Re MGM

[2008] QMHC 6

MENTAL HEALTH COURT

CITATION:

Re MGM [2008] QMHC 006

PARTIES:

REFERENCE BY THE DIRECTOR OF MENTAL HEALTH IN RESPECT OF MGM

PROCEEDING:

Proceeding No 0207 of 2007

DELIVERED ON:

28 March 2008

DELIVERED AT:

Brisbane

HEARING DATE:

28 March 2008

JUDGE:

Philippides J

ASSISTING
 PSYCHIATRISTS:

Dr J M Lawrence
Dr E N McVie

FINDINGS AND ORDER:

1. That the defendant was of unsound mind at the time of the alleged offences 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 (“The Park”)

3.   That limited community treatment is approved, in the nature of escorted leave on the grounds of The Park and closed bus trips on and off the grounds of The Park

CATCHWORDS:

MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where defendant charged with two counts of murder and three counts of attempted murder – where psychiatric evidence that defendant suffered from schizophrenia or a Major Depressive Episode – whether the defendant was of unsound mind as defined in Schedule 2 of the Mental Health Act 2000 (Qld) at the time of the alleged offences – whether forensic order necessary – whether limited community treatment should be approved

COUNSEL:

Ms C L Morgan for the defendant
Mr W Isdale for the Director of Mental Health

Mr D R Mackenzie 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. J:PHILIPPIDES MGM is charged with the murder on 6 July 2007 of her sister and of a son, D.  She is also charged with the attempted murder of her daughter A, another son, T, and a cousin M.

1. The matter of the defendant's mental condition at the time of the alleged offences has been referred to this Court.  The Court has had the benefit of reports from Dr Voita, Dr Reddan and Dr Van de Hoef and additionally of having heard oral evidence from those clinicians.

1. Dr Voita first assessed the defendant on 7 July 2007, the day after the events in question, and has been her treating psychiatrist since the defendant's admission to The Park High Security In-patient Unit on 9 July 2007.  Dr Voita assessed the defendant as suffering from a psychotic illness, namely schizophrenia.  Her clinical assessment was that at the relevant time the defendant was floridly psychotic with religious and persecutory delusions, auditory hallucinations and marked formal thought disorder.  She obtained a history from the defendant which indicated a clear psychotic motivation for the offences and an intent to kill herself and her three children due to delusional ideas relating to beliefs that the world was going to end, that the Antichrist was coming and that her children would not be cared for if she was gone.  It appears that her sister attempted to intervene to prevent the defendant from killing herself and the children when she was fatally stabbed.

1. Dr Voita in her second report noted significant collateral evidence supporting the history given to her by the defendant. She concluded that the defendant was, as a result of her mental illness, deprived of the capacity of knowing that she ought not to do the acts in question and the capacity of control.

1. Dr Van de Hoef also diagnosed the defendant as suffering from schizophrenia and concluded that the illness was characterised by auditory and visual hallucinations and delusional beliefs that caused intense fear and anxiety by threatening what the defendant held most dear, the safety of her children and her capacity to be a good mother.  Dr Van de Hoef concluded that the defendant was, as a result of her mental illness, deprived of the capacity to know she ought not to do the acts and possibly the capacity for control.

1. Dr Reddan’s preferred diagnosis was that at the relevant time, the defendant suffered a Major Depressive Episode, severe with psychotic features.  As a result the defendant was deprived of the capacity to know that she ought not to do the acts in question, and the capacity to control her actions.  Dr Reddan accepted, however, that it might be that ultimately the appropriate diagnosis may be one of schizophrenia and that that was a matter which may take some time to determine, although she did favour the diagnosis of Major Depressive Episode.

1. It is, therefore, apparent that all the expert clinicians agreed that, at the relevant time, the defendant was suffering from a disease of the mind and was psychotic.  The area of difference was, as I mentioned, as to whether the diagnosis should be seen as one of schizophrenia as opposed to one of major depressive disorder.  Nothing flows from that difference of opinion for present purposes, although, as has been noted, there are significant implications in terms of the ongoing treatment needs of the defendant.

1. All the clinicians giving evidence agree that there was a deprivation, at least of the capacity to know that she ought not to do the acts in question, and additionally two of the clinicians found a deprivation of capacity for control.

1. In the circumstances, I am satisfied that the defendant was of unsound mind at the relevant time.

1. It is clearly indicated in this case that a forensic order be made bearing in mind the seriousness of the alleged offences, the very significant ongoing treatment needs of the defendant and the need to ensure the protection of the community.

1. In those circumstances, I make a forensic order detaining the defendant as a forensic patient at The Park High Security Program.

1. In addition I approve limited community treatment.  The limited community treatment is confined to escorted leave only consisting of escorted leave on the grounds of the hospital and closed bus trips on and off the grounds of The Park.  I am satisfied that such limited community treatment is appropriate in the circumstances and will assist in the management of the defendant and would not pose any unnecessary risk to the community.

1. The question of ongoing management of the defendant is clearly one which is complex and will require very careful consideration.  I note the advice given to the Court by the assisting psychiatrists in this regard and it is appropriate that a transcript of today's proceedings be provided to those involved in the care of the defendant.