Re Price

[2005] QMHC 56

MENTAL HEALTH COURT

CITATION:

Re Price [2005] QMHC 56

PARTIES:

REFERENCE BY THE DIRECTOR OF MENTAL HEALTH IN RESPECT OF STEPHEN WARREN PRICE

PROCEEDING NO:

198 of 2004

DELIVERED ON:

2 November 2005

DELIVERED AT:

Brisbane

HEARING DATE:

21 October 2005

JUDGE:

ASSISTING PSYCHIATRISTS:

Holmes J

Dr J F Wood
Dr D A Grant

FINDINGS AND ORDER:

1.   There is a reasonable doubt, pursuant to s 268 of the Mental Health Act 2000 (Qld), that the defendant committed the alleged offences of rape, torture and deprivation of liberty.

2.   The defendant was not of unsound mind as described in the Mental Health Act 2000 (Qld), Schedule 2 at the time of the alleged offences of unlawful wounding and grievous bodily harm.

3.   The defendant is temporarily unfit for trial.

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.4.   

CATCHWORDS:

MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where defendant charged with rape, torture, deprivation of liberty, unlawful wounding and grievous bodily harm – where the defendant disputes the facts of the first three alleged offences – where examining psychiatrists agreed that the defendant suffers from chronic paranoid schizophrenia – whether intentional intoxication contributed to the defendant’s mental state – whether the defendant had psychotic symptoms at the time of the alleged offences so as to deprive him of the capacity to understand what he was doing, or the capacity of control, or the capacity to know that he ought not do the act.

Criminal Code Act 1899 (Qld), s 27

Mental Health Act 2000 (Qld), s 268, s 288(4), Schedule 2

COUNSEL:

Ms C Morgan for the defendant

Mr J Tate for the Director of Mental Health
Ms C Kelly for the Director of Public Prosecutions (Qld)

SOLICITORS:

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

Director of Public Prosecutions (Qld)

[1] HOLMES J: Mr Price is charged with rape, deprivation of liberty, torture, unlawful wounding and grievous bodily harm, all of those offences allegedly committed against one complainant on 28 August 2004. In this proceeding, counsel for Mr Price said that I should refrain from a finding as to soundness of mind in relation to the charges of rape, deprivation of liberty and torture, on the basis that he disputes the facts alleged in relation to those charges, and the psychiatric evidence is to the effect that that dispute is not the product of mental illness. As to the remaining charges, the issues were whether Mr Price was deprived of any of the capacities identified in s 27 of the Criminal Code at the time of the alleged offending, and, if so, whether intoxication with alcohol or cannabis had contributed to any extent to his mental state[1].  In addition, the question arose as to whether he was fit for trial on any charges not the subject of an unsoundness finding.

[1] See the definition of “unsoundness” in Schedule 2 of the Mental Health Act 2000.

The Crown case

[2]      At the time of the events giving rise to the charges, Mr Price had been living for two weeks at a boarding house at Spring Hill.  The complainant was also a resident.  The Crown case is that over the evening of 27 August 2004 Mr Price, the complainant and two other men were drinking at the boarding house; for some of the time, outside, and at other times in Mr Price’s room.  One of the two other men, Mr Phineasa, joined them between 7pm and 8pm.  He says in his statement that Mr Price and the complainant had a pack of 30 cans of VB; when he saw them it looked as if they had drunk about 15 cans between them.  They did not seem affected by the alcohol and were talking normally.  The other man, Mr Fowler, was with them at different intervals, culminating in a period between 10pm and 1am.  Over that period, he says, Mr Price was not noticeably intoxicated, but the complainant was very drunk, falling out of his seat.  By the time he left, Mr Price was “a little bit tipsy”.  Mr Price and the complainant were “still drinking and just chatting”; there had been no arguments, nor any aggression.   

