Peo in Interest of Harris

25CA1642 Peo in Interest of Harris 10-30-2025

COLORADO COURT OF APPEALS

Court of Appeals No. 25CA1642
Mesa County District Court No. 25MH30128
Honorable Gretchen B. Larson, Judge

The People of the State of Colorado,

Petitioner-Appellee,

In the Interest of James Harris,

Respondent-Appellant.

ORDERS AFFIRMED

Division VI
Opinion by JUSTICE MARTINEZ*
Welling and Sullivan, JJ., concur

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

Todd M. Starr, County Attorney, Richard B. Tuttle, Assistant County Attorney,
Brad Junge, Assistant County Attorney, Grand Junction, 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. 2025.
¶1 Respondent, James Harris, appeals the district court’s orders

(1) certifying him for short-term treatment and (2) authorizing the

administration of medications to him without his consent. He

contends that the evidence was insufficient to sustain either order.

We disagree and therefore affirm.

I. Background

¶2 In late July 2025, Harris voluntarily sought treatment at a

hospital emergency room (the ER) and, due to his symptoms of

psychosis, was placed on an emergency mental health hold.

¶3 He was transferred to Centennial Peaks Hospital (the hospital)

for inpatient psychiatric care. His symptoms included responding

to internal stimuli, having conversations with people who were not

there, expressing delusional beliefs and disorganized thoughts, and

being manic and verbally aggressive. His psychiatrist at the

hospital diagnosed him with schizoaffective disorder.

¶4 The psychiatrist filed a notice of certification for short-term

treatment of Harris under section 27-65-109, C.R.S. 2025, along

with a request for authorization to administer to Harris several

antipsychotic medications, an antianxiety medication, and a

medication to treat any side effects.

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¶5 At the hearing, the psychiatrist and Harris both testified. The

psychiatrist, whom the parties stipulated was an expert in

psychiatry, testified that Harris’s schizoaffective disorder

constitutes a substantial disorder that grossly impairs his

judgment, his ability to recognize reality, and his ability to control

his behavior. In support of the short-term certification, the

psychiatrist opined, among other things, that Harris is gravely

disabled because he is incapable of making informed decisions

about or providing for his essential needs without significant

supervision and assistance from other people. In terms of

medications, the psychiatrist requested authorization to

involuntarily administer to Harris the following: (1) three

antipsychotic medications — Haldol (haloperidol), Prolixin

(fluphenazine), and Invega (paliperidone); (2) Ativan (lorazepam), an

antianxiety medication; and (3) Cogentin (benztropine), an as-

needed medication to treat any side effects. The psychiatrist opined

that the medications are “essential” to effectively treat Harris’s

mental health disorder, and that without treatment, “[h]e will

definitely continue to deteriorate.”

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¶6 The psychiatrist also testified that Harris does not possess any

insight into his mental health disorder, explaining that Harris has

expressed that he doesn’t need the medications because he doesn’t

have a mental illness. The psychiatrist testified that Harris has

been voluntarily taking one pill of the antipsychotic medication

Zyprexa (olanzapine) at night as a sleep aid. The psychiatrist

testified that Harris has only “improved slightly” taking the single

pill of Zyprexa, explaining that “there’s a slight improvement in

terms of mania and slight reduction of the aggressiveness.”

However, the psychiatrist testified that Harris has already

“plateaued” on the single pill of Zyprexa and remains gravely

disabled, explaining that the single pill of Zyprexa has not

addressed his psychosis, delusions, or hallucinations, and his

symptoms continue to be “very disruptive and severe.”

¶7 During Harris’s testimony, when he was asked whether he has

a mental illness, he responded, “I kind of do. . . . It’s called Juggalo

Clown syndrome. We’re almost like bipolar.” When he was asked

whether he has schizoaffective disorder, he responded, “I don’t

know. I don’t believe much of what they say.” However, Harris

repeatedly made clear during his testimony that he was only willing

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to take the single pill of Zyprexa at night as a sleep aid, and that he

wants to be either immediately transferred to a different facility or

released so he can stay at his girlfriend’s house. As we explain in

more detail in our analysis below, he also testified regarding the

reasons he does not want to take the medications requested by the

psychiatrist.

