1923, 1928 (1996).
	All 50 states, the District of Columbia and the federal courts
recognize a psychiatrist-patient privilege, either by statute or
common law. Jaffee, 518 U.S.  at 12, 135 L. Ed. 2d  at 346, 116 S. Ct.  at 1929. Clearly, this reflects an understanding that people will
increasingly avail themselves of needed treatment if they are
confident that their privacy will be protected. It is in the public
interest, then, that we zealously guard against erosion of the
confidentiality privilege. See Jaffee, 518 U.S.  at 11, 135 L. Ed. 2d 
at 345-46, 116 S. Ct.  at 1929 ("The mental health of our citizenry,
no less than its physical health, is a public good of transcendent
importance"); Doe v. McKay, 183 Ill. 2d 272 (1998).
Consequently, anyone seeking the nonconsensual release of
mental health information faces a formidable challenge and must
show that disclosure is authorized by the Act.
	In the present case, it is undisputed that records and
communications concerning mental health treatment Steven may
have received are subject to the privilege provided by the Mental
Health Act and that Steven has not consented to its release.
Furthermore, since the term "communications" includes "any
communication made by a recipient or other person to a therapist
*** in connection with providing mental health or developmental
disability services to a recipient," Steven's lack of consent also
prevents his parents from disclosing their conversations with
therapists in relation to Steven's mental health treatment.(3)
	Plaintiff, however, contends that she is entitled to discovery
of this information because Steven has waived the privilege in the
present proceedings by: (1) raising an insanity defense in his
criminal trial, (2) revealing mental health information to Dr.
Markos at his fitness examinations, and (3) providing mental
health information to school officials, a probation officer, and
others. We shall consider each claim of waiver individually.

Raising an Insanity Defense in the Criminal Case
	Although there is a general prohibition against nonconsensual
disclosure of mental health information, exceptions are recognized
by the Act. One such exception is found in section 10(a)(1) of the
Act, which provides in pertinent part, that "[r]ecords and
communications may be disclosed in a civil, criminal or
administrative proceeding in which the recipient introduces his
mental condition or any aspect of his services received for such
condition as an element of his claim or defense ***." 740 ILCS
110/10(a)(1) (West 2000).
	In the case at bar, neither Steven nor his parents have
introduced Steven's mental health care or treatment as an element
of their defense to the civil claims filed against them. Plaintiff
does not dispute this. Nevertheless, plaintiff claims that Steven
forfeited his right to the confidentiality privilege in these
proceedings by raising an insanity defense in his criminal case. As
sole support for her position, plaintiff relies on this court's
decision in Novak v. Rantham, 106 Ill. 2d 478 (1985).
	In Novak, Robert Lee Endicott shot and killed Beverly Novak
after he was released from Zeller Mental Health Center, where he
had been involuntarily committed. At Endicott's homicide trial,
Endicott asserted the defense of insanity and presented the
testimony of four psychiatrists, including Rantham, who had
treated Endicott at Zeller. Endicott also introduced at his criminal
trial all of his medical records from Zeller. Endicott received a
"not guilty by reason of insanity" verdict. Subsequently, Beverly's
father, David Novak, brought a wrongful-death action against
Rantham and Girmscheid, a psychologist who treated Endicott at
Zeller, claiming that they had been negligent for approving
Endicott's discharge.
	Before requiring Rantham and Girmscheid to submit
themselves for depositions, the circuit court certified a question
for review pursuant to Supreme Court Rule 308, asking whether
Rantham and Girmscheid were barred from testifying by the
Mental Health and Developmental Disabilities Act. In answering
the certified question, we recognized that, pursuant to section
10(a)(1) of the Act, Endicott waived the privilege of keeping his
mental health records confidential at his criminal trial by raising
the insanity defense. "Indeed, when a defendant raises an insanity
defense and calls his own medical expert as a witness to establish
the defense, he cannot thereafter assert the privilege to prevent the
State, at the same trial, from calling other medical experts who
treated him for the same condition." Novak, 106 Ill. 2d  at 483. It
had long been recognized that a defendant, by raising the insanity
defense, opened the door to discovery of his mental health
records. See People v. Newbury, 53 Ill. 2d 228, 234 (1972).