[3]      During the evening, the complainant had been wearing a t-shirt and tracksuit pants. At about 2:30am on the following morning he was found lying, naked from the waist down, in the roadway outside the boarding house.  There were marks indicating he had been dragged to that position.  His scrotum had been sliced with a sharp object, exposing one testicle and dislodging the other, and his anus penetrated.  A garden fork with a blood-stained handle was found in the boarding house hallway.  Mr Price’s bedding was blood-stained, as were other items around his room.  The complainant himself said he had no recall of what happened; his last recollection was of being in the boarding-house room, drinking with the other three men. 

[4]      When they arrived at the boarding house, the police carried out a door-knock of residents.  Mr Price appeared to have been woken from his sleep.  He said that he had been drinking with Mr Fowler and Mr Phineasa and no one else; he knew nothing of the victim.  He had drunk about 3 cans of VB.  He explained that the blood stains on his bedding were left there by a girl he had picked up the previous night, who had been menstruating.  The police officers who had, and recorded, this conversation with Mr Price made no comment in their statements as to his sobriety, but two other officers who transported him to the City Police Station described him as smelling of liquor and “moderately intoxicated”. 

[5]      At the police station, Mr Price was asked whether he wished to be interviewed.  There was some discussion of a caution and what had happened in terms of his being questioned at the boarding house and brought to the police station.  He said he barely knew the complainant and was asleep at the time of the incident.  His answers appear lucid.  But he does give, as a reason for not wishing to continue with the interview, an account of a previous experience with a restraining order, in which everything he said under oath was the truth and everything the girl in question said was “absolute rubbish”; which, he said, inclined him to “just stick with that silence policy”.   

[6]      A drug screen of a sample of urine taken from Mr Price at 9.30 pm on 30 August 2004 was positive for cannabinoids, but that, of course, provides no certain evidence as to time of ingestion.

Mr Price’s psychiatric history

[7]      Mr Price is now 32.  At 19, he was involved in a motor vehicle accident in which he sustained head injury and likely frontal lobe damage; those injuries seem to have produced some personality change.  Dr Beech, who gave evidence, explained that frontal lobe damage was likely to have rendered him more susceptible to the effects of alcohol.  That accords with his parents’ observation, as recorded in a recommendation for assessment after these events, that it takes little alcohol to have a major effect on his mental state. 

[8]      In 1999, Mr Price began to develop symptoms of a psychotic disorder, which all four reporting psychiatrists say is chronic paranoid schizophrenia.  Part of his delusion system is that he has been stalked and molested by a former girlfriend, with, relevantly for present purposes, specific accounts of sexual assaults:  suspension by his testicles and anal rape.  In that connection he made repeated complaints to the police and sought, unsuccessfully, a restraining order.  Among his delusions is the belief that his ex-girlfriend has manipulated a particular police officer, various authorities and his parents so that they discount his complaints of assault.  (His ex-girlfriend did in fact obtain a restraining order against him.)  The degree of his psychosis, it seems, varies over time, but it has never entirely resolved.  Dr Beech described it as fluctuating between moderate and severe. 

[9]      Mr Price was admitted to the Logan Hospital for a brief period in October 1999 and again in 2001 for two periods of, respectively, 3 months and 3 weeks.  In May 2004 a Justice Examination Order was obtained in respect of him, as a result of the increasing severity of his psychotic symptoms.  Staff members at the supported accommodation where Mr Price previously lived received telephone calls from him in which he complained of being hung up by his testicles at Logan Hospital and said, among other things, that he wanted to stab someone with a knife; his parents made similar reports.  He was admitted to Royal Brisbane Hospital on 5 May 2004 and remained there until 25 June 2004 when he was discharged, to be monitored by the Valley Mental Health Service.  The notes of that service indicate that his delusional ideas had not significantly remitted.  He continued in his beliefs about persecution by his ex-girlfriend, with additional notions that the staff of both the hospitals to which he had been admitted had hung him up by the testicles and raped him.  He was still voicing those delusional beliefs to his case manager on 26 August, at his last appointment before the incidents the subject of the charges. 

