Re N
[2010] QMHC 37
•16 June 2010
MENTAL HEALTH COURT
CITATION:
Re N [2010] QMHC 37
PARTIES:
REFERENCE BY THE DIRECTOR OF MENTAL HEALTH IN RESPECT OF N
PROCEEDING:
No 238 of 2009
DELIVERED ON:
16 June 2010
DELIVERED AT:
Brisbane
HEARING DATE:
31 May 2010
JUDGE:
Philippides J
ASSISTING PSYCHIATRISTS:
Dr E N McVie
Dr F T VargheseFINDINGS AND ORDER:
1. That in respect of the charges of attempted murder and acts intended to cause grievous bodily harm:
- the defendant was of unsound mind as described in Schedule 2 of the Mental Health Act 2000 (Qld) at the relevant times;
- the defendant be detained as a forensic patient at The Park High Security Program Authorised Mental Health Service;
- approval of limited community treatment confined to escorted leave on the grounds of the hospital at the discretion of the authorised psychiatrist on the conditions that:
(i)the patient is to remain under the escort of two health service staff member/s nominated by the authorised psychiatrist for the duration of the limited community treatment;
(ii) for the purposes of escorted limited community treatment, the patient complies with the directions of the nominated staff member/s for the duration of the limited community treatment.
n respect of the charge of deprivation of liberty:hat iT2.
there is reasonable doubt as to the commission of the alleged offence within the meaning of s 268 of the Mental Health Act 2000 (Qld); a.
the defendant is fit for trial;b.
the proceedings continue according to law; c.
pursuant to s 273(1)(b) of the Mental Health Act 2000 (Qld), the defendant be detained in The Park High Security Program Authorised Mental Health Service until:d.
(i) the defendant is granted bail under the Bail Act 1980; or
the defendant is brought before a court for continuing proceedings.(ii)
CATCHWORDS:
MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where defendant charged with attempted murder, acts intended to cause grievous bodily harm and deprivation of liberty – where defendant held delusional beliefs that his wife and friends were poisoning him and as to his wife’s infidelity – where defendant displayed behaviour of morbid jealousy – where expert opinions differed as to the diagnosis of defendant’s mental disorder – whether defendant was of unsound mind at the time of the alleged offences as described in Schedule 2 of the Mental Health Act 2000 (Qld) – whether defendant was deprived of any relevant capacity at the time of the acts in question – whether defendant’s acts in question resulted from anger management problems or a psychotic disorder – relevance of conduct after the events in question
Mental Health Act 2000 (Qld), s 268, s 273(1)(b), Schedule 2
Re HW [2008] QMHC 14
R v Porter (1933) 55 CLR 182
R v Stapleton (1952) 86 CLR 358Re SAM [2003] QMHC 3
COUNSEL:
J Briggs for the Defendant
J Tate for the Director of Mental HealthJ Finch for the Director of Public Prosecutions (Qld)
SOLICITORS:
Legal Aid Queensland for the Defendant
Crown Law for the Director of Mental Health
The Director of Public Prosecutions (Qld)PHILIPPIDES J:
The defendant N is charged with the attempted murder on 2 June 2009 of his wife SN and with one count of acts intended to cause grievous bodily harm and one count of deprivation of liberty.
Circumstances of the offences
At the time of the alleged offences, the defendant, who is 43 years of age and originally from Tonga, was living with his wife and three daughters.
The evidence indicates that at about 2.00 pm on 2 June 2009, the defendant telephoned triple 0 requesting an ambulance “as his wife had been assaulted”. Police arrived with the ambulance soon after and found the defendant, who made partial admissions in relation to assaulting his wife. The police found the defendant’s wife in a bedroom naked, semi-conscious and with severe head injuries. She was taken to hospital where the police were able to speak with her.
The defendant’s wife told police that she had come home from a night shift and was sitting at her computer while her husband was asleep. She said she noticed that her husband had woken. He confronted her saying, “I’ve had enough of this and being poisoned” and “I’m sick of being poisoned”. The victim turned to talk to him and noticed that he had a baseball bat. He demanded that she tell him the truth about her poisoning him and accused her of having an affair. He then repeatedly beat her with the bat, chasing her and inflicting serious injuries. At one point he took hold of her neck and tried to strangle her. After the assault, the defendant undressed her and showered her. The defendant had limited recall of the events. He reported that he changed his clothes, “because [he] thought [he] needed to go to the hospital” to accompany his wife and he therefore needed to change out of his bloodied clothes, which he made no attempt to conceal. He also telephoned his brother to look after the children.
