Cal. Dept. of State Hospitals v. F.G. CA1/4

Filed 3/16/26 Cal. Dept. of State Hospitals v. F.G. CA1/4

NOT TO BE PUBLISHED IN OFFICIAL REPORTS

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IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

FIRST APPELLATE DISTRICT

DIVISION FOUR

CALIFORNIA DEPARTMENT OF

STATE HOSPITALS, A174497

Plaintiff and Respondent,

v. (Napa County Super. Ct.

F.G., No. 25PR000167)

Defendant and Appellant.

F.G. appeals from the trial court’s order compelling his involuntary

treatment with antipsychotic medication. He contends that insufficient

evidence supports the trial court’s finding that he lacks the capacity to refuse

treatment. We affirm.

BACKGROUND

Following a verdict of not guilty by reason of insanity, F.G. was

admitted to the Department of State Hospitals-Napa (Department). He has a

history of schizophrenia and psychotic symptoms, including auditory

hallucinations, persecutory delusions, paranoia, and disorganization of

thoughts and behavior. According to F.G., he transitioned at some point from

the status of a person not guilty by reason of insanity (NGI) under

Penal Code section 1026, to the status of an offender with a mental disorder

under Penal Code section 2960 et seq.1

In September 2024, a court entered an order allowing the Department

to administer antipsychotic medication to F.G. without his consent. In

July 2025, the Department filed a petition to renew the order. The trial court

appointed counsel to represent F.G., and a few weeks later it held a hearing,

which F.G. did not attend.

Dr. Domingo Laguitan, F.G.’s treating psychiatrist, testified for the

Department. He recounted his medical degree, his four-year residency

training program in psychiatry, his twenty years as a staff psychiatrist at the

Department, his job duties (including diagnosing patients and devising

treatment plans involving medications), the instances in which he had

qualified as a psychiatry expert, and his treatment of thousands of patients

over the course of his career. He testified that he was not currently board

certified. When questioned by F.G.’s counsel, he testified that he could

remember testifying in at least one other case involving an involuntary

medical order. The trial court accepted Dr. Laguitan as a psychiatry expert.

Dr. Laguitan testified as follows. F.G. was assigned to his caseload in

January 2025, at which point he reviewed F.G.’s records. Dr. Laguitan

1 The record does not support this statement. The verified petition

alleges that F.G. was admitted to the Department as an NGI patient, hearing

testimony characterized F.G. as an NGI patient, the trial court’s order

determined that F.G. is an NGI patient, and the notice of appeal form

represents that F.G. is an NGI patient. The distinction is immaterial to the

appeal, however, as the relevant standards are the same for both categories.

(In re Greenshields (2014) 227 Cal.App.4th 1284, 1293–1294 [concluding that

NGI patients are entitled to same standard as mentally disordered offenders

for determining whether they may be involuntarily medicated].)

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generally talked to his patients at least once a month. He testified

specifically about speaking to F.G. in June, July, August, and September.

F.G. has a diagnosis of schizophrenia , which Dr. Laguitan described as

an umbrella term “for symptoms that render somebody as not fully in contact

with reality.” Dr. Laguitan testified that his observations of F.G. support the

diagnosis, including observations of persecutory delusions, auditory

hallucinations, and diminished functional abilities. F.G.’s symptoms are

associated with violence and when they are not under control, they render

him dangerous. He has not displayed aggressive behaviors “in any extensive

way” while he has been taking medication.

The Department has been treating F.G. with clozapine, a very effective

antipsychotic that is more likely to cause side effects than other such

medications. It was recommended for F.G. in 2020 because he had not

progressed in treatment and because he had previously been given two or

three medications in combination, which was not a best practice.

F.G. objects to clozapine because he believes a corrupt psychiatrist who

did not like him prescribed it as a form of punishment, he believes it gives

him mental confusion, and it causes him to drool. Dr. Laguitan agrees that

some of F.G.’s complaints are legitimate. F.G. recently has been willing to

talk to Dr. Laguitan about medications and how to mitigate side effects. But

Dr. Laguitan believes that F.G. would discontinue his medication if he were

not subject to the involuntary medication order.

In Dr. Laguitan’s opinion, F.G. is not aware of his mental illness.

Although F.G. acknowledges feeling paranoid sometimes, he does not

understand the feeling as a symptom of mental illness. When Dr. Laguitan

told him that his auditory hallucinations are a psychotic symptom, he did not

believe it. F.G. asked how that could be when he could hear the voices so

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clearly, even though he could not see the people. F.G. does not believe that

he has mental illness, and he does not believe that he needs medication over

the long term, though he acknowledges some medicines have helped him

think straight. F.G. does not understand the potential consequences of

stopping his medication, including violence and aggression. In Dr. Laguitan’s

opinion, F.G. does not have the capacity to make decisions about his medical

treatment.

F.G. is not currently refusing medication, he is aware that he is

committed to the Department, he appears alert when Dr. Laguitan speaks

with him, he recognizes Dr. Laguitan when they meet, he responds to

Dr. Laguitan’s questions, his speech is coherent and, for the most part, linear,

and he is not aggressive toward Dr. Laguitan or other staff.

