Peo in Interest of Ballard

25CA0459 Peo in Interest of Ballard 06-12-2025

COLORADO COURT OF APPEALS

Court of Appeals No. 25CA0459
Pueblo County District Court No. 25MH30021
Honorable Gregory J. Styduhar, Judge

The People of the State of Colorado,

Petitioner-Appellee,

In the Interest of Everett Johnta Ballard,

Respondent-Appellant.

ORDER AFFIRMED

Division I
Opinion by JUDGE BERGER*
Kuhn and Moultrie, JJ., concur

NOT PUBLISHED PURSUANT TO C.A.R. 35(e)
Announced June 12, 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

*Sitting by assignment of the Chief Justice under provisions of Colo. Const. art.
VI, § 5(3), and § 24-51-1105, C.R.S. 2024.
¶1 Everett Johnta Ballard appeals the district court’s order

authorizing staff at the Colorado Mental Health Hospital in Pueblo

(the hospital) to medicate him without his consent. We affirm.

I. Background

¶2 Ballard was admitted to the hospital in November 2024 after

being found incompetent to proceed in a criminal case. His

symptoms during this and previous hospitalizations have included

experiencing auditory hallucinations, paranoia, thought

broadcasting, delusional beliefs, mood lability, impulsivity,

agitation, and physical aggression. He has been diagnosed with

“unspecified schizophrenia spectrum and other psychotic disorder.”

¶3 Ballard initially agreed to take psychiatric medications

voluntarily. In December 2024, he hit another patient on the head

and, as a result, was started on emergency medications. The next

month, Ballard began refusing to take his medications voluntarily.

In February 2025, he physically postured at, and verbally

threatened, a staff member, and was again started on emergency

medications.

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¶4 The People then filed a petition seeking authorization to

medicate Ballard involuntarily with olanzapine (Zyprexa), valproic

acid (Depakote), and hydroxyzine (Vistaril).

¶5 At the hearing on the petition, Ballard’s psychiatrist at the

hospital testified as an expert witness that Ballard’s unspecified

schizophrenia spectrum and other psychotic disorder constitutes a

substantial disorder that grossly impairs his judgment or capacity

to recognize reality or to control his behavior. The psychiatrist also

testified that Ballard does not have any insight into his mental

illness and does not believe he needs psychiatric medications. The

psychiatrist opined that Ballard needs olanzapine (an antipsychotic)

and valproic acid (a mood stabilizer) on a scheduled basis, and

hydroxyzine as needed for instances of severe agitation. He testified

that, without the medications, Ballard would pose a serious risk of

harm to others at the hospital (as evidenced by the incidents where

he hit another patient on the head and threatened a staff member)

and there would be a likely and significant long-term deterioration

of his mental condition.

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¶6 When Ballard was asked at the hearing whether he has a

mental illness, he responded, “They claim I do,” and then later

clarified that he sometimes has a hard time believing what he’s

seeing or hearing. He denied being a danger to others. He testified

that he would not take the medications without a court order but

would participate in talk therapy. He also suggested that his

Islamic beliefs preclude him from taking the medications.

¶7 In rebuttal, the psychiatrist opined that Ballard required

treatment with medications, and that he could not be effectively

treated with talk therapy alone.

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

psychiatrist had testified credibly and persuasively. The court then

examined each of the four elements of the test from People v.

Medina, 705 P.2d 961, 973 (Colo. 1985), concluded that the People

had met their burden of proving all four elements in this case, and

granted the petition.

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II. Applicable Law and Standard of Review

¶9 The parties agree that the Medina test applies here.1 Under

that 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 at the institution;

(3) a less intrusive treatment alternative is not available; and (4) the

person’s need for treatment is sufficiently compelling to override

1 A different test applies to petitions to administer medication

involuntarily for the purpose of restoring competency for a criminal
proceeding. See People in Interest of R.F., 2019 COA 110, ¶¶ 10-15
& n.1 (discussing the test from Sell v. United States, 539 U.S. 166,
180 (2003)). Although Ballard was admitted to the hospital for that
purpose, we agree with the parties that the test from People v.
Medina, 705 P.2d 961 (Colo. 1985), applies here because the
petition’s stated purpose, and the district court’s basis for granting
the petition, was to prevent a significant and long-term
deterioration in Ballard’s mental condition and to prevent the
likelihood of him causing serious harm to others at the hospital.
See R.F., ¶ 11 n.1.

