25CA2161 Peo in Interest of Depatie 01-22-2026
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA2161 Pueblo County District Court No. 25MH30109 Honorable Amiel Markenson, Judge
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Andrew Jason Depatie,
Respondent-Appellant.
ORDER AFFIRMED
Division A Opinion by JUDGE TAUBMAN* Román, C.J., and Graham*, J., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced January 22, 2026
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 Respondent-Appellant
*Sitting by assignment of the Chief Justice under provisions of Colo. Const. art. VI, § 5(3), and § 24-51-1105, C.R.S. 2025. ¶1 Respondent, Andrew Jason Depatie, appeals the district
court’s order authorizing staff at the Colorado Mental Health
Hospital in Pueblo (the hospital) to medicate him involuntarily. We
affirm.
I. Background
¶2 Depatie was committed to the hospital after being found
incompetent to proceed in a criminal case. He was diagnosed with
unspecified mood disorder and presented with symptoms that
included grandiose delusions, paranoia, impulsivity, agitation, and
threatening behavior. After Depatie became verbally aggressive and
physically assaultive to a peer in his unit and was observed
engaging in self-harming behavior, the hospital staff placed him on
suicide precautions and began giving him emergency medication.
¶3 The People then petitioned the district court for authorization
to treat Depatie against his will with various antipsychotic and
mood stabilizing medications. The district court held an evidentiary
hearing, at which Dr. Hareesh Pillai, Depatie’s psychiatrist, and
Depatie testified. Dr. Pillai described Depatie’s disorder and
accompanying symptoms. He also described the requested
medications — valproic acid (Depakote), lithium, risperidone
1 (Risperdal), and olanzapine (Zyprexa) — and explained their
possible side effects. He opined that the medications were
necessary to treat Depatie’s symptoms.
¶4 Depatie denied having a mental illness but agreed that he had
previously been diagnosed with a mental illness in 2007. He
testified that he was unwilling to take Depakote and lithium due to
side effects that “put [him] on the floor” — namely, extreme
drowsiness, slurred speech, dry mouth, and shaking. However, he
also testified that he would be willing to take risperidone — “a
miracle drug” that had worked for him in the past. Depatie further
agreed to take Zyprexa, to the extent it was needed to cross titrate
to risperidone alone.
¶5 The district court granted the petition. It found that Dr. Pillai
testified “credibly and persuasively” and that the People had proved
all four elements of the test for involuntary medication of drugs in
People v. Medina, 705 P.2d 961, 973 (Colo. 1985). The court issued
an order authorizing the involuntary administration of the
requested medications.
2 II. Applicable Law and Standard of Review
¶6 A district court may order the involuntary administration of
medication if the People prove by clear and convincing evidence that
(1) the patient is incompetent to effectively participate in the
treatment decision; (2) the treatment is necessary to prevent a
significant and likely long-term deterioration in the patient’s mental
health condition or to prevent the likelihood of the patient causing
serious harm to himself, herself, or others at the institution; (3) a
less intrusive treatment alternative is not available; and (4) the
patient’s need for treatment is sufficiently compelling to override
any bona fide and legitimate interest of the patient in refusing
treatment. Id.
¶7 Application of the Medina test involves mixed questions of fact
and law. People v. Marquardt, 2016 CO 4, ¶ 8, 364 P.3d 499, 502.
We defer to the district court’s factual findings if they have record
support and review its legal conclusions de novo. Id. It is for the
district court, as the fact finder, to determine the credibility of
witnesses; the sufficiency, probative effect, and the weight of the
evidence; and the inferences and conclusions to be drawn from the
3 evidence. People in Interest of R.C., 2019 COA 99M, ¶ 7, 451 P.3d
1229, 1231.
¶8 When a patient challenges the sufficiency of the evidence
supporting an involuntary medication order, we must affirm if the
evidence, viewed as a whole and in the light most favorable to the
People, is sufficient to support the order. People in Interest of
R.K.L., 2016 COA 84, ¶ 13, 412 P.3d 827, 832. The testimony of
the treating psychiatrist alone may suffice. Id. at ¶ 30, 412 P.3d at
834.
III. Analysis
¶9 Depatie challenges the sufficiency of the evidence supporting
the order. In particular, he contends that the evidence was
insufficient to support the district court’s findings that the third
and fourth Medina elements were met. We address each contention
in turn.
A. Less Intrusive Alternative
¶ 10 First, we address Depatie’s contention that the evidence was
insufficient to prove the third Medina element — that a less
intrusive treatment alternative was not available. Medina, 705 P.2d
at 973. This element “encompasses not only the gravity of any
4 harmful effects from the proposed treatment but also the existence,
feasibility, and efficacy of alternative methods of treating the
patient’s condition or of alleviating the danger created by that
condition.” Id. at 974. A less intrusive alternative is “an available
treatment that has less harmful side effects and is at least as
effective at alleviating a patient’s condition as the proposed
treatment.” People in Interest of Strodtman, 293 P.3d 123, 133
(Colo. App. 2011).
