25CA0928 Peo in Interest of Hetzel 09-18-2025
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA0928 Douglas County District Court No. 20MH94 Honorable Brian P. Fields, Magistrate
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Enoch Hetzel,
Respondent-Appellant.
ORDER AFFIRMED
Division I Opinion by JUDGE SCHUTZ J. Jones and Grove, JJ., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced September 18, 2025
Jeffrey A. Garcia, County Attorney, Andrew C. Steers, Deputy County Attorney, Castle Rock, Colorado, for Petitioner-Appellee
Tezak Law, P.C., Mary Tezak, Florence, Colorado, for Respondent-Appellant ¶1 Enoch Hetzel appeals the district court magistrate’s May 2025
order authorizing a six-month extension of the order certifying him
for long-term care and treatment of his mental health disorder
under section 27-65-110(1)(a), C.R.S. 2025. He contends that the
evidence was insufficient to show that he is “gravely disabled.” We
disagree and therefore affirm.
I. Background
¶2 In May 2020, Hetzel was admitted to AllHealth Network on a
seventy-two-hour mental health hold because his symptoms were
deemed too severe for him to keep himself safe. He was diagnosed
with paranoid schizophrenia. The record reveals that Hetzel had a
history of psychiatric illness and noncompliance with taking his
prescribed psychotropic medication and that in 2019, he used
substances “quite a bit” and had a psychotic break.
¶3 Hetzel was certified for three months of short-term treatment
to treat his schizophrenia, which constituted a grave disability, and
the certification was extended for another three months in August
2020. At some point during that period, he began treatment on an
outpatient basis.
1 ¶4 In November 2020, based on the parties’ stipulation, the
district court certified Hetzel for six months of long-term care and
treatment of his schizophrenia on an outpatient basis. Over the
next four years, the court repeatedly extended that certification for
additional six-month periods, based on either the parties’
stipulations or his counsel’s representations to the court that Hetzel
remained gravely disabled and in need of long-term care and
treatment.
¶5 During that four-year period, Hetzel’s psychologist at AllHealth
submitted written statements to the court in support of the
extensions of the certification. In September 2022, Hetzel began
expressing skepticism whether he had a mental illness; he also
began voicing a desire for the certification to end so he could stop
taking medication.
¶6 Also, by September 2022, Hetzel was smoking marijuana
“almost every day.” But in March 2023, Hetzel reported that he had
stopped smoking marijuana and, since quitting, his “mental health
ha[d] gotten a lot better.” However, by March 2024, he was again
smoking marijuana daily, despite reporting that his auditory
hallucinations were worse when smoking marijuana. And in
2 September 2024, he conceded that marijuana “makes [him] feel
worse,” said that he tried to find alternatives to marijuana like
“mushrooms,” and said that, rather than using exercise as a coping
tool, he “use[s] drugs instead.”
¶7 The most recent stipulated order took effect in November 2024
and was set to expire in May 2025.
¶8 In April 2025, the State filed the petition at issue, seeking to
extend Hetzel’s long-term care and treatment for an additional six
months. According to the psychologist’s statement submitted with
the petition, Hetzel reported that, in addition to smoking marijuana,
he was drinking alcohol regularly, splitting “a bottle” with friends.
¶9 This time, Hetzel’s counsel requested a hearing before a
magistrate to contest the extension.
¶ 10 At the hearing, the parties clarified that the sole issue for the
magistrate to decide was whether Hetzel was gravely disabled as a
result of a mental health disorder, which is one of the bases for
extending a certification for long-term care and treatment under
section 27-65-110(1)(a).
¶ 11 Hetzel’s psychologist at AllHealth and Hetzel both testified at
the hearing. The psychologist, whom the parties stipulated was an
3 expert in that field, testified that Hetzel’s diagnoses are
schizophrenia, cannabis use disorder, and alcohol use disorder.