Circumstances leading up to 3 June 2009
The defendant’s decline in health appears to have commenced when he suffered work related back injuries in 2000 and later in 2003, which prevented him from continuing to work. Dr Chung, the defendant’s general practitioner, reported that during this period the defendant displayed irritable behaviour, a demanding demeanour and complained of depressive symptoms. The defendant’s father subsequently died in 2006, during which time the defendant was reported to display further irritability.
During this time the defendant confronted his wife about suspicions that she was having extramarital affairs. In June 2006, the defendant presented to his GP, complaining of his wife’s infidelity and concerned that his daughters may not belong to him. The defendant’s GP treated him with an antidepressant and referred him to a psychologist. In late 2007, the defendant again presented to his GP, complaining of further depression and irritability. His GP subsequently prescribed Sertraline. The defendant seems to have taken Sertraline for some time until around April 2008. In May 2009, the defendant again presented to his GP, complaining that his wife had been poisoning him for months. He reported vague physical symptoms (tired/dizzy) and requested drug screening and blood tests to be performed on himself. The defendant also asked his wife to undergo a lie detector test about her affairs. There were also reports that the defendant believed that his kava group were talking about his wife and that he complained they had been poisoning him (such that he stopped attending).
The defendant’s wife reported that the defendant exhibited particularly bizarre behaviour leading up to the day in question. He had accused his wife of stealing his music and had put a padlock on his side of their wardrobe to lock away his belongings, especially his CDs, so that she would not steal them.
There was evidence from the defendant’s wife as to his behaviour in the weekend before the events in question. The defendant complained to her that his brother had poisoned him. In addition, while washing the family car, he was observed scraping the car window of the driver’s side with a paint stripper, apparently to get rid of poison that he accused his wife of putting there in order to poison him. The defendant’s wife reported that these were only some of the behaviours that she observed at the time in question and that she was unable to reason with him, stating that his conduct was such that, “he was definitely not my husband Fahina”.
Assessments after arrest
Upon the defendant’s arrest he was assessed by a court liaison officer and subsequently by Dr Neillie and by Dr Heffernan at the Arthur Gorrie Correctional Centre before his transfer to The Park High Secure In-Patient Unit. All three were able to obtain a history going back some years of beliefs held by the defendant that his wife had been poisoning him and his children and that she had been having affairs. To the court liaison officer, the defendant reported that he felt that “someone at home was trying to poison him” and that he was finding that when he ate food he became drowsy and had severe stomach cramps. He stated that he believed this had been happening over the last two to three years and that he had approached his GP in December 2008 to request a blood and urine sampling.
When Dr Neillie interviewed the defendant on 5 June 2009, he made an assessment that the defendant was suffering from a psychotic illness characterised by a “delusional system with themes of infidelity/persecution into which his wife is incorporated”. The defendant was commenced on anti-psychotic medication and placed on a recommendation to the High Secure Unit at The Park.
The defendant told Dr Heffernan on 12 June 2010 that he believed his wife was poisoning him and that it was happening “with increasing frequency”. When seen by Dr Heffernan on 18 June 2009, the defendant continued to report his ongoing belief that his wife was poisoning him. When seen again by Dr Heffernan on 26 June 2009, the defendant had become concerned about being poisoned in custody and believed that his food could be poisoned because of various physical symptoms he was experiencing. It appears that while in custody the defendant experienced nausea and drowsiness that he connected with his beliefs of being poisoned.
The defendant was assessed on 2 July 2009 by Dr Voita at The Park. A provisional diagnosis of schizophrenia or delusional disorder was made and the defendant was placed on an involuntary treatment order. The defendant continued to report that he had been poisoned by his wife and he repeated his concerns that people may have been poisoning him through the kava he drank. He stated that in the days prior to the events in question it was happening most days and prior to that “once or twice a week for a year or two”. He reported to Dr Voita that in the week leading up to the alleged offences he was having a physical reaction on a daily basis which he attributed to his wife poisoning him. He also reported that the poisoning had occurred while he was in custody.
Expert evidence as to diagnosis
In her report dated 10 September 2009, Dr Voita opined that the defendant was suffering from a psychotic illness, most likely schizophrenia-paranoid type, and that his illness was characterised by delusions of persecution and of infidelity. Dr Voita acknowledged that a differential diagnosis of schizoaffective disorder and major depressive disorder with psychotic features would also need to be considered. Dr Voita also considered that the defendant fulfilled the criteria for a substance use disorder, specifically alcohol abuse (and possibly alcohol dependence).