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

psychiatrist’s testimony was “much more compelling and

persuasive” than Harris’s testimony. The court then certified Harris

for short-term treatment based on, among other findings, a finding

that Harris is gravely disabled as a result of his schizoaffective

disorder. See § 27-65-109(1)(a). Further, after analyzing the four

elements of the test from People v. Medina, 705 P.2d 961, 973 (Colo.

1985), the court also granted the request for authorization to

involuntarily administer the requested medications.

II. Standards of Review

¶9 On a challenge to the sufficiency of the evidence, we review the

record de novo to 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. People in Interest of Ramsey,

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2023 COA 95, ¶ 23. We review de novo the court’s conclusions of

law and defer to the court’s findings of fact if sufficient evidence in

the record supports them. Id. The resolution of conflicts in

testimony and determinations of witness credibility are solely within

the province of the fact finder. Id.

III. Certification for Short-Term Treatment

¶ 10 A person may be certified for up to three months of treatment

under section 27-65-109 if he has a mental health disorder and, as

a result of the disorder, (1) is a danger to himself or others or (2) is

gravely disabled. § 27-65-109(1)(a); Ramsey, ¶ 25. The State has

the burden of proving that by clear and convincing evidence, but a

psychiatrist’s testimony alone may be sufficient to do so. § 27-65-

113(1), C.R.S. 2025; Ramsey, ¶ 25; People v. Pflugbeil, 834 P.2d

843, 846-47 (Colo. App. 1992).

¶ 11 Again, the district court based the certification on its finding

that Harris is gravely disabled as a result of his schizoaffective

disorder. 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

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person’s essential needs without significant supervision and

assistance from other people.” § 27-65-102(17), C.R.S. 2025.

¶ 12 In explaining its finding that Harris is gravely disabled, the

district court found that if he were released from the hospital, he

would be dependent on his girlfriend to provide shelter for him, and

his behavior in public would likely lead to interaction with law

enforcement. But more importantly for our review, the court also

found that Harris “is not at this time capable of making informed

decisions about [his] medical or mental health issues.” In support

of that, the court found that (1) Harris “does have schizoaffective

disorder”; (2) he “is still currently psychotic and in need of

medications . . . to address his psychosis”; (3) “the medications that

[the psychiatrist] is requesting in this case are essential to treat

[his] mental health issues”; and (4) “[h]e has been advised of

voluntary treatment and has refused.” As explained above in our

description of the hearing testimony, those findings are well

supported by the psychiatrist’s testimony. See Ramsey, ¶ 23.

¶ 13 In arguing that the evidence was insufficient to support the

district court’s finding that he is gravely disabled, Harris relies on

three particular pieces of evidence. First, he points out that “[h]e

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initially sought assistance voluntarily [by going to the ER].”

Although Harris’s initial act of seeking help at the ER did evidence

some ability to make informed decisions at that time, he has now

been thoroughly evaluated at the hospital regarding how best to

treat his schizoaffective disorder but he has not been willing to take

the medications that, according to the district court’s finding and

the psychiatrist’s testimony, are essential to effectively treat his

condition. That supports the finding that Harris “is incapable of

making informed decisions” about providing for his “essential

needs.” § 27-65-102(17).

¶ 14 Second, Harris emphasizes that he “has agreed to take

[Zyprexa]” voluntarily. But he has agreed only to take one pill of

Zyprexa in the evening as a sleep aid. The district court found that

Harris’s “continued use of [one] Zyprexa [pill at night] will not

resolve his mental health issues,” which, as explained above in our

description of the hearing testimony, is well supported by the

psychiatrist’s testimony. See Ramsey, ¶ 23.

¶ 15 And third, Harris points out that when the psychiatrist was

asked at the hearing whether Harris was presently able to take care

of his basic needs, “[the psychiatrist] simply answered, ‘He is not

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able to’ without providing any explanation to support his opinion.”

