Filed 8/26/20 P. v. Fisher CA5

NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS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 This opinion has not been certified for publication 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

FIFTH APPELLATE DISTRICT

THE PEOPLE,

Plaintiff and Respondent,

v.

JACQULINE FISHER,

Defendant and Appellant.

F080416

(Super. Ct. No. F19904565)

OPINION

THE COURT*

APPEAL from an order of the Superior Court of Fresno County. Adolfo M. 

Corona, Judge.

Conness A. Thompson, under appointment by the Court of Appeal, for Defendant 

and Appellant.

Xavier Becerra, Attorney General, Lance E. Winters, Chief Assistant Attorney 

General, Michael P. Farrell, Assistant Attorney General, Daniel B. Bernstein and Peter H. 

Smith, Deputy Attorneys General, for Plaintiff and Respondent.

-ooOoo-

* Before Smith, Acting P.J., Snauffer, J. and DeSantos, J.
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INTRODUCTION

Appellant Jacquline Fisher was found incompetent to stand trial and the superior 

court ordered the involuntary administration of antipsychotic medication. Fisher 

contends there is no substantial evidence supporting the order. We affirm.

FACTUAL AND PROCEDURAL SUMMARY

On July 11, 2019, Fisher was charged with second degree robbery, felony 

vandalism, and misdemeanor battery. On August 23, 2019, the trial court suspended 

criminal proceedings pursuant to Penal Code1section 1368 based upon defense counsel’s 

doubt regarding Fisher’s competence to stand trial. Dr. Howard Terrell was appointed to 

examine Fisher.

Pursuant to the trial court’s order, Terrell conducted a psychiatric evaluation of 

Fisher on September 15, 2019, and issued a written report. Terrell noted that Fisher 

claimed to be Asian but appeared to be African-American and jail records stated she was 

“ ‘Black.’ ” Fisher told Terrell she was receiving Zyprexa, Depakote, and hydroxyzine 

while in jail.

Fisher reported she had been diagnosed as having bipolar disorder and 

schizophrenia and received SSI disability payments based on the diagnosis. However, 

Fisher did not believe she had any mental illness. Fisher also reported five inpatient 

psychiatric hospitalizations under Welfare and Institutions Code section 5150. She 

initially denied ever having auditory hallucinations, then later admitted experiencing 

them. She also first admitted visual hallucinations, then denied ever experiencing them. 

Fisher reported receiving numerous psychotropic medications over the years and 

experiencing paranoia. She also reported experiencing manic episodes. Fisher admitted 

to using methamphetamine for 10 to 15 years and cocaine for 30 years.

1 References to code sections are to the Penal Code.
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Terrell observed Fisher demonstrated very poor eye contact; frequently appeared 

to be responding to internal stimuli; and often gave paranoid responses. Terrell found 

Fisher’s judgment and insight to be poor. Fisher’s IQ was within the borderline range for 

mild mental retardation, but this was difficult to assess because of her paranoid and 

psychotic state of mind. Her thought processes fluctuated from coherent to loose with a 

paranoid theme.

Terrell concluded Fisher suffered from a psychotic mental disorder that rendered 

her incompetent to stand trial. He did not believe competency could be restored without 

the use of antipsychotic medication. Terrell concluded Fisher was not mentally 

competent to give informed consent for psychotropic medication. Therefore, Terrell 

recommended the trial court authorize the involuntary administration of antipsychotic 

medication. He opined that without antipsychotic medication, Fisher was at substantial 

risk of harming herself or others.

On September 27, 2019, the trial court found Fisher incompetent to stand trial 

based on Terrell’s report. The trial court also ordered that Fisher be involuntarily treated 

with psychotropic medications if necessary. A placement evaluation was ordered.

A placement evaluation was conducted of Fisher on October 30, 2019. In the 

interview, Fisher again stated she was Asian. She had difficulty maintaining eye contact, 

her mood was dysthymic, and her responses evidenced paranoia. Fisher again denied any 

mental illness, although she acknowledged being diagnosed with schizophrenia and 

bipolar disorder.

Fisher acknowledged taking medication for mental illness, but also claimed to be 

taking “ ‘Anthrax.’ ” She seemed hesitant to continue her medications after release from 

jail. Fisher denied experiencing any current visual or auditory hallucinations. She 

admitted abusing drugs since she was “ ‘young’ ” and stated she frequently used cocaine, 
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heroin, and methamphetamine. Fisher did not believe she would abuse drugs again if 

released but could not identify any support system.