She testified that Hetzel’s condition had improved since he’s been
on the certification “because he’s been adhering to medication, and
he’s had a lot of support from the various team members.” She
reported that Hetzel was “doing fairly well” but had recently had
“some decompensation regression behavior.” She also testified that
Hetzel has made it clear he wants to stop taking medication
because he doesn’t believe it’s necessary, and she opined that if he
stops taking his medication, “he would very quickly decompensate
and be re-hospitalized.” And she explained what decompensation
looks like for Hetzel:
Historically, he begins experiencing worsening hallucinations. His thought process is more disorganized. He makes poor judgments and impulse control. So what we’ve seen before is either taking off all of his clothes in public in the winter or wearing multiple layers of clothing, like multiple sweaters in the middle of summer. He has gotten lost and driven places without knowing where he is, run out [of] gas, and . . . there’s equal periods of silence causing the family to be concerned. He has shown up in his apartment without clothing on in the public areas, resulting in police being called or roommates contacting crisis services for concern.
4 The psychologist then confirmed, “I believe similar behaviors would
happen if he were to cease taking medication again.” Finally, she
testified that Hetzel’s substance use reduces the efficacy of his
medications, can trigger psychosis (as it did in 2019), and causes
him to decompensate more quickly.
¶ 12 During Hetzel’s testimony, when he was asked if he had a
mental health disorder, he responded, “I believe I’ve gotten mental
health disorders because of the medication I’m taking. But I don’t
believe I have a mental illness; I have a disorder.” He continued, “I
believe [it’s] miscommunication is the biggest key part of having a
mental disorder . . . or not having a mental disorder, but just the
lack of communication makes it harder for other people to
understand my point of view.” Hetzel also made it clear that,
although he was willing to continue therapy, he did not want to
continue taking medication. He discussed what would happen if he
stopped taking medication, and he appeared to suggest that he
would initially have some withdrawal symptoms that would
negatively impact his stability, but that he would eventually
stabilize:
5 I’m not saying I’m going to be stable right away or anything. I’m just saying like the medication is what makes me unstable in the first place. So if I were to get off . . . the medication, it would make me even more unstable. . . . [I]t’s like taking a drug for a long time, and then getting off the drug, . . . you’re going to have side effects, you’re going to have withdrawals, and . . . you’re going to have negative symptoms, like with anything else you take. So I just believe . . . the medication is not helping in that sense, because there will be side effects and there will be withdrawals.
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25CA0928 Peo in Interest of Hetzel 09-18-2025
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA0928 Douglas County District Court No. 20MH94 Honorable Brian P. Fields, Magistrate
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Enoch Hetzel,
Respondent-Appellant.
ORDER AFFIRMED
Division I Opinion by JUDGE SCHUTZ J. Jones and Grove, JJ., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced September 18, 2025
Jeffrey A. Garcia, County Attorney, Andrew C. Steers, Deputy County Attorney, Castle Rock, Colorado, for Petitioner-Appellee
Tezak Law, P.C., Mary Tezak, Florence, Colorado, for Respondent-Appellant ¶1 Enoch Hetzel appeals the district court magistrate’s May 2025
order authorizing a six-month extension of the order certifying him
for long-term care and treatment of his mental health disorder
under section 27-65-110(1)(a), C.R.S. 2025. He contends that the
evidence was insufficient to show that he is “gravely disabled.” We
disagree and therefore affirm.
I. Background
¶2 In May 2020, Hetzel was admitted to AllHealth Network on a
seventy-two-hour mental health hold because his symptoms were
deemed too severe for him to keep himself safe. He was diagnosed
with paranoid schizophrenia. The record reveals that Hetzel had a
history of psychiatric illness and noncompliance with taking his
prescribed psychotropic medication and that in 2019, he used
substances “quite a bit” and had a psychotic break.
¶3 Hetzel was certified for three months of short-term treatment
to treat his schizophrenia, which constituted a grave disability, and
the certification was extended for another three months in August
2020. At some point during that period, he began treatment on an
outpatient basis.
1 ¶4 In November 2020, based on the parties’ stipulation, the
district court certified Hetzel for six months of long-term care and
treatment of his schizophrenia on an outpatient basis. Over the
next four years, the court repeatedly extended that certification for
additional six-month periods, based on either the parties’
stipulations or his counsel’s representations to the court that Hetzel
remained gravely disabled and in need of long-term care and
treatment.