Mr Price’s subsequent explanations for the events

1. Mr Price was seen by Dr MacDonald of the court liaison service on 30 August 2004, in the watch house.  He told him that he had used two or three cones of marijuana on the night in question and drunk some 10 beers.  Dr MacDonald recorded this passage as to the alleged offences:  “Denied any knowledge of offence but wanted to write a letter of apology for what he had done, which interestingly is what he also said he had done to someone else who he believes has been attacking him.  He refused to discuss his delusional ideation in detail saying ‘you would laugh at me and walk away thinking I am crazy.’”

1. On the same day, Mr Price was transferred to The Park High Security Unit.  The hospital notes are in evidence.  On admission, Mr Price disclosed his persecutory delusions, that he had been sexually assaulted by hospital staff elsewhere and that his previous girlfriend had attacked him.  He was seen to check his room for cameras.  But he attributed the incidents involving the complainant to intoxication with alcohol, and said he had also had three cones of cannabis. 

1. On 31 August 2004, the hospital notes record that Mr Price said he could not recall the incident of 28 August, but denied it.  He said he had drunk 10-12 cans on the night in question and smoked possibly one cone of cannabis.  On 1 September 2004, Mr Price was seen for the first time by Dr McVie, who gave evidence here.  Again, while denying the offence, he said that he was intoxicated with alcohol and cannabis at the time. 

1. On 13 September 2004 Mr Price was examined by a registrar, Dr Chiu, and, it appears, for the first time, raised self-defence.  He told her that the complainant had been drinking with him and Mr Fowler.  Later the complainant had come to his room and taken some medication that belonged to him, Mr Price.  Subsequently he returned “and tried to have sex with” Mr Price.  He had grabbed him by the testicles in self defence.  Dr Chiu records that in giving this account Mr Price was thought-disordered at times.  On 20 September 2000, again speaking to Dr Chiu, he expressed anger about the charges, claiming his actions were in self defence.  She noted, however, that he appeared psychotic.   

1. In early October 2004, Mr Price produced a written account of the night in question. In it, he said the complainant had come to his room, pushed him onto his bed, punched him, taken his pants off and tried to rape him.  In that process, he had straddled Mr Price, and sat on his face.  In response, Mr Price had grabbed his testicles and squeezed them, causing one to split through the skin.  He dragged the complainant outside and then rang the ambulance, returning then to see if he could help the complainant.  The complainant threatened to kill him, so he assumed he did not really require assistance.  Significantly, in this account Mr Price said that he was hearing both male and female voices during the incident which told him that the complainant was going to smash his possessions, rape and kill him.  From this point he has maintained in all discussions that he was not intoxicated at the time, that he had heard voices, that his acts were in self defence and that no weapon was involved. 

The psychiatrists’ evidence

1. The complainant’s treating psychiatrist at The Park throughout the balance of 2004 was Dr McVie.  She saw him again this year, on 31 May, in order to examine him and report.  Dr McVie thought the varying explanations that Mr Price had given arose from a denial of his mental illness and a desire to distance himself from the events of the night.  He would have been unwilling to disclose that he was hearing voices, and was unable to explain his thought processes when he was first admitted to hospital.  It was of some significance, though, that Mr Price had raised his difficulties with his ex-girlfriend when he was interviewed by the police. (Presumably, Dr McVie was referring here to what Mr Price said about the unsatisfactory restraining order process).  In May 2005 he told her that he had initially denied any recall of what happened at the instruction of the voices in his head, but his writing down of the account was equally at the voices’ direction.  She did not think he had been well enough to seek actively to engineer a mental illness defence.

1. Dr McVie considered that Mr Price’s illness was sufficient to deprive him of the capacity to know he ought not do the acts of unlawful wounding and grievous bodily harm.  It was likely that he was experiencing command hallucinations, and he may have had a delusional belief that he was being assaulted.  He had consistently maintained that he knew nothing of the allegations of anal rape, torture and deprivation of liberty and she thought it more likely than not that that dispute did not arise out of any delusional belief.  When asked about the role of intoxication, Dr McVie said that it was “very difficult to exclude” that it must have played some part in combination with his illness and brain injury but she maintained that the mental illness of itself was sufficient to deprive him of capacity. 

