Re WJM

[2005] QMHC 8

MENTAL HEALTH COURT

CITATION: 

Re WJM [2005] QMHC 008

PARTIES:

APPEAL BY WJM AGAINST A DECISION OF THE MENTAL HEALTH REVIEW TRIBUNAL

PROCEEDING NO:

0138 of 2004

DELIVERED ON:

22 April 2005

DELIVERED AT:

Brisbane

HEARING DATE:

22 April 2005

JUDGE:

ASSISTING PSYCHIATRISTS:

Holmes J

Dr J F Wood
Dr D A Grant

FINDINGS AND ORDER:

Appeal dismissed. The decision of the Mental Health Review Tribunal dated 4 February 2005 is confirmed.

CATCHWORDS:

MENTAL HEALTH – CONFINEMENT AND RESTRAINT OF MENTALLY ILL PERSONS AND SIMILAR ORDERS – GENERALLY – where forensic order initially made in respect of the respondent after a finding of unsoundness of mind in relation to various offences involving violence - where WJM appealed decision of Mental Health Review Tribunal to confirm forensic order – where psychiatric evidence supports that appellant still suffers from chronic paranoid schizophrenia with accompanying delusional ideation and lack of insight - whether the defendant represents an unacceptable risk to the safety of himself or others having regard to his mental illness 

COUNSEL:

Ms C Morgan for the appellant
Mr K Fisher for the Director of Mental Health

Mr W Isdale for the Attorney-General

SOLICITORS:

Legal Aid Queensland for the appellant
The Crown Solicitor for the Director of Mental Health
The Attorney-General of Queensland

1. This is an appeal by WJM against a Mental Health Review Tribunal decision to confirm a forensic order.  The Tribunal's decision was made on 4 February 2005.

1. The forensic order was made on 21 January 2000, upon a finding of unsoundness of mind in relation to charges of attempted murder, grievous bodily harm, going armed in public so as to cause fear, two charges of aggravated assault, wilful damage, assault occasioning bodily harm and assault occasioning bodily harm while armed.

1. The forensic order was made with regard to Dr A's report of 4 January 2000 and not surprisingly, the Tribunal has had reference to the same report in its decisions since, including the one subject to appeal.

1. Dr A diagnosed paranoid schizophrenia.  She referred to some delusions from which WJM suffered, for example, that he was the son of Queen Elizabeth and was resisting attempts to steal the Monarchy's gold.

1. The charges, he thought, arose out of attempts to discredit him.  The assaults were of persons unknown to him, and were, it is alleged, committed by him under the operation of delusions.  One took place while he was armed with a knife.

1. The attempted murder involved a stabbing of a man of 64, who WJM believed intended to rape him. 

1. The Tribunal had regard also to the Community Treatment Review Committee's report by Dr B of 19 January 2005, for the purposes of the forensic order review.  Dr B said that WJM continued to dismiss the charges against him as the consequence of a conspiracy.  He had not responded to anti-psychotic treatment, although he believed that he was now fixed up by his medication.  His limited community treatment consists only of closed secure bus trips, and there was no alteration recommended in respect of that.  The report indicated there was a high risk of harm if WJM was released, because of the persistence of his persecutory delusions and beliefs and his intention to cease medication, should he be discharged.  Another contributing factor was his certainty that the offences were justified.

1. WJM indicated to the Tribunal his view that he had spent long enough in the institution and that he was coping well on Clozapine, his current medication.

1. Here, Ms Morgan on his behalf, has put WJM’s position.  He says he is much better, he does not require hospitalisation.  He has seen others obtain limited community treatment and not surprisingly, thinks that he ought also to be similarly favoured.  And Ms Morgan points out that although there are references to an attempt to abscond, that took place some six years ago.  Ms Morgan also says that WJM has a concern that the examiner who saw him is not independent, in effect that those treating him and those reviewing him share a common view of him, so that his position is not accepted nor his submissions heard.

1. What I have to consider is the decision below and the current state of affairs in light of the report of Dr C.  The Tribunal accepted there was a very high risk of harm if WJM were discharged into the community.  On the basis of that, the forensic order was continued with no greater level of limited community treatment than the closed bus trips which he has already been receiving. Since the Tribunal's decision, the report of Dr C has been obtained and in relation to that, I should say that I share Dr Wood's view, that it is essential that any examiner have access to all the material available in respect of the patient and it is entirely appropriate that that occurred in this case.  It does seem that some pains were taken to find an independent examiner to see WJM.

1. Dr C confirms the diagnosis of chronic paranoid schizophrenia, with symptoms continuing over almost 20 years.  The delusional ideation, she says, continues.  WJM believes that individuals are plotting against him.  He will defend himself against them if he feels threatened. He has also indicated he will stop his medications if discharged.  Dr C says that he does not have insight into his past actions or delusions and that he should continue to be treated at The Park Centre for Mental Health, with the current restrictions.

1. I accept that evidence.  It seems to me there must be a concern even in relation to escorted leave, that WJM, thinking his treatment pointless, may see no value in remaining with his escorts.

1. If he were to abscond, he is, I think there can be no doubt, an unacceptable risk to the community.  I confirm the decision of the Mental Health Review Tribunal.