Filed 11/3/20

CERTIFIED FOR PUBLICATION

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

SECOND APPELLATE DISTRICT

DIVISION EIGHT

Conservatorship of the Person of 

S.A.

______________________________

Y.A., as Conservator, etc.,

Petitioner and Respondent,

v.

S.A.,

Objector and Appellant.

B302038

(Los Angeles County

Super. Ct. No. ZE042237)

APPEAL from orders of the Superior Court of Los Angeles 

County, Mark S. Priver, Judge Pro Tempore. Affirmed.

Jean Matulis, under appointment by the Court of Appeal, 

for Objector and Appellant.

Sarah M. Javaheri, under appointment by the Superior 

Court, for Petitioner and Respondent.

_______________________
2

S.A. appeals reappointment of her conservator under the 

Lanterman-Petris-Short Act (Welf. & Inst. Code, § 5000 et seq.) 

(“the Act”). S.A. also attacks the court’s order that she can be 

medicated against her will. We affirm. Undesignated statutory 

citations are to the Welfare and Institutions Code. 

I

On September 13, 2019, Y.A. filed for reappointment as 

conservator for her adult daughter, S.A. (We refer to S.A. and 

Y.A. by their initials to protect S.A.’s privacy. (§ 5325.1, subd. 

(b).)) Y.A. asked the court to continue Y.A.’s authority over S.A., 

including Y.A.’s authority to force S.A. to take psychotropic 

medications. Y.A. correspondingly asked the court to override 

S.A.’s right to refuse medication. 

S.A. asked for a bench trial, which the court held on 

October 17, 2019. S.A. was 33 years old at trial. 

Two witnesses testified: Dr. Alete Arom and S.A. 

Arom testified first. She interviewed S.A. the morning of 

the trial and reviewed S.A.’s charts and records. S.A. did not 

challenge Arom or move to exclude her as unqualified. Neither 

side questioned Arom about her credentials. We grant S.A.’s 

uncontested request to notice materials showing Arom is a 

licensed psychologist—a fact Y.A. does not dispute. 

Arom testified S.A. had symptoms of schizophrenia. S.A. 

“has a complicated set of ideas about what reality is to her.” 

Arom said S.A. asserted that S.A. was not her name and that her 

true name is completely different. This name has initials “M.R.” 

S.A. denied she had a mental illness and believed instead she had 

anemia. S.A. told Arom the one with schizophrenia was not S.A. 

but rather Y.A.: S.A.’s mother and conservator. 
3

Arom described S.A.’s beliefs about her family. Y.A. had 

kidnapped S.A. S.A.’s true parents were movie stars Michelle 

Pfeiffer and Michael Keaton. Y.A. is from India but S.A. denied 

her Indian heritage. When Arom testified about S.A.’s beliefs, in 

open court S.A. interjected, “I have American features.” (The 

reporter’s transcript misattributes this statement to Arom. In 

her respondent’s brief, Y.A. attributes the statement to S.A.—a 

fact S.A. does not dispute.) 

Arom testified S.A. thought the month was December. In 

fact it was October.

Arom discussed S.A.’s plans for shelter. Under her 

guardianship, she had been residing at View Heights 

Convalescent Hospital. Arom described a discussion she had 

with S.A. about board and care facilities: “She does not believe 

she has a mental illness and therefore she does not like the idea 

of staying there. Then she decided she certainly could not stay 

there because a requirement for those types of facilities is [to] 

take medication. And she is not willing to take the medication.” 

Arom explained that, if S.A. were not on a conservatorship, S.A.’s 

plan was to return to a place where she used to live, to stop 

taking medication, and to get a job in fashion. Based on her 

observations of S.A., Arom opined this plan was not viable. 

Arom discussed S.A.’s medication. Doctors prescribed 

Clozaril for S.A. S.A. would stop taking the medication if she 

were unsupervised. S.A. believed Clozaril darkened her skin, 

causing her to have a darker complexion than Michelle Pfeiffer 

and Michael Keaton, whom S.A. insisted were her true parents. 

S.A. was “quite symptomatic” even on this medication and would 

be “much worse” without it. Arom opined S.A. would be unable to 

plan for her own food, clothing, and shelter without medication. 
4

When Arom testified about medication, S.A. again interrupted in 

open court, saying, “Those drugs don’t like me.” (The reporter’s 

transcript misattributes this statement to “Attorney1.”) 

Arom described S.A.’s beliefs as delusions. A delusion is a 

false, fixed belief. At trial and on appeal, S.A.’s attorneys do not 

dispute S.A.’s beliefs are delusions. S.A.’s appellate attorney 

writes S.A. “may have atypical views.” 

