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March 27, 2026 Get Citation Alerts Download PDF Add Note

People v. Watkins CA1/4

California Court of Appeal

• Citations: None known
• Docket Number: A173093

• Precedential Status: Non-Precedential

• Opinion

• Authorities (3)

• Cited By (0)

• Summaries (0)

• Similar Cases (30K)

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Combined Opinion

Filed 3/27/26 P. v. Watkins CA1/4
NOT TO BE PUBLISHED IN OFFICIAL REPORTS
California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not
certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not
been certified for publication or ordered published for purposes of rule 8.1115.

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

FIRST APPELLATE DISTRICT

DIVISION FOUR

THE PEOPLE,
Plaintiff and
Respondent, A173093

v. (Alameda County
ANDREW WATKINS, Super. Ct. No.
24MH0021221)
Defendant and
Appellant.

Defendant was found incompetent to stand trial and
committed to the Department of State Hospitals (the
Department) (Pen. Code1, § 1368). At issue in this appeal is an
involuntary medication order under section 1370, subdivision
(a)(2)(B)(i)(I) and (II). Defendant argues that the court’s order is
not supported by substantial evidence. We affirm.
BACKGROUND
The People filed a felony complaint against defendant
alleging multiple counts of assault. The trial court thereafter
adjudicated defendant incompetent pursuant to section 1368 and
ordered him committed. The court also issued an initial

1 All further statutory references are to the Penal Code.

1
involuntary medication order, finding that defendant lacked the
capacity to make decisions regarding antipsychotic medication,
and that his mental disorder, if not treated, would result in
serious harm to his physical or mental health. Defendant was
admitted to Atascadero State Hospital (Atascadero) in May 2024.
In February 2025, the Department moved to renew the
court’s involuntary medication order, and the court held hearings
in March 2025 on this motion. Dr. Sonya Jackson, defendant’s
treating psychiatrist at Atascadero, was the only witness.2
Dr. Jackson testified that she saw defendant weekly, she
had reviewed his records, and she had spoken with members of
his treatment team. Dr. Jackson diagnosed defendant with
schizophrenia. His symptoms included hearing voices and
poverty of speech and thought, with the latter meaning that he
has “difficulty elaborating” when expressing himself and often
nods rather than providing verbal responses. Schizophrenia
requires treatment with antipsychotic medication, and there are
no other viable treatment options.
When Dr. Jackson asked defendant which medications
helped him, he answered, “I don’t know.” When Dr. Jackson
asked what led to defendant’s most recent arrest, defendant said
he “was having an episode” that included hearing voices. At
Atascadero, defendant acknowledged that he heard voices and

2 There is a dispute regarding whether the court considered

the report supporting the 2024 involuntary medication order in
the present proceeding. We do not describe this earlier report
because we find Dr. Jackson’s testimony was sufficient to support
the court’s current involuntary medication order.

2
the voices were very distressing. Around January 28, 2025,
defendant told Dr. Jackson that the voices instructed him to “get
mad.” Dr. Jackson also reported that, earlier in the week of the
hearing, defendant had punched himself in the head because of
the voices. Defendant sometimes reported hearing voices and
other times denied the voices, but staff continued to see him
talking to himself or yelling in his room, which Dr. Jackson
stated was objective evidence of the voices persisting. Dr.
Jackson agreed that defendant’s symptoms were “[n]ot exactly”
the same every day, “but the voices [we]re very prominent.”
Dr. Jackson testified that defendant was unable to express
what he believed caused the voices. He did not believe
medication alleviated the voices and “was not able to
acknowledge” his improvement while on medication, although he
said that the medication, including PRN medications, which are
“as-needed” medications, helped with his stress and kept him
calm. Dr. Jackson testified that, when defendant arrived at
Atascadero, he was “very paranoid,” heard “much more extreme”
voices, and “was unable to sit down” or have a discussion with or
listen to staff. He physically went after some staff at admission
(although there was no documentation of injury), and he had to
be put in seclusion and full-bed restraints.
Defendant had been taking medication pursuant to a court
order since July 2024 when he was transferred to Dr. Jackson’s
unit. Dr. Jackson testified that defendant had PRN prescriptions
for chlorpromazine and olanzapine for when he experienced

3
severe symptoms or refused his regularly scheduled medication.
He also sometimes coped with his symptoms by pacing.
Although defendant told Dr. Jackson the day before the
hearing that he would take medication, defendant had a history
of refusing medication, including when he arrived at Atascadero
and when Dr. Jackson treated him in 2018. Dr. Jackson testified
that defendant was unable to engage in an intelligent
conversation with her about the risks and benefits of treatment.
In her professional opinion, defendant lacked capacity to make
decisions regarding antipsychotic medication.
Dr. Jackson described the progressive loss of functioning
that occurs when someone with schizophrenia does not receive
treatment with medication. Without treatment, the overall
functioning of a patient with schizophrenia will gradually
deteriorate. In contrast, with consistent medication, a patient
can maintain their level of functioning. If a patient
intermittently takes medication, the medication often does not
work as well once restarted, which can necessitate taking a
higher dose or multiple medications. Stopping and starting
medication also leads to a decrease in overall functioning, and the
patient may never return to the prior level of functioning.
On March 28, 2025, the court found that defendant
“lack[ed] the capacity to make decisions regarding antipsychotic
medication and if [his] mental disorder is not treated, serious
harm to his physical or mental health is the probable result,
pursuant to [section] 1370(a)(2)(B)(i)(I).” The court also found

