25CA0840 Peo in Interest of McNair 08-14-2025
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA0840 Pueblo County District Court No. 25MH30036 Honorable Amiel Markenson, Judge
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Lonny Lynn McNair,
Respondent-Appellant.
ORDER AFFIRMED
Division IV Opinion by JUDGE MEIRINK Freyre and Gomez, JJ., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced August 14, 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 Lonny Lynn McNair appeals the district court’s order
authorizing the involuntary administration of an antipsychotic
medication for the purpose of restoring him to competency to stand
trial in a criminal case. We affirm.
I. Background
¶2 In Adams County District Court case number 20CR2735,
McNair was charged with numerous serious crimes, including class
1 felonies.
¶3 After being found incompetent to proceed in that case, McNair
was admitted to the Colorado Mental Health Hospital in Pueblo (the
hospital) in September 2024 to restore his competency. McNair’s
psychiatrist at the hospital diagnosed him with delusional disorder,
persecutory type. His primary, consistent symptom has been
having prominent persecutory delusions that he is being targeted
and surveilled by a secret, expansive, and sophisticated network of
people. His delusions include believing that this network of people
“take[] over” his phone, leading him to destroy the phone and get a
new phone every month; that people in the network tried to poison
him; and that strangers he meets are involved in the network.
1 ¶4 In March 2025, McNair was again found incompetent to
proceed. In April, the State filed a petition for authorization to
medicate McNair involuntarily with aripiprazole (Abilify), olanzapine
(Zyprexa), and paliperidone (Invega).
¶5 At the hearing on the petition, McNair’s psychiatrist at the
hospital and McNair both testified. The psychiatrist, an expert in
clinical psychiatry, testified that McNair’s delusional disorder
constitutes a substantial disorder that grossly impairs his judgment
or capacity to recognize reality or control behavior. The psychiatrist
also testified that antipsychotic medication is necessary to improve
McNair’s delusional disorder, and that without the medication, he
will not be restored to competency.
¶6 The psychiatrist clarified that he was no longer seeking to
treat McNair with paliperidone, but that he was requesting
authorization to treat him with aripiprazole and olanzapine. He
testified that he planned to initially treat McNair with only
aripiprazole, and that if McNair did not adequately respond to
treatment with that medication, he would instead treat McNair with
olanzapine. The psychiatrist also reported that McNair does not
2 believe he has delusional disorder, does not believe he needs any
antipsychotic medication, and will not take medication voluntarily.
¶7 During McNair’s testimony, he testified that he does not have
a delusional disorder, or any other mental illness, and does not
want to take medication. He also testified at length about the
network of people targeting and surveilling him.
¶8 Following the testimony, the district court found that the
psychiatrist had testified credibly and persuasively, and it adopted
the psychiatrist’s opinions. As to olanzapine, the court found that
the People had not met their burden of proving the need to use that
backup medication. However, as to aripiprazole, the court granted
the petition, finding that the People had met their burden of proving
all four elements of the test from Sell v. United States, 539 U.S. 166,
180-81 (2003).
II. Applicable Law
¶9 The parties agree that the four-part test from Sell applies here.
Under that test, the State must prove that:
(1) “important governmental interests” — such as “bringing
to trial an individual accused of a serious crime” — are at
stake,
3 (2) involuntarily medicating the person will “significantly
further” those interests,
(3) involuntarily medicating the person is “necessary” to
further those interests, and
(4) administering the medication to the person is “medically
appropriate,” in other words, “in the patient’s best
medical interest in light of his medical condition.”
Id. (emphasis omitted).
¶ 10 The State must prove these elements by clear and convincing
evidence. People in Interest of Joergensen, 2022 COA 126, ¶ 12;
People in Interest of R.F., 2019 COA 110, ¶ 16. A physician’s
testimony alone may constitute clear and convincing evidence. See
People v. Pflugbeil, 834 P.2d 843, 846-47 (Colo. App. 1992).
III. Analysis
¶ 11 McNair does not contest the district court’s rulings that the
People met their burden of proving the first, second, and third
elements of the Sell test. However, he challenges the sufficiency of
the evidence supporting the fourth Sell element — that treating him
with aripiprazole is “medically appropriate.”
4 ¶ 12 In determining whether the evidence was sufficient to support
an involuntary medication order, we view the evidence as a whole
and in the light most favorable to the prevailing party. See People in
Interest of R.K.L., 2016 COA 84, ¶ 13.
¶ 13 A district court’s findings with respect to the fourth Sell
element are factual in nature and are therefore subject to review for
clear error. R.F., ¶ 21; People in Interest of Hardesty, 2014 COA
138, ¶ 17. We defer to findings of fact that are supported by
evidence in the record. People in Interest of Ramsey, 2023 COA 95,
¶ 23. We also defer to a district court’s credibility determinations
and its weighing of conflicting evidence. Id. at ¶ 30.