Dr Schramm in his report of 17 February 2010 commented as follows on the defendant’s mental condition at the time in question:
“With no clear mental illness prior to the last decade, N has developed an illness characterised by depressed mood (featuring irritability) and persecutory delusions (featuring delusional jealousy) over a period of several years. The disturbance, which seemed initially to be mostly a disorder of mood, commenced in the context of loss of role as caregiver, the death of his father and chronic back pain. It seems to have occurred initially in the context of abstinence from alcohol but those more florid symptoms (the belief that he was being poisoned) did seem to correlate with a return to heavy drinking).
After a youth characterised by alcohol and cannabis use, he was reportedly abstinent for about 15 years, resuming heavy alcohol intake in early 2007.
As is culturally very common, N has been a regular participant in the drinking of kava. My understanding is that psychotic reactions to its use are very rare. Although I would suggest that his lengthy history of ingestion without ill effect would argue against it having an aetiological role in N’s disturbance, I cannot be certain.
Although involved in fights and conduct disordered behaviour in his youth (the former associated with heavy alcohol use) it is his report, which would seem consistent with that given by his wife to Dr Voita, that his irritability in recent years is uncharacteristic and responded to antidepressant medication. I consider that it is most likely of morbid origin. That is, it is part of the illness in question.
His account given to myself and to all those other persons who have interviewed him, along with that known by his GP, wife and siblings all seem to be consistent in regards his development of this illness and being preoccupied by delusional beliefs. For some time he has acted on the beliefs as though they were true on numerous occasions and well before the offences (including going to great lengths to avoid ingesting further poison, seeking evidence from his GP of the poisoning and complaining to his siblings etc).
I note also that, although his delusional ideas seem to have centred on his wife’s infidelity and poisoning, they also included other areas in his life such as WorkCover and members of his kava group. There seems to be an absence of other first rank schizophrenic type symptoms such as formal thought disorder, hallucinations and bizarre delusions.”
Dr Schramm made a primary diagnosis of a mood disorder with psychotic features, but accepted that a differential diagnosis of a delusional disorder (morbid jealousy type) was also a possibility. He did not agree with the diagnosis of schizophrenia provided by Dr Voita. He observed that, in favouring that diagnosis, Dr Voita appeared to adopt the view that the defendant’s psycho-social decline could be explained by schizophrenia, rather than a delusional disorder. However, Dr Schramm was of the view that the defendant’s declining function could be explained by his back injuries and descent into depression and delusion. Dr Schramm opined that, “Other than delusions, there do not seem to be any other psychotic symptoms and [the defendant] seems to have a preserved personality, an absence of affective blunting and other negative symptoms of schizophrenia.”
Dr Van de Hoef favoured the diagnosis adopted by Dr Voita. In her report dated 2 February 2010, she opined that “the defendant was suffering from a psychotic illness at the material time, most likely paranoid schizophrenia, which had its onset in early 2006 (but perhaps before that.)”. She noted that the defendant’s illness was currently being effectively treated, and appeared to be in remission, but that when most unwell, he became deluded, mainly about his wife, paranoid, irritable and insightless. In relation to his schizophrenic illness, Dr Van de Hoef observed that it “was characterised by sleep and mood disturbance, persecutory and morbidly jealous delusional beliefs (that he was being poisoned, stolen from and cuckolded) and by physical symptoms of nausea and dizziness, that may have become incorporated into somatic delusions”.
The defendant’s current treating psychiatrist, Dr Aboud, noted in his report of 26 May 2010 that the working diagnoses are psychotic disorder (schizophrenia – paranoid type), alcohol dependence and kava abuse – currently abstinent in a protected environment.
Expert evidence as to unsoundness of mind
While finding that the defendant suffered from a mental illness, Dr Voita was unable to conclude that the defendant suffered a deprivation of any capacity as a result of his mental illness. She did accept, however, that the defendant was impaired in respect of the capacity to know he ought not do the acts in question. In this regard, she opined that:
“I have considered carefully the issue of deprivation of this capacity and I am of the opinion that he was impaired but not fully deprived of this capacity … this is supported by the varying accounts of the alleged offences and attempts after the fact to conceal the act and to get rid of the evidence i.e. by making his wife have a shower and only calling the ambulance after this occurred and by subsequently changing and concealing his clothing before police and the ambulance arrived. He also allegedly told police on arrival at the house that he was responsible for the offences.”