¶5 During that four-year period, Hetzel’s psychologist at AllHealth
submitted written statements to the court in support of the
extensions of the certification. In September 2022, Hetzel began
expressing skepticism whether he had a mental illness; he also
began voicing a desire for the certification to end so he could stop
taking medication.
¶6 Also, by September 2022, Hetzel was smoking marijuana
“almost every day.” But in March 2023, Hetzel reported that he had
stopped smoking marijuana and, since quitting, his “mental health
ha[d] gotten a lot better.” However, by March 2024, he was again
smoking marijuana daily, despite reporting that his auditory
hallucinations were worse when smoking marijuana. And in
2 September 2024, he conceded that marijuana “makes [him] feel
worse,” said that he tried to find alternatives to marijuana like
“mushrooms,” and said that, rather than using exercise as a coping
tool, he “use[s] drugs instead.”
¶7 The most recent stipulated order took effect in November 2024
and was set to expire in May 2025.
¶8 In April 2025, the State filed the petition at issue, seeking to
extend Hetzel’s long-term care and treatment for an additional six
months. According to the psychologist’s statement submitted with
the petition, Hetzel reported that, in addition to smoking marijuana,
he was drinking alcohol regularly, splitting “a bottle” with friends.
¶9 This time, Hetzel’s counsel requested a hearing before a
magistrate to contest the extension.
¶ 10 At the hearing, the parties clarified that the sole issue for the
magistrate to decide was whether Hetzel was gravely disabled as a
result of a mental health disorder, which is one of the bases for
extending a certification for long-term care and treatment under
section 27-65-110(1)(a).
¶ 11 Hetzel’s psychologist at AllHealth and Hetzel both testified at
the hearing. The psychologist, whom the parties stipulated was an
3 expert in that field, testified that Hetzel’s diagnoses are
schizophrenia, cannabis use disorder, and alcohol use disorder.
She testified that Hetzel’s condition had improved since he’s been
on the certification “because he’s been adhering to medication, and
he’s had a lot of support from the various team members.” She
reported that Hetzel was “doing fairly well” but had recently had
“some decompensation regression behavior.” She also testified that
Hetzel has made it clear he wants to stop taking medication
because he doesn’t believe it’s necessary, and she opined that if he
stops taking his medication, “he would very quickly decompensate
and be re-hospitalized.” And she explained what decompensation
looks like for Hetzel:
Historically, he begins experiencing worsening hallucinations. His thought process is more disorganized. He makes poor judgments and impulse control. So what we’ve seen before is either taking off all of his clothes in public in the winter or wearing multiple layers of clothing, like multiple sweaters in the middle of summer. He has gotten lost and driven places without knowing where he is, run out [of] gas, and . . . there’s equal periods of silence causing the family to be concerned. He has shown up in his apartment without clothing on in the public areas, resulting in police being called or roommates contacting crisis services for concern.
4 The psychologist then confirmed, “I believe similar behaviors would
happen if he were to cease taking medication again.” Finally, she
testified that Hetzel’s substance use reduces the efficacy of his
medications, can trigger psychosis (as it did in 2019), and causes
him to decompensate more quickly.
¶ 12 During Hetzel’s testimony, when he was asked if he had a
mental health disorder, he responded, “I believe I’ve gotten mental
health disorders because of the medication I’m taking. But I don’t
believe I have a mental illness; I have a disorder.” He continued, “I
believe [it’s] miscommunication is the biggest key part of having a
mental disorder . . . or not having a mental disorder, but just the
lack of communication makes it harder for other people to
understand my point of view.” Hetzel also made it clear that,
although he was willing to continue therapy, he did not want to
continue taking medication. He discussed what would happen if he
stopped taking medication, and he appeared to suggest that he
would initially have some withdrawal symptoms that would
negatively impact his stability, but that he would eventually
stabilize:
5 I’m not saying I’m going to be stable right away or anything. I’m just saying like the medication is what makes me unstable in the first place. So if I were to get off . . . the medication, it would make me even more unstable. . . . [I]t’s like taking a drug for a long time, and then getting off the drug, . . . you’re going to have side effects, you’re going to have withdrawals, and . . . you’re going to have negative symptoms, like with anything else you take. So I just believe . . . the medication is not helping in that sense, because there will be side effects and there will be withdrawals.
