Re Troy Leslie Taylor

[2006] QMHC 9

MENTAL HEALTH COURT

CITATION:

Re Troy Leslie Taylor [2006] QMHC 009

PARTIES:

REFERENCE BY THE DEFENDANT'S LEGAL REPRESENTATIVE IN RESPECT OF TROY LESLIE TAYLOR

PROCEEDING NO:

No 0273 of 2005

DELIVERED ON:

18 April 2006

DELIVERED AT:

Brisbane

HEARING DATE:

18 April 2006

JUDGE:

ASSISTING PSYCHIATRISTS:

Holmes J

Dr J F Wood
Dr D A Grant

FINDINGS AND ORDER:

1. The defendant was not of unsound mind at the time the offences were allegedly committed
2. The defendant is permanently unfit for trial
3. The defendant is detained at the Toowoomba District and Area Authorised Mental Health Service
4. Limited community treatment at the discretion of the authorised psychiatrist to extend to escorted limited community treatment on and off the hospital grounds to be escorted by Mental Health staff is authorised
5. The defendant is to comply with the reasonable directions of the Mental Health staff
6. The defendant is not to drink alcohol and is to undertake any tests as directed by the authorised psychiatrists in that respect

CATCHWORDS:

MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where defendant charged with serious assault of a police officer and two breaches of bail – where defendant suffers from an intellectual disability which renders him permanently unfit for trial – where defendant was on remand in prison – where Disability Services Queensland provided report on availability of services for the defendant – where the defendant would be cared for after prison – whether a forensic order was required

Mental Health Act 2000 (Qld)

COUNSEL:

Mr Farmer for the defendant
Mr Tate for the Director of Mental Health
Mr Vasta for the Director of Public Prosecutions

SOLICITORS:

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

1. HOLMES J:  Mr Taylor is charged with serious assault of a police officer on the 19th of May 2005, breach of a bail condition on the 3rd of November 2005 and breach of a bail condition on the 24th of January 2006. 

1. On the 19th of May the police had been called to a disturbance involving him.  He was said to have locked himself in a room and was threatening self-harm.  He was seen to be in possession of a knife.  Eventually he dropped it at his carer's request.  He had, however, threatened the police officer with it from some distance.  It was apparent that he had been drinking that day.

1. On the 3rd of November 2005 he breached his bail conditions, the relevant condition being that he have no alcohol and not leave home without his carer.  A relative actually took him to the police station on that occasion.  On the 24th of January 2006 there was another alleged breach of a bail condition.  This time the condition was that he reside at accommodation which I take to be a hostel, and not leave it unless in the company of a support worker; it appears that he breached that condition.  That led to his being placed on remand in the Arthur Gorrie Correctional Centre.

1. Mr Taylor suffers from an intellectual disability. In 2001 he was assessed by a psychologist who found that he had a full scale IQ of 61 which would put him in the mildly mentally retarded range.  She noted, however, certain practical matters.  Mr Taylor was unable to live independently.  He had never learned to drive a car.  He could not use public transport or follow a timetable.  He could not handle money transactions or work out correct change.  He needed to be supervised to take his daily medication.  He could not cook, or care for himself in most areas.

1. Mr Taylor was also reviewed by Dr Fama in April 2001 in the context of other charges.  Dr Fama took a rather dimmer view of his level of functioning, although he did not have the psychometric test results.  He estimated his intellectual disability at a level of moderate mental retardation, that is to say, corresponding to an IQ below 50.  He was virtually illiterate and was not, at that time, considered to be fit for trial. 

1. A forensic order was made in May of 2002.  It was discharged in September 2002.  I think it is self-evident from that fact that he was not considered a particularly appropriate candidate for the psychiatric system; and, indeed, there is nothing in any of the reports which suggest that Mr Taylor suffers from any psychiatric illness.  But what is apparent from the current reports, including a further report of Dr Fama, is that he has a lifelong mental retardation which renders him unfit for trial. 

