SDM

[2003] QMHC 9

MENTAL HEALTH COURT

CITATION:

 SDM [2003] QMHC 009

PARTIES:

REFERENCE BY THE DEFENDANT’S LEGAL REPRESENTATIVE IN RESPECT OF SDM

PROCEEDING NO:

0328/02

DELIVERED ON:

12 September 2003

DELIVERED AT:

Brisbane

HEARING DATE:

8 September 2003

JUDGE:

Wilson J

ASSISTING PSYCHIATRISTS:

Dr J M Lawrence
Dr J F Wood

FINDINGS AND ORDERS

1. The defendant was not suffering from unsoundness of mind as described in Schedule 2 of the Mental Health Act 2000 (Qld);
2. The defendant is fit for trial;
3. Order that the proceedings be continued according to law. 

CATCHWORDS:

MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where defendant is charged with three counts of wilful damage, one count of entering a vehicle with intent to commit an indictable offence, one count of assault occasioning bodily harm and three counts of serious assault of a police officer – where defendant suffered from mental illness – where defendant was a regular user of marijuana – where defendant was feeling anxious and nervous – where defendant ingested alcohol and marijuana – where defendant had psychotic episode – whether state of mind of defendant resulted to any extent from intentional intoxication or stupefaction

Mental Health Act 2000 (Qld), schedule 2

COUNSEL:

J Farmer for the defendant
J Tate for the Director of Mental Health
M Nicolson 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. WILSON J:  SDM (“the defendant”) has been charged with three counts of wilful damage, one count of entering a vehicle with intent to commit an indictable offence, one count of assault occasioning bodily harm and three counts of serious assault of a police officer, all allegedly committed on 31 July 2002.  The matter of his mental condition in relation to the offences was referred to this Court by his legal representative.

1. The defendant was born on 27 July 1977.  In May 2002 he returned from living in Japan for three years, and went to stay with his parents in Melbourne.  Just after his birthday, he left Melbourne bound for Cairns.  On arrival in Cairns he stayed overnight in a backpackers hostel, and the next day went on to Port Douglas to stay with a friend.   The offences are alleged to have been committed in Port Douglas on the evening of 31 July 2002.

1. The defendant was a regular user of marijuana, smoking about a quarter of a gram in a bong each day.  He stopped smoking marijuana a few days before he left Melbourne, and did not resume smoking it until the day of the alleged offences.

1. In the two weeks immediately before his departure from Melbourne, the defendant began to develop psychotic symptoms.  (Because of the differing accounts the defendant gave to the reporting psychiatrists, Drs Gynther and Kingswell, it is not clear whether the symptoms began while he was still using marijuana.) He told Dr Gynther about his experience at a service station in Melbourne about a week before he left for Cairns: he believed that other people were talking about him and that they knew of a sexual relationship he had had with a niece several years previously. 

1. On his arrival in Cairns he felt anxious and nervous.  His delusional beliefs intensified in Port Douglas.  He heard people outside yelling “molester” and was certain that people knew of his relationship with his niece.  He felt in danger and believed that a man named Jack Love might attempt to kill him.  His friend tried to calm him down, and accompanied him to a hotel where he consumed marijuana (two cones according to his account to Dr Kingswell) and beer (five pots according to his account to Dr Gynther or two to three beers according to his account to Dr Kingswell). 

1. They returned to the friend’s house, but he remained frightened and convinced that his friend and others were warning him he was at risk, and believed that others knew all about him.  He took a bicycle from the house in an attempt to flee to Cairns, but he crashed the bicycle.  He then tried to stop passing cars, allegedly wilfully damaging them in the process and assaulting one of the drivers.  Police were called.  They used capsicum spray in an attempt to calm him, but it had no effect.  They could smell liquor on his breath. 

1. The defendant was admitted to Cairns Base Hospital the next day.  He was treated with anti-psychotic medication, and his mental state gradually improved until he was discharged on 5 August 2002 to be followed up by Community Mental Health. 

1. In October 2002 the defendant had another psychotic episode.  He had ceased anti-psychotic medication about a month before, and had resumed smoking marijuana occasionally, although less heavily than before.  His delusional beliefs were similar to those he had held in July.  Again he was treated with anti-psychotic medication, but this time the symptoms persisted longer and he was not discharged until 14 October. 

1. Dr Sherman Franz, psychiatrist, saw the defendant in August 2003, at a time when he had been off medication for about four months and off illicit drugs for at least eight months.  There was no evidence of any psychotic phenomena; insight was fair to good and judgment was essentially unimpaired. 

1. Drs Gynther and Kingswell agreed that the defendant was psychotic at the time of the alleged offences, and that he was deprived at least of the capacity to know that he ought not act as he did. The issue for determination is whether his state of mind resulted to any extent from intentional intoxication or stupefaction. If it did, then he was not of unsound mind within the definition of that term in schedule 2 to the Mental Health Act 2000 (Qld).

1. Dr Gynther said in his report -

“His friend attempted to calm him down by taking him to a hotel where he consumed approximately 5 pots of beer, and smoked marijuana.  This appeared to provoke a further deterioration [in] his mental state, and he became increasingly fearful for his life, and attempted to escape Port Douglas. 

[…]

Each of the alleged offences occurred within a short period and were the result of beliefs held with a delusional intensity that he was at risk of being killed and that he had to flee.  It is my opinion that in regard to each of the alleged offences, [the defendant’s] delusional ideation deprived him of the capacity to know that his actions were wrong, as he believed that he was attempting to protect himself.  In view of [the defendant’s] poor recollection of many events surrounding the alleged offences, it is also possible that [the defendant] may have been deprived of the capacity to know what he was doing.  His fear was of an intensity which, with regard to each of the alleged offences, deprived him of the capacity to control his actions. 

It is my opinion therefore in regard to each of the alleged offences [the defendant] is of unsound mind. While intoxication may have contributed to his behaviour, psychosis preceded and persisted beyond the intoxication, and was the cause of his disturbed behaviour.”

1. In cross-examination of Dr Gynther by the defendant’s counsel some emphasis was put on the recurrence of the psychosis in October.  The defendant’s drug use had been much less than it had been in July, but the psychosis recurred and took longer to respond to treatment.  This may be an indicator of some endogenous cause for the psychosis - although the absence of further recurrence since the defendant has ceased using the drug may be an indicator to the contrary.  Even if there was an endogenous cause, the question remains whether at the time of the alleged offences on 31 July 2002 the defendant’s mental state was affected to any extent by intentional intoxication or stupefaction, and as I interpret Dr Gynther’s evidence, it was.  In his report Dr Gynther described the marijuana and alcohol consumed on the night as provoking “a further deterioration in his mental state” and intensifying his delusional beliefs.  In oral evidence he said that the combination of the marijuana still in the defendant’s system from his smoking in Melbourne combined with that consumed on the night of the alleged offences would have produced a mild degree of intoxication. 

1. Dr Kingswell was clearly of the opinion that at the time of the offences the defendant’s previously relatively low grade psychotic symptoms had been abruptly worsened by the use of marijuana immediately before. 

1. On the evidence I am satisfied that the defendant’s state of mind at the time of the alleged offences resulted in part from intentional intoxication. Accordingly I am bound to find that he was not suffering from unsoundness of mind as described in schedule 2 to the Mental Health Act 2000.

1. I find that the defendant is fit for trial.

1. I order that the criminal proceedings be continued according to law.