Attorney-General v Lawrence [2016] QSC 58

SUPREME COURT OF QUEENSLAND CITATION: Attorney-General (Qld) v Lawrence [2016] QSC 58 PARTIES: ATTORNEY-GENERAL FOR THE STATE OF QUEENSLAND (applicant) v MARK RICHARD LAWRENCE (respondent) FILE NO/S: BS No 7468 of 2007 DIVISION: Trial PROCEEDING: Application ORIGINATING COURT: Supreme Court DELIVERED ON: 18 March 2016 DELIVERED AT: Brisbane HEARING DATE: 16 November 2015 JUDGE: Atkinson J ORDER: 1. The decision made on 3 October 2008 that Mark Richard Lawrence is a serious danger to the community in the absence of an order under Division 3 of the Dangerous Prisoners (Sexual Offenders) Act 2003 (Qld) is affirmed. 2. Mark Richard Lawrence is to continue to be subject to the continuing detention order. CATCHWORDS: CRIMINAL LAW – SENTENCE – SENTENCING ORDERS – ORDERS AND DECLARATIONS RELATING TO SERIOUS OR VIOLENT OFFENDERS OR DANGEROUS SEXUAL OFFENDERS – DANGEROUS SEXUAL OFFENDER – GENERALLY – where a continuing detention order was made with regard to the respondent on 3 October 2008 that has been affirmed on many occasions since – where the applicant seeks, at annual review, that the respondent continue to be subject to the continuing detention order or, in the alternative, that he be released from custody subject to a supervision order – whether the respondent is such a danger to the community that adequate protection of the community cannot reasonably be provided by a supervision order Dangerous Prisoners (Sexual Offenders) Act 2003 (Qld), s 13, s 27, s 28A, s 29, s 30 -- 1 of 41 -- 2 A-G (Qld) v Francis [2007] 1 Qd R 396; [2006] QCA 324, cited A-G v Lawrence [2009] QCA 136, cited A-G (Qld) v Lawrence [2011] QCA 347, cited Attorney-General for the State of Queensland v Lawrence [2011] QSC 291, cited Attorney-General for the State of Queensland v Lawrence [2012] QSC 386, cited Attorney-General v Lawrence [2010] 1 Qd R 505; [2009] QCA 136, cited Attorney-General (Qld) v Lawrence [2014] QSC 77, cited Attorney-General (Qld) v Lawrence [2014] QCA 220, cited R v Lawrence [2002] 2 Qd R 400; [2001] QCA 441, cited R v Lawrence [2002] QCA 526, cited COUNSEL: J B Rolls for the applicant J J Allen QC for the respondent SOLICITORS: Crown Law for the applicant Legal Aid Queensland for the respondent [1] This was the hearing of an application to review a continuing detention order made under the Dangerous Prisoners (Sexual Offenders) Act (Qld) 2003 (“DPSOA”). The application was made pursuant to s 27(2) of the DPSOA which requires the Attorney- General to make an application to initiate a review of a continuing detention order. [2] A continuing detention order was made with regard to the respondent, Mark Richard Lawrence, on 3 October 2008. That continuing detention order has been affirmed on many occasions since. The application by the Attorney-General proposed that the respondent continue to be subject to the continuing detention order or, in the alternative, that he be released from custody subject to a supervision order. Each of those orders may only be made if the court affirms the decision that the prisoner is a serious danger to the community in the absence of an order of that type. [3] The conduct of a review hearing is governed by s 30 of the DPSOA which provides: “30 Review hearing (1) This section applies if, on the hearing of a review under section 27 or 28 and having regard to the required matters, the court affirms a decision that the prisoner is a serious danger to the community in the absence of a division 3 order. (2) On the hearing of the review, the court may affirm the decision only if it is satisfied— -- 2 of 41 -- 3 (a) by acceptable, cogent evidence; and (b) to a high degree of probability; that the evidence is of sufficient weight to affirm the decision. (3) If the court affirms the decision, the court may order that the prisoner— (a) continue to be subject to the continuing detention order; or (b) be released from custody subject to a supervision order. (4) In deciding whether to make an order under subsection (3)(a) or (b)— (a) the paramount consideration is to be the need to ensure adequate protection of the community; and (b) the court must consider whether— (i) adequate protection of the community can be reasonably and practicably managed by a supervision order; and (ii) requirements under section 16 can be reasonably and practicably managed by corrective services officers. (5) If the court does not make the order under subsection (3)(a), the court must rescind the continuing detention order. (6) In this section— required matters means all of the following— (a) the matters mentioned in section 13(4); (b) any report produced under section 28A.” [4] The required matters are referred to in s 13(4) as follows: “(4) In deciding whether a prisoner is a serious danger to the community … the court must have regard to the following— (aa) any report produced under section 8A; (a) the reports prepared by the psychiatrists under section 11 and the extent to which the prisoner cooperated in the examinations by the psychiatrists; (b) any other medical, psychiatric, psychological or other assessment relating to the prisoner; (c) information indicating whether or not there is a propensity on the part of the prisoner to commit serious sexual offences in the future; -- 3 of 41 -- 4 (d) whether or not there is any pattern of offending behaviour on the part of the prisoner; (e) efforts by the prisoner to address the cause or causes of the prisoner’s offending behaviour, including whether the prisoner participated in rehabilitation programs; (f) whether or not the prisoner’s participation in rehabilitation programs has had a positive effect on the prisoner; (g) the prisoner’s antecedents and criminal history; (h) the risk that the prisoner will commit another serious sexual offence if released into the community; (i) the need to protect members of the community from that risk; (j) any other relevant matter." [5] Section 28A provides that s 8A applies to any application for a continuing order. Section 8A provides that the Attorney-General may produce to the court a report prepared by the Chief Executive for the Attorney-General about the prisoner. No report of that type was produced. Rather various correctional officers filed affidavits which I have taken into account. In addition under s 29 of the DPSOA, psychiatric reports by two psychiatrists were produced for the purposes of the review. [6] The respondent did not dispute that the court should affirm the decision made on 3 October 2008 that he is a serious danger to the community in the absence of an order for his continuing detention and submitted that he should be released from custody subject to a supervision order. Nevertheless the court may affirm the decision only if satisfied in accordance with subsection 30(2) that the evidence is of sufficient weight to affirm the decision. That requires the court to consider the matters set out in s 13(4) of the DPSOA. The evidence as to whether or not the decision will be affirmed will necessarily be similar to the evidence relevant to whether or not the court should order the respondent to continue to be subject to the continuing detention order or to be released from custody subject to a supervision order, nevertheless they are distinct questions. [7] If the court is satisfied that the decision should be affirmed then the court must determine whether the respondent should continue to be subject to the continuing detention order or be released from custody subject to a supervision order. It is significant to note that the paramount consideration for the court when deciding whether to make a continuing detention order or a supervision order is the need to ensure adequate protection of the community.1 The effect of the need to ensure adequate community protection on the choice made by the court of a continuing detention order or a supervision order was discussed by the Court of Appeal in A-G (Qld) v Francis2 as follows: “The question is whether the protection of the community is adequately ensured. If supervision of the prisoner is apt to ensure adequate protection, having regard to the risk to the community posed by the prisoner, then an order for supervised release should, in principle, be preferred to a continuing detention order on the basis that the intrusions of the Act upon the liberty of 1 DPSOA s 30(4)(a). 2 [2006] QCA 324 at [39]; [2007] 1 Qd R 396 at 405 [39]. -- 4 of 41 -- 5 the subject are exceptional, and the liberty of the subject should be constrained to no greater extent than is warranted by the statute which authorised such constraint.” [8] The respondent has been examined on many occasions by psychiatrists and psychologists who have prepared reports for the court. Before turning to them however I should refer to Mr Lawrence’s background and his present situation. Mr Lawrence has been in jail since December 1983, more than 32 years. He is now 54 years of age. Apart from his time in prison, he has also spent periods of time detained as an involuntary patient receiving treatment for mental health problems. His criminal history predates and postdates that final incarceration. I will summarise his criminal history from that set out by Chesterman JA in Attorney-General v Lawrence.3 [9] In May 1978 the respondent appeared in the Ipswich Children’s Court charged with the aggravated assault of a male child under the age of 14 on 4 May 1978. He was admonished and discharged. Later that year he was charged with the aggravated assault of a male child under the age of 14 years and sentenced to two years’ probation. On 23 February 1979, he appeared in the Ipswich Magistrates Court charged with the aggravated assault of a female child under the age of 17. He was sentenced to three years’ probation and ordered to undergo any psychiatric treatment which the probation officer might direct including treatment as an inmate of a psychiatric hospital. His next appearance in the Ipswich Magistrates Court was on 23 December 1980 where he was again charged with aggravated assault on a male child under the age of 14. He was fined $75. [10] It appears that in 1981 he was admitted as an involuntary patient at Wolston Park Hospital. On 11 April 1981 he and three other patients absconded, caught a taxi and decided to rob the driver. One of them held a knife to the driver’s throat. The driver was not harmed and refused to give up his takings. On 3 September 1981 the respondent appeared before the Brisbane District Court charged with conspiracy to commit a crime and assault with intent to steal with the threatened use of violence whilst armed and in company. He was sentenced to four months’ imprisonment and required to undergo a further three years’ probation. [11] After the respondent had served that period of imprisonment, he was returned to the Wolston Park Hospital where, on 26 December 1983, he and another patient killed a female patient. On 7 February 1985 he was sentenced to 15 years’ imprisonment for manslaughter. His conviction for manslaughter was on the basis of diminished responsibility. The young female patient was killed as an enactment of his compelling sexual fantasies about rape and murder. [12] I have had the advantage of reading a report prepared for the Public Defender by Dr Joan Lawrence on 31 January 1985. The respondent told Dr Lawrence that since the age of 15 he had always wanted to kill a girl. He told her that he had violent fantasies associated with masturbation which he engaged in at least daily and usually three to four times daily. He described his fantasy to Dr Lawrence as being “he starts off by picking up a girl, dragging her into a car and taking her into the bush, ripping her clothes off and that he then rapes and murders her by cutting her throat.” He told Dr Lawrence that cutting the throat was “the usual manner of killing her and that this was the best part of the fantasy.” 3 [2010] 1 Qd R 505 at 506-507, [5]-[11] quoted by the court in Attorney-General (Qld) v Lawrence [2014] QCA 220 at [1]. -- 5 of 41 -- 6 [13] The killing occurred in circumstances where he and a co-offender at first persuaded and then dragged another patient to an isolated spot. His co-offender started trying to rape her and she screamed so Mr Lawrence choked her. He thought his co-offender was also involved in the choking. Mr Lawrence said that after he thought she was dead he cut her throat with a glass bottle as he so often did in his fantasy. He thought that he ejaculated while cutting her throat. He told Dr Lawrence that he himself thought that it was perfectly acceptable to want to do such things but he realised that “other people say it’s wrong”. She said he displayed no evidence of remorse or regret for his actions. [14] Dr Lawrence then referred to his history. She said that he had been detained since 23 February 1979 in prison or in mental hospitals but that he had a period of leave from early November 1979 until 26 December 1980 where he committed offences of a sexual nature involving children. She also reported that his sexual history showed that somewhere between 1974 and 1976, and therefore before he was 15, there was a report of his attempted rape of a young girl at the Opportunity School he attended. When aged about 15½ to 16 there were reports of sexual approaches to younger siblings in his family. He told Dr Lawrence that he tried to kill his 12 year old sister one night by putting a tea towel over her mouth after turning off the power in the house. [15] At the age of 16, in October 1977, his first conviction was recorded when he attempted to approach a 10 year old boy. In December 1978 he was charged with aggravated assault on a young boy in a public toilet and placed on youth probation but in February 1979 a further aggravated assault on an eight year old female child occurred which led to his admission to the Barrett Psychiatric Centre at the age of 17 and a half on 23 February 1979. He absconded from psychiatric care on 11 April 1981 and committed an attempted armed robbery of a male cab driver and conspiracy to rob a female taxi driver whilst armed with a knife before he was returned to psychiatric detention on the following day. He reported to Dr Lawrence having violent sexual fantasies about women he came across including even more disturbing and sadistic sexual fantasies