Re RCP

[2004] QMHC 19

MENTAL HEALTH COURT

CITATION:

Re RCP [2004] QMHC 019

PARTIES:

REFERENCE BY THE ATTORNEY-GENERAL IN RESPECT OF RCP

PROCEEDING NO:

0202 of 2003

DELIVERED ON:

28 September 2004

DELIVERED AT:

HEARING DATE:

Brisbane

23 July 2004

JUDGE:

ASSISTING PSYCHIATRISTS:

Wilson J

Dr J F Wood
Dr D A Grant

FINDINGS:

1) That at the time of the alleged offences, the defendant was suffering from unsoundness of mind as described in schedule 2 of the Mental Health Act 2000;

2)   that the defendant be detained as a forensic patient in the Bayside District Authorised Mental Health Service for involuntary treatment and care;

3)   approval of limited community treatment to commence immediately on the following conditions:

(a)   that he reside at[address stated] or at an address approved in advance in writing by the authorised psychiatrist;

(b)     that he present to Dr Mark Rowe at Redland Health Service Centre, Cnr Wellington and Weippin Streets, Cleveland, on a date and at a time to be advised by the Director of Mental Health and attend all follow-up appointments and in-patient care as required by the authorised psychiatrist;

(c)   that he comply with the requirements of the authorised psychiatrist in relation to the taking of prescribed medication and other treatment;

(d)     that he abstain from using alcohol and illicit drugs and make himself available and co-operate fully in random medical tests for those substances as required by the authorised psychiatrist;

(e)   that he not drive a motor vehicle unless permitted to do so by the authorised psychiatrist.

CATCHWORDS:

MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where the defendant is charged with driving under the influence of liquor or a drug, dangerous operation of a motor vehicle, and failing to give his particulars at the scene of a crash – where the defendant suffers paranoid schizophrenia – where the defendant had consumed alcohol and an ecstasy tablet before the alleged offences – whether the defendant’s voluntary intoxication prevented him from being of “unsound mind” as defined in the Mental Health Act 2000

Criminal Code 1899, s 27

Mental Health Act 2000, schedule 2

COUNSEL:

B Devereaux for the defendant
D Grealey for the Director of Mental Health
M Copley for the Director of Public Prosecutions

SOLICITORS:

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

1. WILSON J:  RCP has been charged with three offences allegedly committed on 18 July 2003: driving under the influence of liquor or a drug, dangerous operation of a motor vehicle, and failing to give his particulars at the scene of a crash.  His mental condition in relation to the alleged offences was referred to this Court by the Attorney-General.

1. The defendant was born on 5 October 1983.  He suffers paranoid schizophrenia. 

1. The circumstances giving rise to the charges occurred on the Gold Coast at about 10.15 p.m. on a Friday.  He was breathalysed shortly afterwards and his blood alcohol concentration was 173 milligrams of alcohol per 100 millilitres of blood. 

1. In the period leading up to the alleged offences, the defendant had been noncompliant with his medication.  Two days before, he had quit his employment as a carpenter.  He told Dr Rowe, a psychiatrist, that he did this because he thought his boss was setting him up for stealing a post.  He also said his boss told him that he was not thinking straight and that this made him feel very uneasy and that he was "going to be beaten up."  He was also unsure of the company name he was working for and wondered if the whole situation was a "set up." 

1. The day before the offences, he took himself down to the Gold Coast and went surfing alone.  His persecutory ideation worsened and he said he thought about killing himself by jumping off a building as "everyone was persecuting him."  He thought his brother was part of the conspiracy and believed that his suspicions were confirmed when he was not invited to a going away party that his brother attended.  He also believed that his brother's girlfriend's name was not her real name. 

1. On the day of the offences, he felt persecuted and felt that his brother was part of the conspiracy.  He became frightened and thought that his brother was going to punish him for "being a bad person".  He was at his brother's place at the Gold Coast where he consumed some alcohol, about two or three beers, before driving himself to a nightclub.  He had further alcohol at the nightclub.  The quantity is not clear as differing accounts were given to Dr Rowe and another psychiatrist, Dr Colls, but it is not in dispute that at the time of the alleged offences he was intoxicated.

1. Further, he purchased one ecstasy tablet at the nightclub, but it is not clear whether he consumed it there or later when he was about to be apprehended by police. 

1. At the nightclub, the defendant felt more persecuted.  He thought the bouncers were talking about him and that someone might be following him.  He thought that if they caught him, they would beat him up.  He decided to leave.  He told Dr Rowe he wandered around Surfers Paradise for a while.  He felt more uncomfortable and that he had to flee, and so retreated to his car.  He sat in the car for a while where he felt people sitting in another car were watching him and about to attack him. 