¶ 13 After hearing argument from the parties, the magistrate
granted the petition to extend the certification for an additional six
months. In doing so, the magistrate recognized that Hetzel “is very
articulate, very pleasant, and clearly is able to articulate and
advocate for . . . his needs and desires”; he is gainfully employed;
and he “is able to currently meet . . . his daily needs . . . and live
independently.” However, the magistrate, specifically crediting the
psychologist’s testimony, found that if Hetzel stops taking his
medication, his “ability to maintain that functioning will critically
deteriorate in rapid form,” leading back to “getting himself into
injurious situations, having hallucinations, . . . and [being unable]
to take care of his daily needs.” The magistrate also found that
Hetzel “doesn’t believe medication is necessary” and that “it’s very
6 clear to the Court that, absent a court requirement or order
requiring that medication, that Mr. Hetzel is not going to continue
to take the medicine.” The magistrate ultimately found that “Mr.
Hetzel is gravely disabled” because he “is in danger of serious, not
only physical harm, but emotional harm [and] mental harm, absent
the certification continuing.”
II. Standard of Review
¶ 14 When considering a challenge to the sufficiency of the
evidence, we must determine whether the evidence, viewed as a
whole and in the light most favorable to the State, is sufficient to
support the district court’s order. See People in Interest of Ramsey,
2023 COA 95, ¶ 23. Resolving conflicting testimony and
determining witness credibility are matters solely within the
province of the fact finder. Id. We review de novo the court’s
conclusions of law and we defer to the court’s findings of fact if
sufficient evidence in the record supports them. Id.
III. Analysis
¶ 15 Under section 27-65-110(1), a district court may extend a
certification for long-term care and treatment under the following
conditions:
7 (a) the respondent has a mental health disorder and, as a
result of the mental health disorder, is a danger to the
respondent’s self or others or is “gravely disabled”;
(b) the respondent has been advised of the availability of, but
has not accepted, voluntary treatment; but, if reasonable
grounds exist to believe that the respondent will not remain in
a voluntary treatment program, the respondent’s acceptance of
voluntary treatment does not preclude an order pursuant to
this section; and
(c) the facility that will provide long-term care and treatment
has been designated by the commissioner to provide the care
and treatment.
¶ 16 The sole issue presented here is whether the State sufficiently
proved that Hetzel is gravely disabled under section 27-65-110(1)(a).
The statutory scheme defines “gravely disabled” as
a condition in which a person, as a result of a mental health disorder, is incapable of making informed decisions about or providing for the person’s essential needs without significant supervision and assistance from other people. As a result of being incapable of making these informed decisions, a person who is gravely disabled is at risk of substantial bodily harm, dangerous worsening of any concomitant
8 serious physical illness, significant psychiatric deterioration, or mismanagement of the person’s essential needs that could result in substantial bodily harm.
§ 27-65-102(17), C.R.S. 2025. The State has the burden to prove
by clear and convincing evidence that a patient is gravely disabled.
§ 27-65-113(1), C.R.S. 2025; Ramsey, ¶ 25. A physician’s credible
testimony alone may constitute clear and convincing evidence.
See People v. Pflugbeil, 834 P.2d 843, 846-47 (Colo. App. 1992).
¶ 17 Hetzel argues that he is not gravely disabled because he “can
take care of his own basic needs,” such as living independently,
working a job to support himself, cooking his own meals, and
maintaining social connections.
¶ 18 However, under the statute, a person is gravely disabled if he
“is incapable of . . . providing for [his] essential needs,” or if he “is
incapable of making informed decisions about . . . [his] essential
needs,” without significant supervision and assistance from other
people. § 27-65-102(17) (emphasis added). So, although Hetzel
may be currently capable of “providing for” his essential needs
(which, as the record indicates, is because he has been taking his
9 medication), he is gravely disabled if he is “incapable of making
informed decisions about” his essential needs. Id.
