Head bowed and speaking in a clear voice, Holly Colino appeared in state Supreme Court on Monday and admitted to the August 2017 slaying of Megan Dix in a Sweden parking lot.

Dix, 33, of Orleans County was sitting in her vehicle eating lunch while on break from the nearby Lowe’s home improvement store on Owens Road when Colino approached and shot her in the head.

Although Colino admitted to her string of crimes before state Supreme Court Justice Charles Schiano Jr. — second-degree murder, criminal possession of weapons, threatening a woman with a gun in Henrietta and a two-hour escape from Monroe County sheriff’s deputies — she pleaded "not responsible by reason of mental disease or defect."

The hearing before Schiano was Colino’s first court appearance in seven months. Last fall, two psychiatrists evaluated the 32-year-old and judged her incompetent to stand trial. In October, Schiano ordered her to receive treatment from a state mental health facility.

She returned to court in March after receiving a “fitness to proceed” report from two court-appointed experts.

Monroe County Assistant District Attorney Perry Duckles said experts for both the prosecution and defense concurred that Colino was acting under mental defect at the time of the crimes; schizoaffective disorder with psychotic symptoms.

For a plea of not responsible by reason of mental defect or disease to go forward, prosecutors must tell the court that the people consent to the plea and that they believe the insanity defense would be proved at trial by a preponderance of the evidence.

Duckles said prosecutors consented to the plea agreement in the interest of justice.

“At the end of the day, the defense counsel would have put their doctor on the stand and would have put our doctor on the stand, who would have reached the same conclusion,” he said. Both would “be getting up and telling the jury in essence that she’s not responsible by reason of mental defect or disease, that she could not appreciate her conduct at that time.”

Defense attorney Mark Foti said the plea acknowledges that what was alleged took place but there was mental disease or illness severe enough to render Colino incapable of being held criminally responsible.

“Ultimately, there are consistent findings that she was delusional at the time of the incident, that she was acting in a manner that she didn’t recognize that what she was doing was wrong,” he said.

Foti said the plea is the best outcome for his client’s unique and terrible case.

“This will allow her to be put in an institution or hospital and she will receive treatment,” he said. “That’s consistent with what the public’s interests should be.”

Schiano said he was satisfied there was both enough evidence to prove the crimes beyond a reasonable doubt and that Colino’s insanity defense would be proved at trial.

Colino is originally from the Rochester area, but she had been living in Arizona for several years, according to police. She returned only days before the homicide, according to then-Brockport Police Chief Dan Varrenti.

A series of bizarre posts to social media, as well as graffiti messages posted at various sites around the Rochester area suggested Colino was suffering from significant mental health problems, apparently believing that others were stalking her and trying to steal not only her identity, but also her very appearance.

In court, Duckles said Colino had told doctors she had moved to Arizona to investigate the women she believed were stealing her identity and she told police she thought Dix had been mimicking her.

Previously, Colino’s cousin Todd Colino said that Colino had been spiraling downward in the months before the killing, appearing delusional at times.

Numerous members of Dix's family attended Monday's court session. After Colino's plea, they left the courtroom together and declined to speak to the media.

After accepting Colino’s plea, Schiano issued an order committing her to the secure custody of the state Department of Mental Hygiene. Colino will be examined by two psychiatrists who will submit their reports to the court. After review of those documents, Schiano will determine the proper place for Colino’s confinement and treatment, as well as the initial duration of confinement and treatment.

If she is determined to be a violent risk to society, Colino could be held indefinitely in an inpatient psychiatric ward for people involved in the criminal justice system. If she is not found to be a risk, Colino could be indefinitely held in a non-secure hospital.

She is scheduled to return to court on Dec. 11.

MCDERMOT@Gannett.com

SLAHMAN@Gannett.com

More:Holly Colino found competent to stand trial for murder

More:Will mental health issues factor in Holly Colino's defense?

More:Holly Colino: From smiling teenager to disturbed woman accused of killing Megan Dix

More:Megan Dix remembered: 'There will never be another person like her'