¶ 11 Depatie contends that a less intrusive alternative to the
proposed treatment exists because he had previously been treated
successfully with risperidone alone and the proposed addition of
Zyprexa, lithium, and Depakote is “unnecessarily intrusive.”
¶ 12 True, Dr. Pillai testified that after speaking with some family
members he learned that Depatie was prescribed risperidone
“earlier in his life” and was “compliant with that medication for the
majority of his adult life.” Based on this information, Dr. Pillai
hoped to “titrate [Depatie] off of Zyprexa and onto the risperidone,
continuing the lithium and Depakote.” Dr. Pillai also testified that
if Depatie were to attain his baseline on a combination of
5 risperidone, Depakote, and lithium, the next step would be to slowly
taper off either Depakote or lithium.
¶ 13 However, Dr. Pillai also testified that while it might be possible
for Depatie to be managed with risperidone alone “once he returns
to his baseline,” right now, “in the midst of his acute mania, he
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25CA2161 Peo in Interest of Depatie 01-22-2026
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA2161 Pueblo County District Court No. 25MH30109 Honorable Amiel Markenson, Judge
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Andrew Jason Depatie,
Respondent-Appellant.
ORDER AFFIRMED
Division A Opinion by JUDGE TAUBMAN* Román, C.J., and Graham*, J., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced January 22, 2026
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 Respondent-Appellant
*Sitting by assignment of the Chief Justice under provisions of Colo. Const. art. VI, § 5(3), and § 24-51-1105, C.R.S. 2025. ¶1 Respondent, Andrew Jason Depatie, appeals the district
court’s order authorizing staff at the Colorado Mental Health
Hospital in Pueblo (the hospital) to medicate him involuntarily. We
affirm.
I. Background
¶2 Depatie was committed to the hospital after being found
incompetent to proceed in a criminal case. He was diagnosed with
unspecified mood disorder and presented with symptoms that
included grandiose delusions, paranoia, impulsivity, agitation, and
threatening behavior. After Depatie became verbally aggressive and
physically assaultive to a peer in his unit and was observed
engaging in self-harming behavior, the hospital staff placed him on
suicide precautions and began giving him emergency medication.
¶3 The People then petitioned the district court for authorization
to treat Depatie against his will with various antipsychotic and
mood stabilizing medications. The district court held an evidentiary
hearing, at which Dr. Hareesh Pillai, Depatie’s psychiatrist, and
Depatie testified. Dr. Pillai described Depatie’s disorder and
accompanying symptoms. He also described the requested
medications — valproic acid (Depakote), lithium, risperidone
1 (Risperdal), and olanzapine (Zyprexa) — and explained their
possible side effects. He opined that the medications were
necessary to treat Depatie’s symptoms.
¶4 Depatie denied having a mental illness but agreed that he had
previously been diagnosed with a mental illness in 2007. He
testified that he was unwilling to take Depakote and lithium due to
side effects that “put [him] on the floor” — namely, extreme
drowsiness, slurred speech, dry mouth, and shaking. However, he
also testified that he would be willing to take risperidone — “a
miracle drug” that had worked for him in the past. Depatie further
agreed to take Zyprexa, to the extent it was needed to cross titrate
to risperidone alone.
¶5 The district court granted the petition. It found that Dr. Pillai
testified “credibly and persuasively” and that the People had proved
all four elements of the test for involuntary medication of drugs in
People v. Medina, 705 P.2d 961, 973 (Colo. 1985). The court issued
an order authorizing the involuntary administration of the
requested medications.
2 II. Applicable Law and Standard of Review
¶6 A district court may order the involuntary administration of
medication if the People prove by clear and convincing evidence that
(1) the patient is incompetent to effectively participate in the
treatment decision; (2) the treatment is necessary to prevent a
significant and likely long-term deterioration in the patient’s mental
health condition or to prevent the likelihood of the patient causing
serious harm to himself, herself, or others at the institution; (3) a
less intrusive treatment alternative is not available; and (4) the
patient’s need for treatment is sufficiently compelling to override
any bona fide and legitimate interest of the patient in refusing
treatment. Id.
¶7 Application of the Medina test involves mixed questions of fact
and law. People v. Marquardt, 2016 CO 4, ¶ 8, 364 P.3d 499, 502.
We defer to the district court’s factual findings if they have record
support and review its legal conclusions de novo. Id. It is for the
district court, as the fact finder, to determine the credibility of
witnesses; the sufficiency, probative effect, and the weight of the
evidence; and the inferences and conclusions to be drawn from the
3 evidence. People in Interest of R.C., 2019 COA 99M, ¶ 7, 451 P.3d
1229, 1231.
¶8 When a patient challenges the sufficiency of the evidence
supporting an involuntary medication order, we must affirm if the
evidence, viewed as a whole and in the light most favorable to the
People, is sufficient to support the order. People in Interest of
R.K.L., 2016 COA 84, ¶ 13, 412 P.3d 827, 832. The testimony of
the treating psychiatrist alone may suffice. Id. at ¶ 30, 412 P.3d at
834.