1. The defendant started his car in an attempt to get away.  He started off driving in a controlled manner but he felt sure someone was following him and then drove in a "panicky" way to get away.  He remembered hitting a parked car and not stopping, but he felt he had to get away or he would be beaten up.  He continued to drive until he stopped at the Lone Star Tavern.  He thought this would be a relatively safe place because there was a group of people inside so "they couldn't beat me up or kill me."  He claimed not to remember police cars following him or sirens.  The next he remembered was that "police put me over the bonnet and arrested me."

1. The definition of "unsound mind" in schedule 2 of the Mental Health Act 2000 picks up section 27 of the Criminal Code - that is, one looks to see whether the defendant was suffering from a disease of the mind in consequence of which he was deprived of one or more of three capacities: the capacity to understand what he was doing; the capacity to control his actions; and the capacity to know that he ought not do the act.  The definition goes on to include the following exception: namely, that it does not include a state of mind resulting to any extent from intentional intoxication or stupefaction alone or in combination with some other agent at or about the time of the alleged offence.

1. Dr Rowe and Dr Colls were both of the view that the defendant was deprived by his paranoid schizophrenia of the capacity to control his actions.  His paranoid fears were so severe that alcohol was merely an incidental factor.  The illness of itself was of such intensity that he was deprived of that capacity regardless of his alcohol intoxication. 

1. The Court heard oral evidence from Dr Rowe and Dr Colls and received advice from the assisting psychiatrists.  That advice is recorded in the transcript.  The interplay of alcohol and psychotic illness was discussed.  The capacity to control one's actions is the volitional capacity.  Alcohol can cause disinhibition, but in this case the defendant's behaviour was in response to fear rather than being disinhibited behaviour.  Alcohol might have affected the intensity of the paranoid delusions, but there was no evidence that it did so either by increasing the paranoid fear or by alleviating it. 

1. The defendant may also have been deprived of the capacity to know he ought not do the act.  However, the doctors' written opinions focussed on the capacity of control and it is difficult to ascertain from their oral evidence whether ultimately they thought there was a total deficit of this cognitive capacity or merely a substantial impairment of it.  The defendant knew that driving under the influence of alcohol was against the law, but the issue is whether in his paranoid state he was able to reason with a moderate degree of composure as to whether it was the right thing to do.  Dr Rowe asked the defendant what he would have done if he had known the police were following him.  His response, "Well, I would have pulled over because they would have been able to offer me assistance" is consistent with his having no choice but to drive the vehicle although intoxicated and in the manner he did in order to flee his persecutors.

1. As to the ecstasy tablet, there is insufficient evidence to conclude that whenever it was consumed (whether at the nightclub or later) it contributed to the deprivation of capacity. 

1. This case has some comparatively unusual features.  Intoxication with alcohol, which was conceded, is itself an element of the first charge, but I am satisfied on the evidence that (to adopt the prosecutor's expression) this is a case where his paranoia drove the driving of the car.  It was not established that intoxication played a part in that paranoia.

1. Counsel for the defendant asked for a finding of unsoundness of mind.  The prosecutor conceded that that would be the correct finding on the evidence.  Mindful of that part of the definition of "unsound mind" which excludes a state of mind resulting to any extent from intentional intoxication, I insisted that the doctors be called so that their opinions could be tested in oral examination and insisted on submissions on the law.  Having heard the doctors' evidence and the submissions of counsel and having received the advice of the assisting psychiatrists, I am satisfied that the concession was properly made and am prepared to act on it.

1. I find that at the time of the alleged offences, the defendant was suffering from unsoundness of mind as described in schedule 2 of the Mental Health Act 2000.

1. Having regard to the seriousness of the offences, the defendant's treatment needs and the protection of the community, a forensic order is called for. 

1. I order that the defendant be detained as a forensic patient in the Bayside District Authorised Mental Health Service for involuntary treatment and care.  I approve limited community treatment to commence immediately on the following conditions:

1. That he reside at [address stated] or at an address approved in advance in writing by the authorised psychiatrist;

2. That he present to Dr Mark Rowe at Redland Health Service Centre, Cnr Wellington and Weippin Streets, Cleveland, on a date and at a time to be advised by the Director of Mental Health and attend all follow-up appointments and in-patient care as required by the authorised psychiatrist;

3. That he comply with the requirements of the authorised psychiatrist in relation to the taking of prescribed medication and other treatment;

4. That he abstain from using alcohol and illicit drugs and make himself available and co-operate fully in random medical tests for those substances as required by the authorised psychiatrist;

5. That he not drive a motor vehicle unless permitted to do so by the authorised psychiatrist.