Re Grant

[2010] QMHC 10

MENTAL HEALTH COURT

CITATION:

Re Grant [2010] QMHC 10

PARTIES:

REFERENCE BY THE DIRECTOR OF MENTAL HEALTH IN RESPECT OF JUSTIN RONALD GRANT

PROCEEDING:

No 252 of 2009

DELIVERED ON:

15 April 2010

DELIVERED AT:

Brisbane

HEARING DATE:

15 April 2010

JUDGE:

Philippides J

ASSISTING
 PSYCHIATRISTS:

Dr J M Lawrence
Dr E N McVie

FINDINGS AND ORDER:

1. That at the time of the alleged offence the subject of the reference, the defendant was of unsound mind as described in Schedule 2 of the Mental Health Act 2000 (Qld);

2.    That the defendant be detained as a forensic patient at The Park High Security Program Authorised Mental Health Service;

3.    Limited community treatment confined to escorted ground leave is approved on the conditions provided in the written submission from the Director of Mental Health with the additional condition that there be no contact with the specified person.

CATCHWORDS:

MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where defendant charged with murder – where defendant has history of mental illness – where defendant diagnosed with paranoid schizophrenia and poly substance abuse – where defendant’s symptoms included paranoid and religious delusions, command and auditory hallucinations, grossly impaired judgment, profound insightlessness – where expert opinion differed as to the extent of limited community treatment that should be approved – whether defendant was of unsound mind as defined in Schedule 2 of the Mental Health Act 2000 (Qld) at the time of the alleged offence

Mental Health Act 2000 (Qld), Schedule 2

COUNSEL:

J Briggs for the Defendant
J Tate for the Director of Mental Health

D Holliday for the Director of Public Prosecutions

SOLICITORS:

Legal Aid Queensland for the Defendant
Crown Law for the Director of Mental Health

The Director of Public Prosecutions (Qld)

1. JPHILIPPIDES:  Justin Ronald Grant is charged with the murder of his brother on 23 August 2009.  The tragic events in question took place at a hostel where the defendant and his 21 year-old-brother who had been his full-time carer were residing.

1. It appears that the defendant retrieved a knife from the kitchen area and repeatedly stabbed his brother until another resident intervened.  He then returned to the kitchen area to obtain another knife to continue stabbing his brother.

1. When questioned by police, he told police that he was Jesus and his brother was Satan and that he decided to kill his brother before his brother dragged everyone to hell.

1. The defendant has a long-standing history of mental illness.  He came into contact with Mental Health Services in April 2004.  In January 2005 he was admitted to the Logan Hospital Mental Health Unit. 

1. He reported having experienced a variety of psychotic symptoms since 2004.  These included auditory and visual hallucinations and delusional ideas of a religiose and grandiose type.

1. He was diagnosed with paranoid schizophrenia and poly substance abuse and treated with Risperidone.  He was placed on an involuntary treatment order and discharged into the community in March 2005.

1. His follow-up was problematic due to ongoing illicit substance use and his lack of full compliance.  Subsequently, in October 2005 he presented to the Logan Hospital with self-inflicted wounds.  These appear to have been inflicted with suicidal intent and in the delusional belief that God wanted him to die.

1. There were a number of further admissions between October 2005 and December 2006 and relapses in the context of lack of abstinence from illicit substance use. 

1. The involuntary treatment order was revoked in January 2008 in circumstances when his mental condition had stabilised.  He, thereafter, received depot medication and was relatively compliant until about May 2009.

1. In June 2009, he moved into supported accommodation with his brother.  He then became non-compliant and ceased all medication for approximately three months prior to the events in question.

1. The Court has heard evidence from Drs Scott, Van de Hoef and Reddan, all of whom provided reports.  The clinical opinion is united in concluding that at the relevant time the defendant suffered from severe chronic paranoid schizophrenia.  Although the defendant has a history of poly substance abuse there was no evidence of intoxication being a factor in the events in question and all of the doctors were clear that intoxication did not arise as a relevant consideration.

1. The doctors chronicled the symptoms associated with the defendant's mental illness.  They included paranoid and religiose delusions, command and auditory hallucinations, grossly impaired judgment, and profound insightlessness.  There was also evidence of thought disorder and thought insertion. Dr Van de Hoef, in her report, referred to the delusions that the defendant thought he was either God or Jesus and that he was somehow pitted against others he perceived to be evil or the devil.

1. Both Drs Reddan and Dr Scott considered that the defendant's mental illness resulted in a deprivation of the capacity to know that he ought not do the acts in question. 

1. Dr Van de Hoef, in addition to finding a deprivation of that capacity, considered that there was also a deprivation of the capacity to control his actions, given that the defendant very nearly returned to stab his brother yet again with the second knife and the evidence that the delusional belief was so intense that the defendant felt compelled to act as he did.

1. I am satisfied, on the basis of the unanimous clinical evidence, that the defendant was at the relevant time suffering from a mental illness, namely schizophrenia and that, as a result of that illness, he was deprived of at least the capacity to know he ought not do the act in question.

1. Given the fatal and shocking consequences that have followed from the defendant's very serious mental illness, it is clear that a forensic order is warranted in order to ensure that the defendant's treatment needs are met and to protect the community.  Accordingly, I order that the defendant be detained in The Park High Security Program Authorised Mental Health Service.

1. There was some divergence of opinion expressed by those giving evidence as to the extent of limited community treatment that should be approved.  The submission from the Director of Mental Health was that limited community treatment should be confined to the grounds of The Park High Security Program in accordance with the written submission provided.

1. The evidence of Dr Scott, who is the defendant's treating psychiatrist and has been since the defendant's admission to The Park, is that limited community treatment ought to be extended to include off the grounds leave.  Dr Reddan supported that approach.  However, a more conservative approach was preferred by Dr Van de Hoef.  That more conservative course was also favoured in the advice given by the assisting psychiatrists.

1. I note that the events in question took place only some eight months ago in August 2009.  Ground leave was only commenced last month on 26 March 2010 and there have only been five occasions of such leave.  I also note that the defendant has had some instability in his mental condition in the recent past.  In those circumstances, I consider that limited community treatment should be confined to escorted ground leave at this stage and only proceed on the conditions provided in the written submission from the Director of Mental Health and the additional condition that there be no contact with the specified person.