The evaluation concluded that Fisher lacked insight and understanding of her 

mental illness, substance abuse history, and need for receiving appropriate treatment. 

Her substance abuse placed her at serious risk because it would alter her psychotropic 

medications and increase her symptoms.

The evaluation concluded Fisher would benefit from an intensive inpatient 

program where she would receive treatment that might include psychotropic medication.

On November 18, 2019, the trial court ordered that Fisher be committed to the 

State Department of State Hospitals for no more than two years. The involuntary 

administration of psychotropic medication also was authorized. There was no objection 

to the placement or the authorization for involuntary medication.

Fisher appealed.

DISCUSSION

Fisher contends the order for the involuntary administration of psychotropic 

medication is not supported by substantial evidence. 

Standard of Review and Applicable Law

A competent adult has a common law and constitutional right to refuse medical 

treatment, including the administration of antipsychotic drugs. (In re Qawi (2004) 32 

Cal.4th 1, 14.) However, an involuntarily committed patient may be forcibly treated with 

antipsychotic medication if a court has determined that she is not competent to refuse 

treatment. (Ibid.; In re Calhoun (2004) 121 Cal.App.4th 1315, 1354.)

The superior court shall determine competence to refuse treatment by clear and 

convincing evidence, “so clear as to leave no substantial doubt, [and] sufficiently strong 

to command the unhesitating assent of every reasonable mind.” (Conservatorship of 

Waltz (1986) 180 Cal.App.3d 722, 733, fn. 14.) A judicial determination of competency 
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to refuse treatment involves consideration of three factors: (1) whether the patient is 

aware of his situation and acknowledges the existence of his condition; (2) whether he 

understands the benefits and risks of treatment, as well as alternatives to treatment; and 

(3) whether he is able to understand and evaluate the information required to be given to 

patients whose informed consent is sought and participate in the treatment decision by 

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

Cal.App.3d 1303, 1322–1323.) 

Section 1370 also requires a trial court to make certain findings regarding a 

defendant’s placement and treatment until competency is restored. With respect to 

involuntary administration of medication, the trial court must determine that the 

defendant lacks capacity to make a decision on medication; the defendant’s disorder 

requires treatment; and if treatment is not provided, it is probable that serious harm will 

result to the defendant. (§ 1370, subd. (a)(2)(B)(i)(I).)

“We review an order authorizing involuntary administration of antipsychotic 

medication for substantial evidence.” (People v. Fisher (2009) 172 Cal.App.4th 1006, 

1016.)

Analysis

Here, substantial evidence supports all three factors and the findings under 

section 1370. Fisher told Terrell that she did not believe she had any mental illness, 

despite five section 5150 inpatient commitments and a diagnosis of bipolar disorder and 

schizophrenia. She variously denied and admitted visual and auditory hallucinations.

Clearly, Fisher was not aware of and did not acknowledge the existence of her condition, 

or that she had a condition requiring treatment. 

Fisher acknowledged taking prescribed psychotropic medication, but additionally

abused cocaine, heroin, and methamphetamine. Her substance abuse would alter the 

psychotropic medication and increase her symptoms. She had poor insight and judgment
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and lacked understanding of her mental illness and benefits of treatment. This evidences

a lack of understanding of the benefits and risks of treatment, the second factor.

Fisher’s thought processes were not always coherent, and her responses evidenced 

paranoia. Terrell opined that Fisher was not mentally competent to give informed 

consent to treatment. Thus, evidence supports the third factor that Fisher was not capable 

of informed consent. This also establishes that Fisher is presently suffering adverse 

effects of her mental illness. (§ 1370, subd. (a)(2)(B)(i)(I).)

Terrell also expressed concern that without medication, Fisher was at risk of 

harming herself or others because of her psychotic state of mind and history of violent 

criminal behavior. (§ 1370, subd. (a)(2)(B)(i)(I).)

Fisher offered no evidence to contradict Terrell’s report in the trial court. The 

evidence before the trial court provided substantial evidence supporting the involuntary 

administration of antipsychotic medication. (People v. Fisher, supra, 172 Cal.App.4th at 

p. 1016.)

DISPOSITION

The order authorizing the involuntary administration of antipsychotic medication 

is affirmed.