Y.A.’s attorney asked Arom whether S.A. had enough 

mental capacity to make an informed refusal of medication. 

Arom said no.

S.A. did not object to any of Arom’s testimony. Nor did she 

cross-examine Arom. 

S.A. also testified. S.A.’s attorney asked whether S.A. 

agreed with her diagnosis or had any mental health conditions, 

whether she took medication, and whether she thought she 

needed medication. The attorney asked S.A., “Is there anything 

else you would like to tell the court why you feel you should not 

be on a conservatorship?” The attorney also asked S.A. about her 

plans for housing if she were not on a conservatorship. 

Much of S.A.’s testimony confirmed Arom’s views. S.A. said 

her name was not S.A. but the name with initials “M.R.” She had 

anemia, not paranoid schizophrenia. Doctors prescribed her 

unnecessary and unhelpful medication. 

S.A. began to read a letter she wrote for the court. S.A.’s 

letter asserted her parents were Michael Keaton and Michelle 

Pfeiffer. Y.A. had kidnapped her, had schizophrenia, and was an 

illegal alien from India. The “best decision” would be to contact 

Homeland Security about Y.A., who owned “illegal property in 

houses in Mexico and Nevada.” 
5

The court broke in and asked S.A. to explain her plan if she 

did not have a conservatorship. S.A. responded, “I need to 

mention this about Homeland Security.” 

Then S.A. explained, a “clear answer” was to put her in 

housing “at UCLA through Huntington Memorial Hospital.” At 

this trial, there was no evidence S.A. had any connection or 

history with either UCLA or Huntington. S.A. offered no 

concrete details about this proposal.

S.A. also testified she could finish her degree, get a job, 

“and look for [her] real family.” S.A. did not explain what this 

degree was. Nor did she testify to employment experience, to 

what sort of work she hoped to get, or to how she planned to 

search for this job. 

S.A. said she had discussed housing with someone from the 

Department of Mental Health but she had “not had the interview 

yet.” S.A. returned to reading her letter and said, “One thing 

before you make your decision, is that [they] assigned me with [a] 

[non] white doctor.” 

Y.A. did not cross-examine S.A. 

S.A.’s counsel “submitted on [S.A.’s] plan for self care” and 

did not otherwise present a closing argument. 

The court found beyond a reasonable doubt S.A. remained 

gravely disabled and reappointed Y.A. as S.A.’s conservator. It 

ordered several powers and disabilities, which it listed by 

number. This list included “8a” and “10.” The same day as the 

trial, the court issued a written order specifying the powers and 

disabilities. Power 8a continued Y.A.’s power to require S.A. to 

accept psychotropic medications. Disability 10 continued the 

corresponding disability: it removed S.A.’s right to “refuse or 

consent to treatment related specifically to [her] being gravely 
6

disabled.” The order stated that, as to each power or disability, 

the court “finds that the evidence presented establishes that the 

power or disability is necessary to the care, custody, maintenance 

and protection of the conservatee.” 

II

The court’s reappointment of a conservator was proper. 

Substantial evidence showed S.A. was gravely disabled. 

A court may establish or renew a conservatorship under the 

Act if a person is gravely disabled, meaning the person, as a 

result of a mental health disorder, is unable to provide for her or 

his basic personal needs for food, clothing, or shelter. (§§ 5350 & 

5008, subd. (h)(1)(A).) The petitioner must prove the conservatee 

is gravely disabled beyond a reasonable doubt. (Conservatorship 

of Roulet (1979) 23 Cal.3d 219, 225–226.) Testimony of one 

witness can suffice to support a finding of grave disability. 

(Conservatorship of Carol K. (2010) 188 Cal.App.4th 123, 134.) 

We review the whole record in favor of the judgment below 

to determine whether there was substantial evidence S.A. was 

gravely disabled beyond a reasonable doubt. (Conservatorship of 

Walker (1989) 206 Cal.App.3d 1572, 1577 (Walker).) Substantial 

evidence includes circumstantial evidence and reasonable 

inferences flowing from it. (Ibid.) 

Evidence conservatees (1) lack insight about their mental 

illness, (2) would not take medication without the support of a 

conservator, and (3) could not provide for themselves without 

medication is enough to support a court’s finding of grave mental 

illness. (Walker, supra, 206 Cal.App.3d at p. 1577.) 

Arom’s and S.A.’s testimony demonstrated S.A. lacked 

insight about her mental illness. S.A. did not believe she had 
7

schizophrenia and instead thought she had an unrelated medical 

issue. 