about a female nurse. [16] Dr Lawrence said that Mr Lawrence qualified for a defence of diminished responsibility under s 304A of the Criminal Code because of his mental retardation, anti-social personality and significant sexual deviation. There was no evidence of psychiatric illness such as psychosis. It was her opinion that there was a very high risk indeed that he could re-offend and that given the slightest degree of freedom or opportunity he had shown that he was unable to maintain any responsible control over his own sexual drives or other anti-social behaviour. [17] On 3 September 1991, the respondent was sentenced to one year’s imprisonment for escaping lawful custody in August 1991 cumulative upon the term of 15 years which he was then serving. [18] On 4 April 2002, the respondent was convicted of rape and sexual assault with a circumstance of aggravation on 14 October 1999. It was the rape of a fellow prisoner. He was sentenced to seven years’ imprisonment for the rape and three years’ imprisonment for the sexual assault to be served concurrently. [19] It follows that the term of imprisonment imposed for the manslaughter expired on 6 February 2000; the one year’s imprisonment for escaping lawful custody expired on 6 February 2001; and the seven years’ imprisonment imposed for rape expired on 7 February 2008. Since then the respondent has been detained under the DPSOA. -- 6 of 41 -- 7 History of detention orders [20] The first detention order under the DPSOA was made on 3 October 2008. The respondent appealed the making of that order and the appeal was dismissed by the Court of Appeal on 22 May 2009.4 An application for special leave to the High Court of Australia was refused on 2 October 2009.5 [21] On 4 October 2011, a judge of this court, having been satisfied that the respondent was a serious danger to the community in the absence of a Division 3 order, decided that the respondent ought to be released upon the “imposition of appropriate conditions”.6 An appeal by the Attorney-General was allowed by the Court of Appeal and the order for his release on a supervision order was set aside on 2 December 2011. It was ordered that the respondent continue to be subject to the continuing detention order that had originally been made.7 An application for special leave to appeal to the High Court was refused on 5 October 2012.8 [22] On 6 December 2012, another Supreme Court judge who conducted a review under Part 4 of the DPSOA affirmed the decision that the respondent was a serious danger to the community in the absence of an order and ordered that he continue to be subject to the continuing detention order made on 3 October 2008.9 [23] On 2 May 2014, another Supreme Court judge affirmed the decision that the respondent was a serious danger to the community in the absence of an order under the DPSOA but ordered that the continuing detention order be rescinded and the respondent be released from custody subject to the requirements set out in his Honour’s reasons for judgment.10 On 2 September 2014, the Court of Appeal allowed the appeal against those orders and ordered that the respondent continue to be subject to the continuing detention order which had been made on 3 October 2008.11 An application for special leave to the High Court by the respondent was dismissed.12 [24] The hearing before me was the hearing of a further annual review on an application made by the Attorney-General. The written evidence consisted of a number of affidavits, two volumes of psychiatric reports and transcripts, an article from a local newspaper and a report as to the respondent’s testosterone level. In addition, oral evidence was called from a psychologist Dr Lars Madsen, psychiatrists Dr Joan Lawrence and Dr Grant, a general practitioner Dr Hayman, and the respondent Mr Lawrence. After the hearing, Dr Grant and Dr Lawrence provided further reports having perused a transcript of Mr Lawrence’s evidence. [25] It is necessary to review the written and oral evidence adduced in this case to determine whether or not to make any of the orders set out in s 30 of the DPSOA. 4 A-G (Qld) v Lawrence [2009] QCA 136. 5 Lawrence v Attorney-General for the State of Queensland [2009] HCA Trans 244. 6 Attorney-General for the State of Queensland v Lawrence [2011] QSC 291. 7 A-G (Qld) v Lawrence [2011] QCA 347. 8 Lawrence v Attorney-General for the State of Queensland [2012] HCA Trans 247. 9 Attorney-General for the State of Queensland v Lawrence [2012] QSC 386. 10 Attorney-General (Qld) v Lawrence [2014] QSC 77. 11 Attorney-General (Qld) v Lawrence [2014] QCA 220. 12 Lawrence v Attorney-General for the State of Queensland [2015] HCA Trans 83. -- 7 of 41 -- 8 Dr Madsen [26] Dr Lars Madsen is a forensic clinical psychologist. Mr Lawrence was referred to him for treatment on 4 June 2012 and has seen him fortnightly thereafter. The documentary evidence before the court included five reports from him: dated 12 November 2012, 4 November 2013, 1 September 2014, 18 May 2015 and 9 October 2015. He also gave oral evidence. [27] In his report of 12 November 2012, Dr Madsen first addressed Mr Lawrence’s presentation and mental state. Dr Madsen said that Mr Lawrence was open and candid in the way in which he answered questions but it was his sense that Mr Lawrence had discussed many of the issues previously and his descriptions occasionally appeared to have a rehearsed quality. Dr Madsen reported that when Mr Lawrence recounted the details of the killing he had committed, he did so in a tone and manner lacking in any obvious emotional experience or response. He thought this was partly due to a “practice effect” as he had discussed it on many occasions with other professional people. However he also thought that Mr Lawrence more generally was indifferent to the consequences experienced by victims of crime. [28] Dr Madsen said that when recounting his personal history Mr Lawrence appeared to contradict himself and gave an example of where Mr Lawrence “provided differing stories on when he had ‘stopped’ masturbating to deviant fantasies”. Dr Madsen’s impression was that on occasions these contradictions were the function of genuine intellectual deficits and poor memory and on other occasions deliberate attempts at “positive impression management”. Dr Madsen formed the view that Mr Lawrence’s self-report was likely to be unreliable partly because of his low intellectual functioning. [29] Dr Madsen then examined what he referred to as the pertinent background information. This was that Mr Lawrence was born in New South Wales and his mother left shortly after his birth. He was largely raised by his grandmother until she died when he was seven years old. Mr Lawrence was then placed in what he described as a home for unwanted children and described an extraordinarily violent and abusive environment after this time. Mr Lawrence recalls being sexually assaulted by the staff and other children and generally being treated in a neglectful and physically abusive way. [30] At the age of 14 Mr Lawrence said he was placed in the care of his father who had remarried. Mr Lawrence recalls having about six or seven step-siblings and he had poor relationships with them and his parental care givers and identified himself as the “black sheep” of the family. [31] Dr Madsen says that the collateral information indicated that sometime prior to the age of 15 he attempted to rape a young girl who was a fellow student at the Opportunity School he was attending. Shortly after that he attempted to kill a younger step-sister by choking her. This incident caused him to be returned to Wolston Park Hospital. At the age of 16 he was convicted of sexual assault on a 10 year old boy. At 17 he was again convicted of sexually assaulting a boy and a month later sexually assaulted an eight year old girl. He was placed in the Barrett Psychiatric Centre at the age of 17 and a half. [32] He was released after nine months and in December 1980 was readmitted after another sexual assault on a boy and on a girl. He absconded in 1981 and committed further offences. In 1982 he was transferred to Wolston Park Hospital and in 1983 was -- 8 of 41 -- 9 transferred to Pearce House (a closed ward in the hospital). He was transferred from Pearce House to an open ward and 10 days later committed the killing. [33] Dr Madsen’s summary of Mr Lawrence’s background is as follows: “Mr Lawrence depicted an extremely difficult early history characterised by high stress, instability, limited structure, poor supervision and ineffectual parenting. From a young age he was consistently exposed to sexual violence and general criminality, and [was] himself the victim of emotional, physical and sexual abuse. He described detached and hostile relationships with his family and peers, and early on struggled with behaviour problems and a range of escalating delinquent behaviours and criminal activity. At a young age he was convicted of serious violent and sexual offences, and he has struggled to exist outside of custodial settings for even brief periods without offending in a serious manner.” [34] Mr Lawrence described the killing in which he engaged to Dr Madsen in terms that suggested that his extremely violent behaviour to the victim was done quite unemotionally. He said he had not raped her because he had already violently killed her. He also set fire to her clothing. He said that on the following day he was missing his watch so he returned to where the body was and moved it around until he found his watch. He said he was unsatisfied because he did not get to rape the victim so he started looking for another patient so he could fulfil his fantasy. Dr Madsen then refers to a description given by Mr Lawrence to Dr Joan Lawrence where he said that he cut the victim’s throat after she had died from being strangled and he decided to cut her throat because that had been a crucial part of the fantasy he had. Dr Lawrence had reported that at that time he probably ejaculated whilst cutting the victim’s throat. His report to Dr Madsen as to how the killing occurred was slightly different from his report to Dr Lawrence. He had reported to Dr Lawrence that he had struggled with fantasies about killing a female since about the age of 15 years. He described having periods of intense sexual preoccupation where he would masturbate three or four times per day. [35] Mr Lawrence acknowledged to Dr Madsen that he had struggled with fantasies of killing women from the age of 14 or 15 and that this had been his sole source of sexual arousal. He described the “murder fantasy” as involving finding an isolated attractive young woman, physically forcing her into some bushland, then raping her and finally choking her. The murder of the victim was considered by him to be crucial and the most sexually arousing element. [36] Dr Madsen said Mr Lawrence denied having those fantasies at present although acknowledged he had maintained them for a long time whilst in prison. He gave Dr Madsen some conflicting dates as to when he had last utilised those fantasies. Dr Madsen reported that it “seemed” that he was saying he had been managing them successfully for about five or seven years. [37] With regard to Mr Lawrence’s offending history Dr Madsen said that in 2001, some time after he had been imprisoned for the killing, Mr Lawrence was convicted of rape of another inmate although he told Dr Madsen that this offence had been overturned on appeal. -- 9 of 41 -- 10 [38] I should here mention that my examination of reported cases shows that his conviction was at first set aside on appeal; but a re-trial was ordered.13 He was again convicted and his appeal against that conviction was unsuccessful. The report of the Court of Appeal decision in which his appeal against conviction was dismissed is R v Lawrence.14 Not only does that decision confirm that the conviction was not in fact finally overturned but the reasons are explicit about the violent anal rape of the complainant fellow prisoner and the threats that Mr Lawrence made to him after he had raped him by saying “Don’t say anything. I’ll be watching you. And, remember, I’m a psychopathic murderer.”15 [39] Under the heading “Previous Treatment”, Dr Madsen said that Mr Lawrence had completed the High Intensity Sex Offender Treatment Program (“HISOP”) in 2007. Apparently after that time he had talked to other inmates about his desire to get out of prison and re-offend. Mr Lawrence denied to Dr Madsen that he had done that. Dr Madsen reported that Mr Lawrence appeared to be very keen to demonstrate that he had learned victim empathy although Dr Madsen expressed some scepticism about that. [40] Dr Madsen then reported on a number of psychometric tests that he had carried out to evaluate various aspects of Mr Lawrence’s personal functioning, his intelligence and also attributes and attitudes related to offending risk. His intelligence was classified as extremely low; he scored within the normal range on impression management. Dr Madsen said the results of the questionnaires did suggest some salient risk factors. They were expressed as follows: “Mr Lawrence is prone to ‘act before thinking’ much more so than the average individual and indeed also the average inmate. He also reports a poor ability to ‘place himself’ in other people’s shoes and is largely indifferent to the distress observed in other people. On the positive side he reports a reasonable capacity to be able to perspective take and describes a ‘high degree’ of empathic concern for others. The results on the anger scale indicates that Mr Lawrence has problems with the expression of anger. He is highly prone to be mistrusting and suspicious of others, and will ruminate on perceived personal slights for long periods. These feelings are likely to act as obstacles to being able to access support, or indeed discuss personal issues that would cause him to feel vulnerable. On the sexual offending specific questionnaires Mr Lawrence’s results indicate that he does continue to endorse some attitudes and beliefs that would be considered supportive of sexual abusive behaviour. His responses suggest that he does not view himself as a ‘risk’ nor see the need for ongoing treatment. These types of beliefs are a concern because it could conceivably affect his preparedness to seek out support, utilise risk reduction strategies and avoid ‘risk elevating’ scenarios or behaviours. On the positive side he has good knowledge and understanding of sexual behaviour and types of things that you should say in relationship situations.” 