	However, in Novak, we further determined that, once the
confidentiality privilege had been waived, it could not be
reclaimed in a subsequent proceeding. We reasoned that "the
testimony of Rantham in favor of Endicott's defense at his trial
was a public disclosure by Endicott of information protected by
the Act and, as Wigmore puts it, took away its confidentiality."
See 8 J. Wigmore, Evidence §2389(4), at 860-61 (McNaughton
rev. ed. 1961); see also People v. Leppert, 105 Ill. App. 3d 514
(1982). Consequently, we held that there was no legal basis for
barring Rantham and Girmscheid from testifying regarding
Endicott's mental health treatment in the wrongful-death action
against them.
	Plaintiff's reliance on Novak in the present case, however, is
misplaced. The facts of Novak are inapposite and readily
distinguishable. Insanity is raised as an affirmative defense when
a defendant admits the offense charged but claims that, at the time
of the offense, he was insane and therefore lacked substantial
capacity either to appreciate the criminality of his conduct or to
conform his conduct to the requirements of the law. People v.
Kashney, 111 Ill. 2d 454, 464-65 (1986). In the case at bar, the
defense of insanity was never raised because Steven never went
to trial in his criminal case. Steven entered a plea of guilty. A plea
of guilty waives all nonjurisdictional defenses or defects. People
v. Burton, 184 Ill. 2d 1 (1998). By pleading guilty, then, the
question of sanity was no longer an issue. Furthermore, no
psychiatrist or mental health therapist ever made a public
disclosure of Steven's mental health records or testified in open
court regarding mental health treatment Steven had received.
Under these circumstances it cannot be said that Steven waived
the confidentiality privilege by raising an insanity defense in a
prior criminal trial. The rationale employed in Novak for finding
that the confidentiality privilege had been waived is not applicable
under the facts of this case.

Waiver of Confidentiality at Fitness Examination
	Plaintiff next contends, pursuant to section 10(a)(4) of the
Mental Health Act, that Steven's mental health information is
admissible in the pending civil litigation because Steven
participated in a court-ordered fitness examination in his criminal
case and, after being admonished that the information he revealed
would not be kept confidential, provided the examining
psychiatrist with information concerning his prior mental health
treatment.
	Section 10(a)(4) of the Mental Health Act provides:
			"Records and communications made to or by a
therapist in the course of examination ordered by a court
for good cause shown may, if otherwise relevant and
admissible, be disclosed in a civil, criminal, or
administrative proceeding in which the recipient is a party
or in appropriate pretrial proceedings, provided such
court has found that the recipient has been as adequately
and as effectively as possible informed before submitting
to such examination that such records and
communications would not be considered confidential or
privileged. Such records and communications shall be
admissible only as to issues involving the recipient's
physical or mental condition and only to the extent that
these are germane to such proceedings." 740 ILCS
110/10(a)(4) (West 2000).
	As earlier noted, this claim was raised in the trial court and,
before deciding whether defendant waived the privilege, the trial
court allowed plaintiff to depose Dr. Markos concerning the
admonishments he gave Steven before his fitness examination. At
the deposition, Dr. Markos testified that he followed standard
protocol. Dr. Markos testified,
		"I do not believe that the instruction that I gave Mr.
Steven Pfiel was in anyway different or was in variance
from the instruction or admonishment that I have
provided to the other defendants in the past. *** What I
informed Mr. Pfiel prior to the clinical examination was
that any information he provided me with may be or
could be contained in a report or reports that I submitted
to the court, including the opinions."
When asked if he mentioned anything about disclosure of the
information in any civil proceedings, Dr. Markos answered, "No,
I did not."
	 Based on Dr. Markos' testimony, there is no basis for
allowing disclosure of Steven's privileged mental health records
and communications pursuant to the exception provided in section
10(a)(4) of the Mental Health Act. When Dr. Markos admonished
Steven regarding confidentiality, it was within the context of a
fitness examination. There are strict rules governing the use of
information revealed to an examiner in a fitness exam.
	Section 104-14(a) of the Code of Criminal Procedure of 1963
provides in relevant part:
			"Statements made by the defendant and information
gathered in the course of any examination or treatment
ordered under Section 104-13, 104-17 or 104-20 shall
not be admissible against the defendant unless he raises
the defense of insanity or the defense of drugged or
intoxicated condition, in which case they shall be
admissible only on the issue of whether he was insane,
drugged, or intoxicated." 725 ILCS 5/104-14(a) (West
2000).