After Dr. Laguitan testified, the trial court found by clear and

convincing evidence that F.G. lacks the capacity to refuse treatment. It

ordered that the Department may administer antipsychotic medication to

F.G. in the dosage and frequency it deems necessary for a period not to

exceed a year.

DISCUSSION

F.G. argues that insufficient evidence supports the trial court’s order.

We disagree.

Both an NGI patient and a mentally disordered offender have a

protected liberty interest to be free from the forced administration of

antipsychotic medication. (See In re Greenshields, supra, 227 Cal.App.4th at

pp. 1290–1294 [NGI]; In re Qawi (2004) 32 Cal.4th 1, 14 [mentally disordered

offender].) Under either categorization, a court may order such treatment

only if the petitioning party presents clear and convincing evidence that the

person is either (1) incompetent or incapable of making medical-treatment

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decisions, or (2) the person is dangerous within the meaning of Welfare and

Institutions Code section 5300. (See In re Greenshields, at p. 1294; In re

Qawi, at pp. 9–10, 27; Riese v. St. Mary’s Hospital & Medical Center (1987)

209 Cal.App.3d 1303, 1322–1323 (Riese), superseded by statute on other

grounds as stated in People v. Lewis (2025) 111 Cal.App.5th 1078, 1103–

1104,[specifying clear and convincing standard for involuntary patients

under Lanterman-Petris-Short Act].) In this case, only the first prong is at

issue.

When determining whether an NGI patient or a mentally disordered

offender is competent to consent to antipsychotic medication, the court

considers whether they aware of their mental-illness condition; whether they

are able to understand the benefits and the risks and the alternatives to the

proposed medication, and they are able to understand and evaluate the

information required for informed consent and otherwise participate

rationally in the treatment decision. (In re Qawi, supra, 32 Cal.4th at

pp. 17–18, citing Riese, supra, 209 Cal.App.3d at pp. 1322–1323.)

We review a trial court’s order to compel involuntary treatment with

antipsychotic medication for substantial evidence, taking into account the

clear and convincing standard of proof. (People v. O’Dell (2005)

126 Cal.App.4th 562, 570; see Conservatorship of O.B. (2020) 9 Cal.5th 989,

995–996 [reviewing court must take account of standard of decision applied

by trial court].) We “view the record in the light most favorable to the

prevailing party below and give appropriate deference to how the trier of fact

may have evaluated the credibility of witnesses, resolved conflicts in the

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evidence, and drawn reasonable inferences from the evidence.”

(Conservatorship of O.B., at pp. 1011–1012.)

Here, the unrebutted testimony from Dr. Laguitan established that

F.G. has schizophrenia, yet he does not believe that he has mental illness or

that he needs medication. He believes that his audio hallucinations are real

and that his paranoia is not a symptom. He does not understand the

potential consequences of stopping his medication, including violence and

aggression. The record as a whole thus contains substantial evidence from

which a reasonable trier of fact could have found it highly probable that F.G.

does not understand his situation or the benefits of the clozapine that the

Department is administering, and that he cannot rationally participate in

discussions about his treatment. (See Conservatorship of O.B., supra,

9 Cal.5th at p. 1011.)

F.G.’s arguments to the contrary do not persuade us. First, F.G.

suggests that Dr. Laguitan was not credible because he was not board

certified at the time of the hearing, he remembered testifying in only one

other case involving an order to compel medication, and he did not recall

precisely when he had last testified as an expert. 2 F.G. also suggests that

Dr. Laguitan had a low level of contact with him. But it is not our role to

redetermine the credibility of an expert or reweigh the strength of his or her

conclusions. (People v. Poe (1999) 74 Cal.App.4th 826, 831.)

F.G. also argues that the evidence shows that he can engage rationally

in the decision-making process about his medication because Dr. Laguitan

acknowledged that F.G.’s complaints about side effects were valid, F.G. is

2 At the hearing, F.G. did not object to the trial court accepting

Dr. Laguitan as an expert, and F.G. does not contend on appeal that the court

erred by doing so.

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currently taking the medication he is given, and he is open-minded about

changing his prescription. This argument misses the point. Neither his

engagement with Dr. Laguitan about his side effects nor his reluctant

compliance with his medication regime (under an order compelling the

compliance) undermines or contradicts the evidence that he does not

understand his mental illness or the benefits and risks of treatment. These

facts thus do not undermine the evidence that he is incompetent to refuse

medication.

Lastly, F.G. contends that he shows awareness of his situation as

demonstrated by his acknowledgements that he feels paranoid and that some

medications have helped him think more clearly. Dr. Laguitan’s full

testimony on these matters, however, shows that the acknowledgments do

not undermine the evidence supporting the trial court’s findings. F.G.

acknowledges feeling paranoid, but he does not understand the feeling as a

symptom of his mental illness. And he has acknowledged that some

medications have helped him think more clearly, but he does not think that

he needs to take them over the long term because he does not think that he is

mentally ill.

DISPOSITION

The trial court’s order is affirmed.

GOLDMAN, J.

WE CONCUR:

STREETER, Acting P. J.

MOORMAN, J. *

*Judge of the Mendocino Superior Court, assigned by the Chief Justice

pursuant to article VI, section 6 of the California Constitution.

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