Re L

[2007] QMHC 16

MENTAL HEALTH COURT

CITATION:

Re L [2007] QMHC 016

PARTIES:

REFERENCE BY THE DEFENDANT’S LEGAL REPRESENTATIVE IN RESPECT OF L

PROCEEDING:

No 173 of 2006

DELIVERED ON:

11 September 2007

DELIVERED AT:

Brisbane

HEARING DATE:

11 September 2007

JUDGE:

Philippides J

ASSISTING PSYCHIATRISTS:

Dr J F Wood
Dr J M Lawrence

FINDINGS AND ORDERS:

1.    The defendant was of unsound mind as described in Schedule 2 of the Mental Health Act 2000 (Qld) at the time of the alleged offences.

2.    The defendant be detained as a forensic patient to the Sunshine Coast and Cooloola Authorised Mental Health Service for involuntary treatment and care.

3.    Limited community treatment be approved on the conditions that the patient:

a.   reside at a stated address or at an address approved in advance in writing by the authorised psychiatrist;

b.   attend all follow up appointments and in-patient care as required by the authorised psychiatrist;

c.   complies with the requirements of the authorised psychiatrist in relation to the taking of the prescribed medication and other treatment;

d.   does not consume alcohol to excess; and

e.   does not use illicit substances and makes himself available for and co-operates fully in random medical tests for those substances as required by the authorised psychiatrist.

CATCHWORDS:

MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where defendant charged with breaches of domestic violence orders, breaches of bail and wilful damage – where the defendant was suffering from a mental illness which was associated with complex delusional beliefs at the time of the alleged offences – where expert opinion differed as to whether the defendant was as a result of his mental illness deprived of any of the relevant capacities at the time of the alleged offending – whether the defendant was of unsound mind at the relevant time – whether a forensic order should be made – whether limited community treatment should be approved

COUNSEL:

C Heaton for the defendant
J Tate for the Director of Mental Health

S Vasta 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. PHILIPPIDES J:  The defendant, a 30 year old man, is charged with 18 offences: seven counts of breach of domestic violence orders, 10 counts of breach of bail conditions and one count of wilful damage.

1. The offences are alleged to have occurred on various dates between 28 December 2005 and 9 September 2006.  The defendant's mental condition at the time of the alleged offences has been referred to this Court.

1. A domestic violence order was first taken out against the defendant on 11 October 2005 by his wife, with whom the defendant has three children.  The breaches of the domestic violence order largely centre on abusive and intimidating behaviour on the part of the defendant in contravention of the order.  For example, on 28 December 2005, the defendant had taken his two children for a walk.  On his return to the family home, a verbal dispute ensued, resulting in his wife ultimately calling the police as she was concerned for her safety and for the safety of her children.  Again, on 8 and 9 February 2006, the defendant breached the domestic violence order then in place by visiting his wife and his conduct appears to have consisted of shouting out at her over the back fence.  There is similar conduct on various other occasions.

1. The breach of bail offences concern the defendant failing to attend on the Maroochydore Police Station on various Fridays as he was required to do.

1. The wilful damage count concerns the defendant attending at the address of the complainant's sister, where his wife was also residing at the time, and engaging in "screaming, ranting and raving" which culminated in the defendant causing damage to a motor vehicle, apparently in retaliation for something which he believed had been said to his daughter by the complainant.

1. The defendant suffers from a severe mental illness.  It has been described as delusional disorder or schizophrenia.  It appears to have begun in about 1999 and resulted in admissions to the Nambour General Hospital.

1. The defendant has a complex set of beliefs involving a range of delusions.  Unfortunately, there was a period during which he was misdiagnosed as suffering from anti-social personality disorder and there appears to have been a prolonged period when the defendant was unmedicated.

1. In his report dated 15 July 2006, Dr Schramm detailed the complex delusions from which the defendant suffered, including a delusional conspiracy involving paedophiles and other delusions involving his family.  These delusions also included a belief that there had been a conspiracy in relation to the initial domestic violence order that was made.

1. Dr Schramm was unable to attribute any particular delusional belief to any particular alleged offending.  However, he considered that, because of the defendant's mental illness and its attendant disturbances with agitation, clouded thinking and poor judgment, the defendant was unable to consider with a modicum of sense and composure the wrongness of his acts.  He considered that the defendant was as a result deprived of the capacity to know that he ought not to do the acts and also the capacity to control his conduct.  He considered that those deprivations were relevant to all of the alleged offending.

1. Dr Chalk, who assessed the defendant on 9 September 2006 and provided two reports dated 13 November 2006 and 12 March 2007, considered that the defendant suffered from a schizophrenic illness with complex delusional system and believed that the defendant was psychotic during the period over which the alleged offences occurred.  While he was also unable to say conclusively that the defendant was acting under the influence of delusional ideas when committing each and every of the alleged offences, he observed that most of the offending alleged against the defendant occurred in the 12 month period prior to his eventual admission to the Nambour Hospital and during a period when he was unmedicated and chronically deluded and preoccupied and highly aroused.  He considered on the balance of probabilities that at the relevant times the defendant was suffering from ongoing agitation with clouded judgment and disorganised thinking as a result of his mental illness and was most likely deprived of the capacity to know that he ought not to do the acts in question.

1. Dr Bourke, who has been the defendant's treating psychiatrist, also provided a report dated 1 June 2007, after having interviewed the defendant in May 2007.  She considered that the defendant was suffering from a delusional disorder.  However, she did not consider that the defendant was deprived of any of the relevant capacities at the time of the alleged offences and was unable to link the alleged offending to the defendant's mental illness.

1. It is therefore apparent that all the reporting doctors agree that the defendant was, during the relevant period, suffering from a mental illness which was associated with complex delusional beliefs.  The difference of opinion between Dr Schramm and Dr Chalk on the one hand and Dr Bourke on the other centred on whether there was any relevant deprivation of capacity.

1. I would prefer the opinion of Dr Schramm and Dr Chalk in this regard.  Dr Schramm saw the defendant closest to the alleged offending.  I note that Dr Bourke accepted that she had seen the defendant only during the period when he had commenced medication and when he was perhaps able to attribute more rational explanations to his behaviour.  In addition, I note that Dr Bourke accepted that the defendant's mental illness had indeed pervaded all aspects of his life: his employment and his relationship with his wife which, during the period in question, had resulted in their separation.  She also, significantly in my view, conceded that, if the defendant had been medicated during the relevant period, she thought that the offending would most likely not have occurred.

1. Accordingly, I find that the defendant was of unsound mind at the relevant time and that he was deprived of the capacity to know that he ought not to do the acts in question when the alleged offences were committed.

1. The issue then arises as to whether a forensic order ought to be imposed.  In my view, a forensic order is warranted in the present case, taking into account the length of time over which the alleged offences were committed, the fact that the defendant, although having made significant progress in relation to compliance and treatment, is nevertheless not fully insightful as to his situation and bearing in mind that the defendant's treatment needs are most likely to be ongoing for quite a prolonged period. 

1. There is a submission from the Director of Mental Health in relation to a forensic order and limited community treatment.  I consider that orders should be made in accordance with that submission.  I order that the defendant be detained in the Sunshine Coast and Cooloola Authorised Mental Health Service.  I approve limited community treatment to commence immediately at the discretion of the authorised psychiatrist on the conditions contained in the submission.