S.A. would not take medication without the support of a 

conservator. S.A. denied needing medication. She did not want 

it. Everyone agrees she would not take medication without a 

conservatorship. 

S.A. could not provide for herself without a conservatorship 

and without medication. Substantial evidence supported this 

finding. Arom testified S.A., if unmedicated, would not be able to 

make and carry out a viable plan for food, clothing, or shelter. 

Evidence showed, for example, S.A. could not provide for 

shelter without a conservatorship. Based on her meeting with 

S.A., Arom believed S.A.’s plans for housing were not viable. S.A. 

had some views about how she might find housing. But, after a 

bench trial, we review the court’s determinations about witness 

credibility with extreme deference. (Schmidt v. Superior Court

(2020) 44 Cal.App.5th 570, 582.) Here we indeed do defer to the 

court’s implied finding that Arom was more reliable and more 

credible than S.A. 

S.A. incorrectly claims Arom’s testimony was speculation. 

Arom’s opinions were based on her observations of S.A., not on 

speculation. S.A. argues she expressed unwillingness to go to 

board and care facilities only because Arom falsely told her such 

facilities always require residents to take medication. This 

argument slights our duty to make inferences in favor of the 

judgment. (Walker, supra, 206 Cal.App.3d at p. 1577.) Arom 

testified S.A. disapproved of living in a board and care facility 

because those facilities are for people with mental illnesses and 

S.A. denied having a mental illness. An inference in favor of the 

judgment is S.A. would not agree to live in such a facility. This 
8

evidence supported a finding that S.A. could not provide for her 

own shelter. 

Sufficient evidence supported the court’s finding that S.A. 

was gravely disabled and that a conservatorship was proper in 

this case. 

III

The involuntary medication order was proper because 

substantial evidence established S.A. was unable to make 

informed treatment decisions. 

A competent adult has the right to refuse medical 

treatment, including the right to refuse psychotropic drugs. (In 

re Qawi (2004) 32 Cal.4th 1, 14 (Qawi).) A court’s determination 

that a conservatee is gravely disabled does not, by itself, justify 

imposing an order allowing involuntary medication. (§ 5005; 

Riese v. St. Mary’s Hospital & Medical Center (1987) 209 

Cal.App.3d 1303, 1312–1313 (Riese).) Conservators may seek 

added authority over conservatees, including a limitation on the 

conservatee’s right to refuse medical treatment. The statute 

refers to medication authority as imposing a “disabilit[y]” on the 

conservatee. (§ 5357, subd. (d).) 

A court may order involuntary medication if clear and 

convincing evidence shows the conservatee is incompetent to give 

or withhold informed consent. (Riese, supra, 209 Cal.App.3d at 

pp. 1322–1323.) In Qawi, the California Supreme Court 

approved Riese and Keyhea v. Rushen (1986) 178 Cal.App.3d 526, 

535, which listed factors a court must consider to determine 

whether a conservatee is incompetent. (Qawi, supra, 32 Cal.4th 

at pp. 17–19.) The factors include whether the conservatee lacks 

mental capacity rationally to understand the nature of the 
9

medical problem, the proposed treatment, and its attendant 

risks. (Id. at p. 18.) 

S.A. quotes the decision in Carter v. Superior Court (2006) 

141 Cal.App.4th 992, 1000 to the effect that orders for 

involuntary medication of antipsychotic drugs are “disfavored.” 

This is not the term we would use. Schizophrenia can be a 

devastating illness. Medication can be the only effective 

treatment. A symptom often is delusional thinking, including 

about the costs and benefits of medication. Under appropriate 

conditions, involuntary medication of antipsychotic drugs can be 

a major benefit to the gravely disabled patient.

We must determine whether the record contains 

substantial evidence from which a reasonable trier of fact could 

have made the finding of high probability demanded by this clear 

and convincing standard of proof. (Conservatorship of O.B. (2020) 

9 Cal.5th 989, 1005, 1009.) We do not reweigh evidence. (Id. at 

p. 1008.) We presume in favor of the judgment the findings of 

fact necessary to support it. (Conservatorship of George H. (2008) 

169 Cal.App.4th 157, 165 (George).)

At the close of trial and in its written order, the trial court 

ordered the power and disability allowing involuntary 

medication. The court’s order stated it found “the evidence 

presented establishes that the power or disability is necessary to 

the care, custody, maintenance and protection of [S.A.].” Thus 

the court found involuntary medication was necessary for S.A.’s 

care and protection. 