III. Analysis
¶9 Depatie challenges the sufficiency of the evidence supporting
the order. In particular, he contends that the evidence was
insufficient to support the district court’s findings that the third
and fourth Medina elements were met. We address each contention
in turn.
A. Less Intrusive Alternative
¶ 10 First, we address Depatie’s contention that the evidence was
insufficient to prove the third Medina element — that a less
intrusive treatment alternative was not available. Medina, 705 P.2d
at 973. This element “encompasses not only the gravity of any
4 harmful effects from the proposed treatment but also the existence,
feasibility, and efficacy of alternative methods of treating the
patient’s condition or of alleviating the danger created by that
condition.” Id. at 974. A less intrusive alternative is “an available
treatment that has less harmful side effects and is at least as
effective at alleviating a patient’s condition as the proposed
treatment.” People in Interest of Strodtman, 293 P.3d 123, 133
(Colo. App. 2011).
¶ 11 Depatie contends that a less intrusive alternative to the
proposed treatment exists because he had previously been treated
successfully with risperidone alone and the proposed addition of
Zyprexa, lithium, and Depakote is “unnecessarily intrusive.”
¶ 12 True, Dr. Pillai testified that after speaking with some family
members he learned that Depatie was prescribed risperidone
“earlier in his life” and was “compliant with that medication for the
majority of his adult life.” Based on this information, Dr. Pillai
hoped to “titrate [Depatie] off of Zyprexa and onto the risperidone,
continuing the lithium and Depakote.” Dr. Pillai also testified that
if Depatie were to attain his baseline on a combination of
5 risperidone, Depakote, and lithium, the next step would be to slowly
taper off either Depakote or lithium.
¶ 13 However, Dr. Pillai also testified that while it might be possible
for Depatie to be managed with risperidone alone “once he returns
to his baseline,” right now, “in the midst of his acute mania, he
requires a higher dosage [of risperidone] along with mood
stabilizers, including Depakote and lithium.” And Dr Pillai further
testified that Depatie would need treatment with both antipsychotic
and mood stabilizing medications for “an extended period of time”
before he expects him to return to baseline. Dr. Pillai explained,
“when individuals suffer from acute manic episodes, the mood
stabilizer is the most important aspect of their outpatient treatment
regimen.”
¶ 14 Crediting this testimony, the district court found that while
treatment with risperidone alone would have fewer harmful side
effects than the proposed treatment plan, adequate evidence did not
support the conclusion that risperidone alone would be enough to
keep Depatie stable. Because the record supports the court’s
determination, we may not disturb it, and to the extent Depatie
6 asks us to draw different inferences from the testimony, we decline
to do so. See R.C., ¶ 7, 451 P.3d at 1231.
B. Need for Treatment and Legitimate Interest in Refusing Treatment
¶ 15 Next, we address Depatie’s contention that the evidence was
insufficient to prove the fourth Medina element — that his need for
the requested medications was sufficiently compelling to override
his bona fide and legitimate interest in refusing to take them. In
assessing this element, a court must first determine “whether the
patient’s refusal is bona fide and legitimate.” Medina, 705 P.2d at
974. If it is, the court must then determine “whether the prognosis
without treatment is so unfavorable that the patient’s personal
preference must yield to the legitimate interests of the state in
preserving the life and health of the patient placed in its charge and
in protecting the safety of those in the institution.” Id.
¶ 16 Pointing to the side effects he has experienced, Depatie
summarily asserts that “the benefits of treating him are clearly
outweighed by the risks to his health and well-being.” However,
Depatie does not address the other side of the equation — his need
for the requested medications. The district court accepted Depatie’s
7 assertion that he had bona fide and legitimate reasons for refusing
to take the requested medications based on his avoidance of
unwanted side effects. Nevertheless, it found that Depatie’s need
for the medications outweighed those concerns.
¶ 17 The record supports the district court’s findings. Dr. Pillai
opined that the failure to medicate Depatie would be more harmful
than the risks posed by the requested medications. In support of
this opinion, Dr. Pillai testified that without the medications
Depatie would “likely suffer a significant deterioration and have
more severe symptoms of mania similar to how he presented when
he . . . initially arrived [at] the hospital.” At that point, Depatie’s
symptoms were “so severe” that he was “unable to adequately
control his behaviors in a manner that [was] safe.” And while Dr.
Pillai agreed that Depatie’s symptoms had “significantly improved”
since being placed on the emergency course of medications, he
testified that “this improvement . . . [was] extremely tenuous” and
Depatie could “rapidly deteriorate within a day or two or even a
week if he was not [medication] compliant.” Because the record
supports the court’s findings, we may not second-guess them. See
R.K.L., ¶ 13, 417 P.3d at 832.
8 IV. Disposition
¶ 18 The order is affirmed.
CHIEF JUDGE ROMÁN and JUDGE GRAHAM concur.