Additionally, Dr Voita stated:
“In my opinion although the argument preceding the alleged assault was based on delusional ideas, the alleged assault was motivated by anger. There is other evidence obtained and outlined in this report that N suffers from anger management problems. There is also a history of alleged lack of recollection of events when under extreme emotion and also when intoxicated.”
However, Dr Voita’s clinical opinion as stated in her report on the issue of whether there was a relevant deprivation was substantially qualified by the evidence she gave orally. In the passage quoted above, Dr Voita appeared to liken the anger which she considered was present at the time, to the “anger management” difficulties of the defendant, which she referred to elsewhere in her report. However, in her oral evidence, Dr Voita accepted that any anger present at the material time could not be seen as having that complexion. Indeed, she accepted that the emotion in question was a psychotically driven one which resulted from the defendant’s delusional thinking. She also accepted that the defendant’s conduct ought to be seen as a delusionally driven and frenzied attack on his wife, for which she was unable to attribute any other basis than his psychosis. She thus moved away from her previous position that a factor against the conclusion that the defendant was relevantly deprived was that his conduct was motivated by anger, accepting that any such anger was the result of psychosis. She also agreed that it had resulted in a substantial impairment of capacity. Ultimately, Dr Voita’s inability to find deprivation, as opposed to substantial impairment, seemed to have rested on her view of the defendant’s post-offending conduct.
Drs Van de Hoef and Schramm, however, adopted the view that the defendant’s mental illness did result in a deprivation of the capacity to know that he ought not do the acts in question.
In her report, Dr Van de Hoef stated:
“After considering the witness statements, medical file, and N’s account of events to me, I have come to the following conclusions:
The attack on SN was savage, perhaps even frenzied, and could have been lethal. It appears to have occurred in response to N’s delusional beliefs he was being poisoned, and cuckolded, by his wife, and in an attempt to get her to ‘confess’. He had mentioned these beliefs before, over a period of at least 3 years, to others; his wife, his brother and sister and his general practitioner. He had also acted on them before: by keeping foodstuffs separate, keeping samples, by washing dishes repeatedly, by getting a blood test (for evidence of poisoning), by hiring a private investigator, and perhaps arranging a lie detector test.
The reasons for his showering his wife, and washing the walls after the assault are not clear. He told the 000 operator he had hit his wife, and also admitted it to the police when they arrived, indicating he knew the nature of his actions. He did not attempt to decamp, and did not resist arrest.
He knew at the time that his actions would get him into trouble with the police. He appeared composed after the attack, and made arrangements for his children to be cared for.
His psychotic symptoms were still evident some weeks later, but appear to have responded well to treatment.
In my view, his mental illness resulted in such overwhelming and threatening delusional beliefs (that his wife had repeatedly betrayed him, and posed a risk to the lives of him and their children) that when he experienced dizziness and nausea again that day, he was compelled to confront her for the ‘truth’, and to put a stop to it. I am sure he was angry at the time, but I think there is evidence it was fuelled by psychosis. I think his illness then deprived him of the capacity to know that he ought not do the act(s).”
Dr Van de Hoef maintained her opinion as to deprivation notwithstanding close questioning of her in oral evidence. Dr Van de Hoef accepted that there was an element of anger in the defendant’s conduct, but did not see it in terms of an “anger management issue” that the defendant had, observing that the longitudinal history she had obtained did not indicate an individual with such problems. She saw the element of anger as deriving from the defendant’s psychotic disorder and as an integral part of it. Dr Van de Hoef also stated that she did not see the defendant’s conduct immediately after the acts in question as inconsistent with a deprivation of the capacity to know. Rather, she saw that conduct as consistent with such a deprivation, observing that, even though the defendant had just inflicted shocking injuries on his wife, he nevertheless believed it appropriate that he change his clothes so that he could accompany his wife to the hospital. Moreover, he made no attempt to conceal his involvement in inflicting the injuries.
In relation to the issue of deprivation of capacity, Dr Schramm likewise considered that there was a deprivation of the capacity to know. He also did not consider that the defendant’s conduct after the assault detracted from a finding of deprivation of capacity. He stated:
“I believe that [the defendant’s] irritability was an integral part of his illness and suggest that this afforded a certain impairment in his ability to control his actions, but I agree with Dr Voita that he probably could not be considered to be completely deprived of this particular capacity. I do suggest that this is still a possibility though.
