Re NRG

[2004] QMHC 21

MENTAL HEALTH COURT

CITATION:

Re NRG [2004] QMHC 021

PARTIES:

REFERENCE BY THE DIRECTOR OF MENTAL HEALTH IN RESPECT OF NRG

PROCEEDING NO:

0207 of 2003

DELIVERED ON:

29 September 2004

DELIVERED AT:

Brisbane

JUDGE:

ASSISTING PSYCHIATRISTS:

Wilson J

Dr J M Lawrence
Dr J F Wood

ORDER:

1)   That at the time of the alleged offence the defendant was suffering from unsoundness of mind;

2)   That the defendant be detained as a forensic patient in The Park High Security Program Authorised Mental Health Service for involuntary treatment and care;

3)   Approval of limited community treatment at the discretion of the authorised psychiatrist of two types: escorted leave on the grounds of The Park Centre for Mental Health and escorted leave off the grounds of The Park.  With respect to the escorted leave on the grounds, it is on condition:

(1)      that she remain under the escort of a health service staff member or members nominated by the authorised psychiatrist for the duration of the limited community treatment; and

(2)      that for the purposes of that escorted limited community treatment she comply with the directions of the nominated staff member or members for its duration.

With respect to the escorted leave off the grounds of The Park, it is to be for a maximum of four hours per week and otherwise on the same conditions as apply to the leave on the grounds.

CATCHWORDS:

MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where the defendant is charged with the murder of her three year old son – where defendant had previously been diagnosed with bipolar affective disorder – where expert psychiatric opinion is that the defendant is suffering from either schizo affective disorder or schizophrenia - where the defendant has a history of non-compliance with treatment – where defendant was of unsound mind – forensic order – conditions of limited community treatment

Mental Health Act 2000, schedule 2

COUNSEL:

B Devereaux for the defendant
J Tate for the Director of Mental Health
R Pointing for the Director of Public Prosecutions

SOLICITORS:

Legal Aid Queensland for the defendant
The Crown Solicitor for the Department of Mental Health
The Director of Public Prosecutions

1. WILSON J:  NRG has been charged with the murder of her three year old son on 8 August 2003.  The matter of her mental condition in relation to the offence was referred to this Court by the Director of Mental Health.

1. The defendant was born on 12 August 1972.  She is of Filipino descent.  At the time of the homicide she was living with her husband and child.  On the day in question at about 6.40 a.m. her husband left for work.  By 7.10 a.m. the defendant reported to the Goodna Police Station that she had killed her son.  The child's body was found with multiple stab wounds to the neck and torso.

1. The Court has had the benefit of reports by Dr William Kingswell and Dr Josephine Sundin.  It is clear that in the period leading up to the fateful day the defendant was mentally unwell and becoming more so.  She had a history of mental illness which had previously been diagnosed as bipolar affective disorder.  Medication had been prescribed but, at the time, she was not compliant with it.

1. At the time of the offence she believed that her body was under the control of an external figure, a female angel named Jeremiah.  Further she said that she became aware of Jeremiah's voice telling her that the child was a bad boy and that she had to kill him.  The voice warned her that the child would grow up in some way abnormal.  The defendant believed that she and the child both had to be sacrificed to prevent some evil from occurring.

1. Throughout the night before the homicide she was also aware of a second voice which she identified as that of Father Abraham of the Bible.  She was convinced that Abraham had sent the female angel, Jeremiah, to lead her to kill her son.  She believed Jeremiah could control her and kill the son through her.

1. Both Dr Sundin and Dr Kingswell were of the opinion that the mental illness from which the defendant suffered deprived her at the relevant time of the capacity to know that she ought not do the act and of the capacity to control her actions. In their reports they both expressed the opinion that she was suffering from schizo affective disorder. In oral evidence, Dr Kingswell said that with the benefit of sustained observations of her over many months he is leaning more towards a diagnosis of schizophrenia, but the evidence of her condition at the time of the offence is such that the precise diagnosis does not affect the outcome of the reference into her mental state. I am satisfied that at the relevant time she was suffering from unsoundness of mind as described in schedule 2 of the Mental Health Act.

1. Having regard to the seriousness of this offence, her treatment needs and the protection of the community, a forensic order must follow.  I order her detention as a forensic patient in The Park High Security Program Authorised Mental Health Service for involuntary treatment and care.

1. The outstanding issue is that of limited community treatment.  The defendant has been in hospital for about 13 months.  Her history of treatment prior to the homicide was poor.  She was non compliant with treatment. 

1. Since she has been hospitalised she has had adverse side effects to some of the medications which have been administered to her.  For some months she has been receiving only Olanzapine which is an anti psychotic medication.  She is not receiving a mood stabiliser.  This is because of her reactions to other medications and ongoing investigations into some of the medical conditions from which she suffers.

1. Not only are there treatment issues still to be worked through.  There are also psycho social issues to be resolved before she might return to the community:  where she is to live, et cetera. 

1. The leave which she has been receiving to date has consisted of escorted leave on and off the hospital grounds.  While I think the Court must always approach these questions with great caution, this is a case where, on the evidence of Dr Kingswell, she has been cooperative with treatment.  Her clinical condition has been relatively stable for some months and she has increasing insight into her condition.

1. There is, as I see it, no reason to restrict the leave that she has been receiving but nor is there a reason, at this time, to liberalise it.  That is a matter which can be considered in due course by the Mental Health Review Tribunal.

1. I approve limited community treatment at the discretion of the authorised psychiatrist of two types; escorted leave on the grounds of The Park Centre for Mental Health and escorted leave off the grounds of The Park.  With respect to the escorted leave on the grounds, it is on condition:

(1)that she remain under the escort of a health service staff member or members nominated by the authorised psychiatrist for the duration of the limited community treatment; and

(2)that for the purposes of that escorted limited community treatment she comply with the directions of the nominated staff member or members for its duration.

With respect to the escorted leave off the grounds of The Park it is to be for a maximum of four hours per week and otherwise on the same conditions as apply to the leave on the grounds.