Peo in Inerest of Hayes

24CA1082 Peo in Interest of Hayes 09-19-2024

COLORADO COURT OF APPEALS

Court of Appeals No. 24CA1082
Pueblo County District Court No. 24MH30033
Honorable Timothy O’Shea, Judge

The People of the State of Colorado,

Petitioner-Appellee,

In the Interest of Armound De Shaun Hayes,

Defendant-Appellant.

ORDER AFFIRMED

Division II
Opinion by JUDGE JOHNSON
Fox and Schock, JJ., concur

NOT PUBLISHED PURSUANT TO C.A.R. 35(e)
Announced September 19, 2024

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

Tezak Law, P.C., Mary Tezak, Florence, Colorado, for Defendant-Appellant
¶1 Respondent, Armound De Shaun Hayes (Hayes), appeals the

district court’s order authorizing the involuntary administration of

medication to him. We affirm.

I. Background

¶2 Hayes was committed to the Colorado Mental Health Hospital

in Pueblo (CMHHIP) for restoration to competency in a criminal

case. He was diagnosed with unspecified mood disorder and

presented with symptoms including agitation, irritability,

impulsivity, and physically aggressive behavior.

¶3 When Hayes was admitted to CMHHIP, he voluntarily agreed

to take Depakote (Depakene/Valproic Acid) but refused to take

Zyprexa (Olanzapine). Two days later, he assaulted two staff

members and was administered emergency medications to stabilize

him.

¶4 The State filed a petition for a court order authorizing the

involuntary administration of medication to Hayes. The district

court held a hearing, at which Hayes and Dr. Mattox, a psychiatrist

at CMHHIP and a supervisor of Hayes’s psychiatric provider,

testified. Dr. Mattox was qualified as an expert in the field of

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clinical psychiatry. At the conclusion of that hearing, the court

found that Dr. Mattox had “testified credibly and persuasively,” and

it concluded that the State had proved all four elements set forth in

People v. Medina, 705 P.2d 961 (Colo. 1985). The court issued an

order authorizing CMHHIP staff to administer Zyprexa (Olanzapine)

and Depakote (Depakene/Valproic Acid), “as scheduled

medications” in the dosages requested by Dr. Mattox, as well as

Chlorpromazine (Thorazine), Hydroxyzine (Vistaril), and Ativan

(Lorazepam) “as needed for severe levels of agitation and

aggression,” and the lab work necessary to monitor the

administration of these medications.

II. Standard of Review

¶5 An involuntarily committed individual retains the right to

refuse medical treatment, including the administration of

antipsychotic medications. Medina, 705 P.2d at 973. Under

Medina, a court may order that such a person be medicated over

his objection only when (1) the person is not competent to

participate in the treatment decision; (2) treatment by antipsychotic

medication is necessary to prevent significant and likely long-term

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deterioration in the person’s mental condition or to prevent the

likelihood of the person causing serious harm to himself or others

in the institution; (3) no less intrusive treatment option is available;

and (4) the person’s need for treatment with antipsychotic

medication is sufficiently compelling to outweigh his bona fide and

legitimate interest in refusing the medication. Id. The State bears

the burden of proving each of the Medina factors by clear and

convincing evidence. Id.1 A psychiatrist’s testimony may suffice to

meet this burden. People v. Pflugbeil, 834 P.2d 843, 847 (Colo. App.

1992).

¶6 When challenging the sufficiency of the evidence, we review

the record de novo, viewing the evidence in the light most favorable

to the State, as the prevailing party. See Clark v. People, 232 P.3d

1287, 1291 (Colo. 2010); People v. Fuentes, 258 P.3d 320, 326

1 When the State seeks to administer antipsychotic drugs to a

mentally ill criminal defendant involuntarily so that the individual
can stand trial, a reviewing court applies the Supreme Court’s test
in Sell v. United States, 539 U.S. 166, 178 (2003). But reviewing
courts apply state law tests if the state, as here, seeks to administer
antipsychotics involuntarily for “a different purpose,” including a
purpose “related to the individual’s dangerousness, or . . . the
individual’s own interests where refusal to take drugs puts his
health gravely at risk.” Id. at 181-82.
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(Colo. App. 2011). As the fact finder, the district court “has

discretion to determine the credibility of the witnesses; the

sufficiency, probative effect, and weight of the evidence; and the

inferences and conclusions to be drawn from it.” People in Interest

of R.C., 2019 COA 99M, ¶ 7 (quoting People in Interest of

S.M.A.M.A., 172 P.3d 958, 962 (Colo. App. 2007)). Where there is

“ample evidence in the record to support the trial court’s findings

and conclusion[s], based on clear and convincing evidence,” we may

not “substitute[] [our] judgment for that of the trial court.” People in

Interest of A.J.L., 243 P.3d 244, 255 (Colo. 2010).