13 R v Lawrence [2002] 2 Qd R 400; [2001] QCA 441. 14 [2002] QCA 526. 15 [2002] QCA 526 at [3]. -- 10 of 41 -- 11 [41] Dr Madsen then went on to assess the risk that Mr Lawrence posed. He said on actuarial scales he would score highly and possess many of the characteristics related to increased risk of recidivism, including having been convicted of multiple sexual offences, having male and female victims and having stranger victims. He had also had convictions for violence and absconding from custody. He had been diagnosed with an antisocial personality disorder and as being highly psychopathic. [42] Dr Madsen said that at the time of his offending he was highly sexually preoccupied with his strong and deviant fantasies which involved murdering a young woman. His offence was planned and not the function of being in a panic or poor problem solving. He killed the victim because it was a desired outcome and afterwards displayed no remorse and for some time appeared to have remained somewhat indifferent to the consequences of his behaviour. [43] His behaviour in prison had, however, stabilised and he has stable relationships with custodial staff and other inmates. The HISOP appeared to have been of benefit although he retained attitudes supportive of offending. Dr Madsen said that Mr Lawrence’s long history of persisting sadistic sexual interests represented a significant concern and an ongoing risk factor to be monitored and managed. Mr Lawrence denied having continuing deviant fantasies and claimed he masturbated infrequently but, as Dr Madsen, said it is difficult to evaluate the veracity of those claims. Dr Madsen made treatment recommendations taking into consideration that his assessed level of risk was high and also the nature of the risk, which was a potential murder. [44] Dr Madsen’s next report was completed on 4 November 2013 after Mr Lawrence had attended 18 sessions since the previous report. Dr Madsen reported that Mr Lawrence was somewhat hesitant in engaging in further therapeutic contact with him initially because he felt that his report was unfair. Dr Madsen again gained the impression that Mr Lawrence was engaging in “positive impression management”. In January of that year a fellow prisoner whom Mr Lawrence referred to as his “partner” had been moved to another area of the prison and that caused Mr Lawrence to be somewhat depressed. [45] Dr Madsen again explained how Mr Lawrence’s upbringing would have led him to social isolation and general hostile detachment from people which would have intensified in parallel to his preference for deviant sexual activities and his preparedness to use violence, intimidation and coercion to meet whatever his needs were. [46] Dr Madsen’s summary of the psychometric tests he undertook on that occasion were that the results from the sexual offender specific questionnaire indicated that Mr Lawrence continued to endorse attitudes that were likely to be supportive of stalking, homosexual assault, voyeurism and exhibitionism. There had been a reduction in his endorsement of attitudes that blamed others for his offending. So far as risk is concerned, Dr Madsen said there was evidence that Mr Lawrence had some capacity to form and sustain relationships with others in the custodial environment and that his behaviour within prison appeared to have stabilised somewhat. [47] Dr Madsen said that Mr Lawrence did not obviously appear to endorse pro-offending attitudes nor from his self-report was there evidence of sexual deviancy although it was not clear to Dr Madsen whether this had dissipated, was lying dormant or he was simply being dishonest about the frequency and intensity of his deviant fantasies. Mr Lawrence had described his deviant fantasy process to involve the abduction, rape and then murder -- 11 of 41 -- 12 of a young provocatively dressed adult female in an isolated location. The murder of the victim and the fear generated in her was an important part of this fantasy. He noted that movies and television shows where rape was depicted would trigger these types of fantasies and thinking processes. Mr Lawrence reported that he was able to manage these fantasies when he experienced them now through a range of processes including distraction and communicating with others. He reported he avoided watching movies that showed high levels of violence. [48] Mr Lawrence also showed that he was acutely aware of the potential negative consequences to him should he disclose experiencing deviant fantasies at present. This was a complicating factor in understanding his true risk. [49] Dr Madsen’s next report was written on 1 September 2014. He had seen Mr Lawrence fortnightly for a total of 15 sessions since the last report. He reported that Mr Lawrence continued to engage well with treatment, although his motivation and focus had been negatively affected by his court matters. This is presumably a reference to the appeal against the order allowing his release on conditions had been heard but not yet determined. He struggled to accept that he could still be considered a “high risk”. Dr Madsen noted that Mr Lawrence had been in custody for extended periods of his childhood and for most of his adult life and was therefore institutionalised and found the routine, structure and predictability of prison to be safe and easily negotiated. [50] Mr Lawrence expressed to Dr Madsen that he felt he was being punished if he acknowledged experiencing deviant fantasies and was worried that if he discussed them that would be used against him in a court process. That put him in an awkward situation where it was difficult for him to feel he could be open and honest about his concerns. Dr Madsen said that Mr Lawrence therefore took the position that his fantasies did not occur. [51] Mr Lawrence said that historically there are a range of triggers to his deviant fantasies some of which included newspapers or television stories depicting rape, female custodial staff wearing skirts, going to court or the Princess Alexandra Hospital where he would see female staff and members of the public, and specific television shows where women wore tight or revealing clothing. Other factors that would trigger these types of thoughts would be feeling in control or being in an isolated situation by himself. Dr Madsen expressed the view that a fear of being returned to custody was not necessarily a sufficiently adverse consequence of further offending as Mr Lawrence had spent most of his adult life in custody and in many ways had been successful in custody. [52] Dr Madsen reported that Mr Lawrence felt suspicious and mistrustful although Dr Madsen regarded it as positive that Mr Lawrence was able to discuss his mistrust in a therapeutic contest. Overall he said Mr Lawrence had engaged well with psychological sessions. [53] In conclusion Dr Madsen said that the issue of sexual deviancy was a core concern with regard to Mr Lawrence’s risk in the community and that Mr Lawrence denied struggling with intrusive deviant thoughts and fantasies and claimed that for some time he had been able to manage those without difficulty. The second area of concern was that Mr Lawrence was vulnerable to experiencing distrust of professionals and other staff involved with him which may predispose him not to seek help or to deny experiencing problems for fear that this could be used against him. -- 12 of 41 -- 13 [54] Dr Madsen’s next report was dated 18 May 2015. He had continued to see Mr Lawrence more or less on a fortnightly basis since his last report. [55] Dr Madsen reported that Mr Lawrence’s behaviour within custody had been stable, that he had been able to maintain work and save money and had undergone a broad range of educational and therapeutic programs. Taken together this suggested that Mr Lawrence did have a capacity to exercise self-control, pursue and achieve goals, and also be compliant with the regulations and rules of the prison. Dr Madsen reported that the main obstacle to his release appeared to be the issue of deviant fantasies and the difficulties by which this could be measured and confidently evaluated. The fantasies were long- standing and were a motivating factor in the killing of his victim in 1983. Mr Lawrence told Dr Madsen that he was rarely masturbating (once a week or fortnight) and did not use deviant fantasies; nor were those fantasies triggered in the way they previously were. Mr Lawrence described that as having occurred because he had a number of long term sexual relationships in custody which had affected him positively in that he felt understood and close to someone, a feeling he had never had previously. [56] Mr Lawrence also described to Dr Madsen experiencing erectile dysfunction and reported that he had been unable to gain or sustain an erection for many years. Mr Lawrence reported feeling despondent after his losses in court and he expressed frustration and angers at assessors, including Dr Madsen. Dr Madsen said that that feeling dissipated during the following therapeutic sessions. [57] Mr Lawrence and Dr Madsen discussed two strategies for dealing with a deviant sexual fantasy. One involved Mr Lawrence identifying the beginnings of a trigger and then linking this to a variety of undesirable consequences for himself. The other strategy was to engage in masturbation in response to appropriate or non-deviant fantasies. Dr Madsen said these strategies were discussed rather than specifically implemented due to Mr Lawrence’s self-reported erectile dysfunction and low libido. [58] Mr Lawrence claimed his deviant fantasies had reduced. He enjoyed the work he was doing in prison which gave him self-esteem and confidence. His sexual deviant fantasies appeared to serve the function of boosting mood and reducing feelings of vulnerability and distress and discharging anger. His work therefore, Dr Madsen thought, made him less vulnerable to those feelings and therefore less inclined to need to utilise deviant fantasies to make him feel powerful. [59] Dr Madsen concluded by saying that it was his impression that Mr Lawrence had likely done as much as he could do with regard to managing and dealing with sexual deviancy. Mr Lawrence reported that he did not struggle with those sorts of fantasies, he was not sexually preoccupied and described experiencing erectile dysfunction. Dr Madsen said it was likely that his circumstances within the prison and the progress that he had achieved through work and study might well have assisted him with developing more adaptive coping skills and that in turn may have reduced the psychological need for him to utilise deviant fantasies to regulate his mood or make him feel powerful or omnipotent. He recommended that Mr Lawrence continue to have fortnightly psychological support where the focus remained on the issues of deviancy, self-management and planning for the future. In his opinion, should Mr Lawrence be released at some point in the future he would be likely to require a significant degree of support as he would lose his routine, his job and likely the personal support that he currently had. -- 13 of 41 -- 14 [60] Dr Madsen’s final report before me was dated 9 October 2015. He continued to have sessions with Mr Lawrence and had met with him on six occasions since the last report. Dr Madsen first referred to Mr Lawrence’s personal and offending history which has previously been covered. With regard to the sexual offence committed against another prisoner in 2001, Mr Lawrence denied the offence however acknowledged that he had sexual contact with the victim and claimed that the contact was consensual. It should be noted that the Court of Appeal decision which dismissed Mr Lawrence’s appeal against conviction referred to the highly distressed state of the complainant after the offence, which, along with the conviction, demonstrates that Mr Lawrence’s interpretation is plainly wrong. [61] Dr Madsen reported that Mr Lawrence’s institutional behaviour continued to be exemplary. He reported he continued to struggle with erectile dysfunction and described infrequent masturbation and that he typically could not sustain an erection to ejaculation. He reported to Dr Madsen that he had spoken to the doctor about this issue and had his testosterone levels checked. He reported that on 21 October 2007 his testosterone level was 20, on 31 March 2008 it was 13 and most recently on 16 June 2015 it was 12. [62] Dr Madsen said that his sessions with Mr Lawrence had specifically focused on the dangers of deviant sexual fantasy both generally and specifically to him. Mr Lawrence claimed that he experienced deviant fantasies infrequently and denied that he ever now masturbated to them. Dr Madsen again identified that his improved interpersonal and institutional behaviour in prison and the work which was a source of pride for him assisted in boosting Mr Lawrence’s mood, self-esteem and confidence making it less likely that he would need to utilise deviant fantasies to dominate, punish or control. Dr Madsen again noted that, as Mr Lawrence is a man who has been institutionalised most of his life, readjusting to a non-institutional environment would be likely to be very stressful for him. [63] During his oral evidence, Dr Madsen explained the content of Mr Lawrence’s deviant sexual fantasies as “a very strong fantasy that involves a lone female which has long hair and a short skirt in an isolated location; taking her into bushland, strangling her and raping her.” That is a fantasy which had been reinforced over many years. Dr Madsen made a distinction between triggers and thoughts and fantasies so he endeavoured in his intervention with Mr Lawrence to try to identify when the thought of a fantasy would be triggered and they were monitored over a four week period. An example of something that was a trigger during that period was watching a television show where there was a rape scene. During the four week period there was another trigger of the same kind. [64] Dr Madsen said that in many cases “We can’t expect cure. We just have to expect folks to be better at being able