Re CSL

[2005] QMHC 15

MENTAL HEALTH COURT

CITATION:

Re CSL [2005] MHC 015

PARTIES:

REFERENCE BY THE DEFENDANT'S LEGAL REPRESENTATIVE IN RESPECT OF CSL

PROCEEDING NO:

0091 of 2004

DELIVERED ON:

6 June 2005

DELIVERED AT:

Brisbane

HEARING DATE:

6 June 2005

JUDGE:

ASSISTING PSYCHIATRISTS:

Holmes J

Dr J F Wood
Dr J M Lawrence

FINDINGS AND ORDER:

At the time the offence was committed the defendant was suffering from unsoundness of mind as described in schedule 2 of the Mental Health Act 2000 (Qld)1.   

The defendant is to be detained as a forensic patient at The Park High Security Program Authorised Mental Health Service for involuntary treatment and care;2.   

Approval of escorted limited community treatment for closed bus trips on the following conditions: 3.   

That the patient is to remain under the escort of Health Service staff member/s nominated by the authorised psychiatrist for the duration of the limited community treatment; and(a)        

For the purpose of escorted limited community treatment, the patient is to comply with the directions of the nominated staff members for the duration of the limited community treatment.(b)       

CATCHWORDS:

MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where the defendant is charged with murder – where evidence that defendant had delusional ideas – whether defendant of unsound mind at the time the alleged offence occurred – whether defendant deprived of one or more of the capacities in s 27 of the Criminal Code

Criminal Code (Qld), s 27

Mental Health Act 2000 (Qld), schedule 2

COUNSEL:

Ms C Morgan for the defendant
Mr J Tate for the Director of Mental Health

Mr R Martin for the Director of Public Prosecutions

SOLICITORS:

Legal Aid Queensland for the defendant
The Crown Solicitor for the Director of Mental Health

The Director of Public Prosecutions

1. :HOLMES J  CSL is charged with the murder of his de facto wife, KM, on 19 November, 2003.  On that date he drove from their house at Carina Heights to his sister's house some 40 km away.  He told his sister he thought he had killed Kerry, his de facto wife, but it was "all blank".  He said he knew he had hurt her.  In the preceding weeks he had told his sister that he feared his wife was going to leave him. 

1. CSL's sister made an emergency call.  Police went to CSL’s house and found Ms M strangled in a bed.  She had bruising to her face and bruising to her neck which suggested strangulation by hands as well as ligature.  CSL was interviewed by police at 4.21 p.m. that afternoon.  When he was told his wife was dead he said repeatedly that she was at home.  When arrested for the murder of his wife he said he did not do it. 

1. The children of CSL and Ms M report past incidents of violence in which their father struck their mother.  Those incidents seem in the main to have been associated with alcohol consumption.  In the months prior to the killing CSL, who had been abstinent for some years, seems to have begun drinking again.  He described himself as hung over from the previous night's drinking on the day of the killing; but on that day there is no suggestion of alcohol consumption, let alone intoxication.  CSL dropped his daughter to school at 8.45 a.m. and she does not report any drinking prior to that. 

1. Looking at the police brief, police were involved as a result of the sister's call by 10.40 a.m.  There seems no opportunity for significant alcohol consumption in that time frame, allowing for the killing itself and the drive to the sister's.  I do not therefore consider that intoxication has any bearing in this case. 

1. The psychiatrists who have examined CSL do agree that the resumption of alcohol consumption itself may be symptomatic of his distress.  Assuming that to be the case, and assuming both an increased level of irritability because of alcohol use and the possibility of chronic pain, it still does not seem, on any of the psychiatric evidence, that those features significantly affect the role of mental illness in this event. 

1. What is significant, however, is that CSL suffered from irrational beliefs that his de facto wife was unfaithful and was engaging in prostitution.  He had been accusing her of having affairs with other men, evidently without any basis, and had approached men on a couple of occasions to ask if they were having an affair with his wife. 

1. He also believed that a neighbour was similarly engaged in prostitution, that her partner was a drug dealer, and he was himself suspicious of someone following him or filming him.  Clear evidence of these delusional beliefs comes from the statements of his children and from a neighbour whom he confided in.  He was also increasingly preoccupied with his wife's plan to leave him; which was a reality, not a delusion.

1. In September, 2003, CSL was admitted to Princess Alexandra Hospital after an overdose of tablets, 50 tablets of Panadeine Forte.  He was prescribed an antidepressant which he did not take for any appreciable period.

1. Three of the four reporting psychiatrists supported a finding of unsoundness of mind.  Doctor Fama examined CSL in the first half of 2004.  He considered CSL suffered from delusional disorder with depressive shift.  CSL, he said, laboured under the irrational beliefs I have already described, about his wife's supposed infidelity and other issues.  CSL told him that on the day of the killing he had armed himself with a tape recorder with which he proposed to tape his wife's conversations to see if she was dealing in drugs; and he had seen a short skirt on a chair he thought she might use for prostitution.  He thought he had hit her and grabbed her, but had no recollection of strangling her.  Doctor Fama thought that loss of memory might be the product of the strong emotions associated with the event and guilt. 

