Re Garcia
[2009] QMHC 3
•12 May 2009
MENTAL HEALTH COURT
CITATION:
Re Garcia [2009] QMHC 003
PARTIES:
REFERENCE BY THE DIRECTOR OF MENTAL HEALTH IN RESPECT OF DANIEL GARCIA
PROCEEDING:
No 0195/08
DELIVERED ON:
12 May 2009
DELIVERED AT:
Brisbane
HEARING DATE:
7 May 2009
JUDGE:
Philippides J
ASSISTING PSYCHIATRISTS:
Dr J M Lawrence
Dr E N McVieFINDINGS AND ORDER:
1. That at the time of the alleged offence on 3 June 2008 the defendant was suffering from unsoundness of mind as described in Schedule 2 of the Mental Health Act 2000 (Qld);
2. That defendant be detained as a forensic patient at The Park High Security Program Authorised Mental Health Service;
3. Approval of Limited Community Treatment confined to the grounds of The Park Centre for Mental Health for up to one hour only twice per week, at the discretion of the authorised psychiatrist, on the following conditions:
a. That the defendant remain under the escort of a health service staff member/s nominated by the authorised psychiatrist for the duration of the Limited Community Treatment; and
b. That for the purposes of the Limited Community Treatment he comply with the directions of the nominated staff members for the duration of the Limited Community Treatment.
CATCHWORDS:
MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where defendant charged with murder – whether defendant was of unsound mind as defined in Schedule 2 of the Mental Health Act 2000 (Qld) at the time of those offences
COUNSEL:
Mr D Shepherd for the Defendant
Mr J Tate for the Director of Mental HealthMr S Vasta for the Director of Public Prosecutions (Qld)
SOLICITORS:
Legal Aid Queensland for the Defendant
Crown Law for the Director of Mental Health
The Director of Public Prosecutions (Qld)
PHILIPPIDES J: Daniel Garcia has been charged with the murder of Sarah Elston on 3 June 2008. The issue of the defendant’s mental state at the relevant time has been referred to this Court.
Personal and psychiatric history
The defendant, who was 28 years of age at the time of the offence, has a long history of mental illness, commencing when he was about 19. He also has a history of substance abuse, particularly of cannabis. The initial onset of his mental illness appears to be correlated with increased cannabis consumption. He was first hospitalised in 2000 suffering from paranoid delusions. In October 2002, he was admitted to the Royal Brisbane Women’s Hospital (RBWH) and diagnosed with schizophrenia. He was treated under an involuntary treatment order (ITO). There were further admissions in April 2003 (when he was found to be suffering from auditory hallucinations and delusional thoughts about being videotaped and studied) and in November 2005 (when he was admitted to the Princess Alexandra Hospital and again maintained under an ITO).
In the period following, he reported hearing voices almost constantly. The defendant reported that around early 2007, he became so concerned that people were accessing his thoughts that he decided to leave Brisbane and travelled to Melbourne. He had by then developed the idea that there were many race based murders of innocent people. In September 2007, police observed him climbing an electrical tower and he was admitted to Broadmeadows Psychiatric Facility after he was found to be suicidal. He left Melbourne after seeing lots of “Celtic People” whom he believed were related to “Neo-Nazi” groups. He returned to Brisbane. During this period, he took his medication intermittently and did not seek follow up at any community health service, fearing hospitalisation.
He was subsequently admitted to the RBWH on 7 January 2008, after concerns about a deterioration in his mental state and reports from staff at the Schizophrenia Fellowship of homicidal ideation. He was noted to have increased paranoia and bizarre thinking and is reported to have spoken of “killing people and tasting first blood”. On admission he was assessed as suffering from an exacerbation of paranoid schizophrenia and placed on depot antipsychotic medication. His mental state apparently improved and he was discharged on 18 January 2008 and maintained on an ITO. He was only partially compliant with community treatment. He required prompting to attend appointments, was difficult to contact and often received his depot a few days late.
On 3 June 2008, he presented to the community clinic five days late for his depot medication. Staff noted that he appeared well mentally. He reported no concerns and voiced no homicidal ideation. He accepted his antipsychotic depot without complaint and left the clinic.
Evidence as to defendant’s mental state
The defendant has consistently reported a complex system of persecutory delusional beliefs. This included beliefs that he was being poisoned, that there was a “New World Order” and that the CIA, through the “Distributed Intelligence Agency”, was implicated in a vast international conspiracy involving civilian movements, revolution, mass extermination and profiteering through stealing people’s houses and credit card details. He thought that people could read his thoughts and that there was a neo-Nazi look-alike of him committing murders as part of a mass extermination plot. He came to incorporate the deceased, whom he had met socially in mid February 2008, into his delusional thinking. He believed that the deceased was “killing people in the Valley, killing ethnics fleeing Melbourne, Asians, Indians, Muslims”, that she held “parties where people die” and “tortures people with a look-a-like of myself”.