to manage the triggers and the urges that might come along with that.” Dr Madsen said he would have been concerned if Mr Lawrence was seeking out television shows with that kind of material in it but he did not get the sense that that was the case. He said that Mr Lawrence was able to appropriately describe his reaction to it and what he did to try to refocus himself on something else and not to dwell on those thoughts. Dr Madsen said that when a person such as Mr Lawrence had a trigger about a particular kind of fantasy, the person had the capacity to make alternative decisions about whether he wanted to pursue or cultivate that fantasy and revel in it, go over it in his mind and play it out in his head and that Mr Lawrence now, perhaps, had greater skills to be able to intervene so he did not allow that kind of fantasy to be dwelt on. -- 14 of 41 -- 15 [65] Dr Madsen said that Mr Lawrence’s fantasies had served historically a function of making him feel powerful, important and good about himself. On the other hand he had been very successful in prison in maintaining work and that had changed the way he thought about himself. He derived positive feelings from work and he also felt good about the better relationships he had with people in custody. Dr Madsen agreed that one of the things that gave Mr Lawrence a good sense of purpose and self-esteem was his responsible job in the steel fabrication unit and that realistically it would be very difficult for him to obtain a position like that outside prison. Dr Madsen thought that that would be very hard for him, as would be the loss of his routine and any media coverage which would result from his release. [66] Dr Madsen thought the way for Mr Lawrence to cope if any triggers arise would be to talk about it; but he agreed with counsel for the Attorney-General that that would present a challenge for him because if he brought it up with a Corrective Services officer who was supervising him he might well be worried that that would lead to his re-incarceration. He would therefore have to be able to talk to his treating psychologist about it. Dr Madsen also thought it was a challenge that he was both the treating psychologist and a person who was required to give evidence. While Dr Madsen’s goal was to assist Mr Lawrence to try to be successful in the community and get his needs met in a healthy and adaptive way and he believed that Mr Lawrence was motivated to do that, if circumstances arose where Dr Madsen felt concerned that Mr Lawrence was a risk to other people or himself, then he would need to intervene to control and manage that risk. Dr Madsen agreed that Mr Lawrence would experience significant stress when released from prison but that he had taken whatever steps he could to prepare himself for that. [67] Dr Madsen agreed that Mr Lawrence had used his fantasies to boost mood, counteract feelings of vulnerability or weakness and discharge anger and resentment and that those emotions were likely to be felt by someone encountering their first time outside an institution in 30 years. There would be no way of telling whether or not that was happening apart from self-disclosure by Mr Lawrence and, accordingly, a woman in an isolated environment would potentially be at great risk. Dr Madsen agreed that it could potentially be a lethal risk to her. Dr Madsen was of the opinion that there was a part of Mr Lawrence that genuinely did not want to re-offend and genuinely wanted to stay out of custody so it was important that he was able to reach out and get help to assist him to survive in the community over the longer term. Dr Joan Lawrence [68] The first report by Dr Lawrence for the purposes of assessing Mr Lawrence for the purposes of annual review of his detention under the DPSOA was made on 2 November 2009. Dr Lawrence attached a copy of the report she had prepared for the Public Defender on 31 January 1985 referred to earlier in these reasons. [69] Dr Lawrence also referred to reports on Mr Lawrence by Professor Barry Nurcombe and Dr Michael Beech where Mr Lawrence gave a personal history that he had no knowledge of his biological mother and that he was raised by his grandmother from birth to about age seven with no contact with his biological parents. He said that when his grandmother died he spent days fending for himself in the bush before being found by authorities and placed in Stuart House in Sydney where he remained until the age of 14. He described being bashed and raped by both staff and other inmates; being treated violently and neglectfully, receiving little or no schooling; and being so disturbed as to attempt suicide -- 15 of 41 -- 16 by intending to jump off a cliff, although someone grabbed him. He told Professor Nurcombe and Dr Beech that his father claimed him at age 14 and he then spent the rest of his adolescence in the care of his father and step-mother along with six or seven step- siblings. [70] Dr Lawrence noted that Dr Beech commented that there was some discrepancy in the accounts of Mr Lawrence’s personal history, particularly related to his upbringing by his father and step-mother. Dr Lawrence had obtained an account of his upbringing from one of Mr Lawrence’s sisters when she examined him in 1985. His sister told Dr Lawrence that he was left with his grandmother at the age of three months but was subsequently collected by his father after he married his step-mother at about the age of 12 months. He was then reared as their own child by his father and step-mother. He had a step-brother and six half-brothers and sisters. Dr Lawrence said that, in summary, the current accounts of his personal background and childhood and family upbringing were grossly incorrect and unreliable. [71] Dr Lawrence said that Mr Lawrence indicated his remorse for the crime of killing the young woman although he spoke only of what the girl’s family must have gone through. However he went on to protest that he was innocent of the jail rape and spoke with passion and indignation and at length about this matter. [72] With regard to his offence of killing the girl, he admitted he had sexual rape and killing fantasies in the past and that they had been present and influential at the time of the killing. However he asserted that he had had no such fantasies for the three years prior to seeing Dr Lawrence, that is from late 2006. He told Dr Lawrence that while he still masturbated, the frequency had decreased significantly. He said that he masturbated initially in prison six to seven times a day but this had now reduced to once a week. He attributed that to increasing age. He went on to say that he also tended to avoid the fantasies; if he got fantasies of rape and killing, he said he made a conscious effort to distract himself and avoided following through with masturbation to those particular fantasies. Mr Lawrence told Dr Lawrence that he had male sexual partners in prison but would prefer women to men if any were available. When she questioned this because of his child victims, three had been male and only one female, he vigorously denied that the attacks on the children were sexual at all. He then said that he had only committed the offences against children or pleaded guilty to them because he wanted to go back to hospital where he felt safer because he wanted to get away from his father who was raping him at home. He agreed that he had never suggested at the time that he was being sexually abused by his father. [73] Dr Lawrence said that he acknowledged the difficulty he would have on release from prison as he had spent most of his life in prison or institutions since 1978 and everything had been done for him. He told Dr Lawrence what programs he liked watching on television. Of some concern were the fact that these included shows about crime such as “Police, NCIS” given that he subsequently told Dr Madsen that these were the types of television programs likely to trigger deviant thoughts. He told Dr Lawrence about family support he might have outside prison but it appears to have been completely unrealistic. He expressed a desire to get out of prison because he wanted to “have a child”. [74] Dr Lawrence reported on a number of risk assessment tools which she used to assess his risk of future offending. On the test for psychopathy she rated him 23 out of 40 giving him highest scores for lack of remorse or guilt, lack of empathy, parasitic lifestyle, promiscuous sexual behaviour, early behavioural problems, lack of realistic long-term -- 16 of 41 -- 17 goals, failure to accept responsibility for his actions, revocation of conditional release and criminal versatility. Dr Lawrence said that in her opinion he did not now reach scores that would equate with a psychopathic personality disorder with its implications of recidivism. He gave the impression of somebody whose personality characteristics had moderated with maturity. [75] She also assessed him on the HCR-20 risk management assessment scale. With regard to historical factors he scored 16 out of a possible 20 points. The only factors that were not present were substance abuse problems and major mental illness. With regard to present factors she scored him at three out of 10 points giving him one out of two for lack of insight, impulsivity and unresponsiveness to treatment. In her opinion he appeared to have some response to treatment but she had reservations about the extent of change. His impulsivity appeared to have moderated over time in the structured environment of the prison but Dr Lawrence could not be confident that impulsive responses to external events would not occur. She was of the opinion that he had limited insight into his own behaviour. [76] For future risk management factors, Dr Lawrence scored him at nine out of 10 points. She scored him highly on all factors except his non-compliance with remediation attempts. She said that he appeared to have accepted and involved himself in therapy programs but there was some doubt in her mind as to the extent of his response to those programs. He claimed considerable benefit but in her evaluation there remained some considerable doubt as to the amount of integration of the concepts into his “psychic thinking.” [77] So far as the Violence Risk Appraisal Guide was concerned, Mr Lawrence’s score placed him in a high risk category of violent recidivism. So far as the Sex Offender Risk Appraisal Guide was concerned, he was in the very high risk category; that is, there was a 100 per cent probability that he would re-offend sexually within seven to 10 years. So far as his Sexual Violence Risk – 20 was concerned, Dr Lawrence scored his overall risk of re-offending as high. Her overall assessment was that Mr Lawrence, as assessed on actuarial scales, remained at high risk of recidivism. [78] In the summary of her opinion, Dr Lawrence expressed her views in the following way: “20.6 He has acknowledged sexual fantasy which he now claims have reduced in frequency and gives information suggesting that, even if he had occasional fantasies (which he denies), he does not obtain sexual satisfaction through masturbation in response to the fantasies. There is no way of obtaining objective corroborative evidence about these statements. Regrettably there is considerable evidence to indicate that Mark Lawrence’s credibility is very questionable. There is evidence of current ongoing lying and denial in other previously corroborated information so that relying on his uncorroborated statements is unwise. 20.7 Mark Lawrence has successfully completed Sex Offender Treatment Programs during his incarceration including the High Intensity Sexual Offender Program (HISOP) with exit reports indicating satisfactory participation. Mark Lawrence is able to recount and claims benefit of concepts imparted as a result of the HISOP program. The manner in which these are recounted suggest an acquisition of jargon rather than a true acquisition of the underlying empathic and emotional -- 17 of 41 -- 18 understanding and acceptance of these concepts. Thus one cannot be assured that really significant change is likely to have occurred in this man’s inner psychic life, particularly as it relates to his sexuality and sexual fantasies. 20.8 He has also voluntarily received treatment with anti androgenic hormones during his period in prison. After a satisfactory period on treatment it seems that the treating Psychiatrist at the time, Dr Robert Moyle, did not consider that there was sufficient benefit to warrant continuing treatment. 20.9 In my opinion the current DSM-IV diagnosis would be:  Axis 1 - Sexual sadism, paraphilia.  Axis 2 - Borderline intelligence probably incorrect and functioning at a higher level; - Antisocial Personality Disorder; - Probable Psychopathic Personality which has matured to a degree.  Axis 3 - Nil relevant  Axis 4 - No social supports in external world - Long Term institutionalisation 20.10 In my clinical opinion Mark Lawrence remains at high risk of recidivism were he to be free in the community. The Actuarial Scales are consistent with this opinion. 20.11 In my opinion the risk factors which would have to be addressed in order to reduce the risk to acceptable levels would involve:  virtually constant close surveillance,  Intensive efforts at re-socialising This man has not lived for any length of time as an independent person in a social community at any time in his adult life. He would therefore be exposed to a very large range of potential destabilising factors.  He has no family or close personal supports and  No ready access to reliable replacements other than of a professional kind. 20.12 Exposure to these destabilising factors is likely to increase the risk of a retreat into self-gratification likely to mean the reactivation and possible acting on sexual sadistic fantasies of rape and killing. 20.13 His past history also involves escape attempts and failure to comply with conditional release. Whilst it may be that maturity has mellowed his personality and he may have modified, in a positive way, his rebelliousness and non compliance (he has apparently functioned well -- 18 of 41 -- 19 in the structured environment of prison for nearly a decade). However the ongoing evidence of denial, his lack of empathy, the ongoing presence, even at decreased frequency of his dangerous sadistic fantasies mean that a Supervision Order is unlikely to be constructed in a practical fashion sufficient to decrease the risk of re-offending. 