1. Dr McVie said that when she had seen Mr Price this year he was, in her view, unfit for trial.  He was vulnerable to any sort of stress.  He had deteriorated significantly when the question of possible use of a garden fork in the assault was raised with him and she thought, at least on her observation at that time, that he was likely to suffer severe adverse consequences from the trial process.  He was also very disorganised in his thinking, and it would be difficult to obtain clear instructions from him. 

1. Dr Beech similarly reported and gave evidence.  He considered it was possible that Mr Price had been psychotic and deprived of the capacity to know that what he was doing was wrong but he did not think it probable.  While he accepted that Mr Price suffered from an ongoing, never entirely resolving, psychotic illness, Dr Beech pointed out that in Mr Price’s dealings with the Community Mental Health Team, with the police who spoke to him after the events of 28 August, with Dr MacDonald and with the staff at The Park on admission, there was no suggestion that he had at any stage incorporated the complainant into his delusional system.  The witnesses’ statements indicated to the contrary: he and the complainant had been drinking amicably over the evening.  It was possible, but unlikely, that there had been a very sudden onset of a psychotic belief that the complainant was assaulting him; but again, the absence of any reference to it in his relatively rational conversations with the police officers tended to negate that view. 

1. Dr Beech characterised the different explanations given by Mr Price as an effort at exculpation, rather than as reflecting any psychotic symptoms.  Mr Price had given no account of auditory hallucinations to the Community Mental Health Team in the weeks leading up to the event, nor immediately after his admission to staff at The Park, although he was willing to describe other psychotic symptoms.  His initial explanations of a non-psychotic nature persisted for at least a couple of weeks after his admission to The Park, although the notes indicated that he had settled quickly, so it did not seem that he was simply too unwell at first to disclose the nature of his psychotic experiences.  If Mr Price had been actively psychotic in the period after his admission, Dr Beech thought that would have been evident to the staff, but no perceptual abnormality had been detected. 

1. Dr Beech accepted that if there were any sort of form of homosexual attack on Mr Price it would be likely to make him acutely psychotic, but on the whole he considered there was no clear evidence that Mr Price had been psychotic at the time of the happening of the events.  If, to the contrary, he had been deprived by psychosis of the capacity to know what he was doing was wrong, it was likely that voluntary intoxication by cannabis and alcohol had contributed to that psychosis.  He noted the likely susceptibility of Mr Price, because of his head injury, to disinhibition and exacerbation of any psychosis when he consumed alcohol.

1. When Dr Beech examined Mr Price in March 2005, he considered him fit for trial, but he accepted that that situation might fluctuate.

1. Dr Fama was the third of the psychiatrists who considered the question of soundness of mind.  He saw Mr Price on 13 October 2005.  Mr Price gave him an account of self defence against the complainant and added that he believed a police officer involved in his delusions about his ex-girlfriend had hypnotised the complainant to attack him.  Dr Fama accepted that Mr Price was afflicted with a mental disease at the time in question, but he did not think that Mr Price’s later accounts of hearing voices and believing in some form of conspiracy were to be given any credit.  He regarded as important the witness information to the effect that Mr Price was drinking quietly with the complainant earlier in the evening, without any sign of disturbed behaviour.  And, Dr Fama said, if indeed Mr Price had been psychotic, the explanations he gave police suggested he had recovered his wits with remarkable celerity; there was an ingenuity in his accounts not consistent with the responses of a person plagued by paranoid delusions.  Generally, Mr Price was forthcoming with delusional material, readily disclosing his persecution by his ex-girlfriend; if he believed he had acted in self-defence on the night in question it seemed odd that he would not divulge it.  Dr Fama thought the most likely explanation was an extravagant response to sexual provocation, made worse by the psychotic process and to some unknown extent by intoxication.