III. Analysis

¶7 Hayes contends that the evidence was insufficient to prove the

first Medina factor: that he is incompetent to effectively participate

in the treatment decision. We are not persuaded.

¶8 The record supports the district court’s finding that Hayes was

incompetent to effectively participate in his treatment decisions.

Dr. Mattox testified that Hayes has no insight into his mental

illness. This opinion was based on Dr. Mattox’s experience with the

patient during this and two prior visits to CMHHIP. Dr. Mattox

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further testified that Hayes is incompetent to effectively participate

in decisions affecting his health, including the decision as to

whether psychiatric medications are needed, because Hayes “does

not believe he has a mental illness” and does not believe that he

“need[s] treatment with psychiatric medications.” And Dr. Mattox

testified that when he discussed with Hayes the possibility of taking

the requested medications voluntarily, Hayes refused.

¶9 We are not persuaded otherwise by the assertion that Hayes is

competent to effectively participate in the treatment decision

because he “did not deny that he had any mental illness” and

“stated a willingness to take both Depakote and Zyprexa, the two

primary medications” requested by Dr. Mattox. Nothing in Hayes’s

testimony evidences a belief that he has a mental illness. Indeed,

when Hayes was asked if he believed that he had a mental illness,

he responded only, “They diagnosed me with ADHD, anxiety, and

depression.” And while Hayes did testify, somewhat conflictingly,

that he was agreeable to taking Depakote and Zyprexa, he also

testified that he would not willingly take the other requested

medications. Iin response to Hayes’s testimony, Dr. Mattox opined,

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“I don’t believe his consent [to taking Depakote and Zyprexa] would

be maintained.” Dr. Mattox explained, “[Hayes] has refused those

medications in the past,” and when Dr. Mattox spoke to him in the

past about voluntarily taking these medications, “similar to . . . his

testimony today, he gave very inconsistent answers saying first that

he would prefer to take the Valproic Acid [Depakote] and not the

Zyprexa and then stating he would prefer to take the Zyprexa and

not the Valproic Acid [Depakote].” Weighing this conflicting

evidence, the court credited Dr. Mattox’s testimony, finding it both

credible and persuasive, and found Hayes’s testimony on this point

to be incredible. We are bound by those findings. See People in

Interest of Strodtman, 293 P.3d 123, 132 (Colo. App. 2011); People

in Interest of Ramsey, 2023 COA 95, ¶ 30.

¶ 10 We likewise reject Hayes’s assertion that his ability to testify

about his symptoms, side effects, and past experiences with

medication demonstrate that he is competent to effectively

participate in the treatment decisions. The first Medina factor does

not ask simply whether a patient has the ability to “articulate his or

her preferences” in regard to treatment. Strodtman, 293 P.3d at

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132. It asks whether the patient is competent to effectively

participate in the treatment decision. Medina, 705 P.2d at 973. “To

participate effectively contemplates action in addition to words.”

Strodtman, 293 P.3d at 132. And for the reasons above, Dr.

Mattox’s testimony is sufficient to support the district court’s

finding that Hayes was not competent to effectively participate in

the treatment decision.

¶ 11 And to the extent Hayes asserts that the district court’s

statement, “it just comes down to a disagreement over which . . .

class of medications to take” evidences an error in the court’s

judgment concerning Hayes’s competence to effectively participate

in the treatment decision, we disagree. This statement was in

reference to the court’s finding that Hayes’s refusal to take the

requested medications was not bona fide and legitimate — a Medina

factor Hayes does not contest on appeal.

¶ 12 Because Hayes does not challenge the district court’s findings

concerning the other Medina factors, we conclude the evidence was

sufficient to support the involuntary medication order.

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IV. Conclusion

¶ 13 The order is affirmed.

JUDGE FOX and JUDGE SCHOCK concur.

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