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In re K.S.

Court of Appeals of Texas, Eleventh District

April 25, 2019

IN THE MATTER OF K.S.

          On Appeal from the County Court Howard County, Texas Trial Court Cause No. M-29954-F

          Panel consists of: Bailey, C.J., Stretcher, J., and Wright, S.C.J. [2]

          MEMORANDUM OPINION

          John M. Bailey, Chief Justice.

         K.S. has filed an appeal from an order authorizing the administration of psychoactive medication-forensic. See Tex. Health & Safety Code Ann. §§ 574.106, .108 (West 2017); see also Tex. Code Crim. Proc. Ann. ch. 46B (West 2018). On appeal, Appellant presents one issue in which she challenges the legal and factual sufficiency of the evidence to support the trial court's order. We affirm.

         Background Facts

         Appellant suffers from delusional disorder and has, in the past, also been diagnosed with psychotic disorder and bipolar disorder. She has been charged with a crime, has been determined to be incompetent to stand trial, and is the subject of a court order for inpatient mental health services. Appellant was eventually sent to Big Spring State Hospital for treatment. While there, Appellant refused to take certain medications, including antipsychotics, mood stabilizers, and an antidepressant. As a result, Dr. Feroz Yaqoob, a physician at Big Spring State Hospital, filed an application to obtain authorization from the county court to administer psychoactive medication to Appellant. See Health & Safety § 574.104.

         At the hearing on the application, Dr. Yaqoob testified that Appellant was at the hospital on a "46(B)" forensic commitment. See Crim. Proc. ch. 46B (incompetency to stand trial). Dr. Yaqoob testified that he did not believe that Appellant had the capacity to understand the need for the medications that he proposed to administer to her: primarily antipsychotics, mood stabilizers, and an antidepressant. According to Dr. Yaqoob, Appellant refuses to take any medications because she does not think that she has a mental illness. Dr. Yaqoob testified that, in his opinion, Appellant's chances to become competent to stand trial will increase with the medications that he proposes to administer to Appellant. He also testified that the proposed medications had been proven to be safe and effective for Appellant's diagnosis.

         Appellant testified at the hearing that neither Dr. Yaqoob nor the nurses had requested that she "take any medicine at all." However, she also testified that there was no reason for her to take medications. Appellant indicated that she was not delusional and that she was cooperative and very stable. She testified that she attended all of the competency classes and that she had no write-ups; she also indicated that she ran her own business.

         In response to Appellant's testimony, Dr. Yaqoob reiterated that Appellant had refused to take her medications and that she lacked insight into her charges and her mental illness. He also stated that Appellant "does not engage in any rational conversation related to her charges." Although Appellant has apparently been charged with a felony, she thinks that she has been charged with misdemeanors, which she believes "were made up." Dr. Yaqoob had seen no improvement in Appellant in the month that she had been at Big Spring State Hospital; he therefore sought authorization for court-ordered medications "as a last resort" to improve the chances of Appellant regaining competency. According to Dr. Yaqoob, Appellant has been in the system since 2013 and has not been able to regain competency at other facilities.

         At the end of the hearing, the county court indicated that it was going to grant Dr. Yaqoob's request. In its written order, the county court found that Appellant "lacks the capacity to make a decision regarding administering of said medication" and that treatment with the proposed medication is in Appellant's "best interest."[1]The order authorizes the Texas Department of State Health Services to administer antipsychotics, anxiolytics/sedative/hypnotics, and mood stabilizers to Appellant.

         Analysis

         A court may issue an order authorizing the administration of one or more classes of psychoactive medication to a patient if the patient is under a court order to receive inpatient mental health services or if the patient is in custody awaiting trial in a criminal proceeding and was ordered to receive inpatient mental health services in the six months preceding a hearing under this section. Health & Safety § 574.106(a). Before entering such an order, the court must hold a hearing. Id. § 574.106(c). The court may issue an order authorizing the mental health care provider to administer psychoactive medication under Section 574.106 only if the court finds by clear and convincing evidence:

(1) that the patient lacks the capacity to make a decision regarding the administration of the proposed medication and treatment with the proposed medication is in the best interest of the patient; or
(2)if the patient was ordered to receive inpatient mental health services by a criminal court with jurisdiction over the patient, that treatment with the proposed medication is ...

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