Re Weir - [2013] QMHC 1

MENTAL HEALTH COURT

CITATION:

Re Weir [2013] QMHC 1

PARTIES:

REFERENCE BY THE DIRECTOR OF MENTAL HEALTH
IN RESPECT OF BRADLEY MARK WEIR

PROCEEDING NO:

No. 107 of 2012

DELIVERED ON:

8 February 2013

DELIVERED AT:

Brisbane

HEARING DATE:

Delivered ex tempore on 8 February 2013

JUDGE:

Ann Lyons J

ASSISTING PSYCHIATRISTS:

Dr E N McVie
Dr N L Khoo

FINDINGS AND ORDERS:

1.    That the defendant was of unsound mind at the time of the commission of the alleged offences.

2.    That the proceedings according to law against the defendant are discontinued and further proceedings must not be taken against the defendant for the acts constituting the offences.

3.    That a Forensic Order be made detaining the Defendant to The Park High Security Program.

4.    That a Limited Community Treatment order to commence immediately is approved on the following conditions:

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

b.   That the patient must not use alcohol unless permitted to do so by the authorised psychiatrist;

c.   That the patient abstain from all illicit drugs and must cooperate fully in random medical tests for those substances as required by the authorised psychiatrist;

d.   That the patient not drive a motor vehicle unless permitted to do so by the authorised psychiatrist;

e.   That the patient have no contact, directly or indirectly, with any victims of the alleged offences;

f.   That the patient not visit, or travel to, the suburbs of Hope Island, Runaway Bay, Paradise Point, Oxenford and Biggera Waters.

Escorted (on and off grounds of the hospital):

g.   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;

h.   For the purposes of escorted limited community treatment, the patient comply with the directions of the nominated staff member/s for the duration of the limited community treatment.

Unescorted (on grounds of the hospital):

i.    That the patient remain within the grounds of the authorised mental health service;

j.    That the leave not exceed 2 hours per day, 5 days per week;

k.   That the patient return to the ward at the time specified by the authorised psychiatrist.

5.   That a copy of the transcript be released to the Mental Health Review Tribunal and the Treating Team

CATCHWORDS:
COUNSEL:

MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where defendant charged with assault or obstructing police, attempted murder, going armed so as to cause fear, injuring an animal, possession of a knife in a public place, committing an act intended to cause grievous bodily harm, animal cruelty and assault occasioning bodily harm whilst armed and in company – whether defendant was of unsound mind as defined in the Schedule of the Mental Health Act 2000 (Qld) at the time of those offences – where persistent psychotic disorder with rapid onset – where accused off antipsychotic medication – where a non-contact order was made – whether a forensic order should be made – whether a limited community treatment order should be made

J Briggs for the defendant
J Tate for the Director of Mental Health
D Holliday for the Director of Public Prosecutions

SOLICITORS:

Legal Aid Queensland for the defendant
Crown Law for the Director of Mental Health
Office of the Director of Public Prosecutions (Qld)

A LYONS J:

