Re SGMT

[2005] QMHC 18

MENTAL HEALTH COURT

CITATION:

Re SGMT [2005] QMHC 018

PARTIES:

REFERENCE BY THE DIRECTOR OF MENTAL HEALTH IN RESPECT OF SGMT

PROCEEDING NO:

172 of 2005

DELIVERED ON:

10 June 2005

DELIVERED AT:

Brisbane

HEARING DATE:

10 June 2005

JUDGE:

ASSISTING PSYCHIATRISTS:

Holmes J

Dr J F Wood
Dr D A Grant

FINDINGS AND ORDER:

At the time the offence was committed the defendant was suffering from unsoundness of mind as described in schedule 2 of the Mental Health Act 2000 (Qld)1.   

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;2.   

Approval of escorted limited community treatment on the grounds of The Park Centre for Mental Health at the discretion of the treating psychiatrists on the following conditions: 3.   

That the patient is to remain under the escort of health service staff member/s nominated by the authorised psychiatrist for the duration of the limited community treatment;(a)        

For the purpose of escorted limited community treatment, the patient is to comply with the directions of the nominated staff members for the duration of the limited community treatment.(b)       

CATCHWORDS:

MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where the defendant is charged with murder –where the defendant suffers from schizophrenia, paranoid type– where defendant had delusional ideas and psychotic experiences– whether defendant of unsound mind at the time the alleged offence occurred – whether defendant deprived of one or more of the capacities in s 27 of the Criminal Code

Criminal Code (Qld), s 27

Mental Health Act 2000 (Qld), schedule 2

COUNSEL:

Ms C Morgan for the defendant
Mr W Isdale for the Director of Mental Health

Mr M Lehane 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. :HOLMES J  SGMT is charged with the stabbing murder of her 11 year old daughter on 26 August 2004.  The child was found in her bed with a number of stab wounds to her chest.  She could not be revived.  SGMT was found elsewhere in the house, holding knives, with self-inflicted chest wounds which were not deep. 

1. There is a strong body of evidence from neighbours, family and health professionals to the effect that in the months prior to the killing SGMT had developed delusional beliefs about being followed and intruders being around her house at night.  Those beliefs revolved around her ex-husband, neighbours and other acquaintances.  She had gone to the length of complaining to the police about her safety concerns in June 2004 and it is plain that the police officers who interviewed her had concerns then about her mental health.

1. Her sister took the step in July 2004 of seeking a mental health assessment. 

   
   

   A psychiatrist's appointment was arranged as a result.  As a result of that consultation SGMT was referred to her general practitioner for treatment.  She was prescribed an anti-psychotic medication but it seems she was reluctant, because of the side-effects, to take it. 

1. SGMT made statements after the killing to people who attended at the scene suggesting that she believed she was protecting her daughter from their enemies and ending her suffering.  In later psychiatric interviews she gave her account of seeing a dark-haired man in a brown coat on her driveway and being overwhelmed by terror.  That was an account, of course, consistent with the persecutory delusions that are well-substantiated by collateral evidence.  There is no evidence of any alcohol or drug use involved in this case.

1. SGMT has been assessed by three very experienced psychiatrists in connection with the question of her soundness of mind at the time her daughter was killed.  All have reached very similar views. 

1. Dr Heffernan saw SGMT at The Park Centre for Mental Health over the course of a number of interviews after her admission there immediately following her arrest.  He has been her treating psychiatrist until very recently.  His opinion is that she suffered from a mental disease, a psychotic illness which was either the result of paranoid schizophrenia or a delusional disorder which deprived her of the capacity to know that she ought not do the act in question; that is, the stabbing of her daughter.

1. In a recent report of 11 May 2005, he has said that she has been treated with anti-psychotic medication and although she is more settled still maintains her delusional beliefs about persecution and harassment.  He says she still does not fully appreciate her illness and the need for treatment although she is compliant. 

   
   

   She presents a low risk, he says, of aggression to others or self harm or absconding.

1. Dr Sundin examined SGMT on 22 January 2005.  She accepted that SGMT had suffered from persecutory delusions.  She thought it likely also that she had experienced auditory hallucinations.  Her diagnosis was of schizophrenia, paranoid type, with a principal differential diagnosis of a delusional disorder.  Dr Sundin considers that the mental disease, that is the paranoid schizophrenia, which had rendered SGMT acutely psychotic, had deprived her of the capacity to know she ought not do the act.

1. Dr Van de Hoef interviewed SGMT in February 2005.  She describes her as having developed a severe, unremitting and worsening psychotic illness in the six months before the offence.  She considers the mostly likely diagnosis to be late onset schizophrenia, with a differential diagnosis of major depressive episode with psychotic features.  Like Dr Sundin, she said in her report that she thought it likely SGMT had experienced auditory hallucination.

1. Dr Van de Hoef raised this matter as a result of a telephone conversation with

   
   

   SGMT's ex-husband, Mr Robert Taylor:  In a statement that he gave to the police after SGMT's arrest he describes a telephone conversation he had with her on the night preceding the killing.  SGMT had rung him on his mobile and said to him things such as that everyone was just playing a game with her life and the worst things were going to happen to him now. 

1. She had said something to the effect of, "The wrath of evil is going to come upon you.  Everything bad is going to come upon you.  It is all going to come upon you.  You are going to rot in hell".  He goes on to say that at the time she was "very irrational and was just raving".  That raises the possibility, which Dr Van de Hoef canvassed in her report, that this might have been some sort of revenge killing. 

   
   

   Not unnaturally, Mr Taylor plainly enough has considered that possibility and it has caused him some concern. 

1. Each of the psychiatrists was asked about that.  Dr Heffernan says that what

   
   

   SGMT said to her ex-husband in that conversation is entirely consistent with her delusional perception of complete abandonment in the course of her psychotic illness.  Dr Sundin says that revenge is a remote possibility.  SGMT was severely psychotic at the time.  She was chaotic and delusional and had not, Dr Sundin considers, the mental capacity to plan a revengeful act. 

1. Dr Van de Hoef herself says that, notwithstanding the raising of that possibility, having considered all the evidence, her opinion is that SGMT stabbed her daughter because of what she describes as "a terrifying belief of imminent threat of attack on herself and on her daughter".  Dr Van De Hoef says that after these months of psychosis SGMT was deprived of the capacity to know she ought not do the act.

1. I am satisfied that SGMT was suffering from unsoundness of mind within the meaning of the Mental Health Act 2000 at the time of the killing of her daughter. A forensic order is clearly necessary. I order that SGMT be detained in The Park High Security Program Authorised Mental Health Service. I approve escorted limited community treatment on the conditions set out in the submission from the Director of Mental Health as follows:

1.          That the patient is to remain under the escort of health service staff member/s nominated by the authorised psychiatrist for the duration of the limited community treatment;

2.          For the purpose of escorted limited community treatment, the patient complies with the directions of the nominated staff members for the duration of the limited community treatment.