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Name: People v. Garcia (2024) 99 Cal.App.5th 1048
Case #: D081713
Court: CA Court of Appeal
District 4 DCA
Division: 1
Opinion Date: 02/21/2024

Substantial evidence supported the superior court’s involuntary antipsychotic medication order. Based on the opinion of a licensed psychiatrist and a licensed psychologist, the trial court found that Garcia was mentally incompetent to stand trial and that she lacked the capacity to make decisions regarding the administration of antipsychotic medication. On appeal, Garcia alleged numerous errors with the court’s order authorizing the state hospital to involuntarily administer antipsychotic medication to her. Held: Affirmed. A trial court is required to permit involuntary administration of antipsychotic medication if it finds one of three sets of conditions to be true. (§ 1370(a)(2)(B)(i)(I)–(III) & (ii).) Here, Garcia argued there was insufficient evidence to support the trial court’s finding that it was probable she would suffer serious harm if not treated with antipsychotic medication. A probability of serious harm requires evidence that either (1) “the defendant is presently suffering adverse effects to their physical or mental health,” or (2) “the defendant has previously suffered these effects as a result of a mental disorder and their condition is substantially deteriorating.” The court considered the reports submitted by Dr. Rice and Dr. Jouhal and concluded substantial evidence showed Garcia was presently suffering adverse effects to her physical and mental health. She had severe symptoms of mental illness, grandiose and paranoid delusions, and her thought process was scattered and illogical. Both reports concluded she lacked the capacity to make decisions about medication and that without appropriate treatment with antipsychotic medication serious harm to her physical and/or mental health would result.

Dr. Rice’s opinion regarding the need for antipsychotic medication did not exceed the scope of her license as a psychologist. An order permitting the involuntary administration of antipsychotic medication must be supported by a psychiatrist or licensed psychologist, and there are different requirements depending on whether the evaluator is a psychiatrist or psychologist. Here, Dr. Rice (a psychologist) opined that Garcia “is suffering from a severe mental disorder which requires medical treatment with antipsychotic medication.” (Italics added.) Garcia argued that Dr. Rice exceeded the limits of section 1369(a)(2)(B), which Garcia argued only allows psychologists to conclude treatment with antipsychotic medication “may be appropriate.” However, the preceding provision (§ 1369(a)(2)(A)) provides that psychologists “shall evaluate” whether treatment with antipsychotic mediation “is appropriate,” and does not limit licensed psychologists in the certainty with which they may express their findings. Further, the language of the statute suggests that psychologists are restricted from opining about specific medications but may still opine as to whether antipsychotic medication is generally appropriate.

The error on the superior court form regarding the likelihood of resulting harm without antipsychotic medication was harmless. The superior court’s form has a box for the court to check if it finds that without treatment with antipsychotic medication, it is “possible” that serious harm to the physical or mental health of the patient will result. Thus, the form order purported to apply a “possible” standard that was less stringent than section 1370(a)(2)(B)(i)(I), which requires a finding of “probable” serious harm. The Court of Appeal assumed without deciding that Chapman applied, and found the error harmless. The superior court relied on two reports in making its findings, one which applied the correct standard and one which applied the less stringent “possible” standard. However, given the contents of the reports, their findings and conclusions would have equally supported the court’s order if it had stated serious harm was “probable” rather than merely “possible” without antipsychotic medication. [Editor’s Note: The court further concluded that Dr. Rice’s and Dr. Jouhal’s opinions did not lack statutorily required information under section 1369 and section 1370, and that Garcia’s counsel was not ineffective for failing to object to the involuntary psychiatric medication order.]