20.14 I consider Mark Lawrence to be a Dangerous Sexual Offender who, in my opinion, represents a High Risk of re-offending if released. I do not believe that a Supervision Order could be formulated with conditions that could manage the multiple and complex risk factors that this man presents.” (emphasis in original) [79] Dr Lawrence then prepared a supplementary report after the annual review of Mr Lawrence’s continuing detention order was adjourned. Her supplementary report was dated 16 June 2010. She had been provided with further materials. She considered a copy of the exit reports from the HISOP. She noted that whilst he acknowledged ongoing sexual fantasies during that program, he subsequently denied any such fantasies in the interview with her and that the supplementary material from the program therefore strongly suggested their ongoing presence. The offender case file with which she had been provided supported the doubts expressed about the reliability of information which Mr Lawrence provided. [80] Additionally Dr Lawrence said that the information provided shows that on 6 September 2007, three months after his completion of the HISOP, an unidentified inmate had not only been the recipient of inappropriate sexual advances towards himself and others but also described more serious matters. He expressed grave concern for his safety if this information was revealed. [81] The affidavit of a psychologist appeared to reveal the ongoing existence of sadistic sexual fantasies against women and also possibly a certain specific female for whom he expressed hostility and a desire for revenge. This again was three months after the completion of the sexual offender program which raised for Dr Lawrence grave concerns about reliance on the benefits of the program undertaken in the assessment of his future risk of very serious, potentially fatal re-offending. [82] Dr Lawrence said that his capacity for denial of issues, concerns about his general reliability and credibility and likelihood of noncompliance with disagreeable conditions of a supervision order gave this information even more significance. Having referred to other extra material that had been provided Dr Lawrence said she remained firmly of the view that Mr Lawrence was a high risk of re-offending in a potentially very serious manner even if released under a very closely monitored supervision order. In her opinion the risks of his re-offending through acting on his paraphilic behaviours continued to provide an unacceptable risk to public safety. [83] A further supplementary report by Dr Lawrence of 29 November 2010 reiterated that opinion. [84] A further supplementary report was prepared by Dr Lawrence on 16 May 2011. This report made further comments on additional material provided, including a revised release plan said to have been done by Mr Lawrence, which addressed some of the issues of concern but was clearly prepared by a support person and in Dr Lawrence’s opinion only -- 19 of 41 -- 20 emphasised some of the issues of concern in contemplating his release from prison, even under supervision. [85] Dr Lawrence also commented on a supplementary report by Professor Morris. Professor Morris had expressed the opinion that there was no reason to keep Mr Lawrence in jail in order for treatment to occur and that treatment in the community would be the most effective and appropriate next step in his management. Dr Lawrence said that she strongly and totally disagreed with that statement, given Mr Lawrence’s particular sexually sadistic and homicidal history and evidence of ongoing fantasies of such behaviour even if they had decreased in frequency with age and even with the fact that he claimed to use strategies to distract himself if and when they occurred. [86] Dr Lawrence remained of the opinion that Mr Lawrence could not be regarded as a reliable historian. She observed that throughout his history it had been demonstrated that he was capable of significant distortions of the truth, lying, denial, minimisation and specious arguments with regard to his offending behaviour. She observed that his ongoing denial, minimisation and minimal acknowledgement of sadistic or other deviant sexual fantasies indicated that his statements as to their current non-existence and his ability to control them were unreliable. His ability to manipulate the truth was likely to be an ongoing influence on his behaviour and she would expect that compliance with any supervision order would be a problem. [87] She remained strongly of the opinion that he continued to be a threat to society and that he was at high risk of re-offending sexually or violently or both and that the risk of harm from his re-offending would be very serious. She did not believe that a supervision order or release plan could be developed such as to address the risks with any degree of certainty. [88] She concluded by saying “I adhere to and reiterate my strong opinion, stated previously, that Mark Lawrence continues to present a very high risk of re-offending sexually and violently and that the harm that could be inflicted by any expression of his sadistic and homicidal previous behaviours could be extreme.” (emphasis in original) [89] Dr Lawrence produced a further report on 29 October 2012. An appointment was arranged for her to interview Mr Lawrence but he declined the interview. Accordingly she relied upon the extensive documentation provided to her. Dr Lawrence said that while it was to his credit that Mr Lawrence did not react in any adverse way to his failure to obtain release and his continuing detention under the DPSOA and that his general behaviour and work ethic had been excellent there was no evidence to suggest any change in his risk status. He remained at high risk of reoffending and in a potentially very serious manner. [90] The next report by Dr Lawrence was dated 31 October 2013. It followed an interview with Mr Lawrence on 11 October 2013 and a review of a substantial amount of documentation set out in her report including a copy of his future release plan and relapse prevention plan dated 30 September 2013 which was discussed with him at interview. [91] Dr Lawrence reported that Mr Lawrence had himself raised the issue of his rehabilitation needs and in response to that he was advised that he was going to be case managed through a collaborative process involving an external provider Dr Lars Madsen. He -- 20 of 41 -- 21 enrolled in the sexual offending maintenance program (SOMP) and continue to work in the engineering workshop. [92] On 12 February 2013 he and another prisoner admitted to being involved in a sexual relationship. They were instructed to cease the relationship immediately and were separated. It was noted that by 9 April 2013 he had been employed in the light fabrication workshop for the past five and a half years. Dr Lawrence reviewed the SOMP exit report which provided useful information, both positive and negative, regarding Mr Lawrence’s participation in the program. Dr Lawrence quoted from the exit report which noted that he was a complex individual who presented: “with a strong self-focus and a pervasive and negative thinking style. He was motivated to engage in the program processes afforded through participation in the program, although few meaningful shifts were noted. He has outstanding treatment needs with regards to his sexual deviancy which is currently being addressed with an experienced, external psychologist. He also has needs with regard to enhancing his understanding of key concepts of the programs he has undertaken specifically in relation to understanding his risk factors and how they connected to his offending pathway. It is acknowledged that prisoner Lawrence has challenges with regard to his literacy and intellectual ability. However, this is offset by his motivation to make positive gains. He was observed to work in simple repeat structured and concrete circumstances and perhaps this experience may be utilised in the future to consolidate the gains prisoner Lawrence has made to this point.” [93] Mr Lawrence expressed his disagreement with the exit report writing “I believe I am not violent any more. I have never been in any fights since completing the violence program (VIP) and I haven’t had breaches for 20 years.” This response appeared to misunderstand the exit report. [94] The exit report also commented on “entrenched thinking patterns” as a “tendency to move to a defensive attitude including victim-stancing (presumably seeing himself as a victim), self-focus, externalising blame and sulking if he became unhappy or experienced feelings of anger or frustration.” It appeared that Mr Lawrence was able to use terminology and concepts but it was doubtful that he had internalised them and understood their true meaning. On the positive side it was noted that Mr Lawrence had clearly established a therapeutic relationship with Dr Madsen who attended the centre regularly to provide individual counselling to Mr Lawrence. He told Dr Lawrence that he is now using strategies to deal with his deviant fantasies as a result of working with Dr Madsen. [95] He told Dr Lawrence that he had not had any deviant fantasies for some time, probably years and said he was masturbating once or twice a week but that he was “starting to get bored with it” and thought it was probably due to age. He said he was having problems getting a full erection. He said he thought that something might be wrong with him to cause this and had consulted a doctor at some time about it. He said that the doctor had said that maybe he should use Viagra but Mr Lawrence said he did not think it was a good idea. Dr Lawrence said that she certainly did not think it was a good idea. [96] As a result of her interview and her reappraisal of the various risk assessment tools, Dr Lawrence had changed her mind about whether or not Mr Lawrence could be released on a supervision order under the DPSOA. Her executive summary set out that changed view as follows: -- 21 of 41 -- 22 “14. EXECUTIVE SUMMARY 14.1 Mark Lawrence is a now 52 year old man who was convicted of manslaughter on the basis of diminished responsibility of a 26 year old woman in company of another male and in circumstances of rape, 30 years ago. 14.2 He had experienced a very dysfunctional and disadvantaged childhood though the exact circumstances of his childhood have been the subject of significant inconsistencies in his accounts in recent years. He appeared to give consistent though variable accounts of being a victim of sexual abuse. 14.3 There was considerable variety of offending behaviours throughout adolescence and some concerning information about homicidal fantasies. Whilst serving his sentence for manslaughter he was convicted (on the basis of 2 separate jury findings in separate trials) of the homosexual rape of a co-prisoner. To the present time, he continues to deny that offence on the basis that the sexual activity was consensual. His minimisation and his denial of offending behaviour, and some lying over years, has been a feature of his behaviour over many years. 14.4 He has however, over time, demonstrated significant efforts and achievements in his education and his employment and displays commendable attitudes, motivation and, indeed, achievements in employment in the prison situation. His current presentation and recent history does not support the initial findings of Borderline Intellectual Capability documented in early adult life. 14.5 Initial Risk Assessments undertaken under the DPSOA legislation lead to findings of HIGH and thus unacceptable a risk of re-offending and he has been indefinitely detained for control in 2008, a finding upheld by the Court of Appeal. 14.6 An application for release led to the order for release on a Supervision Order. In 2011, the Attorney-General’s Appeal to the Appeal Court led that Court to set aside that decision and affirmed the Order for continuing detention, made in October 2008. 14.7 In recent years Mark Lawrence has successfully completed both a Preparatory and High Intensity Sexual Offending Treatment Program and for the last 2 years has been receiving individual counselling for his sexual offending issues from an external experienced Forensic Psychologist in the area, Dr Lars Madsen. He appears to have benefited significantly from this individual attention with evidence of change in attitudes, such that, when combined with an absence of evidence of behaviours of an antisocial kind, continued compliance and high level of achievement and employment in the prison situation, it is my opinion that the evidence suggests that a high risk of re-offending based primarily on historical past factors has been modified by recent therapeutic changes to lower the risk now to a moderate level. 