Re GIS
[2005] QMHC 17
•9 June 2005
MENTAL HEALTH COURT
CITATION:
Re GIS [2005] QMHC 017
PARTIES:
APPEAL BY GIS AGAINST DECISION OF MENTAL HEALTH REVIEW TRIBUNAL
PROCEEDING NO:
10 of 2005
DELIVERED ON:
9 June 2005
DELIVERED AT:
Brisbane
HEARING DATE:
9 June 2005
JUDGE:
ASSISTING PSYCHIATRISTS:
Holmes J
Dr J F Wood
Dr D A GrantFINDINGS AND ORDER:
Appeal dismissed
CATCHWORDS:
MENTAL HEALTH – CONFINEMENT AND RESTRAINT OF MENTALLY ILL PERSONS AND SIMILAR ORDERS – GENERALLY – where patient detained pursuant to a forensic order on 10 September 2002 – where GIS appealed decision of Mental Health Review Tribunal to confirm forensic order – where stable lifestyle indicated – where not wholly compliant with forensic order – where appellant has limited insight into illness and believes he has been cured – where psychiatric opinion evidences a likely deterioration in mental state without ongoing treatment – whether the defendant represents an unacceptable risk to the safety of himself or others having regard to his mental illness
Mental Health Act 2000 (Qld), s 203, s 204
COUNSEL:
Mr D Shepherd for the appellant
Mr W Isdale for the Director of Mental Health
SOLICITORS:
Legal Aid Queensland for the appellant
The Crown Solicitor for the Director of Mental Health
HOLMES J: This is an appeal from a Mental Health Review Tribunal decision confirming a forensic order made on 10 September 2002. The forensic order was made in respect of the charge of arson which was said to have occurred in August 2001. At that time, it seems, on the material before me, GIS made admissions to setting a fire in a barricaded bedroom of a house where he and his wife and daughters resided. That followed a domestic dispute. The forensic order provided for limited community treatment to commence immediately, in effect allowing GIS to be treated in the community.
Dr A was the treating psychiatrist at the time that the forensic order was made and provided a report. In it he set out some background. GIS was admitted to the Princess Alexandra Hospital in 1993 and was then treated with anti-psychotics. Prior to the 2001 incident his wife had reported that he had become increasingly religious and aggressive, and was using increasing amounts of cannabis; and he himself reported what can be described as an elevated mood with grandiose schemes. It is clear that when he was taken into custody at that time he was psychotic.
Dr A diagnosed bipolar disorder and said that GIS was manic with psychosis at the time that the fire was lit. Dr A then anticipated that there might be some difficulties with compliance with medication because of some deficits in insight on the part of GIS.
Drs B and C also reviewed GIS at that time and agreed with the diagnosis of bipolar disorder. Dr C set out something of GIS's history which included convictions for assault occasioning bodily harm in 1990 and 1993 and a deprivation of liberty and assault in 1994 as well as a breach of domestic violence order in that year. It is inevitable that this appeal has to be considered against that background.
GIS, in making his application for revocation of the order, made strongly the points that he has since those events been drug and alcohol abstinent; that he is a born again Christian; and, in his application for review, that he has adhered to his treatment conditions. There are many things which show that GIS is presently in a stable lifestyle. He has steady employment. He has remarried.
On the other hand, though, there are some matters which indicate less than full compliance. The treating team report provided to the Mental Health Review Tribunal indicates that he required admission to hospital in October 2003 following a failure to comply with the conditions of the forensic order. He had ceased medication and cancelled appointments. He displayed some longstanding religiosity and preoccupation about injustices of the system. He was admitted again to the Gold Coast psychiatric unit in November 2004 following failure to comply with medication, once again, failing to attend appointments with case managers and exhibiting increased religiosity.
The Tribunal, in its account of the oral evidence given at that time, said that
GIS put the view that although he had had a mental illness he no longer had it and did not need treatment. And it is apparent from all the material that GIS takes the view that his offending was a result of drug and alcohol use. He discounts the role of his illness and he now maintains that he is cured of the illness.
Dr D, in her more recent report of March 2005, says that he has a belief that God has cured him of bipolar disorder and that his Christian beliefs protect him so that he does not require medication.
Dr E has also given a report. He takes the view that GIS requires ongoing treatment and that there is an ongoing risk that he may cause harm to himself or someone else if he is not treated. He also considers GIS is likely to suffer mental deterioration if left untreated. He says that he has limited insight.
In view of the background, the seriousness of the offence initially alleged and the clear intention of GIS that he would not, unless required, comply with treatment, it seems to me inevitable that the forensic order must be confirmed. I appreciate what has been said about the stability now of GIS's lifestyle, his belief that his religious commitment enables him, of itself, to function at a high level. But I have to take into account broader considerations of the history and of the risk involved to the community if there were any further re-offending, and what seems to be the inevitability that GIS would not comply with medication or any other form of treatment if the forensic order did not continue.
Given those circumstances, I am satisfied under s 203 that the forensic order should continue. I am also inclined to think, although it is not necessary to make a firm finding, that s 204 of the Act would preclude revocation of the order in any event, because of the risk attendant on untreated illness in this case.
For those reasons I dismiss the appeal and confirm the continuation of the forensic order.
0
0
1