Peo in Interest of McNair

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.

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¶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

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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,

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(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.”

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¶ 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

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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

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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

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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.

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¶ 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.

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