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any bona fide and legitimate interest of the person in refusing

treatment. Id.

¶ 10 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

matters solely within the province of the district court. People in

Interest of Ramsey, 2023 COA 95, ¶ 23.

¶ 11 We must affirm the district court’s ruling if the evidence,

viewed as a whole and in the light most favorable to the prevailing

party, is sufficient to support the court’s order. People in Interest of

R.K.L., 2016 COA 84, ¶ 13. The testimony of the physician seeking

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

the Medina test. Id. at ¶ 30.

III. Analysis

¶ 12 Ballard does not contest the district court’s ruling that the

People met their burden of proving the second and third elements of

the Medina test. However, he challenges the sufficiency of the

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evidence supporting the first Medina element — that he is

incompetent to effectively participate in the treatment decision —

and the fourth Medina element — that his need for the medications

is sufficiently compelling to override any bona fide and legitimate

interest he has in refusing the medications.

A. The First Medina Element

¶ 13 In finding that Ballard is incompetent to effectively participate

in the treatment decision, the district court expressly adopted the

psychiatrist’s opinion on that point. The court also made specific

findings that (1) Ballard has no or limited insight into his mental

illness; (2) the medications are necessary to treat his mental illness;

and (3) he has repeatedly refused to take the medications

voluntarily.

¶ 14 The court’s findings are well supported by the psychiatrist’s

testimony, which the court credited, as well as the psychiatrist’s

opinions expressed in his sworn affidavit, which the court admitted

at the hearing. See Marquardt, ¶ 8; Ramsey, ¶ 23; R.K.L., ¶¶ 13,

30.

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¶ 15 In arguing the contrary, Ballard highlights the psychiatrist’s

statement at the hearing that, “[a]s [the psychiatrist] previously

testified,” Ballard does not believe that he has a mental illness or

requires treatment with psychiatric medications. Ballard points out

that the psychiatrist made that statement early during his

testimony, which calls into question what prior “testimony” the

psychiatrist was referring to. The psychiatrist may have been

referring to the statements in his sworn affidavit, but regardless, we

need only determine whether the district court’s findings are

sufficiently supported by the evidence as a whole. See Marquardt,

¶ 8; Ramsey, ¶ 23; R.K.L., ¶¶ 13, 30. We conclude that they are.

¶ 16 Ballard also relies on his own testimony at the hearing —

including that he prefers talk therapy over medications — in

arguing that he “has effectively participated in the discussion

regarding his treatment, and his contribution to the conversation is

that he disagrees with [the psychiatrist’s] diagnosis and proposed

treatment.” He also argues that a patient’s mere disagreement with

their physician does not mean that the patient is incompetent to

effectively participate in the treatment decision.

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¶ 17 But significantly, the district court credited the psychiatrist’s

opinions, including that Ballard needed the requested medications

and that talk therapy alone would not be effective. See Ramsey,

¶ 23. Given that, Ballard’s disagreement with the psychiatrist’s

diagnosis and recommended treatment was why Ballard was

incompetent to effectively participate in the treatment decision. See

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 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 Fourth Medina Element

¶ 18 As to the fourth Medina element — that Ballard’s need for the

medications is sufficiently compelling to override any bona fide and

legitimate interest he has in refusing the medications — he

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contends that the district court erred by not giving sufficient weight

to his Islamic beliefs regarding not using psychiatric medications.

¶ 19 On that issue, the district court appears to have concluded

that Ballard did not sufficiently explain why or how being Muslim

precluded him from taking the medications. The court did not

determine the bona fides of Ballard’s religious beliefs or address

whether, in fact, those religious beliefs had any bearing on the

question before the court. The court ruled only that Ballard had

not articulated any religious prohibition on the taking of the

medications at issue. That was a permissible inquiry. Indeed,

when Ballard was specifically asked at the hearing “what in Islam

precludes [him] from taking medications,” he responded, “The fact

that man believe that drugs are strong and that God -- I’m still

studying, so I -- I based my beliefs on that God is strong.” We agree

that Ballard’s response to that question was vague. Further, given

that the district court’s ruling was based on that vague testimony,

Ballard cannot remedy that vagueness by suggesting, for the first

time on appeal, that he was referring to “divine healing” of his

psychiatric disorder.

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IV. Disposition

¶ 20 The order is affirmed.

JUDGE KUHN and JUDGE MOULTRIE concur.

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