¶ 14 Here, the district court found that treating McNair with
aripiprazole was medically appropriate. It expressly based its
finding on “everything [the psychiatrist] has already testified to,”
which it found to be “very credible.”
¶ 15 The district court’s finding is supported by the psychiatrist’s
testimony that treating McNair with antipsychotic medication was
“medically appropriate” and was in McNair’s “best medical interest,”
given his mental condition. Specifically, the psychiatrist testified
that there is a “substantial likelihood” that treating McNair with
5 antipsychotic medication would improve his delusional disorder,
aripiprazole is particularly effective in treating delusional disorders,
and there was no alternative treatment that would work as
effectively as antipsychotic medication. The psychiatrist also
testified that (1) McNair would be regularly monitored for any side
effects that aripiprazole might cause; (2) the risk is “extremely low”
that McNair would experience any side effects that would impair his
ability to assist in his defense in the criminal case; (3) aripiprazole
has a more favorable side effect profile relative to other
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25CA0840 Peo in Interest of McNair 08-14-2025
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA0840 Pueblo County District Court No. 25MH30036 Honorable Amiel Markenson, Judge
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Lonny Lynn McNair,
Respondent-Appellant.
ORDER AFFIRMED
Division IV Opinion by JUDGE MEIRINK Freyre and Gomez, JJ., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced August 14, 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 Lonny Lynn McNair appeals the district court’s order
authorizing the involuntary administration of an antipsychotic
medication for the purpose of restoring him to competency to stand
trial in a criminal case. We affirm.
I. Background
¶2 In Adams County District Court case number 20CR2735,
McNair was charged with numerous serious crimes, including class
1 felonies.
¶3 After being found incompetent to proceed in that case, McNair
was admitted to the Colorado Mental Health Hospital in Pueblo (the
hospital) in September 2024 to restore his competency. McNair’s
psychiatrist at the hospital diagnosed him with delusional disorder,
persecutory type. His primary, consistent symptom has been
having prominent persecutory delusions that he is being targeted
and surveilled by a secret, expansive, and sophisticated network of
people. His delusions include believing that this network of people
“take[] over” his phone, leading him to destroy the phone and get a
new phone every month; that people in the network tried to poison
him; and that strangers he meets are involved in the network.
1 ¶4 In March 2025, McNair was again found incompetent to
proceed. In April, the State filed a petition for authorization to
medicate McNair involuntarily with aripiprazole (Abilify), olanzapine
(Zyprexa), and paliperidone (Invega).
¶5 At the hearing on the petition, McNair’s psychiatrist at the
hospital and McNair both testified. The psychiatrist, an expert in
clinical psychiatry, testified that McNair’s delusional disorder
constitutes a substantial disorder that grossly impairs his judgment
or capacity to recognize reality or control behavior. The psychiatrist
also testified that antipsychotic medication is necessary to improve
McNair’s delusional disorder, and that without the medication, he
will not be restored to competency.
¶6 The psychiatrist clarified that he was no longer seeking to
treat McNair with paliperidone, but that he was requesting
authorization to treat him with aripiprazole and olanzapine. He
testified that he planned to initially treat McNair with only
aripiprazole, and that if McNair did not adequately respond to
treatment with that medication, he would instead treat McNair with
olanzapine. The psychiatrist also reported that McNair does not
2 believe he has delusional disorder, does not believe he needs any
antipsychotic medication, and will not take medication voluntarily.
¶7 During McNair’s testimony, he testified that he does not have
a delusional disorder, or any other mental illness, and does not
want to take medication. He also testified at length about the
network of people targeting and surveilling him.
¶8 Following the testimony, the district court found that the
psychiatrist had testified credibly and persuasively, and it adopted
the psychiatrist’s opinions. As to olanzapine, the court found that
the People had not met their burden of proving the need to use that
backup medication. However, as to aripiprazole, the court granted
the petition, finding that the People had met their burden of proving
all four elements of the test from Sell v. United States, 539 U.S. 166,
180-81 (2003).
II. Applicable Law
¶9 The parties agree that the four-part test from Sell applies here.
Under that test, the State must prove that:
(1) “important governmental interests” — such as “bringing
to trial an individual accused of a serious crime” — are at
stake,
3 (2) involuntarily medicating the person will “significantly
further” those interests,
(3) involuntarily medicating the person is “necessary” to
further those interests, and
(4) administering the medication to the person is “medically
appropriate,” in other words, “in the patient’s best
medical interest in light of his medical condition.”
Id. (emphasis omitted).
¶ 10 The State must prove these elements by clear and convincing
evidence. People in Interest of Joergensen, 2022 COA 126, ¶ 12;
People in Interest of R.F., 2019 COA 110, ¶ 16. A physician’s
testimony alone may constitute clear and convincing evidence. See
People v. Pflugbeil, 834 P.2d 843, 846-47 (Colo. App. 1992).
III. Analysis
¶ 11 McNair does not contest the district court’s rulings that the
People met their burden of proving the first, second, and third
elements of the Sell test. However, he challenges the sufficiency of
the evidence supporting the fourth Sell element — that treating him
with aripiprazole is “medically appropriate.”
