After a day of testimony between dueling psychiatrists, the question of whether or not the gunman accused of killing 10 people in a Boulder King Soopers will stand trial is now in the hands of a Boulder County District judge.

Ahmad Al Aliwi Alissa listened quietly, did not appear to speak with his attorneys and often looked at the ground and fidgeted during Wednesday’s day-long competency hearing.

Alissa listened with little emotion as 20th Judicial District Attorney Michael Dougherty argued that proper medication, individual therapy sessions and formal testing at the Colorado Mental Health Institute in Pueblo has restored him to competency.

“Is he competent to stand trial today as we sit here now? Has he been restored to competency? Either way the answer is yes,” Dougherty said.

On the other hand, Alissa’s attorney, Kathryn Herold, said that the fact he improved once he was given the right medications “doesn’t mean that he has been restored to competency.” In her closing statements, she remarked that Alissa had eight evaluations after which six psychiatrists diagnosed him with a “serious illness,” namely schizophrenia.

“Mr. Alissa a has a fundamental right not to stand trial while incompetent,” Herold said.

Alissa was placed at the Colorado Mental Health Institute in Pueblo in December 2021 when he was found mentally incompetent to stand trial, which postponed the case against him.

The defendant is accused of killing 10 people on March 22, 2021 at King Soopers on Table Mesa Drive. He faces more than 100 charges and sentence enhancers, including first-degree murder, counts of attempted murder and charges related to possessing banned high-capacity gun magazines.

The victims killed were Denny Stong, 20; Neven Stanisic, 23; Rikki Olds, 25; Teri Leiker, 51; Suzanne Fountain, 59; Kevin Mahoney, 61; Lynn Murray, 62; Jody Waters, 65; Tralona Bartkowiak, 49; and, Boulder Police Officer Eric Talley.

In August, psychologists did a reversal and found him competent. He was forced to start taking medications last March and mental health professionals who worked with him agreed that he was gradually improving.

At issue for Scott Bender, an associate professor of clinical psychiatric medicine at the University of Virginia, was whether Alissa was feigning mental illness in order to avoid going through a trial. Though he admitted it was impossible to tell whether or not Alissa was faking symptoms, he concluded that “there was insufficient evidence to conclude that he was incompetent to stand trial.”

Defense expert Dr. Hareesh Pillai, who worked with Alissa on and off in Pueblo at the mental health hospital, disagreed, saying that he was not fit to stand trial.

Prosecutors called on two mental health professionals to discuss Alissa’s competency to stand trial Wednesday morning. 

Julie Gallagher, a clinical and forensic psychologist with a Ph.D in clinical psychology who has worked on about 500 court competency cases throughout her career, said she found Alissa competent to stand trial after an August evaluation. 

In his first evaluations, Alissa showed both positive and negative symptoms of schizophrenia, Gallagher said. She defined positive symptoms as those which are present in a person that are not there normally and negative symptoms as things not present in a person that are normally present. 

In March, Alissa began refusing doses of the medication he was prescribed to cope with schizophrenia during restoration therapy.

When he began refusing medication, doctors saw a decline in Alyssa’s mental health. Shortly afterward, the hospital got a court order to involuntarily medicate him, Gallagher said. 

Doctors put Alissa on a new drug, clozapine, which he had initially denied due to the intensity of blood work needed to take the drug and possible side effects.

Gallagher called this episode a “significant turning point” in Alissa’s mental health. 

Gallagher categorized her evaluations of Alissa’s competency into four prongs: factual understanding or knowledge of basic court proceedings; rational understanding or the understanding of how court proceedings could lead to certain outcomes; reasoning and decision making; and, the ability to assist council. 

In initial evaluations before Alissa began taking the new medication involuntarily, Gallagher’s biggest competency concern for Alissa was in his lack of ability to communicate — both with evaluators and with others around him — saying he “was not entirely there.”

After being involuntarily medicated and send to individual therapy rather than group therapy, Alissa was able to communicate more clearly, identifying what he was charged with, giving a description of the events and demonstrating factual understanding of court proceedings. 

In an Aug. 14 evaluation, Gallagher said she found him competent to stand trial — but warned that she hoped he wouldn’t go back to jail if deemed competent by the judge. 

Since Alissa involuntarily takes medication, it’s likely that he would “decompensate” in jail due to refusal to take medication and increased stressors in a jail environment. 

Herold, the defense attorney, brought forth the issue of bias in Alissa’s defense, questioning Gallagher on her education and ability to avoid bias in evaluations. 

The fact that Gallagher was hired by prosecutors to conduct evaluations could be a bias, Herold said. 

Not much research has been done in Gallagher’s field about reducing biases in decision-making, but she is writing a book with a colleague that focuses heavily on bias — meaning she herself has done extensive research on the matter, she said. 

Loandra Torres, the clinical director of Colorado’s court services who has worked with Alissa since he came to the hospital, also deemed him competent to stand trial, she said Wednesday.

Torres also cited Alissa’s lack of ability to communicate as the major concern originally, saying it was “hard to get anywhere” in conversations due to his impoverished speech. In January, she deemed him incompetent but restorable.

In April, Torres reported seeing “some  improvement” shortly after Alissa began taking the new medication. 

By August, Torres said she saw “significant improvement,” specifically, he showed no signs of experiencing hallucinations. 

Alissa told Torres he had experienced hearing voices in his head and disclosed to her that he had purchased weapons with the intent of committing a mass shooting. 

She saw consistency and logic in his thinking, improved decision-making abilities and improved communication — all making him competent to proceed in trial, Torres said. 

Like Gallagher, Torres agreed that Alissa should be kept in the hospital, rather than taken to jail, due to his need for a “structured therapeutic environment.”

Boulder County District Judge Ingrid Bakke will now decide whether to confirm the evaluators’ findings from August and move forward to trial, or find that Alissa is incompetent due to his mental illness. She said that she would have a decision next week.

“He remains incompetent until court decides otherwise,” Bakke said. 

If she decides that he is competent enough to go to trial, Alissa’s next court date is a preliminary hearing scheduled for Nov. 14 where prosecutors will lay out their evidence to Bakke to determine if it’s enough to send him to trial.