This is a reference by the Director of Mental Health in relation to Bradley Mark Weir. The reference was filed on 18 May 2012 and relates to eight offences which occurred in December 2011 and February 2012. There is one charge of assault or obstructing police on 7 December 2011. There are also charges of attempted murder, going armed so as to cause fear, injuring an animal, possessing a knife in a public place, committing an act intended to cause grievous bodily harm, animal cruelty and assault occasioning bodily harm whilst armed and in company. All of those offences are alleged to have occurred on 11 February 2012, which I note is not yet one year ago.
By way of factual background, Mr Weir was observed on 7 December 2011 to be aggressive and violent to the extent that neighbours at the marina where he resided notified police. When police attended the marina, they indicated that Mr Weir's presentation was consistent with an acute psychotic episode with religious delusions. He abused the police and called them “deceivers who had breached commandments”. He was resistant to being interviewed and barricaded himself inside the house.
He was subsequently subdued, made subject to an emergency examination order, transferred from the watch-house and admitted to the Gold Coast Mental Health Unit. Upon admission and assessment, he was noted to be highly irritable and agitated. His thought content was observed to be that of religious and grandiose delusions which related to revelations from God.
He received antipsychotic medication for a short period but was discharged one week later on 13 December 2011 into the care of his wife. As the psychiatrists have indicated, he was not given any discharge medication, a follow-up appointment or any referrals to treatment or counselling.
On 9 February 2012, Mrs Weir expressed further concerns in relation to her husband as he was behaving oddly, for example, walking around the marina and speaking animatedly to himself whilst pushing a stroller with their son in it.
The alleged offences
On the morning of Saturday 11 February 2012, Mr Weir was arrested by police after it was alleged that he stabbed the Hope Island harbourmaster, assaulted a female resident and decapitated her dog. It is also clear that he was abusive and threatening to a number of other residents.
The evidence indicates that Mr Weir was running towards a number of people with a large carving knife and yelling in an incoherent and threatening manner. These are very serious offences and the police statements indicate that Mr Weir was rambling and incoherent.
The harbourmaster suffered a deep puncture wound to his diaphragm, spleen and one of the main arteries to his heart. His spleen was removed and the puncture wound was surgically corrected. The injuries were life-threatening and obviously extremely traumatic and painful. This series of events clearly traumatised all concerned and terrified the greater community of Hope Island.
Psychiatric evaluation
Turning then to the psychiatric evaluation in relation to that factual background. The Court had the benefit of a number of reports, including the reports of Dr Pamela van de Hoef and Dr Russ Scott, who both gave evidence in Court. The Court also had the benefit of the advice of both of the assisting psychiatrists, who posed important questions to both Dr Scott and Dr van de Hoef.
Dr van de Hoef indicated that at the time of all of the offences, Mr Weir was suffering from a psychotic disorder with manic features. She stated that he had developed disorganised thinking and delusional beliefs of a persecutory, grandiose and bizarre religious type in association with elevated irritable mood, decreased sleep, agitation and increased activity.
She considered that Mr Weir had those symptoms for at least a week before the December 2011 offences and that those symptoms, whilst fluctuating, persisted after his discharge from hospital on 13 December 2011 and then culminated in the offences of 11 February 2012. She considered that Mr Weir had been suffering from either a recurrent episode of a bipolar affective disorder (manic episode with psychotic features) or schizophrenia.
I note that there is some controversy in relation to diagnosis which has been explored by both Dr McVie and Dr Khoo. Dr Scott is firmly of the view that Mr Weir has a diagnosis of bipolar affective disorder, based on the fact there have been only two episodes some 17 years apart, with well-documented high functioning during those episodes. Dr Scott also indicated that Mr Weir's mental state had been maintained after withdrawal of antipsychotic medication over six months whilst subject to persistent and close observation. I note, however, that Mr Weir has only been completely weaned off antipsychotic medication for six weeks and that he is in a very secure and contained environment, with very few stressors of the type he was experiencing whilst in the community.
It is clear from the reports of Dr Scott and Dr van de Hoef, as well as from the advice of the assisting psychiatrists, that despite this concern about the accurate diagnosis, there is no dispute that at the time of the alleged offences, Mr Weir was suffering from a mental illness.
Unsoundness of mind
I am satisfied that at the time of all the offences in both December 2011 and February 2012, Mr Weir was of unsound mind. I am satisfied that he was deprived of the capacity to know he ought not do any of the acts.
He was floridly psychotic and it is well documented that his actions were driven by this thinking. Whilst his actions were such that he is not criminally responsible, this does not alter the enormous impact those actions have had on his victims. I have read all of the victim impact statements and they describe in clear detail the devastating consequences for all of those who were involved. I note the serious physical injuries suffered, as well as the deep psychological scars which have followed for many of the victims.
Dr Scott has indicated that Mr Weir is well aware of those consequences and he has expressed his deep remorse, and in fact finds it difficult to understand how he could have committed those actions.
Whether intoxication contributed to the alleged offences
Mr Weir’s episode involved a rapid onset and whilst there was some initial concern that there could have been intoxication, I am ultimately satisfied that there is no evidence in this case that there was intoxication. Dr van de Hoef considered that the severity and the persistence of the psychotic disorder, which took several months to arrest and resolve, would indicate that it was not simply an intoxication syndrome, but a psychotic disorder, and I make that clear in these reasons.
Forensic Order and Limited Community Treatment
In terms of whether a Forensic Order is required, it is quite clear from the evidence of both Dr Scott and Dr van de Hoef, and from the advice of the assisting psychiatrists, that a Forensic Order is required, given the very serious nature of these incidents. In fact, Mr Weir’s offences involved serious activity that could have resulted in very serious criminal prosecution. This is why I have referred to them in some detail.
As I have indicated, Mr Weir’s episode involved a rapid onset and it is clear that he will require very close monitoring. I note the concerns of the assisting psychiatrists in relation to his current medication regime and their concerns about the withdrawal of antipsychotic medication and the fact that he is currently only on a mood stabiliser.
In terms of the conditions for the Forensic Order, in my view, they should accord with the submission from the Director of Mental Health, subject to certain additions. Namely, given the advice of the assisting psychiatrists in relation to the importance of unescorted on-ground leave, I consider that there should be a condition which allows some unescorted on-ground leave, up to two hours a day, five times a week, but that should obviously be implemented at the discretion of the treating psychiatrist and after full assessment and monitoring.
Other than the unescorted leave on grounds, there is to be only escorted leave on and off the grounds of the hospital. There will also be a condition that the patient is not to have any contact with any of the victims and I am also satisfied that there should be an additional condition that the patient is not to attend the suburbs of Hope Island, Runaway Bay, Paradise Point, Oxenford or Biggera Waters.
A copy of the transcript of these proceedings should be provided to the Mental Health Review Tribunal and the treating team.
FINDINGS AND ORDERS
That the defendant was of unsound mind at the time of the commission of the alleged offences
That a Forensic Order be made detaining the defendant to The Park High Security Program.
That the proceedings according to law against the defendant are discontinued and further proceedings must not be taken against the defendant for the acts constituting the offences.
A Limited Community Treatment order to commence immediately is approved on the following conditions:

