Re Alan William Bell

[2011] QMHC 32

MENTAL HEALTH COURT

CITATION:	Re Alan William Bell  [2011] QMHC 32
PARTIES:	REFERENCE BY THE DIRECTOR OF MENTAL HEALTH IN RESPECT OF IN RESPECT OF ALAN WILLIAM BELL
PROCEEDING NO:	0252/10
DELIVERED ON:	22 August 2011
DELIVERED AT:	Brisbane
HEARING DATE:	22 August 2011
JUDGE:	Ann Lyons J
ASSISTING PSYCHIATRISTS:	Dr J M Lawrence Dr E N McVie
FINDINGS AND ORDERS:	That at the time of the alleged offence on 27 July 2010, the alleged offence on 18 June 2010 and the two alleged offences on 9 July 2010 the defendant was not suffering from unsoundness of mind as described in Schedule 2 of the Mental Health Act 2000 (Qld); There is a reasonable doubt within the meaning of s 268 of the Mental Health Act 2000 (Qld) that the defendant committed the alleged offence of common assault on 28 July 2010; That at in relation to the four alleged offences referred to in Order 1 and the alleged offence referred to in Order 2 the defendant is fit for trial; That the proceedings in respect of the four alleged offences referred to in Order 1 and the alleged offence referred to in Order 2 should continue according to law; That at the time of the alleged offence of wilful damage between 29 August 2008 and 1 September 2008 the defendant was suffering from unsoundness of mind as described in Schedule 2 of the Mental Health Act 2000 (Qld); That the defendant be detained, pursuant to a forensic order to the Sunshine Coast Authorised Mental Health Service. That limited community treatment is approved at the discretion of the authorised psychiatrist, on the conditions set out in the submission of the Director of Mental Health
COUNSEL:	J Briggs for the defendant K Parrott for the Director of Mental Health A Lossberg for the Director of Public Prosecutions
SOLICITORS:	Legal Aid Queensland for the defendant Crown Law for the Director of Mental Health Director of Public Prosecutions (Qld)

ANN LYONS J:

1. This is a reference in relation to Alan William Bell by the director of Mental Health dated 5 November 2010. Mr Bell is charged with six offences, namely: wilful damage between 29 August 2008 and 1 September 2008; wilfully making unnecessary noise or smoke on 18 June 2010; driving and other offences on 9 July 2010; failing to give the right change of directions signal on 9 July 2010; failing to stop at a sign on a line 27 July 2010 and common assault on 28 July 2010.

Nature of the offences

1. It is necessary to consider the factual background of the charges in some detail in order to determine the reference.

Wilful damage between 29 August 2008 and 1 September 2008

1. In relation to the wilful damage charge in Cairns, Mr Bell was charged with damaging the electrical fittings in a rental house. Every electrical fitting inside the dwelling had been removed and the wires behind them were exposed. A bedroom door was also removed, as were some shelves and internal fixtures. A range hood over the stove had been removed and all of the air conditioning units had been tampered with and were partially covered with cardboard. Most of the safety switches were missing at the external power box of the dwelling. Most of the fittings were located outside the dwelling in a heap in the backyard. Neighbours indicated that Mr Bell had spent a lot of time over the weekend of 30 to 31 August 2008 making loud banging noises inside the dwelling and then dumping the items mentioned onto a heap in the yard.

Driving and other offences on 9 July 2010

1. In relation to the offences which occurred on 9 July 2010 it is alleged that whilst driving along Hume Street, Toowoomba at 9.30 pm Mr Bell failed to signal an intention to change lanes and that he was driving at night without his lights on. In relation to the charge of making unnecessary noise or smoke, it would seem that Mr Bell spun the wheels of his car on an unsealed car park. In relation to the failure to stop at a sign on 27 July, it is alleged that Mr Bell only stopped momentarily and went on without stopping fully.

