People ex rel. R.F.

          Pueblo County District Court No. 19MH34 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

          HARRIS, JUDGE.

         ¶ 1 Sell v. United States, 539 U.S. 166 (2003), established a four-part test for evaluating petitions to involuntarily administer antipsychotic medication to render the respondent competent to stand trial. In this case, we adopt the framework as set out by the Supreme Court, thus disagreeing with another division of this court, People in Interest of Hardesty, 2014 COA 138, which framed the test as having eight parts.

         ¶ 2 Respondent, R.F., appeals the district court's order allowing doctors at the state mental health hospital to involuntarily administer antipsychotic medication for the purpose of restoring him to competency to stand trial. Because he expressly concedes the sufficiency of the evidence to support the district court's order, we affirm.

         I. Background

         ¶ 3 The People charged R.F. with second degree assault. The district court ordered a competency evaluation, and, in July 2018, R.F. was diagnosed by a psychiatrist at the state mental health hospital with "psychosis - not otherwise specified" and found incompetent to stand trial.

         ¶ 4 In January 2019, after other restoration efforts proved unsuccessful, the People petitioned the court under section 16-8.5-112(1), C.R.S. 2018, for permission to involuntarily administer antipsychotic medications and to monitor any side effects. The district court held an evidentiary hearing on the petition.

         ¶ 5 R.F. and his treating psychiatrist, Dr. Lennart Abel, testified at the hearing. Dr. Abel offered expert testimony that R.F. suffered from persistent delusions and was unlikely to be rendered competent without antipsychotic medications. He opined that the medications the People sought to involuntarily administer were substantially likely to render R.F. competent, but he did not provide any basis for his conclusion, other than a brief reference to "somebody who suffer[ed] from psychosis not otherwise specified" whom he had once restored to competency.

         ¶ 6 Dr. Abel acknowledged that R.F. had not previously taken antipsychotic medication and that he did not know "how [R.F. was] going to react to these medications." He conceded that R.F. might be part of the "small group" of patients with delusional disorders who do not respond to antipsychotic medication; in that event, Dr. Abel testified, he would "try other medications, other antipsychotic medications that are not currently on this list."

         ¶ 7 R.F. testified that he had refused the medication because he disagreed with Dr. Abel's diagnosis and treatment plan. He said he would not consider taking the medications voluntarily until he received a second opinion.

         ¶ 8 The district court found that the People had met their burden to show that administration of the medication was necessary to advance the state's interest in restoring R.F. to competency. Specifically, the court found that

• R.F. suffers from psychosis;

• R.F. is incapable of making treatment decisions because of his mental health disorder;

• reasonable efforts have been made to obtain voluntary acceptance of treatment, but R.F. objects to the proposed treatment and ...