FILE - In this Dec. 9, 2015 file photo, Robert Lewis Dear, middle, talks during a court appearance in Colorado Springs, Colo. The man who acknowledges killing three people at a Colorado Planned Parenthood clinic will return to court for a discussion of his mental health. The Thursday, April 28, 2016 hearing will focus on whether 57-year-old Dear is competent to continue with his criminal case. (Andy Cross/The Denver Post via AP, Pool, File)

COLORADO SPRINGS | A man who acknowledges killing three people at a Colorado Planned Parenthood clinic said he did not want to be declared incompetent because he feared being forcibly medicated. But that could happen when Robert Dear begins treatment following a judge’s ruling that he is mentally incompetent — a decision that will stall the proceedings.

Wednesday’s decision by Judge Gilbert Martinez puts the case against Dear, 57, on hold until it’s determined that treatment has restored his ability to understand the proceedings and assist in his defense.

Such treatment will likely include a mix of psychotropic drugs and therapy to address the delusion disorder two psychologists say he suffers, as well as education about the case against him.

Dear’s mental health will be reviewed in August.

The psychologists who conducted the mental exam said Dear’s disorder keeps him from trusting almost anyone, including his lawyers. The judge agreed with their findings, writing in his order that Dear’s “perceptions and understanding are not rational and are not grounded in reality.”

As he was led out of the courtroom Wednesday, Dear yelled at the judge: “That’s called prejudiced! Prejudiced! Filthy animal!”

Dear is charged with 179 counts, including murder and attempted murder, stemming from the Nov. 27 shooting at the Colorado Springs clinic that also left nine injured.

During previous courtroom outbursts, he has declared himself a “warrior for the babies” and said he was guilty. He told investigators he attacked the clinic because he was upset with the reproductive health organization for “the selling of baby parts.”

Martinez ordered the competency exam in December after Dear announced that he wanted to fire his public defenders and represent himself. Two psychologists who interviewed Dear testified that they agreed he is not competent and that his delusion disorder makes him believe the FBI is persecuting him.

Dear told people in phone calls from jail that he believes his attorneys’ attempt to have him declared incompetent is part of a plot to diminish his message opposing abortion. He claims they want him committed to a psychiatric hospital so they can “silence him forever.”

Restoring Dear to competency could take months or longer. But the overwhelming majority of defendants initially determined to be incompetent are eventually able to understand the proceedings and stand trial, said Steven Pitt, a forensic psychiatrist who has conducted competency exams but is not involved in Dear’s case.

Prosecutors argued that Dear’s courtroom disruptions showed he understood the case against him. They have not decided whether to seek the death penalty against the man described by family and acquaintances as a man with a violent temper, anti-government sentiments and longstanding disdain for abortion providers.

Dear has not entered a plea. If and when his court case resumes, the incompetency finding could help the defense during the trial and a potential sentencing phase.

“In a case of this magnitude when a defendant is initially found incompetent to stand trial and is then restored to competency, there is a strong possibility that there will be a mental health defense,” Pitt said. “It is an absolute certainty that the defendant’s mental health history will be front and center during the penalty phase.”

Dear held police at bay for more than five hours during the clinic attack, scattering hundreds of post-Thanksgiving shoppers who scrambled to hide inside surrounding buildings until the standoff ended.