	In subsection (b) of section 104-14, it provides that any
further use of statements made in the course of a fitness
examination, beyond what is allowed in subsection (a), must be
with defendant's informed written consent.
	Based on this statutory scheme, it is reasonable to conclude
that by participating in the court-ordered fitness examinations,
Steven agreed to waive his confidentiality privilege only to the
extent provided by the strict procedural rules contained in the
Criminal Code.(4) Since admonishments given to Steven by Dr.
Markos did not go beyond the typical cautionary warnings, we
must also conclude that Steven did not waive his confidentiality
privilege for purposes other than that which is provided for by the
rules of criminal procedure. See People v. Gemeny, 313 Ill. App.
3d 902, 909 (2000) ("This legislative care in limiting permissible
disclosure strongly suggests that we may not assume that
eliminating confidentiality in one judicial setting means
eliminating it in all settings"). Steven was not notified "as
adequately and as effectively as possible *** that such records and
communications would not be considered confidential or
privileged" (740 ILCS 110/10(a)(4) (West 2000)). Consequently,
the admonishments given to Steven at his fitness examinations
were insufficient to allow disclosure of Steven's mental health
information in the civil proceedings.

Release of Information to Third Parties
	In plaintiff's third and final argument concerning waiver,
plaintiff contends that the confidentiality privilege should be
considered waived because Steven voluntarily shared information
with school officials and court personnel, such as Steven's
probation officer, and because there was a public disclosure
concerning Steven's mental health treatment in an article in a
local publication, Chicago Magazine. Plaintiff does not provide
any authority, either statutory or case law, for a finding of waiver
under these circumstances. Furthermore, one need only look to the
Mental Health Act to find that plaintiff's position is untenable.
	The Mental Health Act provides for the consensual disclosure
of information by a recipient. 740 ILCS 110/5 (West 2000).
Section 5 of the Act makes it clear that a recipient may consent to
disclosure of information for a limited purpose and that any
agency or person who obtains confidential and privileged
information may not redisclose the information without the
recipient's specific consent.
	Assuming that, as plaintiff contends, defendants have shared
Steven's mental health treatment records with school officials and
a probation officer, we draw from this fact no conclusion that
Steven intended to waive his confidentiality privilege. Any
confidential information which may have been shared was
released for a limited purpose and did not constitute a general
waiver of the confidentiality privilege.
	Nor do we find that there has been a public disclosure of
Steven's mental health record merely because an issue of Chicago
Magazine contained an article in which a single, brief reference
was made to Steven having been treated for a "chemical
imbalance." By all indications, this article was not authorized by
either Steven or the Pfiels. Consequently, any information which
has come into the public domain through this article was without
Steven's consent and cannot be considered as evidence that he
waived the confidentiality privilege.
	Furthermore, even if we ignored the unauthorized nature of
the article, we would be constrained to find that, to the extent the
article constitutes a public disclosure, waiver of the confidentiality
privilege would be limited to the information contained in the
public disclosure. The magazine article cannot provide the basis
for allowing the type of full-scale disclosure of Steven's mental
health records which plaintiff seeks.
	In sum, the Mental Health Act places strict limits on the
circumstances under which disclosure of confidential information
may be allowed, as well as the amount of confidential information
that may be released. In most instances, when a party seeks the
admission of mental health records and communications in legal
or administrative proceedings, section 10(a)(1) of the Act will
provide the framework for determining when confidential
information may be disclosed. Accordingly, an initial hurdle will
be showing that the recipient's mental condition was introduced
by the recipient. If this hurdle cannot be met, the information may
not be admitted, regardless of whether the opposing party's claim
or position would be advanced or facilitated by the disclosure of
the information. Waiver of the privilege is recognized in very
limited circumstances. In the present case, the circumstances do
not support a finding that the mental health confidentiality
privilege has been waived.

The Fundamental Fairness Exception
	The final issue, and the crux of this appeal, is whether
Steven's mental health records and communications, which are
decidedly confidential and privileged under the Mental Health
Act, should, nevertheless, be disclosed in the pending civil
proceedings based on considerations of fundamental fairness.