1. Dr Fama, in a report of the 30th of October 2005 reported that Mr Taylor could not grasp any of the relevant details so far as any prospective trial was concerned, even when carefully instructed in simple terms.  Dr Fama thought it would be appropriate that there be a funded management program to be provided by Disability Services Queensland implemented jointly with an outside provider, Quality Lifestyle Support.

1. There are two things that are obvious about Mr Taylor.  One is that he cannot manage for himself.  He needs support, supported accommodation and supervision.  The other is that he gets into trouble when he is drinking alcohol. 

1. Disability Services have provided support to Mr Taylor in the past.  He was referred to them in January 2003.  According to a report from Disability Services he received an individualised funding package through the family support program.  He was then living with his mother but, it is said, he engaged in challenging behaviours.  In January 2005, it seems that there were difficulties in his relations with his support worker; and, I must say, the support worker who assisted Mr Taylor in January 2005 seems to have been doing his very best to keep Mr Taylor out of trouble.  The bone of contention then seems to have been, on Mr Taylor's part, that the support worker tried to keep him from drinking alcohol.

1. In February 2005 Mr Taylor's mother indicated she was no longer prepared to have him living in the family home.  At that stage emergency accommodation was provided with support from the outside care provider that I have referred to, Quality Lifestyle Support Pty Ltd.  Difficulties arose in mid-2005.  By this time Mr Taylor was on bail.  The two breaches I have referred to led to his being taken into custody.

1. It is clear that since Mr Taylor is, on any view, permanently unfit for trial, and I should indicate that that is not just the view of Dr Fama; Dr Arthur, another psychiatrist who has reported, takes the same view; and, of course, it is consistent with the finding which was made in respect of Mr Taylor in 2002.  Since that is the case, the charge against him clearly cannot proceed and he must be released from the Arthur Gorrie Correctional Centre where he is currently being held, no doubt causing some strain on facilities there.

1. Because it was evident that his release would have to take place, there being no argument about the appropriateness of that from any party involved in this matter, a mention was arranged of the matter on 10th of April 2006 to seek the assistance of Disability Services Queensland, among other things, as to what was to become of Mr Taylor.  On that date a Ms Sweet from Disability Services Queensland happened to be in the Court in relation to another matter.  I asked her if Disability Services Queensland would provide some information as to services which could be given to Mr Taylor; specifically, where on earth he was going to go once he walked through the doors of the Arthur Gorrie Remand Centre?

1. I should say, that at that stage a report had been received from Disability Services Queensland already, but it had not proved of much practical assistance.  It set out some of the history I have already referred to about Disability Services' dealings with Mr Taylor.  It went on to set out the various services provided by Disability Services to adults 18 years and over.  For example, the "post school services program"; but he was not eligible for that program.  The "adult lifestyle program"; Mr Taylor was eligible to apply for this program, which provides assistance to support someone at home managing their household, taking part in recreation and leisure activities, strengthening personal and family relationships and networks and purchasing necessary aids and equipment.  However, while saying that Mr Taylor was eligible, the report pointed out that applying for the program would not guarantee access, because applications had to be prioritised.  Also, of course, it did not give him anywhere to live. 

1. There was the "family support program, adults", which provided a number of supports to families but, the report pointed out, it required the person with a disability to be living in the family home.  Mr Taylor was not, so he was not eligible.

1. There were "professional and specialist services" which provided things like the assistance of a social worker, a psychologist, a speech pathologist or an occupational therapist for persons with high support needs.  It was said, Mr Taylor would be eligible, but service provision was dependent on available resources.  Again, it would not give him anywhere to live.

1. There was the "friendship program", the name of which, I think, speaks for itself.  He was eligible to apply and could be assessed on that.  There was no "local area coordination program", so I can pass over that.  The one of real interest, of course, was the "accommodation support and respite services".  DSQ provides accommodation support, the report says, through operation of houses and units for shared accommodation of persons with a disability with support of DSQ staff.  Unfortunately, Mr Taylor does not have an intellectual disability in the moderate to severe range; that, presumably, is based on the psychometric testing.  Therefore, he is not eligible for that program.