4
that defendant was a danger to others pursuant to section
1370(a)(2)(B)(i)(II). Defendant timely appealed.
DISCUSSION
“[A]n individual has a ‘significant’ constitutionally
protected ‘liberty interest’ in ‘avoiding the unwanted
administration of antipsychotic drugs.’ ” (Sell v. United
States (2003) 539 U.S. 166, 178.) This interest is protected under
California’s right to privacy, which “clearly extends to the right to
refuse antipsychotic drugs.” (In re Qawi (2004) 32 Cal.4th 1, 14.)
Our Legislature has amended section 1370 to meet the
constitutional standards related to involuntary medication orders
for defendants deemed incompetent to stand trial and committed
to the Department. (People v. Lameed (2016) 247 Cal.App.4th
381, 396; § 1370, subd. (a)(2).) Section 1370 permits involuntary
medication in three circumstances (§ 1370, subd. (a)(2)(B)(i)(I-
III)), and here the court found that two of the three
circumstances existed. The question before us is whether the
record contains substantial evidence from which the court could
have found it highly probable that the requisite facts were true
(the clear and convincing evidence standard of proof). (People v.
Garcia (2024) 99 Cal.App.5th 1048, 1054.) For the reasons set
forth post, we conclude that Dr. Jackson’s testimony was
sufficient to support the court’s order.
To order involuntary administration of antipsychotic
medication under section 1370, subdivision (a)(2)(B)(i)(I), a court
must find the following three facts true: “[1] the defendant lacks
capacity to make decisions regarding antipsychotic medication,

5
[2] the defendant’s mental disorder requires medical treatment
with antipsychotic medication, and [3] if the defendant’s mental
disorder is not treated with antipsychotic medication, it is
probable that serious harm to the physical or mental health of
the defendant will result.” Defendant disputes the court’s
findings as to the first and third condition.3
First, the record supports the court’s conclusion that
defendant lacked capacity to make decisions regarding
antipsychotic medication. Defendant contends the record shows
he understood that he had a mental illness and the effects that
antipsychotic medication had on this illness, but we disagree.
Defendant was able to acknowledge that he had an episode when
arrested and that he heard “very distressing” voices.
Nonetheless, Dr. Jackson testified that defendant had been
unable to articulate what he thought caused the voices.
Defendant believed that medication, including PRN medications,
helped his stress and kept him calm; however, he did not believe
that medication helped the voices. Dr. Jackson testified that
defendant had not been able to engage in an intelligent
conversation regarding the risks and benefits of treatment. She
also testified that antipsychotic mediation had “absolutely”
improved defendant’s condition since his admission, but he was
nonetheless unable to acknowledge that medication played a role
in this improvement. This evidence supports the conclusion that

3 Regarding the second condition, defendant was
undisputedly diagnosed with schizophrenia, and Dr. Jackson
testified that the only treatment for schizophrenia is
antipsychotic medicine.

6
defendant was unable to understand that his mental illness
caused the voices or recognize that antipsychotic medication
improved his symptoms, which in turn supports Dr. Jackson’s
opinion that defendant did not have the capacity to make
decisions regarding the administration of antipsychotic
medications.
On appeal, defendant asserts that the People did not
establish that he lacked understanding that medication had
improved his condition because there was no clear and convincing
evidence that antipsychotic drugs had in fact alleviated his
symptoms as he still heard “very prominent” voices. We cannot
agree with defendant. The record shows that, when defendant
arrived at Atascadero, he was paranoid and heard voices to an
extreme degree. Defendant would not listen to staff or take
medication, he physically went after staff, and his response to the
voices was so severe that he had to be put in seclusion and
physically restrained. Since defendant’s move to Dr. Jackson’s
unit in July 2024, he had been taking antipsychotic medication,
and he had not had any incidents requiring seclusion or
restraints. Even though defendant still heard voices, the
evidence thus supports Dr. Jackson’s opinion that she
“absolutely” saw an appreciable improvement in defendant after
he began taking medication.
Next, the record was sufficient for the court to find, by clear
and convincing evidence, that if “defendant’s mental disorder is
not treated with antipsychotic medication, it is probable that
serious harm to the physical or mental health of the defendant

7
will result.” (§ 1370, subd. (a)(2)(B)(i)(I).) “Probability of serious
harm to the physical or mental health of the defendant requires
evidence that the defendant is presently suffering adverse effects
to [his or her] physical or mental health, or the defendant has
previously suffered these effects as a result of a mental disorder
and his or her condition is substantially deteriorating. The fact
that a defendant has a diagnosis of a mental disorder does not
alone establish probability of serious harm to the physical or
mental health of the defendant.” (Ibid.)
Here there was more than just a diagnosed mental
disorder. Dr. Jackson testified that, without medication, a
schizophrenic’s overall functioning will deteriorate, and when
defendant was not taking antipsychotic medication upon his
admission to the hospital, he had responded to hearing the
internal voices to such an extreme degree that the Department
had to restrain him and put him in seclusion. Presently as a
result of his schizophrenia, defendant was suffering from poverty
of speech and thought, hearing voices that he found “very
distressing,” and he had recently punched himself in the head
because of the voices. This testimony provides clear and
convincing evidence that defendant “is presently suffering

8
adverse effects to [his] physical or mental health.” (§ 1370, subd.
(a)(2)(B)(i)(I).)4
DISPOSITION
The order is affirmed.

BROWN, P. J.

WE CONCUR:

STREETER, J.
GOLDMAN, J.

People v. Watkins (A173093)

4 Defendant also argues there was insufficient evidence to

support the court’s finding that he was a danger to others under
section 1370, subdivision (a)(2)(B)(i)(II). Given our determination
that substantial evidence supports the court’s finding
under section 1370, subdivision (a)(2)(B)(i)(I), we need not
address this argument.

9