Peo in Interest of Foisel

• Court: Colorado Court of Appeals
• Decided: October 30, 2025
• Docket: 25CA1502
• Status: Unpublished

Opinion

25CA1502 Peo in Interest of Foisel 10-30-2025

COLORADO COURT OF APPEALS

Court of Appeals No. 25CA1502 Pueblo County District Court No. 25MH30069 Honorable Amiel Markenson, Judge

The People of the State of Colorado,

Petitioner-Appellee,

In the Interest of Richard Wayne Foisel,

Respondent-Appellant.

ORDER AFFIRMED

Division V Opinion by JUDGE PAWAR Freyre and Yun, JJ., concur

NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced October 30, 2025

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 ¶1 Respondent, Richard Wayne Foisel, appeals the district court’s

order authorizing the staff at the Colorado Mental Health Hospital

in Pueblo (the hospital) to involuntarily medicate him. We affirm.

I. Background

¶2 In May 2025, Foisel was committed to the hospital after being

found incompetent to proceed in his criminal case. He was

diagnosed with schizophrenia and presented with symptoms that

included delusions, paranoia, auditory hallucinations, poor

hygiene, and disorganized thinking. The hospital started Foisel on

emergency medication after he threatened security staff, attempted

to barricade himself in his room, and started “swinging his fists”

when staff entered the room. Foisel refused all medication, denied

having a mental illness, and insisted he did not need medication.

¶3 In July 2025, the State filed a petition to involuntarily

medicate Foisel with olanzapine (also known as Zyprexa). The

district court held an evidentiary hearing, at which Foisel’s treating

psychiatrist, Dr. Hareesh Pillai, testified; Foisel refused to attend

the hearing. During the hearing, the court heard evidence that

Foisel had a history of previous hospitalizations, and that during a

prior hospitalization from August 2022 to July 2024, he was treated

1 with olanzapine. With that treatment, Foisel’s condition improved

and he was eventually released from the hospital.

¶4 After hearing the evidence, the court found that Dr. Pillai had

testified “credibly and persuasively” and that the State had

established all four elements for the involuntary administration of

medication under People v. Medina, 705 P.2d 961, 973 (Colo. 1985).

The court therefore granted the State’s petition.

¶5 Foisel appeals, arguing only that the State presented

insufficient evidence to support one of the Medina factors.

II. Applicable Law and Standard of Review

¶6 A district court may order the involuntary administration of

medication if the State proves 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 themself 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.

2 ¶7 Application of the Medina test involves mixed questions of fact

and law. People v. Marquardt, 2016 CO 4, ¶ 8. We defer to the

district court’s factual findings if they have record support and

review its legal conclusions de novo. Id.

¶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 (“The testimony of the physician seeking

to administer treatment may be sufficient by itself to satisfy” the

Medina elements.). As the fact finder, the district court determines

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

with the inferences and conclusions to be drawn therefrom. People

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

III. Analysis

¶9 Foisel’s sole contention on appeal is that the State presented

insufficient evidence to prove the first Medina element. We

disagree.

¶ 10 Under the first Medina element, the district court may not

order the forced medication of an involuntarily committed patient

3 unless it is satisfied that the patient’s mental illness has so

impaired their judgment as to render them incapable of

participating in decisions affecting their health. Medina, 705 P.2d

at 973.

¶ 11 The district court found that Foisel was incompetent to

effectively participate in his own treatment decisions. Specifically,

the court found that Foisel suffered from schizophrenia and lacked

insight into his mental illness because he did not believe he was

mentally ill. The court also relied on evidence that Foisel had

previously been hospitalized and responded positively to

medication, but later “became non-compliant with the medications”

and was readmitted “in a deteriorated state.” Despite his previous

success on medication, the court found that Foisel “does not believe

he needs medication.” The record supports the court’s findings.

¶ 12 Dr. Pillai opined that, due to Foisel’s mental illness, he could

not effectively participate in decisions about his treatment. Dr.

Pillai testified that Foisel had no insight into his mental illness

because he did not believe that he was mentally ill. He also said

that Foisel did not think he needed medication and could not

understand “how the medications treat some of the symptoms of his

4 schizophrenia.” For example, Dr. Pillai recounted that Foisel had

been successfully treated with olanzapine during a previous

hospital stay, which resulted in his discharge, but after his release,

he stopped taking his medications and was readmitted in a

“deteriorated state.” And although his symptoms improved once

back on the medications, Foisel still refused to take them.

¶ 13 Despite this record, Foisel asserts that the district court erred

by basing its decision on his mere “disagreement” with Dr. Pillai

regarding the need for medication. But as discussed above, the

district court did not find that Foisel was incompetent to participate

in treatment decisions simply because he disagreed with Dr. Pillai.

Rather, the court found, with record support, that Foisel lacked

insight into his mental illness and did not believe he needed

medication despite his history of success while on medication. We

therefore reject Foisel’s assertion. See People in Interest of

Strodtman, 293 P.3d 123, 132 (Colo. App. 2011) (a patient must

demonstrate more than the ability to “articulate his or her

preferences”; rather, “[t]o participate effectively contemplates action

in addition to words”); see also R.K.L., ¶ 33 (affirming the court’s

finding because the patient did not believe he had a mental illness

5 and the psychiatrist testified that she did not believe the patient

would voluntarily take any medication to treat the illness).

¶ 14 In sum, given the evidence supporting Foisel’s lack of insight

into his need for the requested medications and the severity of his

illness, in combination with the weight the district court placed on

Dr. Pillai’s credibility, we cannot conclude that insufficient evidence

supported the court’s determination that Foisel is incompetent to

effectively participate in the relevant treatment decision. See People

in Interest of D.N.W., 2024 COA 129, ¶ 20 (deferring to the court’s

determination of witness credibility and the weight afforded that

testimony).

IV. Disposition

¶ 15 The order is affirmed.

JUDGE FREYRE and JUDGE YUN concur.