14.8 In contrast to my previous opinion, I believe that a Supervision Order could be constructed for Mark Lawrence such as to monitor and -- 22 of 41 -- 23 supervise his return to the moderated. Were a release under a Supervision Order be ordered, my opinion is that it should be in place for at least 15 years. Conditions under the Supervision Order should be capable of modification according to circumstances during that period of time. Recommendations for some of those conditions have been set out in the body of the report.” (emphasis in original) [97] As previously mentioned, Mr Lawrence was made the subject of a supervision order but that was overturned on appeal and he was required to remain in continuing detention. [98] Dr Lawrence prepared another report for the purpose of this annual review. The date of the report was 14 October 2015. She interviewed Mr Lawrence on 2 October 2015. She remarked that there was a paucity of collateral material provided so she accepted Mr Lawrence’s account with regard to the events of the past 12 months. [99] Dr Lawrence said that it was apparent that understandably he was anxious to make a positive impression on her and hope to achieve a supervised release. She said her opinion was based on the evidence that he produced of efforts that he had made to address, appropriately and adequately, those things he would need to address such as housing, employment, financial support, social support, therapy and his own psychological functioning in very new and different circumstances for him. She observed that his aspirations and plans appeared realistically based and his management approach was also realistic and practical. She said in discussion he was able to explain, amplify and justify his actions and plans in detail and that he was aware of the potential difficulties or dangers for him that he might need to address given certain circumstances which were not currently foreseeable. She said that such an approach contrasted significantly from that which characterised his approach to release in 2009. [100] Dr Lawrence said that Mr Lawrence denied any interest in masturbation in recent times. She observed that the issues of his sexual fantasies and masturbation appeared to be inextricably entwined. He was aware of the significance of his disclosure of sadistic fantasies since adolescence and their role in his offending behaviour. He had learnt from past reports of their relevance to issues of his release. He had also learnt techniques to manage any sexual fantasies. In particular, he had learnt not to masturbate in association with the fantasies so as to avoid the re-enforcing effect of an orgasmic release in connection with the fantasy. He reported that he virtually never masturbated and had not done so for some time. She gained the impression from his claims that he had lost interest in masturbation for possibly a year or more because he found difficulty in getting an erection using whatever stimulus or fantasy he was using. He told her that he had not used any deviant fantasies and thus had not successfully achieved an erection “since last seen” and in the face of lack of satisfaction he had stopped trying. He also referred to having had a low testosterone test. [101] Dr Lawrence asked Mr Lawrence to recount the actions of the night he attacked and killed his victim. He did so without any significant affect accompanying it. However he commenced an emotionally charged attack on the Courier-Mail newspaper over articles which he showed her in cuttings dated 11 and 14 April 2015. The articles recounted the details of his rape and murder of his victim in 1983 and included a detailed account of an interview with the victim’s sister. Dr Lawrence said “In the course of what was almost a diatribe against the Courier Mail, he referred to the sister as an artist working at Chermside. This was a focus for his outrage, saying that, by revealing such details, the -- 23 of 41 -- 24 paper was putting the sister at risk, ‘somebody could go out and do it to her.’” Dr Lawrence said she quickly scanned the article interviewing the sister and could see no reference to her occupation or address for work or accommodation and she said he interrupted his verbal outburst to check the article and agreed that it did not say anything about her occupation or address. [102] He reported his dealing with his general practitioner, Dr Haymans, for a rash on his leg and back, stomach reflux and a cough for which he had been using codeine for about a year. [103] Mr Lawrence told Dr Lawrence about the value of his relationship with Dr Madsen and the therapeutic help he had received from him through fortnightly visits over nearly three years. He said that it had helped him to understand the deviant nature of his sexual fantasies, of being able to acknowledge their presence and of learning ways in which to control them and to avoid the destructive acts that could follow if he acted out the fantasies. He acknowledged the need for communication between counsellors and supervising Corrective Services officers. In that context, however, Dr Lawrence said he also raised the inherent dilemma that, if he sought assistance for a concern such as the emergence of a deviant fantasy and revealed this seeking assistance in dealing with it outside, that information given in therapeutic confidence could be misinterpreted and reported and he could be breached and returned to prison for the thought not the deed. [104] Dr Lawrence said that the only concerning response in her interview with Mr Lawrence on this occasion was his vehement attack on the Courier-Mail and that an element of his concern, the publication of the occupation and address of the family member, was demonstrably wrong since the article did not contain that information about the family member. Whilst his outburst was explained as stemming from his own understanding of victim empathy, Dr Lawrence’s interpretation was that it was an expression of his own anger at the Courier-Mail for reminding him in a public forum of the heinous crimes that he had committed. [105] Dr Lawrence said as a result of the risk assessment tools, she would regard his risk of sexual violence as now being “moderate or even moderate to low” whereas previously she had regarded it as high. It was Dr Lawrence’s opinion that the assessment of his active involvement in an individualised sexual therapy program provided by an experienced therapist, possibly combined with a degree of maturity through age and experience, meant that the risk of Mr Lawrence’s re-offending had decreased and could be adequately managed by conditions under a supervision order. [106] Dr Lawrence also expressed the opinion that the most significant risk factors were the presence or otherwise of ongoing deviant sexual fantasies which he now denied. However Mr Lawrence’s credibility, that is the reliability of the truth of his statements, had always been a factor under consideration and thrown doubt upon the reliability of his statements relating to such matters as masturbatory fantasies. She concluded by saying: “His early rebellious anti-social and sexually deviant behaviour was prominent in his adolescent and early adult life, continuing after he was first admitted to prison. His history suggests that he has benefitted from the structured, supervised routine of the prison environment and has developed a maturity with attendant prosocial attitudes and behaviours. It is reasonable in -- 24 of 41 -- 25 the circumstances to accept the validity of his improvement and give greater credence to his credibility and reduction of risk.” [107] Mr Lawrence made no reference on this occasion to the use of substances such as Viagra to enhance his sexual functioning. Dr Lawrence said that she recalled that at a previous interview he had made a passing reference to the fact that he had discussed his lowered libido with his GP and Viagra had been mentioned. She said that she had recommended that he further discuss it with his GP to ensure that such stimulation did not occur. [108] Dr Lawrence produced a further report on 21 October 2015. By then she had been provided with Dr Madsen’s latest report and had seen Mr Lawrence’s offender case file from 22 August 2013 to 24 July 2015 which were consistent with the information provided by him at interview. Accordingly her opinion did not change. [109] Dr Lawrence gave oral evidence at the hearing of this annual review. Dr Lawrence used the analogy of a thought which is triggered as being like looking at a photograph whereas to develop the fantasy would be similar to allowing a video to roll. That was dependant on a choice he made. In cross-examination Dr Lawrence said if he is not masturbating because whatever sexual fantasy he uses is not sufficient to get a satisfactory release then she would expect that in those circumstance he might be tempted to use a deviant sexual fantasy. [110] When she was examined about the fact that Mr Lawrence would feel disempowered when released from prison she agreed that it would be a disempowering experience for him but said that we should be cautious in comparing it to the experience he had when he was committing the offence when she said “He was a very disturbed adolescent, early 22-year old man at the height of sexual drives and prowess, so to speak, and who felt very lost, disempowered, and not in control of his life at that time.” She said that times had changed so that the actions and decisions of the 22 year old person that committed that terrible crime would be different from the actions and thoughts and understanding of the 54 year old man who had undergone the sort of pro-social education that he had undergone during his 30 years in prison. [111] Dr Lawrence said that his plans on his release were realistic. Dr Lawrence said there was less evidence now of significant distortions of the truth by him although he continued to deny the rape offence in prison. She did say however he may be engaging in some “positive impression management”. Dr Lawrence was of the opinion that the treatment he had received had been efficacious and he had also matured in his understanding of what was necessary to live comfortably and securely in the world outside. She said his outrage and the Courier-Mail article was framed by him in terms suggesting that the Courier-Mail did not understand victim empathy. She thought that that demonstrated that his understanding of victim empathy was not what we mean by victim empathy. [112] Dr Lawrence remained however of the opinion that the risk of his re-offending would not be manifested under a supervision order although the first two or three years of release would be the most difficult. She said that the person who would be in the best position to tell if he was having sexually deviant fantasies would be his psychologist, his treating therapist, but that the therapeutic relationship would be likely to be destroyed if he reported Mr Lawrence to the authorities at the time of risk. -- 25 of 41 -- 26 Dr Donald Grant [113] Dr Grant presented a number of reports about Mr Lawrence. The first was dated 6 August 2012. At that time Mr Lawrence had an application for special leave to appeal to the High Court outstanding. Dr Grant’s report was for the purpose of an annual review. [114] With regard to the offences he had committed against children many years earlier Mr Lawrence denied that they were sexual. Dr Grant described in detail Mr Lawrence’s accounts of all of the other occasions when he offended. Mr Lawrence explained to Dr Grant that at the time he was in the psychiatric hospital he was experiencing very strong violent sexual fantasies which he reinforced by frequent masturbation to the fantasy. On the day of the killing he decided he would carry out his fantasies of raping and killing a woman. Dr Grant said that the version of the killing which he gave to Dr Lawrence was different in certain particulars from the version he gave to Dr Grant. [115] He told Dr Grant that two days after the killing, he and his co-offender went looking for another female victim to rape and kill. The second victim was to be the woman that they had originally intended to rape and the reason for killing her was, according to Mr Lawrence, because he had had recurrent fantasies about raping and killing a particular woman and that the assault on the woman he did kill had not completed his fantasy. [116] Dr Grant said that Mr Lawrence still denied his guilt for the rape offence in prison and said that it was consensual sex. [117] Mr Lawrence confirmed to Dr Grant various details that were referred to in an earlier report by Dr Beech. They included an incident when he was about 15 years old when he took a carving knife to a public park, looking for someone to kill. He reported seeing a group of young women playing netball and waiting nearby with the intention of killing one of them. He was apprehended by the police and taken home. [118] A Queensland Community Corrections Parole Board assessment in 1999 noted a number of concerning behaviours including an attempt at the age of 15 to strangle an eight year old girl when she would not get off a train with him. In the interview with Dr Grant, Mr Lawrence claimed that the female whom he tried to drag off a train was not eight years old but was in fact a woman in her early 20s who turned out to be an off duty police officer. He said he had been alone on the train with her and had decided he wanted to rape her and tried to drag her from the train without success. [119] There was also an allegation that he had attempted to smother his younger sister with a pillow. Mr Lawrence told Dr Grant that he could not really recall it but was not saying it did not happen. Mr Lawrence said it could have been related to his having sadistic sexual fantasies. [120] Dr Grant reported that a probation officer report following the 1978 charges indicated that 18 months earlier he had attempted to sexually interfere with a neighbour’s son. He had also attempted to induce his friend’s daughter to have intercourse with him. He had told the probation officer that he had masturbated for as long as he could remember and that he had minor sexual relations with other people since he started Opportunity School. [121] When he was about 10 years old he had been befriended by a married man at Rosewood and admitted to having had mutual masturbation sessions with him but claimed that this -- 26 of 41 -- 27 was as far as it went. He also admitted that up to a short time previously he had been paying his younger brother, aged seven, to masturbate him and to allow him to perform the same service for the boy. He at first claimed his fantasies involved only women but later admitted that he had a preference for boys, then later again said that he claimed to like both boys and girls equally. [122] Dr Grant said that there were further concerns at different times that Mr Lawrence had behaved in a sexually inappropriate way with one of his sisters and that in fact she had become pregnant and there was concern that he might have been the father of the child. A door that led from Mr Lawrence’s bedroom to his sister’s bedroom had previously been nailed up but had been freed. There was also some indication of concern that Mr Lawrence may have had some kind of sexual interaction with pigs. [123] Dr Grant said that in his interview with him Mr Lawrence denied any kind of bestiality and denied any sexual interaction with his sister. He said he never masturbated in public but agreed he masturbated frequently in other situations. He described himself as having been the “black sheep” of the family and was very resentful of other family members. He said he was very violent