People ex rel. R.C.

          Pueblo County District Court No. 19MH81 Honorable Jill S. Mattoon, Judge

          Cynthia Mitchell, County Attorney, Kate H. Shafer, Special Assistant County Attorney, Pueblo, Colorado, for Petitioner-Appellee

          The Law Firm of John L. Rice, John L. Rice, Pueblo, Colorado, for Respondent-Appellant

          OPINION

          LIPINSKY, JUDGE

         ¶ 1 Appellant, R.C., appeals the district court's order authorizing mental health personnel to medicate him involuntarily. We reverse.

         I. Background

         ¶ 2 R.C. was committed to the Colorado Mental Health Institute at Pueblo (CMHIP) after being found incompetent to proceed in a criminal case. A CMHIP staff psychiatrist, Dr. Lennart Abel, diagnosed R.C. with bipolar disorder mania with psychosis.

         ¶ 3 Following R.C.'s assault of a staff member at CMHIP, the People filed a petition seeking a court order authorizing the administration of involuntary medication. At a hearing on the petition, Dr. Abel testified that R.C. was voluntarily taking Zyprexa. Dr. Abel opined that R.C. would not continue to take this drug voluntarily because he had previously refused to take medication.

         ¶ 4 The People did not seek an order allowing R.C. to be involuntarily medicated with Zyprexa, however. Rather, the People sought authorization to medicate R.C. involuntarily with six other drugs: Olanzapine, Haldol, Abilify, Lithium, Depakote, and Clozapine (the Six Medications). Dr. Abel testified that R.C. "can be treated with Zyprexa but I'm not sure if that would be the case over the time. Therefore, I have the other medications on the petition."

         ¶ 5 The district court granted the People's petition and entered an order authorizing the involuntary administration of the Six Medications, effective immediately. On appeal, R.C. contends that insufficient evidence supported the order. We agree and, therefore, reverse.

         II. Involuntary Administration of Medication

         ¶ 6 An order for involuntary administration of medications must be supported by clear and convincing evidence

(1) that the patient is incompetent to effectively participate in the treatment decision; (2) that treatment by antipsychotic medication is necessary to prevent a significant and likely long-term deterioration in the patient's mental condition or to prevent the likelihood of the patient's causing serious harm to himself or others in the institution; (3) that a less intrusive treatment alternative is not available; and (4) that the patient's need for treatment by antipsychotic medication is sufficiently compelling to override any bona fide and legitimate interest of the patient in refusing treatment.

People v. Medina, 705 P.2d 961, 973 (Colo. 1985). The People bear the burden to prove each element. People in Interest of Strodtman, 293 P.3d 123, ...