But the psychiatrist was not explicitly asked to support his opinion

at that point in the questioning. But the psychiatrist also testified

that Harris “couldn’t manage any medication for a prolonged time

without nurses overseeing that.” Moreover, the psychiatrist’s

testimony as a whole strongly supports the district court’s finding

that, due to Harris’s refusal to take the medications that are

“essential” to treat his schizoaffective disorder, he is incapable of

making informed decisions about his essential needs. See § 27-65-

102(17); Ramsey, ¶ 23.

¶ 16 For these reasons, we will not disturb the district court’s

finding that Harris is gravely disabled under sections 27-65-

109(1)(a) and 27-65-102(17). See Ramsey, ¶ 23.

IV. Involuntary Administration of Medication

¶ 17 Regarding Harris’s appeal of the medication order, we first

note that a district court may authorize the involuntary

administration of medication if the State demonstrates 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

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patient’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

patient’s need for treatment is sufficiently compelling to override

any bona fide and legitimate interest of the patient in refusing

treatment. Medina, 705 P.2d at 973. Here too, a psychiatrist’s

testimony alone may be sufficient to satisfy the Medina test by clear

and convincing evidence. See People in Interest of R.K.L., 2016 COA

84, ¶ 30.

¶ 18 Harris does not contest the district court’s rulings that the

first, second, and third Medina elements were satisfied. However,

he challenges the sufficiency of the evidence supporting 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 to take them voluntarily.

¶ 19 In analyzing the fourth Medina element, a court first

determines “whether the patient’s refusal is bona fide and

legitimate.” Medina, 705 P.2d at 974. If it is, the court then

determines “whether the prognosis without treatment is so

unfavorable that the patient’s personal preference must yield to the

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legitimate interests of the state in preserving the life and health of

the patient placed in its charge and in protecting the safety of those

in the institution.” Id.

¶ 20 On appeal, Harris advances two interests he has in not taking

the medications. First, he asserts that he is “greatly agitated” and

in “great distress” in having to take medications against his will.

The district court briefly addressed this interest, saying, “Mr. Harris

understandably does not want to take medications. The Court

recognizes that, that he doesn’t want injections.” However, the

court ultimately found that Harris’s “need for treatment is

sufficiently compelling to override any bona fide and legitimate

interest that he may have in refusing medications.”

¶ 21 The second interest Harris advances on appeal is that taking

the medications violates his religious beliefs, an issue he testified to

and that his counsel argued during closing argument. For example,

Harris testified, “[The psychiatrist is] trying to feed me drugs

against my religious beliefs. I’m a Universal Life Church

minister. . . . Please do not make me take [the psychiatrist’s] drugs

against my religious beliefs.” In its oral ruling, the district court did

not specifically address that interest, but again, it found generally

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that “any” bona fide and legitimate interest Harris may have in

refusing medications is overridden by his compelling need for

treatment.

¶ 22 We assume that Harris’s interest based on his religious beliefs

is bona fide and legitimate even though he did not explain why he

may not, or should not, take the medications at issue due to his

religious beliefs. Thus, we must determine whether the district

court erred in how it weighed that interest, and Harris’s agitation

and distress, against Harris’s need for treatment with the

medications. Again, the psychiatrist testified that the medications

were “essential” to treat Harris’s mental health disorder, and he

opined that, without them, Harris was at risk of “significant

psychiatric deterioration.” The risk of “significant psychiatric

condition” is particularly compelling given the evidence of the

severity of Harris’s psychiatric condition during his time at the

hospital leading to the hearing. Given the district court’s finding

that the psychiatrist’s testimony was “much more compelling and

persuasive” than Harris’s testimony, we discern no error in its

finding that Harris’s “need for treatment is sufficiently compelling to

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override any bona fide and legitimate interest[s] that he may have in

refusing medications.”

V. Disposition

¶ 23 The orders are affirmed.

JUDGE WELLING and JUDGE SULLIVAN concur.

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