at home and that he used to steal and lie. Mr Lawrence told Dr Grant that he had been sexually abused when he was sent to Stuart House in Sydney at the age of seven after his grandmother died. He alleged that both his father and his father’s friend sexually abused him with oral sex and sodomy. [124] Mr Lawrence reported to Dr Grant that from about the age of 15 he had vivid fantasies or raping and killing women and would masturbate to those fantasies up to seven times a day. He said that the frequency of the fantasies had slowly dropped off over the years that he had been in custody. At first he said that he had not had any such fantasies for a long time but then agreed that such fantasies would pop into his head if he saw some violent stimulus on a television program and that thoughts of raping and killing might come into his mind “for about a minute”. He then avoided that situation and refrained from reinforcing it by masturbating to such fantasies. He estimated that the last time he masturbated to a violent sexual fantasy would have been about three or four years ago. He said that he now masturbated about once a week. [125] Mr Lawrence told Dr Grant that he was currently seeing Dr Madsen, having seen him for the first time on 5 July 2012. Mr Lawrence said that he was not sure how interested Dr Madsen was as he seemed to be always looking at his watch during appointments. Mr Lawrence told Dr Grant that he rated his own risk of re-offending as “very minimal”. [126] Dr Grant diagnosed Mr Lawrence as suffering from the sexual paraphilia of sadism and anti-social personality disorder with psychopathic traits, almost reaching the threshold for a diagnosis of psychopathy. Dr Grant’s overall clinical risk assessment was as follows: “The risk assessment instruments indicate high risk when static factors are measured, with some reduction of risk to more moderate levels when dynamic factors are taken into account. For example, Mr Lawrence’s increasing age and a degree of personality maturation, combined with the effects of education and increased skills and better communication abilities, with some insight into past behavioural problems and improved self esteem, would all be elements that might reduce the risk to moderate. However, if one looks at the potential consequences of re-offending there is little indication that the factors that might have reduced the risk of behaviour -- 27 of 41 -- 28 have in fact had any significant effect on the risk of severe consequences to potential victims. Thus, while the chance of re-offending may be potentially avoided, if offending does occur the harm to the victims is potentially great – that is, rape or murder. The risk of re-offending is most likely to be a consequence of increasing sadistic sexual fantasies and impulses. It is evident from information given to me by Mr Lawrence that his sadistic fantasy life has not ceased, but is currently apparently under reasonable control in the environment in which he is placed and through strategies that he has learnt. These factors, combined with the effects of increasing age and personality maturation, along with a reduced sexual drive, have reduced the prominence of any sexual sadistic fantasies and impulses. Drug and alcohol abuse has not been an issue for Mr Lawrence and seems not relevant to re-offending risk. Mr Lawrence’s risk of re-offending would be associated with increased fantasies that would likely occur in the context of him experiencing stress, social isolation, relationship problems or general anxiety and conflict. Mr Lawrence is very institutionalised after 28 years in prison and previous institutionalisation as a child and he will have great difficulty adjusting to life outside prison. He will need a great deal of support, education and counselling to survive and adapt. Should that process of adaptation start to go wrong he will be at risk of re-offending or possibly absconding. This would be associated with increased sadistic sexual fantasies and a consequent increased risk of re-offending, with potentially disastrous consequences. When he was younger Mr Lawrence reports re-offending sexually to achieve the safety of hospital care. It is possible that if he once again felt out of control outside of prison he might re-offend in order to engineer a return to the relative safety of prison life. In my opinion, the release of Mr Lawrence into the community carries considerable risk. Whilst that risk may be manageable by a very comprehensive supervision order and intensive support, there is at least a moderate risk of re-offending and that re-offending could take on a very serious form with extreme harm to potential victims. Mr Lawrence’s credibility and reliability as a reporter of his own emotions and behaviour has in the past not been very good. Positive engagement with a supervision order would require a great deal of commitment on his part with openness and engagement in the process. Whilst the HISOP indicated that he was making progress in understanding, it remains fairly unpredictable as to Mr Lawrence’s ability to take the lessons and strategies that he has learnt into a new life in the community. The changes that he has demonstrated may not endure in the face of the challenge to adapt and the loss of the prison structure and security. If Mr Lawrence is released, a supervision order would need to be comprehensive and vigorously applied. It would need to include a curfew, electronic monitoring, close scrutiny of his relationships and community activities and a great deal of positive support, counselling and treatment. He -- 28 of 41 -- 29 would need to attend a maintenance sexual offender program and undergo individual therapy, with close monitoring of his sexual drive, sexual activity and fantasy life. If Mr Lawrence does not become well-engaged, honest and committed to these processes, they are likely to fail. His limited empathy, insight and understanding, combined with continuing levels of minimisation of past offending and sexual behaviours, all give rise to considerable concern about the success of a supervision order in maintaining safety for Mr Lawrence and the community. The question of medical treatment with a testosterone-lowering drug such as Androcur has been raised in the past as a possible way of reducing risk of sexual re-offending. This path could be considered, but in a situation where Mr Lawrence is reporting a lowered sexual drive and lower level fantasy life that he can reportedly control with psychological strategies, it is unlikely that Androcur would add significantly to the lowering of risk. However, such treatment could be considered in the future if his fantasy life was to become more troublesome and harder for him to control, especially when he is in the community. Overall, my opinion is that there are too many concerns and uncertainties to recommend that Mr Lawrence could safely be released into the community at this stage, even with the benefit of a comprehensive supervision order. The particular difficulties raised in Mr Lawrence’s case are that monitoring of his future progress will depend extremely heavily on his honest and open reporting of his sexual fantasy life and sexual impulses, rather than being able to rest on observations of his activities or contacts. There might then be a rapid transition from increased fantasies to very serious offending, which could not be accurately predicted or preventable. In this sense he differs from many other sex offenders where risk can be predicted by factors such as increased substance abuse or grooming of potential victims. In Mr Lawrence’s case there may be no externally obvious changes between a rise in sadistic fantasies and him acting on those fantasies in a very violent way.” [127] Dr Grant prepared another report on 28 October 2013 before an earlier annual review of Mr Lawrence’s detention. By then Mr Lawrence had been seeing Dr Madsen fortnightly since mid 2012. [128] Dr Grant said that the major issue of consideration was that Mr Lawrence’s serious past offences had been motivated by sadistic sexual fantasies and poor impulse control in regard to those fantasies. Dr Grant thought that over the past 12 months, with the assistance of the treatment he had undergone, he had become more willing to discuss those fantasies and their relevance to future offending and was more open to working on strategies to deal with such fantasies should they become more prominent in the future. [129] Dr Grant said that the major concern in terms of future offending revolved around the recurrence of sadistic sexual fantasies, Mr Lawrence’s ability to detect and deal with those fantasies, and the ability of supervision and therapy both to recognise the presence of fantasies and to assist him in dealing with them. Clearly, he said, if Mr Lawrence was to act on those sadistic sexual fantasies the results could be quite catastrophic. His current positive engagement and therapy gave Dr Grant more confidence that he could be safely managed in the community under appropriate management. In conclusion Dr Grant said: -- 29 of 41 -- 30 “Overall, in my opinion, the actuarial high risk of re-offending as exhibited on formal instruments is reduced by dynamic factors such as his age, lessons he has learnt from treatment and his current response to therapy, to a moderate level of risk which has the potential to be reasonably contained by a strict program of supervision and support outside custody. Any supervision order would need to be comprehensive and strictly applied. It would need to include a curfew, electronic monitoring, close scrutiny of his relationships and community activities, allied with intensive positive support, counselling and treatment. Individual psychological treatment will need to continue and that could be supported by further sexual offender treatment programs in the community. The major issue will be monitoring Mr Lawrence’s fantasy life and detecting recurrence of any prominent sexual sadistic fantasies. Mr Lawrence does appear to have become somewhat more open about discussing such fantasies and I believe that if his treatment continues to be satisfactorily progressed and his supervision be delivered by experienced and dedicated personnel, it is likely that he will be report the recurrences of risky sexual fantasies. Whilst this cannot be guaranteed, I believe that he has now reached the point where the risk is containable by appropriate supervision and treatment in the community.” [130] Dr Grant prepared a further report dated 22 August 2015 for purposes of this review. In discussing Mr Lawrence’s current risk of re-offending Dr Grant expressed the view that the main risk factor was whether or not Mr Lawrence’s sexual sadistic deviance is now sufficiently settled and amenable to management strategies to ensure the safety of the community. His sexual offending was primarily motivated by his sexual deviance, in combination with his anti-social personality factors. In terms of the risk assessment for the court, Dr Grant observed: “In terms of risk assessment, the dilemma for the Court remains the extent to which Mr Lawrence’s assertions about change, improvement and increased insights can be accepted as valid, and whether appropriate supervision and ongoing treatment strategies will be adequate to deal with any significant recurrence of active deviance that might lead to violent sexual behaviour. Mr Lawrence has in the past demonstrated dishonesty and unreliability in his history and it remains a matter of judgement as to whether he has matured and changed sufficiently to now accept the validity of his assertions.” [131] Dr Grant referred to the increased understanding Mr Lawrence had gained through therapy and that the risk of a future serious sexual offence had been reduced to a moderate level which could be addressed in the community by an appropriate, comprehensive supervision order and treatment strategies. He concluded: “Close attention would need to be paid by experienced personnel to monitoring his sexual fantasy life, as best they could, to address any early indications of increase in deviant fantasy. Clearly this would be reliant to a considerable extent upon Mr Lawrence’s willingness and ability to cooperate with such supervision and treatment and report changes in his inner fantasy life. As indicated in my previous report, it cannot be guaranteed that Mr Lawrence will be completely open and honest during such a process, but in my opinion the indications are that he has made sufficient gains for his risk -- 30 of 41 -- 31 to be adequately managed in the community under such an intensive supervision and treatment program.” [132] In his oral evidence Dr Grant said there was some objective indications that his anti-social personality disorder had settled including that his behaviour in prison had settled and that he had not been breached for a long time; his relationship with prison officers had changed; his relationship with prisoners had improved in terms of lack of aggression; he had had sexual relationships with prisoners that had given him greater self-esteem; and his work performance in prison was regarded as good. [133] So far as sexual sadism is concerned, Dr Grant said that sexual sadism is one of the paraphilias and paraphilia tend to be a lifelong disorder. Paedophilia and sexual sadism are the most serious sexual paraphilias. Those disorders can tend to moderate, particularly if acting on those sexual impulses is partly motivated through psychopathic traits in personality. However the paraphilia would not entirely disappear. While Mr Lawrence’s sexual behaviour might modify with age, he would not lose the tendency towards paraphilia. Dr Grant said that Mr Lawrence’s paraphilia of sadism was linked to the level of his libido and his anti-social personality characteristics. As those aspects had settled and given the education and treatment he had received those matters reduced his risk from high to moderate. Dr Grant said that while other paraphilias run the risk of recurrence if they are not contained, a sadistic paraphilia which led to homicidal behaviour or rape was extremely dangerous if it was out of control. He agreed it would be difficult to tell in Mr Lawrence’s case if the risk was increasing and there was a risk that his paraphilia