The defendant reported that prior to the events in question he had gone to various public places and telepathically communicated messages to people. In particular, he reported that he had attempted to give the deceased an “ultimatum” by communicating with her telepathically in the period leading up to 3 June 2008. The ultimatum was to the effect that the deceased must “change sides” and choose the “good side of the new world order”. The tragic events in question were precipitated by the defendant’s belief that the deceased had not responded to his ultimatum. He arranged to meet the deceased and give her a last “ultimatum”. Believing that she had not responded to his ultimatum, he killed her, stabbing her with a knife that he had brought with him.
Shortly after the events in question, on 5 June 2008, the defendant was assessed by an officer with the Court Liaison Service, who considered that it was likely the defendant was suffering from schizophrenia. From the initial interview, the defendant maintained that he believed he had done the right thing by murdering his victim, telling the officer, “I know she was a murderer”. Also on 5 June 2008, the defendant was seen by Dr Kovacevic in his capacity as a consultant psychiatrist for the Court Liaison Service. In referring to his conduct, the defendant told Dr Kovacevic:
“I had to stop her … I did not want to kill her. It was the right thing to do … otherwise she would have kept killing people with the person that looks exactly like me … they then planned to implicate me in all those murders.”
Dr Mann assessed the defendant the following day (6 June 2008) following his admission to The Park High Security Inpatient Service and found him to be psychotic. In this report of 20 August 2009, Dr Mann noted:
“Mr Garcia’s account of events around the time of the offence has remained largely consistent throughout his admission. He continues to state that at the time he believed Sarah Elston was involved with a CIA conspiracy to exterminate large sections of the community. This included her using a double of himself to implicate him in the killings. The delusional beliefs Mr Garcia expressed upon admission to HSIS are similar to those described in his handwritten diaries kept over several years. I note that the diary entries include references to ethnic killing in which he believed Sarah Elston was involved. In the diary on the page of 16/4/2009 he wrote that she was ‘running around with my imposter’.”
Reference was made at the hearing before this Court to extensive entries in diaries kept by the defendant and postings on the internet during the period leading up to 3 June 2008 consistent with the defendant’s reported beliefs. The diary entries in particular record the bizarre and delusional thinking of the defendant, which he kept hidden from those treating him. As the assisting psychiatrist, Dr Lawrence observed, the defendant had “a very extensive internal world” as revealed in the diaries and was able to conceal:
“from virtually all the outside world … that he had this extensive delusional system which was influencing his life. That’s not particularly uncommon in people suffering from severe mental illnesses, but it complicated the process and assessment, and also with the monitoring of treatment and the response to treatment that the treating people had.”
Diagnosis
All the reporting psychiatrists are agreed that the defendant suffers from severe schizophrenia. I note in this regard that Dr Kovacevic stated in his report of 15 December 2008:
“The available evidence consistently points to the conclusion that Mr Garcia suffered from active symptoms of his psychotic illness, namely schizophrenia, when he allegedly murdered Ms Sarah Elston. In my opinion, Mr Garcia was labouring under the influence of paranoid persecutory delusions (these are the most common type of delusions and involve the theme of being followed, harassed, poisoned, conspired against, spied on, attacked or obstructed in the pursuit of goals). Mr Garcia’s abnormal beliefs formed a well-organized and systematized delusional belief system, which was so broad and complex that it was capable of explaining almost everything that was happening to him.
Mr Garcia also experienced auditory hallucinations, delusions of reference (false beliefs that the behaviour of others refer to oneself, and that events have particular and unusual significance, usually of a negative nature) and thought broadcasting (feeling that one’s thoughts are being broadcast or projected into the environment). Such mental phenomena are typical of schizophrenia.”
Intoxication
The defendant reported use of cannabis in the period leading up to the offence, but no usage on the day in question. The defendant admitted to consuming a small amount of alcohol on that day. A toxicology report indicated the presence of cannabis metabolites in a urine test of 6 June 2008. Although that was consistent with cannabis use at some stage in the period leading up to the offence, there was no evidence of intoxication at the time and none of the reporting psychiatrists considered that intoxication was a contributing factor in the defendant’s mental state at the relevant time.
As counsel for the Director of Public Prosecutions acknowledged in his submissions:
“[the defendant’s] state of mind had existed for some time and the diary entry of the 16th of April is extremely telling. [Taking that into account and] comparing that with what he told the police and what he told Dr Kovacevic on the 5th of June, shows a consistency where one cannot say that the state of mind has been affected by any sort of intoxicants.”
Unsoundness of mind
The unanimous view of the three reporting psychiatrists who examined the defendant was that he was of unsound mind at the relevant time, in that the defendant was, as a result of his schizophrenic illness, deprived of the capacity to know that he ought not to do the acts in question. None of the doctors considered that there was a deprivation of any other capacity.