I do believe that he was completely deprived of the capacity to know that he ought not do the act in that his delusional belief that his wife was again poisoning him and the attendant grossly impaired judgment and irritability rendered him unable to reason with any degree of sense and composure.”
In his oral evidence, Dr Schramm indicated that he also favoured the view that there was a deprivation of the capacity for control resulting from the defendant’s psychosis, notwithstanding that there were no command hallucinations or passivity phenomena, but instead a delusional belief system operating at the time.
Conclusion
Diagnosis
All the reporting psychiatrists considered that the defendant was at the relevant time suffering from a psychotic disorder which was undiagnosed and untreated, although there were differing views as to the exact diagnosis. The differing views do not affect the issue of whether the defendant was of unsound mind, although they impact on the issue of future management. I note that intoxication was not considered to be an issue by Drs Van de Hoef and Schramm and I accept that clinical evidence.
I note that Dr Varghese in advising the court on the clinical evidence made the following observations in respect of diagnosis:
“It seems to me … while there is no doubt that [the defendant] was delusional, the question of diagnosis is of some importance in that it has implications for treatment and also for risk management in the future. It seems to me … looking at the totality of the clinical evidence that the appropriate diagnosis is probably paranoid schizophrenia with morbid jealousy as a predominant symptom rather than a pure morbid jealousy given that the delusions involve more than mere jealousy and also there is an increasingly bizarre element in some of the delusions with respect to poisoning.
The fact that the schizophrenia is of late onset I think explains what Dr Schramm has observed as preservation of affect and absence of negative symptoms as well as the absence of formal thought disorder. … one could make a diagnosis of schizophrenia on the basis of the delusions and their type without having to invoke further symptoms like hallucinations.
I don't think it is likely that he suffers a mood disorder given what has been described longitudinally. It is not an episodic delusion but rather a persistent, consistent delusion lasting several years. Moreover the observations with respect to his clinical state soon after does not emphasise depressed mood.”
In the circumstances, I am satisfied that at the relevant times the defendant suffered from a mental illness.
The charge of deprivation of liberty
In respect of the charge of deprivation of liberty there is a relevant dispute as to whether the defendant forced his wife into the shower. In respect of that charge, I find that in the light of the evidence of the defendant’s wife, there is a dispute of fact not arising from the defendant’s mental condition, such that a reasonable doubt arises as to the commission of that offence. As the defendant is fit for trial, that matter will proceed according to law.
The charges of attempted murder and acts intended to cause grievous bodily harm
In respect of the other charges of attempted murder and acts intended to cause grievous bodily harm, there is no dispute of fact. Given that the clinical evidence is that the defendant suffered a mental illness at the time, the real question for determination is whether there was a deprivation of one of the relevant capacities at the time, resulting from the defendant’s mental illness. I note that the last reported use of alcohol by the defendant occurred approximately 12 hours before the events in question. There was no clear clinical support for the view that intoxication was a relevant factor in any deprivation of capacity.
In considering the defendant’s capacity to know that he ought not do the acts constituting the offences, it is the capacity for moral judgment, not an understanding of lawfulness, that is in issue and which the defendant must be deprived of (see R v Stapleton (1952) 86 CLR 358, 372). In Stapleton, the High Court endorsed the following formulation of the test by Dixon J in R v Porter (1933) 55 CLR 182, 189 - 190:
“If through a state of mental disease or natural mental infirmity the defendant could not reason about the matter with a moderate degree of sense and composure it may be said that he could not know that what he was doing was wrong. … What is meant by wrong is wrong having regard to the everyday standards of reasonable people.”
In other words, the inquiry is whether, as a result of a state of mental disease, the defendant was deprived of the capacity to know that the act in question was a wrong act to commit in the sense that ordinary reasonable men and women understand right and wrong, and whether he was disabled from considering with some degree of composure and reason what he was doing and its wrongness (Porter, 190; Re HW [2008] QMHC 14, [25]).
I note that the preponderance of the expert evidence was that, as a result of his mental illness, the defendant was deprived of the capacity to know he ought not to do the acts at the relevant time. The weight of the clinical evidence is that the defendant was overwhelmed by delusional ideation and thereby deprived of the capacity to know. Drs Van de Hoef and Schramm gave detailed clinical evidence to support that position. As I have already said, while Dr Voita was unable to reach the same conclusion in her report, she substantially modified her reasoning in giving oral evidence. Initially, her reservations centred on her view that, at the time of the offending behaviour, anger was present as a motivating factor in addition to the defendant’s mental illness. However, as already explained, Dr Voita conceded that the defendant’s anger ought to be seen as a part of and arising out of his psychosis.
