Re Rudolph

[2009] QMHC 19

MENTAL HEALTH COURT

CITATION:

Re Rudolph [2009] QMHC 19

PARTIES:

REFERENCE BY THE LEGAL REPRESENTATIVE IN RESPECT OF JOHN WENDON RUDOLPH

PROCEEDING NO:

0127 of 2006

DELIVERED ON:

14 October 2009

DELIVERED AT:

Brisbane

HEARING DATE:

14 October 2009

JUDGE:

Philippides J

ASSISTING
 PSYCHIATRISTS:

Dr J M Lawrence
Dr E N McVie

FINDINGS AND ORDER:

1. That at the time of the alleged offence the subject of the reference, the defendant was suffering from unsoundness of mind as described in Schedule 2 of the Mental Health Act 2000 (Qld);

2.   That the defendant be detained as a forensic patient at Redcliffe/Caboolture Authorised Mental Health Service;

3.   That limited community treatment is approved to

commence immediately on the conditions contained in the submission from the Director of Mental Health.

CATCHWORDS:

MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where defendant charged with robbery with personal violence – where defendant suffered from chronic schizophrenia – where expert opinion differs as to whether the defendant was deprived of the capacity to know he ought not do the acts in question – whether a forensic order is appropriate – whether defendant was of unsound mind as defined in Schedule 2 of the Mental Health Act 2000 (Qld) at the relevant time.

Mental Health Act 2000 (Qld), Schedule 2

COUNSEL:

C Morgan for the Defendant
W Isdale for the Director of Mental Health
B Campbell 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)

1.   PHILIPPIDES J:John Wendon Rudolph is charged with robbery with personal violence on 11 September 2004.  The defendant has a diagnosis of chronic schizophrenia of longstanding duration with a first documented psychotic episode in 1996. In relation to the circumstances concerning the charge, the defendant gave an account to police and to the clinical reporters of being in a very desperate situation.  He also gave an account of auditory hallucinations.

1. Dr Varghese, in his report, opined that the defendant had a severe form of schizophrenia with ongoing hallucinations and delusions including, he noted, at the time of his interview with the defendant, despite treatment with anti-psychotic medication.  In oral evidence, Dr Varghese elaborated on his report and reiterated that he considered that the defendant was suffering from auditory hallucinations at the relevant time such that the defendant was compelled to do the acts in question.  The defendant also was preoccupied with a belief system that he was a sinner deserving of punishment.  Dr Varghese also referred to other psychotic symptoms such as thought broadcast and thought insertion which the defendant was experiencing.

1. Dr Varghese was of the view that, on balance, the defendant's account ought to be accepted with the conclusion that he was psychotic at the relevant time.  In this regard, I note that the account given to Dr Varghese is largely consistent with the account given to police soon after the event in question.

1. Dr Varghese was of the view that there was a deprivation of capacity as a result of the defendant's mental illness.  He identified the relevant deprivation of capacity as being the capacity to control his actions rather than the capacity to know he ought not do the acts in question.  He was questioned quite closely in relation to that view, but it was a view which he maintained and in respect of which he gave very clear evidence.  While Dr Varghese accepted that there was some ambivalence by the defendant in relation to carrying out the commands the subject of the auditory hallucinations and some contest in the defendant's mind with respect to the voices, his firm opinion was that the defendant ultimately was compelled to do the acts in question as a result of the auditory hallucinations and accordingly was of unsound mind at the relevant time.

1. Dr Puriri, who has been the defendant's treating psychiatrist since March 2005, provided a report which reached a conclusion that was different from Dr Varghese's.  She also gave oral evidence.  In her report she opined that at the relevant time the defendant was mentally stable.  She indicated that that conclusion was reached largely from looking at the defendant's medical chart. However, the view expressed in her report was significantly undermined by the nature of her oral evidence.  In giving oral evidence, Dr Puriri ultimately accepted that the defendant was probably psychotic on the day in question, experiencing auditory hallucinations and not in such a state that he could reason with a moderate degree of composure.  Nevertheless, her view was that she was not able to say that the defendant’s inability to so reason could be entirely sheeted home to his psychosis.  She therefore did not support the view that the defendant was deprived of the capacity to know he ought not do the acts in question as a result of his mental illness.

1. Notwithstanding that position, in relation to the question of deprivation of the capacity to control his acts, Dr Puriri did shift from the view expressed in her report.  She accepted that the defendant was progressively losing the battle with the voices that he was hearing, that the voices were coercing him to do the acts in question and that it would have been hard for him to resist the voices.  She stated that, whilst she could not be certain that there was deprivation of control, she accepted that it was more probable than not that there was a deprivation of control, and in that respect she reached a position which accorded with the view expressed by Dr Varghese.

1. I note the advice of the assisting psychiatrists and I take that into account in reaching my conclusion.  I accept that at the relevant time the defendant was suffering from a mental illness, namely schizophrenia.  I find, given the clear evidence of Dr Varghese, which ultimately was largely supported by the oral evidence given by Dr Puriri, that the defendant was deprived as a result of his mental illness of the capacity to control his acts.  I therefore find that the defendant was of unsound mind at the relevant time.

1. In relation to the question of a forensic order, that is a finely balanced one in this case.  The actual offending the subject of the charge is not at the more serious range of offences that come before the Court.  However, the evidence of Dr Puriri is that the defendant, who is on an ITO, needs to continue to be on an ITO and it is clear that the defendant has very significant ongoing treatment issues. 

1. Additionally, there has been a history of non-compliance and abuse of illicit substances which has exacerbated his mental illness.  Whilst he is currently well-engaged and supported in the community both by Mental Health Services and his family, that position may alter.  But there is also the further complicating aspect of the defendant suffering from a physical illness which will require medication and which may well impact upon the medication for his mental illness.  In those circumstances, I consider that it is appropriate that a forensic order be made. 

1. I order that the defendant be detained to the Redcliffe/Caboolture Authorised Mental Health Service.  I approve limited community treatment to commence immediately on the conditions contained in the submission from the defendant's legal representatives.