Authority for claiming the existence of a fundamental fairness
exception to the Mental Health Act confidentiality privilege is
grounded on this court's decision in D.C. v. S.A., 178 Ill. 2d 551
(1997). Consequently, we look to our opinion in D.C. and its
foundational principles. We begin with a review of the facts and
procedural history of the case.
	The plaintiff in D.C. filed a negligence action against
defendants seeking recovery for injuries he allegedly suffered
when he attempted to walk across a highway and was struck by a
car driven by S.A. Defendants answered the complaint, raised the
affirmative defense of plaintiff's contributory negligence, and
filed a counterclaim alleging plaintiff's negligence was the
proximate cause of damages to S.A.'s vehicle.
	In the course of discovery, defendants issued subpoenas for
deposition to the Edwards Hospital, where plaintiff was treated
after the accident, and to Dr. Georgeson, plaintiff's treating
physician, directing them to produce plaintiff's "medical,
psychiatric and/or psychological records for copying." Plaintiff
sought a protective order and the trial court ordered that
production be limited to plaintiff's medical records, which were
discoverable on the issue of damages. The medical records which
were produced showed that upon plaintiff's release from Edwards
Hospital, he was referred to Linden Oaks Hospital, the psychiatric
unit of Edwards Hospital. Additionally, plaintiff's treating
physician prepared a medical treatment summary in which it was
noted that the referral for psychiatric treatment was made based on
indications by plaintiff that he might have been attempting suicide
at the time of the accident. Defendants then moved to compel
production of plaintiff's psychiatric and psychological records.
	Plaintiff invoked the privilege afforded by the Mental Health
Act, but the trial court ruled that plaintiff had introduced his
mental condition into the proceedings. The trial court ordered that
all of plaintiff's medical and psychiatric records be produced for
in camera inspection. After reviewing the records, the trial court
ruled that three pages of records from Edwards Hospital and three
specific items of information contained in the records from Linden
Oaks were relevant and admissible pursuant to the factors set forth
in section 10(a)(1) of the Mental Health Act. Before releasing this
information to defendants, however, the trial court certified for
interlocutory appeal the question of whether plaintiff had
introduced his mental condition into the case, thereby making the
specified records discoverable.
	The appellate court reframed the certified question and held
that a plaintiff who files a negligence suit does not introduce his
mental condition as an element of his claim. Consequently, the
appellate court reversed the trial court's finding that plaintiff had
introduced his mental condition into the case.
	This court reversed the appellate court. Although we agreed
that the specified records were privileged communications within
the meaning of the Act and that, in the strictest sense, plaintiff had
not introduced his mental condition into the proceedings, we held
that "fundamental fairness commands that the privilege yield."
Underpinning this ruling was our refusal to place our imprimatur
on plaintiff's wielding the privilege as a sword to manipulate the
legal system, coupled with the recognition that, after in camera
inspection, the trial court restricted discovery to information
which met all other requirements of section 10(a)(1) of the Act
and had little to do with plaintiff's mental health treatment and
more to do with plaintiff's conduct at the time of the accident.
Furthermore, the information was obtainable from no other source
and could, potentially, absolve defendants of any liability and bar
plaintiff's recovery. We concluded that, on balance, the interests
of substantial justice and fundamental fairness outweighed
plaintiff's right to assert the confidentiality privilege under the
unique facts of the case.
	The facts in D.C. do not resemble the situation in the present
case. First, there is nothing in this case to indicate that defendants
are invoking the confidentiality privilege as a means to exploit or
subvert the legal process. In fact, it may be that by protecting
Steven's right to assert his privilege, the Pfiels are actually
hampering their own defense to the extent that they will be unable
to respond fully to allegations that they failed to take action to
control Steven's behavior. Thus, contrary to plaintiff's assertions
that defendants "are trying to hide behind" or "playing a game
with" the privilege, there is nothing devious or underhanded about
defendants' invocation of the privilege. Indeed, the confidentiality
privilege is being employed precisely as intended-to shield
information which our legislature has seen fit to protect. While
plaintiff may be prevented from gaining complete access to
information which could be beneficial to her cause, any unfairness
"is that [which is] present any time a *** defendant seeks to bar
potentially damaging evidence on the basis of a discovery
privilege or other exclusionary rule." People v. Gemeny, 313 Ill.