The assault charge 28 July 2010

1. The victim was an employee of the Longreach Shire Council and was a caretaker at the Longreach Civic Centre. On 28 July 2010 Mr Bell was asleep in his vehicle which was parked at the rear of the Longreach Civic Centre. At about 6am the victim began working in the area as part of his caretaking duties with a motorised leaf blower. It is alleged that Mr Bell took exception to the noise created, stepped out of his vehicle and approached the victim. It is then alleged that he struck him on the back of the head without warning. As the victim turned to face Mr Bell, Mr Bell punched him in the face and tore his shirt. The victim then punched Mr Bell. Mr Bell was then located by police asleep in his vehicle. He denied any knowledge of the offence and said he had no recollection of the offence.

1. Two psychiatric reports have been provided to the court namely the reports of Dr Todorovic and Dr Morris.

The Psychiatric Reports

1. In a report dated 25 October 2010, Dr Todorovic noted that Mr Bell has had numerous admissions to Cairns, Toowoomba and Rockhampton Mental Health Services after adopting an itinerant lifestyle. Mr Bell has the diagnosis of paranoid schizophrenia. Dr Todorovic stated that Mr Bell presented numerous paranoid or delusional outside of reality stories during his interview. He also blamed others or produced a completely different story in relation to the alleged offences.  In relation to the offence of common assault he stated that he did not touch the Council worker and that the worker had assaulted him.

1. Dr Todorovic also noted that Mr Bell had other delusions involving a woman who was stalking him around the country. When he was asked to describe her, he admitted that he had never seen her. Whilst Mr Bell was oriented to time, person and place, Dr Todorovic considered he had poor insight into his mental condition and in describing the offences for which he was charged, he stated that others misinterpreted his behaviour.

1. Dr Todorovic concluded that on the basis of the observation of Mr Bell’s mental functioning whilst admitted to the psychiatric ward in September 2010, as well as the descriptions of his previous mental functioning, the description of the officials and his accounts of the offences, Mr Bell was constantly denying or minimising, misinterpreting the reality and his participation in these events. Dr Todorovic noted that this happened around the time that he had not been compliant with medication. He stated that over the last two years Mr Bell has been on oral medication only and had been travelling around Queensland with numerous episodes of non compliance. 

1. Dr Todorovic’s conclusion was that Mr Bell appeared to be of unsound mind at the time of all of the offences due to his mental condition. He was not capable of understanding that what he was doing was wrong and he was not capable of controlling his behaviour.

1. However I prefer the opinion of Dr Morris which also accords with the views of the assisting psychiatrists. In a report dated 20 May 2011 Dr Adrian Morris noted that Mr Bell had a clear history of schizophrenia dating back to over 30 years. He stated that he had intermittently received treatment which was mainly due to his continued lack of insight, non compliance with treatment and itinerant lifestyle. Dr Morris stated that when unwell Mr Bell becomes increasingly paranoid, over entitled, intimidating as well as being verbally and physically aggressive and violent.

1. Dr Morris concluded that Mr Bell has a clear history of mental illness, schizophrenia, with the presence of strange behaviours and problematic incidence littering his history. He considered that Mr Bell’s schizophrenia needs regular and reliable treatment delivery in the form of anti-psychotic mediation, plus psychological treatments, including illness education, medication education and possibly psychological strategies to combat his paranoia. Dr Morris considered that Mr Bell appears to respond well and rapidly to medication although his insight appears to have remained unresolved and absent.

1. Dr Morris considered Mr Bell does not understand his illness or his problematic and different experiences as part of his illness or the role consistent treatment makes in reducing his problems for society. He considered that a function of his illness is an over-entitled presentation that can appear threatening and intimidating to others and this may lead to physical violence if his desires are not met.

1. Dr Morris noted that Mr Bell has difficulties interacting with others in an appropriate and acceptable manner when unwell. This has forced him to live a nomadic lifestyle since the breakdown of his marriage. Dr Morris considered that Mr Bell has persistent persecutory delusions, as well as likely negative symptoms in the form of mild affective blunting, reduced activities of daily living and self care. He also has a gross and persistent attitude of irresponsibility and disregard for social norms which is shown by his recurrent and extensive criminal history. He also considers he has a very low tolerance to frustration and a low threshold for the discharge of aggression, including violence as shown by his past history. Dr Morris considers that he has an incapacity to experience guilt or to profit from adverse experiences, particularly punishment which is also shown by his recent troublesome police interactions.

