Peo in Interest of Hayes

• Court: Colorado Court of Appeals
• Decided: April 17, 2025
• Docket: 24CA2113
• Status: Unpublished

Opinion

24CA2113 Peo in Interest of Hayes 04-17-2025

COLORADO COURT OF APPEALS

Court of Appeals No. 24CA2113 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,

Respondent-Appellant.

ORDER AFFIRMED

Division VII Opinion by JUDGE MOULTRIE Lipinsky and Johnson, JJ., concur

NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced April 17, 2025

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

Tezak Law, P.C., Mary E. Tezak, Florence, Colorado, for Respondent-Appellant ¶1 Armound De Shaun Hayes 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 After two prior admissions to the hospital in 2018 and 2023,

Hayes was readmitted in May 2024 after being found incompetent

to proceed in a criminal case. He was experiencing agitation,

irritability, and impulsivity, and was exhibiting hypersexual and

physically aggressive behavior. Soon after his admission, he was

placed in seclusion and restraints and administered medications on

an emergency basis after he grabbed a female staff member’s

buttocks and hit a male staff member in the face.

¶3 The next month, the district court granted the People’s petition

authorizing the involuntary administration of olanzapine (Zyprexa),

valproic acid (Depakote), chlorpromazine (Thorazine), hydroxyzine

(Vistaril), and lorazepam (Ativan). On appeal, a division of this

court affirmed the district court’s order. See People in Interest of

Hayes, (Colo. App. No. 24CA1082, Sept. 19, 2024) (not published

pursuant to C.A.R. 35(e)).

1 ¶4 In November 2024, the People filed the petition at issue, again

seeking authorization to medicate Hayes involuntarily with Zyprexa,

Depakote, Thorazine, and Vistaril (but not Ativan).

¶5 At the hearing on the petition, Hayes’s psychiatrist, an expert

in clinical psychiatry, testified that Hayes’s diagnosis was an

unspecified mood disorder. The psychiatrist opined that Hayes was

mentally ill because he had “a substantial disorder of the cognitive

volitional or emotional process that grossly impairs judgment or

capacity to recognize reality or to control behavior.” At the time of

the hearing, Hayes was taking Zyprexa, Depakote, and a low dose of

Thorazine on a scheduled basis to stabilize his mood, decrease his

irritability, and reduce his hypersexual and aggressive behavior. He

was also being given Vistaril and additional Thorazine on an

as-needed basis for acute agitation.

¶6 According to the psychiatrist, Hayes had shown improvement

on the medications in terms of his physical aggression, but he

continued to be sexually inappropriate at times, including trying to

corner female staff and proposition them. The psychiatrist specified

that the Thorazine remained necessary to decrease Hayes’s

inappropriate sexualized behavior, but that he hoped to treat Hayes

2 with only Zyprexa and Depakote in the future if Hayes remained

stable and continued to improve.

¶7 The psychiatrist opined that, if Hayes were to stop taking the

medications, his severe behaviors would return, he would pose a

serious risk of harm to others in the hospital, and he would suffer a

significant and likely long-term deterioration of his mental

condition. The psychiatrist also testified that the involuntary

medication order was necessary because Hayes did not believe he

had a mental illness or needed any medication, and he had a

history of refusing medication.

¶8 When asked whether he has a mental illness, Hayes testified,

“I’ve been told I got ADHD, Anxiety, and Depression.” But Hayes

said he “kind of disagree[d]” with the psychiatrist’s diagnosis that

he has a mood disorder. He also denied being a danger to others

unless he feels threatened or has uncontrollable impulses. Hayes

clarified that he was willing to take Zyprexa and Depakote because

“[t]hey help calm [him] down.” However, Hayes said he did not want

to take Thorazine and Vistaril — particularly Thorazine, because it

made him fatigued and caused his speech to be slurred — and

3 testified that he would not take those medications without a court

order.