Substantial evidence supported a finding that S.A. lacked 

the mental capacity rationally to understand the nature of her 

mental illness, her medication, and the risks of stopping her 

medication. S.A. denied having schizophrenia and rejected any 
10

need for medication. She thought her medication caused her skin 

to darken. This belief is related to her delusion Michael Keaton 

and Michelle Pfeiffer were her parents. Arom testified S.A. 

lacked mental capacity to make an informed refusal of her 

medications. This evidence supported the court’s order. 

In her opening brief, S.A. incorrectly says Arom “did not 

specifically address incapacity to make treatment decisions.” 

During oral argument, she conceded Arom did address 

incapacity. Indeed, at trial, Y.A.’s attorney asked Arom whether 

S.A. had “sufficient mental capacity to make an informed refusal 

of medication” and Arom said no. Arom testified directly on this 

point. 

S.A. erroneously says Arom was unqualified to testify about 

S.A.’s competency. Because Arom was a psychologist and thus 

could not prescribe medication, S.A. claims Arom could not 

provide “competent evidence” about incapacity. To the extent 

this argument is about the admissibility of Dr. Arom’s testimony, 

S.A. waived the argument by failing to object at trial. (Evid. 

Code, § 353.) On the merits, S.A. cites no legal authority for the 

notion only medical doctors may testify in this situation. We are 

aware of no such authority. Courts of Appeal have relied on 

testimony of psychologists in this same context. (E.g., 

Conservatorship of D.C. (2019) 39 Cal.App.5th 487, 492 (D.C.); 

George, supra, 169 Cal.App.4th at pp. 160 & 166.) 

S.A.’s sole argument against the competence of 

psychologists in this setting is the rule that the “practice of 

psychology shall not include prescribing drugs . . . .” (Bus. & 

Prof. Code, § 2904.) S.A. does not explain why this fact should be 

decisive. S.A. does not offer theoretical or empirical arguments to 

support her proposed conclusion.
11

Arom’s credentials did not preclude her from helping the 

court make what is a legal and not a medical finding. (See Riese, 

supra, 209 Cal.App.3d at p. 1324 [involuntary medication 

“involves moral and ethical considerations not solely within the 

purview of the medical profession, and must be measured by the 

social consensus reflected in our laws”].) 

Arom did not recommend specific medications or dosages. 

Rather, she provided an opinion about whether S.A. could 

understand her mental illness and medication. This psychologist 

was competent to testify on these matters. 

S.A. says the court failed to make explicit findings, oral or 

written, about S.A.’s incapacity to make rational decisions about 

her medical treatment. There is no statutory requirement the 

court make an express finding of decisional incapacity. (K.G. v. 

Meredith (2012) 204 Cal.App.4th 164, 179.) If sufficient evidence 

supports the need for involuntary medication, the lack of express 

reasoning on the record is not enough to support reversal. (D.C., 

supra, 39 Cal.App.5th at p. 495.) The evidence here was 

sufficient. 

On October 26, 2020, S.A. gave notice of the new decision 

People v. Ford (October 23, 2020, B300043) __Cal.App.5th__ 

(Ford). This decision does not alter our analysis. Ford pleaded 

guilty by reason of insanity to a criminal charge, went to a state 

hospital, and the People petitioned to extend his involuntary 

commitment. (Id. at [p. 3].) Without Ford’s presence, the trial 

court found Ford incompetent to waive his right to a jury and 

permitted Ford’s counsel to waive this right. (Id. at [pp. 4–5].) 

The People did not dispute that the court erred by finding Ford 

incompetent in his absence. (Id. at [p. 9].) The Ford court found 

this error prejudicial. (Id. at [pp. 10–11].) 
12

S.A.’s case is entirely different. It is about medication, S.A. 

was present at trial, and Y.A. does not concede error. The 

relevant statute in Ford, Penal Code section 1026.5, required the 

trial court to advise Ford in court and on the record of his right to 

a jury. (Ford, supra, B300043 at [p. 8]; People v. Tran (2015) 61 

Cal.4th 1160, 1165–1166.) In S.A.’s case, there was no missing 

advisement. S.A. identifies section 5326.2, but that section 

describes requirements for voluntary informed consent and does 

not mandate the court to advise S.A. about anything. 

We stand by our position in D.C. that it is good practice for 

a trial court to make a finding of incompetency and explicitly to 

apply the factors Riese set forth. (D.C., supra, 39 Cal.App.5th at 

p. 495.) A written order would suffice. 

DISPOSITION

We affirm.

WILEY, J. 

WE CONCUR:

BIGELOW, P. J. 

GRIMES, J.