1. Dr Morris also noted a marked proneness to blame others or to offer plausible rationalisations for the behaviour that has brought the individual into conflict with society. Dr Morris concluded that the offences all appear to have a clear relationship with Mr Bell’s mental illness of schizophrenia.  

1. In relation to the charge of wilful damage, I agree with Dr Morris and the assisting psychiatrists that at the time, Mr Bell was deprived of the required capacities. I consider that at the time of the alleged offence of wilful damage in August 2008 Mr Bell was very isolated and paranoid. He believed he was being watched and he eliminated all the ways he was being watched. He considered he was being watched by surveillance devices. “They were all to do with the electrics by surveillance devices, all to do with the electrics.”  I agree that Mr Bell was indeed very ill at the time and became paranoid. I consider that at the time he did not have the capacity to understand that what he was doing was wrong or the capacity to weigh up the proposed act and decide he should undertake it with a normal degree of composure and sensibility. Mr Bell was consumed with the idea of being spied on and in a state of distress and possibly fear, he single-mindedly acted to stop this from occurring.

1. In relation to the traffic offences in June and July 2010, I do not consider there is any evidence that Mr Bell was deprived of any of the capacities at the relevant time. This view is supported by Dr Morris and the assisting psychiatrists. Whilst these capacities were impaired by his active mental illness he was not deprived of any of the relevant capacities. Dr Morris considered that his mental illness appears to create a presentation of over entitlement which may have led him to believe he does not have to adhere to others’ rules. Dr Morris considered however that Mr Bell at the time did have the capacity to recognise the rules and consider if he wished to adhere to them rigidly. Accordingly there is no finding of unsoundness of mind and the charges should proceed according to law. 

1. In relation to the assault charge, it is clear that Mr Bell disputes this charge. He states he did not assault the council worker. Accordingly due to s 268 and s 269 of the Mental Health Act 2000 (Qld) the Court cannot proceed to determine the reference in relation to this charge. The assault charge therefore should continue according to law.

1. The assisting psychiatrists consider that Mr Bell requires a forensic order. Dr Morris also considers Mr Bell requires a forensic order. He also suggests Mr Bell would benefit from attending an enhanced thinking skills course, as well as attending illness education and insight programs for further education and treatment in relation to his illness. Dr Morris considers that this should involve compulsory attendance. Dr Morris considers he could be managed safely on a forensic order with limited community treatment provided he was required to attend psychiatric appointments, treatments and psychological work as stipulated by his treating team. Dr Morris also considers he may benefit from a permanent reintroduction of a larger depot antipsychotic medication dose. This approach was also endorsed by Dr Lawrence.

1. Accordingly, the following Orders are made:

1. That at the time of the alleged offence on 27 July 2010, the alleged offence on 18 June 2010 and the two alleged offences on 9 July 2010 the defendant was not suffering from unsoundness of mind as described in Schedule 2 of the Mental Health Act 2000 (Qld);

2. There is a reasonable doubt within the meaning of s 268 of the Mental Health Act 2000 (Qld) that the defendant committed the alleged offence of common assault on 28 July 2010;

3.          That at in relation to the four alleged offences referred to in Order 1 and the alleged offence referred to in Order 2 the defendant is fit for trial;

4.          That the proceedings in respect of the four alleged offences referred to in Order 1 and the alleged offence referred to in Order 2 should continue according to law;

5. That at the time of the alleged offence of wilful damage between 29 August 2008 and 1 September 2008 the defendant was suffering from unsoundness of mind as described in Schedule 2 of the Mental Health Act 2000 (Qld);

6.          That the defendant be detained, pursuant to a forensic order to the Sunshine Coast Authorised Mental Health Service.

7.          That limited community treatment is approved at the discretion of the authorised psychiatrist, on the conditions set out in the submission of the Director of Mental Health