1. Finally, there is "innovative support and housing" which "helps people transition into long term support arrangements"; but those housing models are based in Townsville, Morayfield and Wacol.  Eligibility determination is activated by a vacancy.  There are no vacancies.  The report says that Mr Taylor may be eligible to access services provided by some non-Government organisations but they do have waiting lists.

1. That report, of course, gave no assistance at all as to where Mr Taylor might go or who might look after him.  That was why I had asked that Disability Services Queensland provide some more practical advice as to what would become of Mr Taylor once he was released from the remand centre.  What has now been provided is what is called an "update report".  It contains all the same information all over again about the history, the various programs, verbatim, I think - I may be unfair, there may be a pronoun or two changed - with a summary which is identical to the summary of the previous report.  In fact, I do rather suspect it is the previous report, redated.

1. The summary says that Mr Taylor is a 28 year old man with an intellectual disability.  That he is in custody.  That accommodation arrangements before have not been sustainable due to his behaviours or his leaving the accommodation.  DSQ professional and specialist staff consider he will continue to be at risk.  And the final paragraph reads:

"Whilst Mr Taylor meets the broad eligibility criteria of the DSQ services, he is eligible to receive a number of services and he is eligible to apply for a number of programs, it is difficult to predict a positive long term outcome from these models given that DSQ services are voluntary and non-custodial."

1. The gist of it is that Disability Services take no responsibility for Mr Taylor's position.  That leaves this Court with the option of placing him on a forensic order which requires his institutionalisation now, because there are no other accommodation options, and in the future should he breach the order.  One might expect again that the forensic order will not be very long lived.  The last one was not, simply because it is hard to justify a continued forensic order in the circumstances of someone who has no psychiatric illness.

1. The other option is to have Mr Taylor walk through the gates of Arthur Gorrie out on to the highway at Wacol and look after himself.  I do not think that option can be taken because Mr Taylor is personally at risk, and a considerable risk to the community if he were left to wander and fend for himself.  That means, then, that the only, unpalatable, option is to make a forensic order requiring his detention in the Baillie Henderson Hospital; in other words, the detention of someone who has no psychiatric illness who is unlikely to receive any particular form of therapeutic care which will advance his condition there. 

1. That is an undesirable outcome from the perspective of the staff at Baillie Henderson who, no doubt, have many cases of psychiatric illness that they have to deal with.  It will require a bed there.  And, I confess, part of the reason for making that order is the hope that Baillie Henderson will be in some sort of position to ensure that he goes to some accommodation when he leaves; that that might trigger some prospect of supported accommodation on his release.

1. There are two apparent problems that emerge from this case which have been identified by this Court in the past.  One is the lack of legislative framework for persons with intellectual disability.  Even had Disability Services been prepared to take Mr Taylor on, there would still have been a problem as to their ability to manage him.  His problems arise when he has been drinking.  There is no means, as I understand it, by which Disability Services could really enforce any non-alcohol regime.  The only prospect would have been a forensic order which, in effect, requires hospitalisation if he drinks.  That is the form of the order I am going to make, but it is inappropriate that that is the only way of managing someone in his situation; that in order to prevent him from drinking and getting into trouble, the only sanction that the Court can impose is that he be re-institutionalised in a psychiatric hospital.  That is the legislative aspect. 

1. The practical aspect is the absence of resources to manage him.  It is a sad state of affairs where somebody with his manifest disabilities could face the prospect of being released from imprisonment without any form of disability service willing to take up his case.  These, I think, are matters that require attention and for that reason I will refer a transcript of my remarks to both the Public Advocate and the Minister for Health.

1. The forensic order in respect of Mr Taylor will be in these terms:

(1)      he is detained to the Toowoomba District and Area Authorised Mental Health Service;

(2)      I authorise limited community treatment at the discretion of the authorised psychiatrist to extend to escorted limited community treatment on and off hospital grounds to be escorted by Mental Health staff; and

(3)      I order that Mr Taylor comply with the reasonable directions of the Mental Health staff;

(4)      I also order that Mr Taylor not drink alcohol and that he undertake any tests as directed by the authorised psychiatrist in that respect.

1. I find that Mr Taylor was not of unsound mind at the time the offences were allegedly committed.