Appeal from the County Court Howard County, Texas Trial Court
Cause No. M-29954-F
consists of: Bailey, C.J., Stretcher, J., and Wright, S.C.J.
M. Bailey, Chief Justice.
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.
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.
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
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.
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
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."The order authorizes the Texas Department
of State Health Services to administer antipsychotics,
anxiolytics/sedative/hypnotics, and mood stabilizers to
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