I note that both assisting psychiatrists favoured the opinions of Drs Van de Hoef and Schramm concerning the deprivation of the capacity to know. As Dr McVie pointed out in her advice to the court, the defendant had previously acted on his delusional beliefs; he had made his wife submit to a lie detector test and he had been to his GP to obtain proof that he had been poisoned, in addition to also verbally confronting his wife. I do not consider that the defendant’s conduct after the acts in question detract from a finding that there was a deprivation of the capacity to know. I note the evidence of Dr Van de Hoef, endorsed by Dr McVie that that conduct can in fact be seen as confirming a lack of that capacity. Dr McVie advised:
“The post offence behaviour is rather odd, in particular N's statement that he changed his clothes and he at one point expected to accompany his wife to the hospital and was surprised that police arrived before the ambulance. This to me is further evidence of a lack of moral reasoning at the time, though he clearly did develop an awareness that police would take him away. Also with that were his open admissions to the police and his lack of concealment.”
I find the evidence of Drs Schramm and Van de Hoef persuasive on the issue of deprivation and am satisfied that at the relevant time the defendant was, as a result of his mental illness, deprived of the capacity to know he ought not do the acts.
Additionally, in respect of the issue of deprivation of capacity, I note that a deprivation of capacity for control was found in Re SAM [2003] QMHC 3, in respect of a defendant suffering from paranoid schizophrenia and experiencing psychotic thinking and responding to delusions. As mentioned, Dr Schramm considered it open to find a deprivation of the capacity for control. I also note that, clinically, both assisting psychiatrists favoured the view that there was a deprivation of the capacity for control. In this respect, Dr Varghese advised:
“It seems to me from a clinical point of view that delusional ideation can be so powerful that an individual could lose control for their actions in certain situations regardless of whether they had knowledge of the wrongness of the act. And, of course, in this case we're talking about his mental state at the material time whatever one's interpretation of events subsequently. So, in summary my advice, your Honour, is that the defendant was of unsound mind at the time with deprivation of capacity to know he ought not to do the act and probably of the capacity for control.”
On balance, I am satisfied that the clinical view suggested by Dr Schramm in respect of the capacity for control should be accepted.
In the circumstances, I am satisfied that the defendant was, as a result of his mental illness, deprived of both the capacity to know that he ought not to do the acts in question and of the capacity for control. Accordingly, I find that he was of unsound mind at the relevant time.
Forensic Order
Bearing in mind the nature of the charged offences and that the defendant’s wife sustained very extensive and serious injuries as a result of the defendant’s conduct, and also the defendant’s need for closely monitored and ongoing psychiatric care and the need to protect the community, a forensic order is clearly warranted. Both assisting psychiatrists noted that the grave long term risks are such that very careful regard will be required in the future in respect of issues of limited community treatment. At this stage, the only limited community treatment appropriate is escorted ground leave in accordance with the submission from the Director of Mental Health.
Orders
In respect of the charges of attempted murder and acts intended to cause grievous bodily harm, I find that the defendant was of unsound mind at the relevant time. I order that the defendant be detained in The Park High Security Program Authorised Mental Health Service. I approve limited community treatment confined to escorted leave on the grounds of the hospital at the discretion of the authorised psychiatrist and on the conditions that:
(a) The patient is to remain under the escort of two health service staff member/s nominated by the authorised psychiatrist for the duration of the limited community treatment;
(b) For the purposes of escorted limited community treatment, the patient complies with the directions of the nominated staff member/s for the duration of the limited community treatment.
In respect of the charge of deprivation of liberty, I find that there is reasonable doubt as to the commission of the alleged offence. As the defendant is fit for trial, those proceedings will continue according to law. Pursuant to s 273(1)(b) of the Mental Health Act 2000 (Qld), in respect of that charge, I order that the defendant be detained in The Park High Security Program Authorised Mental Health Service until:
(a) The defendant is granted bail under the Bail Act 1980; or
(b) The defendant is brought before a court for continuing proceedings.
I grant leave to the parties to use the medical reports in any further proceedings. I direct that a copy of the transcript be provided to the defendant’s treating psychiatrist and to the Mental Health Review Tribunal on any review of the forensic order.
4
1