¶9 Following the testimony, the district court found that the

psychiatrist had testified credibly and persuasively, and it expressly

adopted the psychiatrist’s opinions. The court also noted its

observation that Hayes was not slurring his speech during his

testimony. The court examined each of the four elements of the test

from People v. Medina, 705 P.2d 961, 973 (Colo. 1985); concluded

that all four elements were met; and granted the petition.

II. Applicable Law and Standard of Review

¶ 10 Under the Medina test, a district court may authorize the

involuntary administration of medication if the People demonstrate

by clear and convincing evidence that (1) the person 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 person’s mental health condition or to prevent

the likelihood of the patient causing serious harm to himself or

others in the institution; (3) a less intrusive treatment alternative is

not available; and (4) the person’s need for treatment is sufficiently

4 compelling to override any bona fide and legitimate interest of the

person in refusing treatment.1 Id.

¶ 11 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, while we

review the court’s legal conclusions de novo. Id. Resolving conflicts

in testimony and determining the credibility of the witnesses are

solely within the province of the fact finder. People in Interest of

Ramsey, 2023 COA 95, ¶ 23.

¶ 12 We must determine whether the evidence, viewed as a whole

and in the light most favorable to the prevailing party, is sufficient

to support the district court’s order. People in Interest of R.K.L.,

2016 COA 84, ¶ 13. The testimony of the physician seeking to

1 A different test applies to petitions to administer medication

involuntarily for the purpose of restoring competency for a criminal proceeding. See Sell v. United States, 539 U.S. 166, 181 (2003); see also People in Interest of R.F., 2019 COA 110, ¶ 11 n.1. Although Hayes was admitted to the hospital for that purpose, the parties agree — as do we — that the test from People v. Medina, 705 P.2d 961 (Colo. 1985), applies because the purpose of the petition here, and the district court’s basis for granting the petition, was to prevent a significant and long-term deterioration in Hayes’s mental condition and to prevent the likelihood of him causing serious harm to others. See R.F., ¶ 11 n.1.

5 administer treatment may be sufficient, without more, to satisfy the

Medina test. Id. at ¶ 30.

III. Analysis

¶ 13 Hayes concedes that the second element of the Medina test

was met. But he challenges the sufficiency of the evidence

regarding the first, third, and fourth elements of the Medina test.

A. The First Medina Element

¶ 14 In addressing the first Medina element — that he was

incompetent to effectively participate in the treatment decision —

Hayes contends that the district court erred in basing its finding on

the evidence that Hayes did not believe he had a mental illness or

needed any medication. He then makes only a generalized

argument that, “[i]f being involuntarily certified for mental health

treatment is not enough [to meet the first Medina element], surely a

mere disagreement regarding diagnosis cannot be sufficient.”

¶ 15 We disagree. The psychiatrist and Hayes disagreed about

Hayes’s diagnosis. The psychiatrist testified that Hayes’s diagnosis

was an unspecified mood disorder, while Hayes said that he “kind

of disagree[d]” with that diagnosis. More importantly, the

psychiatrist testified that, if Hayes were to stop taking the requested

6 medications, his severe behaviors would return, he would pose a

serious risk of harm to others in the hospital, and he would suffer a

condition. But Hayes denied having severe behavior that he could

not control and testified that, although he was willing to take

Zyprexa and Depakote, he would not take Thorazine and Vistaril

without a court order. His testimony that he would not take

Thorazine and Vistaril voluntarily was consistent with the evidence

presented of his history of refusing medication. Hayes also

testified — although it is not clear whether he was referring to all

four medications or just Thorazine and Vistaril — that the

medications “have not helped [him] . . . [They] just kind of mess[ed]

[him] up more.”

¶ 16 Hayes’s disagreement with the psychiatrist’s diagnosis and the

psychiatrist’s opinion that the requested medications were

necessary for Hayes to improve rather than deteriorate were at the

core of why Hayes was incompetent to effectively participate in the

treatment decision. It was up to the district court to resolve the

conflicts in the evidence, and significantly, the district court found

7 the psychiatrist’s testimony credible and persuasive, and it

expressly adopted the psychiatrist’s opinions. See Ramsey, ¶ 23.