¶ 19 The second sentence in section 27-65-102(17) clarifies that a
person who is “incapable of making informed decisions about” his
essential needs is “at risk of,” among other things, “significant
psychiatric deterioration.” That is the central issue here: whether
Hetzel is incapable of making informed decisions about his essential
needs and, as a result, is at risk of significant psychiatric
deterioration.
¶ 20 On that subject, the county attorney had the following
exchange with the psychologist during her testimony at the hearing:
Q You mentioned earlier Mr. Hetzel’s desire to get off medication. Do you currently believe that he is capable of making informed decisions about meeting his essential needs?
A I believe where he is right now on medication, yes.
However, the county attorney then reframed the question, and the
following exchanges occurred:
Q Do you believe that [Hetzel] is currently capable of making informed decisions about medical needs, including his ability to continue taking medication?
10 A No.
Q Why not?
A I do not believe that he thinks the medication is necessary. He thinks that it has caused him to have hallucinations, rather than it aiding in stabilizing the symptoms. And so I think he has no insight into how the medication is keeping him stable and doing well and remaining out of the hospital.
Q Do you believe that that is a result of his mental illness?
A Yes.
¶ 21 That testimony — along with the psychologist’s testimony
about the decompensation that Hetzel would experience if he stops
taking his medication — sufficiently supports the magistrate’s
finding that Hetzel is gravely disabled. See Ramsey, ¶ 23; Pflugbeil,
834 P.2d at 846-47. The testimony establishes that Hetzel
continuing to take his medication is an “essential need[]” for him to
avoid “significant psychiatric deterioration.” Therefore, the record
supports the magistrate’s findings that Hetzel is incapable of
making an informed decision about taking his medication, and that
he is therefore gravely disabled.
¶ 22 Hetzel argues that the State’s position is that he will “become
gravely disabled” if he stops taking his medication, but the
11 determination of grave disability “must be based on [his] existing
condition, not prospective.” But that argument focuses too
narrowly on the question of whether Hetzel is currently “providing
for” his essential needs; it ignores the alternative basis for a finding
of grave disability because Hetzel is “incapable of making informed
decisions about” his essential needs. § 27-65-102(17). Likewise,
under the second sentence of section 27-65-102(17), a person need
not have already experienced “significant psychiatric deterioration”
to be gravely disabled; instead, a person need only be “at risk of”
significant psychiatric deterioration based on his inability to make
informed decisions about his essential needs.
¶ 23 Hetzel also argues that the issue of whether he will take his
medication solely pertains to the “voluntary treatment” provision in
section 27-65-110(1)(b), and that it cannot be considered for
purposes of determining whether he is gravely disabled under
section 27-65-110(1)(a). We disagree. As applicable here, section
27-65-110(1)(b) simply clarifies that a certification can be extended,
even if the respondent has accepted voluntary treatment, “if
reasonable grounds exist to believe that the respondent will not
remain in a voluntary treatment program.” But the question of
12 whether a patient will remain in a voluntary treatment program
under section 27-65-110(1)(b) is not entirely distinct from the
question of whether he is capable of making informed decisions
about his essential needs. That there may be overlap between the
provisions as applied in this case is not problematic. See People v.
Market, 2020 COA 90, ¶ 18 (“When it appears that two statutes
conflict, we strive to ‘construe the statutes in harmony [to] give
effect to each.’” (quoting DeCordova v. State, 878 P.2d 73, 75 (Colo.
App. 1994))); see also Larson v. Sinclair Transp. Co., 2012 CO 36,
¶ 71 n.7 (Hobbs, J., dissenting) (“The fact that overlapping
condemnation statutes exist does not render any of the overlapping
statutes superfluous or command any particular interpretation.”);
Avery v. State, 359 S.W.3d 230, 236 (Tex. Crim. App. 2012) (“When
statutory provisions overlap . . ., there is no inherent reason to infer
that the Legislature intended them to be mutually exclusive.”).
IV. Disposition
¶ 24 The order is affirmed.
JUDGE J. JONES and JUDGE GROVE concur.