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

b.That the patient must not use alcohol unless permitted to do so by the authorised psychiatrist;

c.That the patient abstain from all illicit drugs and must cooperate fully in random medical tests for those substances as required by the authorised psychiatrist;

d.That the patient not drive a motor vehicle unless permitted to do so by the authorised psychiatrist;

e.That the patient have no contact, directly or indirectly, with any victims of the alleged offences;

f.That the patient not visit, or travel to, the suburbs of Hope Island, Runaway Bay, Paradise Point, Oxenford and Biggera Waters.

Escorted (on and off grounds of the hospital):

g.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;

h.For the purposes of escorted limited community treatment, the patient comply with the directions of the nominated staff member/s for the duration of the limited community treatment.

Unescorted (on grounds of the hospital):

i.That the patient remain within the grounds of the authorised mental health service;

j.That the leave not exceed 2 hours per day, 5 days per week;

k.That the patient return to the ward at the time specified by the authorised psychiatrist.

The transcript of these proceedings will be released to the Mental Health Review Tribunal and the treating team.

CITATION:	Re Weir [2013] QMHC 1
PARTIES:	REFERENCE BY THE DIRECTOR OF MENTAL HEALTH IN RESPECT OF BRADLEY MARK WEIR
PROCEEDING NO:	No. 107 of 2012
DELIVERED ON:	8 February 2013
DELIVERED AT:	Brisbane
HEARING DATE:	Delivered ex tempore on 8 February 2013
JUDGE:	Ann Lyons J
ASSISTING PSYCHIATRISTS:	Dr E N McVie Dr N L Khoo
FINDINGS AND ORDERS:	1. That the defendant was of unsound mind at the time of the commission of the alleged offences. 2. That the proceedings according to law against the defendant are discontinued and further proceedings must not be taken against the defendant for the acts constituting the offences. 3. That a Forensic Order be made detaining the Defendant to The Park High Security Program. 4. That a Limited Community Treatment order to commence immediately is approved on the following conditions: a. That the patient comply with the requirements of the authorised psychiatrist in relation to the taking of prescribed medication and other treatment; b. That the patient must not use alcohol unless permitted to do so by the authorised psychiatrist; c. That the patient abstain from all illicit drugs and must cooperate fully in random medical tests for those substances as required by the authorised psychiatrist; d. That the patient not drive a motor vehicle unless permitted to do so by the authorised psychiatrist; e. That the patient have no contact, directly or indirectly, with any victims of the alleged offences; f. That the patient not visit, or travel to, the suburbs of Hope Island, Runaway Bay, Paradise Point, Oxenford and Biggera Waters. Escorted (on and off grounds of the hospital): g. 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; h. For the purposes of escorted limited community treatment, the patient comply with the directions of the nominated staff member/s for the duration of the limited community treatment. Unescorted (on grounds of the hospital): i. That the patient remain within the grounds of the authorised mental health service; j. That the leave not exceed 2 hours per day, 5 days per week; k. That the patient return to the ward at the time specified by the authorised psychiatrist. 5. That a copy of the transcript be released to the Mental Health Review Tribunal and the Treating Team
CATCHWORDS: COUNSEL:	MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where defendant charged with assault or obstructing police, attempted murder, going armed so as to cause fear, injuring an animal, possession of a knife in a public place, committing an act intended to cause grievous bodily harm, animal cruelty and assault occasioning bodily harm whilst armed and in company – whether defendant was of unsound mind as defined in the Schedule of the Mental Health Act 2000 (Qld) at the time of those offences – where persistent psychotic disorder with rapid onset – where accused off antipsychotic medication – where a non-contact order was made – whether a forensic order should be made – whether a limited community treatment order should be made J Briggs for the defendant J Tate for the Director of Mental Health D Holliday for the Director of Public Prosecutions
SOLICITORS:	Legal Aid Queensland for the defendant Crown Law for the Director of Mental Health Office of the Director of Public Prosecutions (Qld)