4 ¶ 12 In determining whether the evidence was sufficient to support
an involuntary medication order, we view the evidence as a whole
and in the light most favorable to the prevailing party. See People in
Interest of R.K.L., 2016 COA 84, ¶ 13.
¶ 13 A district court’s findings with respect to the fourth Sell
element are factual in nature and are therefore subject to review for
clear error. R.F., ¶ 21; People in Interest of Hardesty, 2014 COA
138, ¶ 17. We defer to findings of fact that are supported by
evidence in the record. People in Interest of Ramsey, 2023 COA 95,
¶ 23. We also defer to a district court’s credibility determinations
and its weighing of conflicting evidence. Id. at ¶ 30.
¶ 14 Here, the district court found that treating McNair with
aripiprazole was medically appropriate. It expressly based its
finding on “everything [the psychiatrist] has already testified to,”
which it found to be “very credible.”
¶ 15 The district court’s finding is supported by the psychiatrist’s
testimony that treating McNair with antipsychotic medication was
“medically appropriate” and was in McNair’s “best medical interest,”
given his mental condition. Specifically, the psychiatrist testified
that there is a “substantial likelihood” that treating McNair with
5 antipsychotic medication would improve his delusional disorder,
aripiprazole is particularly effective in treating delusional disorders,
and there was no alternative treatment that would work as
effectively as antipsychotic medication. The psychiatrist also
testified that (1) McNair would be regularly monitored for any side
effects that aripiprazole might cause; (2) the risk is “extremely low”
that McNair would experience any side effects that would impair his
ability to assist in his defense in the criminal case; (3) aripiprazole
has a more favorable side effect profile relative to other
antipsychotic medications; (4) there are additional medications that
could neutralize potential side effects; and (5) McNair does not have
any underlying medical conditions that would be exacerbated by
using antipsychotic medication.
¶ 16 Given this record support and the district court’s credibility
determination, we defer to the court’s finding that treating McNair
with aripiprazole was medically appropriate and, therefore, that the
fourth Sell element was met here. See Sell, 539 U.S. at 181;
Ramsey, ¶ 23; R.F., ¶ 21.
¶ 17 In contesting the district court’s finding on the fourth Sell
element, McNair points to the psychiatrist’s testimony that his
6 delusional disorder does “not significantly impair his ability to
function” or cause him to act in “any obviously bizarre or odd
ways,” and that, despite his delusional disorder, he is able to take
care of his basic needs and has not been a danger to himself or
others at the hospital.
¶ 18 However, the district court found that medicating McNair with
aripiprazole would help reduce his belief in the delusions, thereby
reducing his anxiety and depression caused by the delusions. That
finding is supported by the psychiatrist’s testimony that McNair’s
delusional disorder causes him to feel “distress[ed]” and
“persecuted,” and that his psychotic symptoms “contribut[e] to his
anxiety” and “a downturn in his mood, feeling depressed about his
current life circumstances.” The psychiatrist also testified that
McNair’s delusions, if left untreated, will “significantly impact his
rational decision making.” So although McNair’s delusional
disorder may not affect, for example, his ability to function in taking
care of his basic needs, the district court’s finding and the record
show that treating McNair’s disorder with antipsychotic medication
will benefit him medically by improving his anxiety, depression, and
rational decision-making. Therefore, we reject McNair’s assertion
7 that “there is no real benefit” in treating him with antipsychotic
medication beyond restoring his competency to stand trial.
¶ 19 McNair downplays the psychiatrist’s testimony that the
medication will improve his feelings of distress and persecution,
arguing that he is “far more distressed” about taking antipsychotic
medication. We acknowledge McNair’s testimony that he is
“terrifie[d]” of taking antipsychotic medication because he “do[es]n’t
know what [it] will do to [him]” but believes it could “mess with
[him] negatively” in “every type of way” and have “aftereffects” on his
“life.” However, we may not reweigh the evidence, and the district
court specifically credited the psychiatrist’s testimony regarding the
reasons that administering the medication was medically
appropriate, which included not only reducing his feelings of
distress and persecution, but also reducing his depression and
improving his rational decision-making. See Ramsey, ¶ 30.
Viewing the evidence as a whole and in the light most favorable to
the prevailing party, as we must, the evidence was sufficient to
show that treating McNair with antipsychotic medication was
medically appropriate. See R.K.L., ¶ 13.
8 ¶ 20 McNair also emphasizes the “plethora” of possible side effects
that aripiprazole could conceivably cause. But again, we cannot
reweigh the evidence, and the district court’s finding that treating
McNair with aripiprazole was medically appropriate was based in
part on the psychiatrist’s testimony that McNair would be regularly
monitored for any side effects and that there were additional
medications that can help neutralize side effects. See id.
IV. Disposition
¶ 21 The order is affirmed.
JUDGE FREYRE and JUDGE GOMEZ concur.