App. 3d 902, 911 (2000). As we acknowledged in D.C.,
		"Privileges which protect certain matters from disclosure
are not designed to promote the truth-seeking process, but
rather to protect some outside interest other than the
ascertainment of truth at trial. 1 J. Strong, McCormick on
Evidence §72, at 269 (4th ed. 1992). Thus, privileges are
an exception to the general rule that the public has a right
to every person's evidence." D.C., 178 Ill. 2d  at 561-62.
	Another major distinction between D.C. and the present case
is the nature of the evidence held discoverable in D.C. and the
impact that evidence had on the outcome of the case. In D.C.,
legitimate discovery revealed information about plaintiff's mental
state at the time of the accident which, if true, had the potential of
completely barring plaintiff's recovery and absolve defendant of
liability. In other words, the privileged information had the
inherent capacity to determine the outcome of the case.
	In the case at bar, the trial court has ordered discovery when
there is nothing to suggest that anything that might be revealed
through the disclosure of Steven's mental health records and
communications could be outcome determinative to any matter
pending in the civil case brought by plaintiff.
	As we noted earlier, the trial court has already ruled that
Steven may not deny liability on the wrongful-death and survival
claims against him. The only other claim pending against him is
that he recklessly caused emotional distress to plaintiff. This claim
relates to events which took place in 1995, when Steven, while
free on bail, killed his brother and assaulted his sister. Plaintiff
was alerted by police and she allegedly suffered worry and strain
due to fear that Steven would retaliate against her. Clearly, records
pertaining to Steven's mental health treatment prior to July 1993
are not pertinent to this claim.
	We realize that plaintiff also seeks to hold the Pfiels liable for
Steven's intentional acts against her daughter on theories of
negligent supervision and negligent entrustment. To succeed on
her claim of negligent supervision, plaintiff must show that: (1)
the Pfiels were aware of specific instances of prior conduct
sufficient to put them on notice that the act complained of (in this
case, Hillary's murder) was likely to occur; and (2) that the Pfiels
had the opportunity to control their minor child Steven. See
Restatement (Second) of Torts §316 (1965); Lott v. Strang, 312
Ill. App. 3d 521, 524 (2000). To prove negligent entrustment,
plaintiff must show that the Pfiels gave Steven express or implied
permission to use a dangerous instrument which they knew, or
should have known, would likely be used in a manner involving
an unreasonable risk of harm to others. See Restatement (Second)
of Torts §308 (1965); Zedella v. Gibson, 165 Ill. 2d 181 (1995).
Thus, it does not appear likely, nor does plaintiff allege, that
Steven's mental health records will reveal evidence which, by
itself, has the potential to establish plaintiff's claims against the
Pfiels. Consequently, unlike the situation in D.C., recognition of
the confidentiality privilege would not have the effect of
determining the outcome on any claim raised by plaintiff in this
case.
	Furthermore, in the present case, confidential records and
communications are not the only source of information concerning
the Pfiels' knowledge. Plaintiff's complaint contains factual
allegations which, if proven, would support her claim that the
Pfiels knew or should have known that Steven was a danger to
others. Plaintiff's arguments before this court belie the need for
disclosure of privileged information.
	For the same reason, we reject plaintiff's claim that by
upholding the confidentiality privilege in this case her
constitutional due process rights will be violated. Plaintiff has no
vested right in an unfettered claim, any more than the defendant
in D.C. had a vested right in an unfettered defense. See D.C.., 178 Ill. 2d  at 567-68.
	In sum, the fundamental fairness considerations which drove
our opinion in D.C. are not present in this case. Absent truly
extraordinary circumstances, not present here, the statutory
privilege must prevail. To recognize a fundamental fairness
exception in this case would eviscerate the statutory privilege.
	As a final observation, we note that an important
consideration in our resolution of D.C. was the scope of disclosure
that was allowed. In D.C. the trial court inspected the plaintiff's
medical and mental health records in camera and ruled that an
extremely limited amount of information, which was related to
plaintiff's conduct at the time of the accident and met the
requirements of section 10(a)(1), should be disclosed.
