Re Jem

[2005] QMHC 14

MENTAL HEALTH COURT

CITATION:

Re JEM [2005] MHC 014

PARTIES:

REFERENCE BY THE DIRECTOR OF MENTAL HEALTH IN RESPECT OF JEM

PROCEEDING NO:

0124 of 2004

DELIVERED ON:

3 June 2005

DELIVERED AT:

Brisbane

HEARING DATE:

3 June 2005

JUDGE:

ASSISTING PSYCHIATRISTS:

Holmes J

Dr J F Wood
Dr D A Grant

FINDINGS AND ORDER:

At the time the offences were 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 limited community treatment on the grounds of The Park Centre for Mental Health on the following conditions:3.   

She is to remain under the escort of Health Service staff members nominated by the authorised psychiatrist for the duration of the limited community treatment and that, for the purposes of escorted limited community treatment, she must comply with the directions of the nominated staff members for the duration of the limited community treatment;a)   

Non-contact order made.4.   

CATCHWORDS:

MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where the defendant is charged with various charges, including attempted murder – where the defendant suffers from chronic and severe schizo-affective disorder – where defendant had delusional ideas and psychotic experiences – 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 P Rutledge for the Director of Public Prosecutions

SOLICITORS:

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

The Director of Public Prosecutions

1. :HOLMES J  JEM is charged with offences of attempted murder, enter dwelling and commit indictable offence, robbery with actual violence, grievous bodily harm with intent committed on 30 June 2004 and possession of a dangerous drug on 3 July 2004.  The last of those offences concerns a very small quantity of cannabis found in her possession when she was arrested.

1. The more serious offences turn around an attack on JEM’s great aunt, Ms T, which caused her extremely severe injuries.  That occurred in the morning of 30 June 2004.  It seems that JEM was at her great aunt's unit at around 9am or 10am that day.  In the hours following, she arrived at a house at West End where some friends used to live.  She was allowed to stay there by the present occupants and they noted that her behaviour was odd.  She referred to things such as being on a quest from God and being able to hear voices and having healing powers.

1. On 3 July when they left to go away, JEM was left, it seems, without any accommodation.  She found her way to the Dutton Park Police Station where she produced a scarf which she said had her aunt's blood on it.  She also said she wanted to talk to the police about a large hole with bodies in it.  A record of interview was conducted that afternoon.  Clearly enough, she was a suspect in the attack on her aunt.  The record of interview itself displays many delusional elements.

1. Dr McVie is JEM’s treating psychiatrist.  She sets out in her report the history of JEM’s psychosis.  She has had previous treatment in the community and through hospital admissions on a number of occasions.  Some of those admissions have been because of events of aggression.  Her last admission was to the Prince of Wales Mental Health Unit in May 2004.  She was given leave on 16 June 2004 and did not return from that leave.  Flat mates living with her in Sydney observed some odd behaviour on her part as well as the ingestion of considerable amounts of cannabis.  She left Sydney, they say, some time at the end of June.

1. As I have said, Dr McVie has given a report and has given evidence today; so have Dr Van de Hoef and Dr Sundin.  The three of them are of one view as to JEM’s suffering from schizo-affective disorder which is chronic and severe.  Each of them also considers that, at the time of the alleged offending, she was deprived of the capacity to know that she ought not do the acts.  They all speak of her delusions, her psychosis and her manic symptoms.

1. There are two aspects of the matter which require some consideration although it can be brief.  There are some aspects of the events which might cause questions to be raised.  At the time Ms T was discovered severely injured in her unit, a number of her possessions had been assembled as if for robbery; but it seems that was in rather a haphazard way, and what is abundantly clear is that JEM had no means of transporting any of these possessions; so there was nothing rational about that set of events.

1. The other aspect is the prospect of cannabis use.  JEM has admitted cannabis use in the days preceding the events.  Specifically, she told Dr Van de Hoef that she had smoked cannabis in the four days prior including the day previous.  I should say also that she had a positive screening for cannabinoids when she was admitted to hospital on 6 July 2004.  So far as that is concerned, there is no clear evidence of any use on the day in question.  JEM had travelled from Sydney to Brisbane by train, which seems to lessen the prospect.  The events themselves are explicable in terms of her undisputed mental illness.  It seems to me, at best, there is a possibility but not a probability that she was intoxicated by cannabis use.

1. Even if that were the case, the common view of the psychiatrists is that while that might disinhibit her, it is really unconnected with her deprivation of the capacity to know right from wrong which is purely and simply the result of psychosis.  I think, therefore, there is no basis for concluding that intoxication contributed to the relevant unsoundness here.

1. I conclude therefore that JEM was of unsound mind at the time of the offences which I have already identified.  So far as the possession of dangerous drug goes, it occurs in that timeframe and it is very clear from Dr McVie's evidence that JEM was obviously and actively psychotic when she was admitted to the High Secure Unit at The Park on 5 July, a couple of days after her arrest. One can take it that the psychosis continued throughout that period.

1. Because I am satisfied of that unsoundness of mind pursuant to the Mental Health Act 2000, schedule 2 the proceedings in respect of each of those charges must be discontinued.

1. There is the question of the forensic order.  I am satisfied it is necessary.  I will make it in the terms of the submission from the Director of Mental Health with the addition of a non-contact provision.

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

1. I approve escorted limited community treatment escorted on the grounds of The Park Centre for Mental Health on the conditions that she is to remain under the escort of Health Service staff members nominated by the authorised psychiatrist for the duration of the limited community treatment and that, for the purposes of escorted limited community treatment, she comply with the directions of the nominated staff members for the duration of the limited community treatment.

1. As a further condition of the forensic order, I order that JEM not intentionally contact in any way Ms T.

1. It will be a matter of review by the Mental Health Review Tribunal how the forensic order develops but I should make it very clear that the evidence has demonstrated strong bases for concern as to the quality of monitoring of JEM.  She has been identified as having chronic and severe schizo-affective disorder.  Her history contains elements of violence.  There is said to have been an attack on each of two relatives, one of which involved a carving knife.  And then there are the circumstances of this attack which left Ms T severely injured.

1. In those circumstances, it is essential that she be monitored into the future for compliance with her treatment.  A lesser concern is that of cannabis ingestion but that in itself may be indicative of the level of compliance, so it is something that must be taken into account.

1. I would strongly recommend that any Tribunal considering the forensic order have regard to those matters, that the prospect of drug screening be strongly considered and also the possible need for a condition that if any screening were positive, she immediately be admitted for further assessment.  It remains to be seen what her progress is and what the reports are at the time, of course, in considering those conditions.