In his report of 13 December 2008, Dr Schramm stated:
“At the time of the offence, Mr Garcia was suffering from the preoccupying delusional concerns and almost constant hallucinatory experiences as part of his chronic schizophrenic illness as described above.
I have no doubt that at the time of the stabbing, he would have been completely deprived of the capacity to understand the wrongness of his actions. Not only did he believe that he had a ‘social responsibility’ to kill the victim to put an end to the ‘mass exterminations’ which she was somehow involved in, but his florid psychotic state and being wholly preoccupied with his beliefs would have grossly damaged any ability to consider that what he was doing (in stabbing her) was wrong.”
Dr Kovacevic likewise opined in his report:
“In my opinion, Mr Garcia was of ‘unsound mind’ when he committed alleged murder of Ms Sarah Elston. This is based on my finding that he was completely deprived of the capacity to know that he ought not to do the act.
...
In terms of Mr Garcia’s capacity to know that he ought not to do the act, it is my opinion that Mr Garcia was deprived of that capacity. He was acting driven by his persecutory delusional beliefs which led to the severe impairment of his ability to think rationally. He believed he had to kill Ms Sarah Elston in order to prevent her from committing massive atrocities against the civilian population and ethnic minorities. He also believed that he was being implicated in murders committed by his impostor who acted in concert with Ms Elston. He felt his life was in danger and that he was eventually going to be executed. He aspired to lead people’s resistance movement against the evil forces represented by the ‘Distributed Intelligence Agency’.In my opinion, at the time of committing the alleged offence, he genuinely believed that he was justified in taking the drastic action, having exhausted all other available alternatives (e.g. issuing warnings). In his mind, he did not think that what he was doing was wrong.”
In support of his conclusion, Dr Kovacevic made the following observations:
“I will outline some of the evidence supportive of the conclusion that Mr Garcia made little or no effort to avoid detection, dispose of the evidence, or to avoid apprehension, which is all suggestive of the deprivation of the abovementioned capacity.
·He contacted the alleged victim prior to the killing and the victim had his mobile phone number written on her hand.
·The presence of a potential witness who could have placed him at the scene of the crime did not function as a deterrent.
·He made no attempt to conceal the weapon or even wipe off the blood from the knife he used to stab his victim.
·After returning home, he went back to the city believing that everybody was aware of what he had done.
·He left the murder weapon at the bedside table where it was later found by the police.
·He may have even worn the same clothes when arrested by the police.
·He made no attempt to avoid or delay his arrest.
In addition to this, in all of his statements following his arrest Mr Garcia consistently maintained that he did not know that what he did was morally wrong. Statements taken from Mr Garcia’s website and his diary entries provide further valuable insight into his disordered state of mind and delusional motives behind his actions.”
In his report, Dr Mann states:
“Based on the information currently available to me, it is my opinion that Mr Garcia’s capacity to understand that he ought not to commit the murder was impaired at the time of the offence. Due to his mental illness he experienced auditory hallucination and delusional beliefs which led to the impairment. On the balance of probabilities I believe that Mr Garcia was fully deprived of the capacity to understand that he ought not commit the act due to his mental illness.
…
It is my opinion that he was not deprived of the capacity to know what he was doing.”
I note that the advice of the assisting psychiatrists accords with the opinions of the reporting clinicians. I accept the unanimous clinical evidence that the defendant suffered from a very severe schizophrenic illness at the time of the events in question and that he was, as a result, deprived of the capacity to know he ought not to do the acts that resulted in the shocking and tragic death of Ms Elston. In the circumstances, I find that the defendant was of unsound mind at the relevant time.
Forensic order and future management
Given the serious nature of the offence, the severity of the defendant’s mental illness, his obvious and long term treatment needs, and the need to protect the community, a forensic order is clearly required. Accordingly, I order that the defendant be detained to the Park High Security Program Authorised Mental Health Service. I approve Limited Community Treatment of a very restricted nature, confined to escorted leave on the grounds of The Park – Centre for Mental Health, of up to one hour twice per week. Limited Community Treatment of that nature was supported by all the treating psychiatrists and by the assisting psychiatrists.
Great caution will be required in the future management of the defendant. The following comments of Dr Mann, that were endorsed by the assisting psychiatrists, are pertinent:
“The defendant will require very close monitoring of his mental state in the future. He will also need to be regularly and randomly tested for substance abuse and attend drug and alcohol counselling. He seems to have been able to disguise the extent of his psychosis and risk of aggression to his treating service up until the day of his offence. His apparent ability to hide the extent of his psychosis, combined with his fixation on conspiracy theories and past history of cannabis abuse, increase his future risk of aggression.”
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