	In the present case, however, the trial court has ordered broad
discovery. Although Steven's mental health records were to be
produced for in camera inspection, but before ruling on the
relevance and admissibility of any information contained in these
records, plaintiff would have been allowed to depose defendants
and question them on matters that go to the heart of the therapist-recipient relationship. Plaintiff would be able to inquire about
diagnoses and treatment plans and learn about private
conversations with therapists regarding mental health treatment
Steven may have received at any time prior to July 1993.
	Even if we believed that fundamental fairness demanded the
abrogation of the confidentiality privilege in this case, which we
do not, such broad discovery would be unwarranted.

CONCLUSION
	It has been universally recognized that significant public and
private interests are served by preserving the confidentiality of
mental health records and communications. To that end, our
legislature has enacted laws which place strict controls on the
disclosure of mental health records and communications.
	In the case at bar, defendants have invoked the protections of
the Illinois Mental Health and Developmental Disabilities Act to
preserve the privacy and confidentiality of mental health records
and communications. Our review of the record indicates that the
discovery ordered by the trial court would reveal information
which is privileged and that no exceptions, statutory or otherwise,
allow for its disclosure. The unique factual and procedural
circumstances found in D.C. are not comparable to the factual
setting in the present case. Consequently, we find no legitimate
reason for refusing to uphold the privilege. We hold that the trial
court erred when it held defendants in contempt for refusing to
comply with discovery orders. We therefore affirm the judgment
of the appellate court.
Appellate court judgment affirmed.
	CHIEF JUSTICE HARRISON, specially concurring:
	Plaintiff's attempt to invoke a "fundamental fairness"
exception to the Mental Health and Developmental Disabilities
Confidentiality Act (740 ILCS 110/1 et seq. (West 1998)) was
properly rejected by the majority. Unlike my colleagues, however,
I would not base that conclusion on factual distinctions between
this case and our decision in D.C. v. S.A., 178 Ill. 2d 551 (1997).
Instead, I would hold that D.C. was incorrectly decided and should
be overruled.
	Where records and communications are privileged from
disclosure under the Act, as the records and communications here
were, a court has no authority to override the statutory privilege
based on its own conceptions of fairness. The terms of the statute
must be enforced as enacted by the General Assembly. Contrary
to the position taken by the court in D.C., we may not rewrite
legislation or ignore express requirements contained in this or any
other statute merely because we believe that doing so might better
serve the interests of justice under the particular facts before us.
If the statute, as enacted, appears to operate unjustly or
inappropriately in certain circumstances, that is a matter for the
legislature, not this court. D.C. v. S.A., 178 Ill. 2d 551, 571 (1997)
(Harrison, J., dissenting, joined by Nickels, J.).
	 
	 
1.      1The trial court has ruled that Steven may not disavow liability on the
assault and battery claims against him. Only the question of damages
remains on these claims.

2.      2Among the numerous factual allegations contained in the amended
complaint, plaintiff claimed "on information and belief" that Steven
began receiving "professional psychiatric treatment" at the age of nine
for a "chemical imbalance." Plaintiff seeks to verify this and other
allegations through discovery and to uncover additional evidence which
might advance her claims against the Pfiels.

3.      3Although argument in this case focuses, for the most part, on
Steven's privilege to maintain the confidentiality of his mental health
records and communications, we note that the parents have an
independent right to maintain the confidentiality of conversations they
may have had with mental health professionals with regard to their
minor son. See In re Marriage of Semmler, 90 Ill. App. 3d 649 (1980)
(mother was a "recipient" within the meaning of the Mental Health Act
when she consulted with her minor child's therapist for parenting advice
and minor child's consent to disclosure did not supplant the mother's
independent privilege to prevent disclosure of conversations with the
therapist).

4.      4We do not decide here whether written consent, required by section
104-14(b) (725 ILCS 5/104-14(b) (West 2000)), is necessary for the
release of Steven's privileged information in civil proceedings pursuant
to section 10(a)(4) of the Act. Without expressing any opinion on the
case, we note that in People v. Sutton, 316 Ill. App. 3d 874 (2000), the
appellate court recently held that the admissibility provision of section
104-14(a) of the Code of Criminal Procedure took precedence over a
homicide exception to the physician-patient privilege under section
8-802 of the Code of Civil Procedure, stating that, to the extent the two
statutes were in conflict, the more specific and detailed fitness scheme
of section 104-14(a) was controlling.