1. Doctor Fama did not think CSL was deprived of the capacity to understand what he was doing, nor of the capacity to control his actions.  He had not experienced any hallucination.  But he would have been deprived of the capacity to know that he ought not do the act because of his longstanding delusions, morbid jealousy and complete preoccupation with righting the wrongs he perceived his wife had committed.  That included her plans to leave him as an extension of her infidelity.  On that basis Doctor Fama supported the defence of unsoundness.  Alternatively, he considered CSL's condition to amount at least to an abnormality of mind substantially impairing his capacity to control his actions and to know he ought not do the act.  He would therefore also support a defence of diminished responsibility.

1. Doctor Schramm has been CSL's treating psychiatrist, seeing him initially while held in jail on remand and then on his transfer to The Park in May 2004 as a result primarily of his delusional beliefs about other prisoners.  Doctor Schramm considered that the primary diagnosis was of a major depressive episode with psychotic features at the time of the offence.  CSL's delusional ideas had become intense with the deterioration in his mood.

1. Dr Schramm considered CSL so preoccupied with delusional beliefs about his wife and so distressed and so confused by his state of depression that he was unable to reason about the rightness or wrongness of his actions.  He was deprived of the capacity to know he ought not do the act.  The deprivation arose from his psychotic and depressed state.  Again, Dr Schramm said that if that were not accepted, CSL's capacity to know that he ought not do the act was at least substantially reduced so as to give rise to a defence of diminished responsibility.

1. Dr Heffernan examined CSL in March 2005.  CSL was able to give him more detail of the killing.  He had seen the short skirt and had grabbed his wife by the neck.  But it was not clear, Dr Heffernan said, whether this was what CSL could recall or whether it reflected his piecing together what he had been told.

1. Dr Heffernan considered the history supported the diagnosis of delusional disorder, becoming increasingly intense over the 12 months prior to the killing, and a co-morbid major depressive disorder.  At the time of the offence, Dr Heffernan said, CSL was psychotic.  That was a psychosis existing both before and after the killing.  It deprived him of the ability to think rationally about his relationship with his wife.  He was thus deprived of the capacity to know that he ought not do the act.  The concern of his wife leaving, rather than being a significant motivation in the killing, was one of the stressors contributing to mental disease.  The mental disease was a state of abnormality of mind which, it followed, would give rise at least to a defence of diminished responsibility, in impairment of the capacity to know he ought not do the act.

1. The dissenter is Professor Varghese, who supports diminished responsibility rather than unsoundness.  He saw CSL in November 2004.  His diagnosis was of a delusional disorder of a jealous type occurring in what he described as a context of probable major depression.  He thought, too, that there was a personality disorder with significant dependent and paranoid traits.  He accepted that CSL was in a state of mental disease, namely, a delusional disorder, and possibly a depressive disorder, at the time of the killing, although here he described the prospect of major depression as at least the subject of doubt.  But he did not think there was deprivation of any of the relevant capacities.  It did not follow from the delusion that CSL's wife was unfaithful that he had lost the capacity to know it was wrong to kill her.

1. Professor Varghese described the delusion of infidelity as a circumscribed delusion, in contrast with the more absolute and extensive delusion of schizophrenia.  It was of importance, Professor Varghese said, that a significant motivation in the killing was the fact that Ms M was going to leave the marital relationship, and that was not the product of any delusion.  He considered that CSL did suffer from an abnormality of mind which substantially impaired his capacity to know that he ought not do the act and his capacity to control his actions.  In evidence here, he conceded that the interaction between depression and delusion could be sufficient to deprive CSL of the capacity of control. 

1. Doctors Fama, Heffernan and Schramm do not give identical diagnoses but their conclusions about the operation of CSL's mental illness in producing an incapacity to tell right from wrong are similar.  Dr Varghese departs from their view only to the extent that, given the existence of the motive to kill in the form of Ms M's intention to leave her husband, he does not think the evidence goes beyond substantial impairment as opposed to deprivation of capacity; or at least he was left with a "nagging doubt" about that.

1. All of the psychiatrists gave perfectly lucid and well-reasoned bases for their conclusions.  On balance, I prefer the view that there was a deprivation of the capacity in CSL to know that he ought not do the act.  Partly that is because of the obvious reason that the preponderance of opinion is behind it.  But also, my impression on the evidence is that there was, in fact, a broader range of delusion than Professor Varghese had allowed for.  There were delusions as to being followed and filmed from a van and there seems to have been a preoccupation with drug dealers which is difficult to fit into the morbid jealousy delusions about Ms M.

1. It also seems to me on the evidence that Dr Schramm is likely to be right about the very significant effect of depression in this event; about which Professor Varghese was rather more tentative.  I accept too the view that Ms M's departure was incorporated into the delusional thinking as an extension of the infidelity rather than operating as an independent trigger for the killing.  There is, I think, as Dr Lawrence has said, a picture of increasing disturbance culminating in the killing.

1. I am reinforced by the views that both Dr Wood and Dr Lawrence have expressed as to the matter. 

1. I find that CSL was of unsound mind pursuant to the Mental Health Act 2000, schedule 2 at the time the offence with which he is charged, that of murder, was committed. I am satisfied too that a forensic order is warranted.

1. I will order that CSL be detained in The Park High Security Program Authorised Mental Health Service.

1. I approve escorted limited community treatment for closed bus trips with conditions that CSL is to remain under the escort of Health Service staff members nominated by the authorised psychiatrist for the duration of that limited community treatment and that, for the purposes of this escorted limited community treatment, he complies with the directions of the nominated staff members for the duration of the limited community treatment.