The People of the State of Colorado, Petitioner-Appellee, In the Interest of R.C., Respondent-Appellant.
County District Court No. 19MH81 Honorable Jill S. Mattoon,
Cynthia Mitchell, County Attorney, Kate H. Shafer, Special
Assistant County Attorney, Pueblo, Colorado, for
Law Firm of John L. Rice, John L. Rice, Pueblo, Colorado, for
1 Appellant, R.C., appeals the district court's order
authorizing mental health personnel to medicate him
involuntarily. We reverse.
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
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
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.
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, ...