¶ 17 Given the district court’s credibility determination, its finding

that the first Medina element was met was well supported, and we

will not disturb it. See id.; Marquardt, ¶ 8; R.K.L., ¶¶ 13, 30; see

also R.K.L., ¶¶ 6-7, 33 (affirming the district court’s finding that the

first Medina element was met where the patient’s psychiatrist

testified that the patient had schizophrenia with possible bipolar

disorder, but the patient testified that he did not think that he had

a mental illness); People in Interest of Strodtman, 293 P.3d 123, 132

(Colo. App. 2011) (affirming the district court’s finding that the first

Medina element was met based in part on the patient’s history of

medication refusal, explaining, “[t]o participate effectively

contemplates action” not just “words”).

B. The Third Medina Element

¶ 18 In challenging the district court’s finding on the third Medina

element — that a less intrusive treatment alternative was not

available — Hayes highlights the psychiatrist’s testimony that,

during his prior hospitalizations in 2018 and 2023, he was

effectively treated with only Zyprexa and Depakote. He argues that

8 this history shows that he can be effectively treated with only those

two medications, and that adding Thorazine and Vistaril constitutes

a “far more invasive [and unnecessary] treatment plan.”

¶ 19 Despite his prior history of effective treatment with only

Zyprexa and Depakote, the record shows that Hayes’s scheduled

medications during his current hospitalization included, in addition

to Zyprexa and Depakote, only a low dose of Thorazine. The

psychiatrist testified that the scheduled Thorazine was added

approximately one month before the hearing “to help [Hayes]

stabilize due to his persistent, inappropriate, sexualized behavior,”

and that Vistaril and the additional Thorazine were being

administered to Hayes only on an as-needed basis “to help him

calm down when he goes through periods of being agitated,

hypersexual, or physically aggressive.” The psychiatrist further

testified that Thorazine, specifically, remained necessary to

decrease Hayes’s inappropriate sexualized behavior. However, the

psychiatrist also testified that he hoped to be able to treat Hayes

with only Zyprexa and Depakote in the future if Hayes remained

9 ¶ 20 The court credited the psychiatrist’s testimony and found that

a less intrusive treatment alternative was not available. We defer to

that finding because it has record support. See Marquardt, ¶ 8;

R.K.L., ¶¶ 13, 30; Ramsey, ¶¶ 23, 52-53.

C. The Fourth Medina Element

¶ 21 In his argument regarding the fourth Medina element — that

the patient’s need for treatment is sufficiently compelling to override

any bona fide and legitimate interest of the patient in refusing

treatment — Hayes contends that his interests in avoiding side

effects “intensely” outweigh the State’s interest. He acknowledges

that his primary complaint regarding side effects is slurred speech,

but he also emphasizes that the potential side effects of the

medications are extensive.

¶ 22 However, in his discussion of potential side effects, the

psychiatrist testified that Hayes “is in a psychiatric unit that is

staffed 24/7 with nurses who monitor him for all his complaints

including side effect[s],” that the psychiatrist and nurse practitioner

also regularly ask Hayes about any side effects he’s experiencing,

and that he is routinely given blood tests to detect any

abnormalities in liver function or white blood cell count. Given this

10 evidence, we discern no basis for reversal based on potential side

effects that Hayes himself has not experienced. See Marquardt, ¶ 8;

R.K.L., ¶¶ 13, 30; Ramsey, ¶ 23.

¶ 23 And in terms of Hayes’s reference to slurred speech, regardless

of the district court’s finding that Hayes was not slurring his speech

at the hearing, the court did not err in finding, with record support,

that Hayes’s need for treatment was sufficiently compelling to

override his interest in avoiding slurred speech. See Marquardt,

¶ 8; R.K.L., ¶¶ 13, 30; Ramsey, ¶ 23.

IV. Disposition

¶ 24 The order is affirmed.

JUDGE LIPINSKY and JUDGE JOHNSON concur.