1. In summary, while Dr Fama accepted that Mr Price was psychotic at the time of the events, in the sense that he chronically suffered from some degree of psychosis, he did not think there existed sufficient evidence that it had caused deprivation of any relevant capacity.  If in fact he had been sexually assaulted by the complainant, that might well have activated psychotic delusions.  But it was a matter of conjecture whether he had been so assaulted. 

1. Dr Fama considered that Mr Price was fit to instruct counsel and take part in a trial.  He did not think there was anything to suggest that a trial, although stressful, would result in any significant decline in Mr Price’s mental condition.  He accepted, however, that if Mr Price were to become acutely distressed by his psychosis, he would not be fit for trial while that state of affairs lasted.

1. Dr Shuer who has been, until very recently, Mr Price’s treating psychiatrist, has given a report of 6 October 2005 expressing the view that he is currently not fit for trial.  He would have some difficulty instructing counsel because of what she describes as “his limited verbal processing and perseverance”, and the consequences of court proceedings might have an adverse affect on his mental state.  She had observed that during periods of stress Mr Price’s psychotic symptoms worsened.  Counsel for the Director of Public Prosecutions conceded that as Dr Shuer had been Mr Price’s treating psychiatrist her evidence as to fitness could be preferred. 

Conclusions

1. I am satisfied, in terms of s 268 of the Mental Health Act 2000, that there is a reasonable doubt, not arising only by reason of Mr Price’s illness, as to his having committed the offences of rape, torture and deprivation of liberty.  I will not, therefore, proceed to any finding in respect of unsoundness in respect of those matters. 

1. Arriving at a satisfactory conclusion on unsoundness in respect of the remaining offences, of unlawful wounding and grievous bodily harm, is made difficult by the complete absence of any evidence of what actually happened between the departure of Mr Fowler and the finding of the wounded complainant in the roadway.  Like Drs Beech and Fama, I do not think Mr Price’s more recent accounts are reliable, although that is not necessarily the result of any deliberate misleading on his part.  It is quite clear that he was mentally ill before and during these events and has remained so ever since. 

1. The question is whether that illness deprived Mr Price of any relevant capacity.  There is some indication that it might have; in particular, it is obvious that the nature of the injuries sustained by the complainant closely reflect the themes of Mr Price’s delusion system.  It is entirely possible that Mr Price’s psychosis was triggered by a real or perceived sexual advance, but this is a matter of conjecture.  There is nothing in the accounts given immediately after the event to suggest he was operating under any delusion with respect to the complainant, or, more particularly, that his established delusional beliefs had extended to incorporate the complainant.  To the contrary, there was a capacity to give diversionary accounts not suggestive of a significantly disturbed mental process.

1. Like Dr Beech, I do not think that one could conclude, at the level of probability, that psychosis deprived Mr Price of any capacity.  Even if one could, it seems to me very probable that intoxication was a significant factor.  Mr Price was drinking with the complainant over some hours that night.  His accounts in the days following were of intoxication, although that should, of course, be treated with considerable caution.  More significantly, he impressed two police officers as moderately intoxicated.  Mr Fowler described him as a “little bit tipsy”.  Those indications have to be taken with what has been said about the likely effects of alcohol on his condition, in causing disinhibition and exacerbating his psychosis.

1. On the whole, I do not think that the evidence supports a finding that Mr Price’s state of mental disease deprived him of any of the capacities defined in s 27, without contribution from intentional intoxication. Accordingly I find he was not of unsound mind within the meaning of the Mental Health Act at the time at which the offences of grievous bodily harm and unlawful wounding were allegedly committed.  I should make it clear, however, that my finding is based on an absence of adequate evidence, resulting largely from the complainant’s lack of recollection and possibly also from the effects of Mr Price’s illness, rather than amounting to a positively-drawn conclusion.

1. I am satisfied, however, that Mr Price is at present unfit for trial, that unfitness not being of a permanent nature. Section 288(4) of the Mental Health Act requires that a forensic order be made.  I order that Mr Price be detained at The Park High Security Program Authorised Mental Health Service.