would become less controlled and more unstable and more stressful when he is released from prison although a supervision order would assist with structure, ensuring treatment and providing support and direction. [134] Dr Grant said there was a catch 22 situation. It is very important for someone that has paraphilia to learn to talk about it and to be open about it because fantasies are at their most powerful when they are secret. That is when they were more likely to be acted upon. Fantasies that are talked about with therapists tend to lose their power to some extent. [135] Dr Grant agreed with counsel for the Attorney-General that although there are objective ways of assessing his mood states and his behaviour there is no objective way of knowing if he was having a detailed sadistic sexual fantasy. Dr Grant referred to the fact that Mr Lawrence had given him inconsistent accounts of whether or not he had had fantasies or deviant thoughts. Dr Grant thought that it might take some time for a trigger into a deviant thought and a failure to use strategies to prevent the fantasy from developing, but the supervisor would not necessarily know that that had happened. The therapist may have sufficient rapport with him to be able to pick it up but this could not be guaranteed. [136] Dr Grant also agreed in examination by counsel for the Attorney-General that Mr Lawrence was inconsistent in what he said to various doctors about the extent of his masturbation. Dr Grant referred to Mr Lawrence “telling slightly variable truths” about the extent of his masturbation. He gave slightly different versions to Dr Madsen, Dr Lawrence and Dr Grant and Dr Grant thought there was a degree of “positive impression management” going on. [137] Dr Grant also thought that the insights he had developed in education and therapy were much better but they were more on an intellectual than an emotional level and the same would apply to his concepts of empathy. He had the right words but he did not necessarily -- 31 of 41 -- 32 actually have the empathy. Dr Grant agreed with Dr Lawrence that erectile dysfunction medication would be inappropriate and that testosterone should be avoided as a prescription drug. Evidence of Mark Lawrence [138] Mr Lawrence the respondent in these proceedings gave evidence-in-chief by way of affidavit. He referred to his imprisonment since 1983 and that he had completed the High Intensity Sexual Offending Program in 2007 after attending 93 sessions and completed the Maintenance Sexual Offender Treatment Program in May 2013. He referred to his good conduct in prison and that he was prepared to comply with all conditions of a supervision order. In paragraph 17 of the affidavit his evidence was as follows: “I acknowledge that there is concern about my thinking and fantasies. I have been frank and honest in what I have said to Lars Madsen and Doctors Grant and Lawrence. This includes what I’ve said as to the nature and frequency of fantasies I now experience, my willingness to disclose fantasies if they occur and my ability and willingness to take appropriate steps to prevent any recurrence of fantasies leading to any risk of re-offending. I confirm that I am willing to disclose and discuss my thoughts and fantasies with my therapist, my case officer and my support team.” [139] In oral evidence he talked about the practical difficulties he might face on release such as how to use a Go card and how to use an ATM machine and how to find employment. In his oral evidence Mr Lawrence disagreed with Dr Lawrence that he was angry about what he read in the Courier-Mail. He said he was frustrated because interviewing the person who lost their daughter would remind the person of what had happened. He said he felt sorry for the family because every time he went to court it was reported in the media and that affects them because he took someone’s life. He acknowledged that he would have to tell Dr Madsen what he was thinking and he knew the disadvantage was that, if he said he had a deviant fantasy and was masturbating to that, that meant he could go back to jail but he also said that if he was not honest he could end up going out and doing something catastrophic and he did not want that because he wanted to try to live a decent and better life. [140] Mr Lawrence then said that Dr Madsen could have taken what he had said about deviant fantasies when they had the one month trial the wrong way. He wrote down what deviant fantasies he experienced. When he was asked in cross-examination what he understood by the term “deviant fantasy” he said “a deviant fantasy can put you back into prison.” When asked again he said that it was about going out and raping or killing someone and having that thought pattern go through his head. When asked about what triggered his deviant thoughts he said this could include American crime investigation programs but also thinking about a girl in an isolated area or seeing a lady by herself, for example in an isolated park. He said he did not think about raping and killing her straight away. The following questions and answers were of particular concern: “Well, you see someone, and then you think about that person, raping and killing that person, don’t you? --- Not all the time, no. Not all the time, but you do on occasions think about – when you see someone isolated, you think about that particular person, raping and killing them? --- Yes.” (emphasis added) -- 32 of 41 -- 33 [141] He then said that he thought Dr Madsen had got it wrong when he said that he had deviant fantasies a couple of times during the month when he was recording them. He said that he does not have any deviant fantasies now. He said that he told Dr Grant he had not had any deviant fantasies because he was not acting on any deviant thoughts. He said that Dr Grant had misunderstood what he said to him. He also said that Dr Lawrence had misunderstood what he said about masturbation because he told her he did masturbate monthly or twice monthly but that he lost interest in it because of his inability to get an erection. Evidence of Dr Noel Hayman [142] The general practitioner who has treated Mr Lawrence for at least the last 10 years is Dr Hayman. Dr Hayman produced a report from Pathology Queensland of three blood tests performed to assess his testosterone levels. The results were for three different years. In October 2003 his testosterone level was shown as 20. On 31 March 2008, his testosterone level was 13 and on 12 June 2015 his testosterone level was shown as 12. The normal range is 9.0 to 35 so it remained within the normal range. Dr Hayman said that Mr Lawrence had discussed erectile dysfunction with him and what remedies he might need including medication such as Viagra or more complicated remedies such as penile injections. Supplementary reports [143] In view of the matters raised by Mr Lawrence in his oral evidence, the court asked for further reports from Dr Grant and Dr Lawrence. Dr Lawrence said that study of the transcript of his oral evidence in court revealed the ongoing difficulty he has with language, both in its comprehension and in his formulation of replies to answers. This leads she says to misunderstandings and misinterpretations by both parties from time to time, as was reflected in the reports by Dr Grant and herself on specific matters. Dr Lawrence said that it was likely that he has occasional deviant fantasies perhaps triggered by a television show and it is more likely than not that he avoids masturbation to the point of ejaculation because he understands the nexus between the fantasies and thoughts and the reinforcement of self-gratification in association with those fantasies. Dr Lawrence said it was not clear what his response was to a fantasy he classified as deviant of seeing a woman in an isolated situation such a park. [144] Another area of confusion was the frequency of masturbation. She said from reading the transcript she was of the opinion that he was currently likely to be masturbating at a frequency of fortnightly intervals with some monthly intervals. She thought that release into the community would lead to an increase in exposure to precipitating triggers. In those circumstances she opined that the community would have to be reliant on the deterrent effect of Mr Lawrence’s other deterrent thought, that is his goal of ensuring that he did nothing which is likely to return him to prison. She believed that his risk of re- offending had decreased from its former high level but she would not be able to say with certainty that the risk had been eliminated. She had formed the view that a supervisory order could be constructed so as to support his own efforts to address the risks of re- offending and support his ongoing therapeutic efforts to manage remaining risks associated with his sexual fantasies and drives. Nevertheless, she said, it could not be denied that notwithstanding that his risk level had been reduced by a significant level, should he act on his fantasies, the outcome to a female member of society could be catastrophic. -- 33 of 41 -- 34 [145] Dr Grant’s supplementary report is dated 2 December 2015. He said that Mr Lawrence’s evidence amply demonstrated his intellectual limitations, his difficulty in understanding some language or words and his rather concrete thinking style. He said it also demonstrated his naive and limited understanding of the challenges that were going to face him if and when he leaves prison. Dr Grant said his answers to questions in court illustrated the difficulties involved in getting a precise understanding from him as to the prevalence of his deviant fantasies. Dr Grant said he clearly prevaricates as to whether he actually made different statements or as to whether his statements were misinterpreted by Dr Grant or Dr Lawrence. Dr Grant said that Mr Lawrence appears to understand the risk involved in entertaining and reinforcing sadistic sexual fantasies. He also appeared to illustrate that he was now aware of the risk of such fantasies and the need to report them, use strategies to avoid them developing and to recognise triggers so that he could short circuit the process of fantasies developing and being reinforced. [146] Dr Grant expressed the opinion that Mr Lawrence experienced potential triggers for sadistic fantasies on an infrequent basis but had developed increased insight into this and was working in therapy on avoiding those infrequent thoughts developing into dangerous fantasies or actions. Dr Grant said that the question in regard to risk revolved around whether it could be accepted that Mr Lawrence now had sufficient motivation and insight to continue that process whereby he avoids the development of frequent mature fantasies which might lead to offending. He remained of the opinion that a carefully-applied, detailed supervision order combined with continued close individual therapy and supervision would have the effect of reducing the risk to low if he were released into the community. Given that the risk if he were to allow the fantasies to develop to a point where he acted upon them meant that the potential offence would be catastrophic Dr Grant was of the opinion that a low threshold must be maintained for Mr Lawrence to be returned to custody under circumstances where the risk was seen to be increasing. [147] Dr Lawrence provided a further addendum to her supplementary report after reading Dr Grant’s further supplementary report. She expressed the view that Dr Grant’s opinion and advice in the supplementary report was accurate and clearly presented. She agreed entirely with his opinion. The applicant’s submissions [148] The applicant suggested that the respondent should be detained in custody for care, treatment and control because a supervision order would not sufficiently reduce the risk to diminish the respondent’s opportunities to commit the offences of rape and murder. [149] The applicant submitted that the psychiatric evidence should be treated with caution, based as it is upon the respondent’s assertions as to an improvement in the frequency and occurrence of and Mr Lawrence’s reaction to his sexually deviant fantasies. Those assertions, it was submitted, should not be regarded as credible and reliable. The applicant submitted that adequate protection of the community could only be ensured by a continuing detention order. The respondent’s submissions [150] The respondent did not resist a finding that the court should affirm the decision that he is a serious danger to the community in the absence of an order pursuant to Division 3 Part 2 of the DPSOA. However the respondent also submitted that the preponderance of -- 34 of 41 -- 35 evidence and, in particular, the expert evidence of the psychiatrists supported findings that adequate protection of the community could reasonably and practicably be managed by a supervision order and that the requirements of such a supervision order could be reasonably and practicably managed by Corrective Services officers. [151] The respondent submitted that the court should be satisfied that in so far as the expert opinions of the psychiatrists were based on the truthfulness and reliability of Mr Lawrence’s self-reporting to those experts, notwithstanding any inconsistencies in his reporting, Mr Lawrence should be accepted as truthful and reliable in his reporting of those matters. In particular, it was submitted, the court would accept the evidence of the respondent that he is willing and able to manage fantasies by deploying and maintaining strategies to contain them. [152] It was submitted that objective factors supporting the veracity of Mr Lawrence as to the crucial matter in issue and the ultimate expert opinions on risk were the increased age and maturity of Mr Lawrence, his more recent prosocial behaviour in prison, his willingness to engage in therapy and continue motivation and good behaviour despite the Court of Appeal’s setting aside his supervision orders on two occasions. The experts referred to the fact that he was far removed in time, circumstances and psychology from the disturbed young man who committed the rape and killing in 1983. The court should therefore, it was submitted, take into account the deterrent effect of his lengthy incarceration in assessing future risk. Consideration [153] There can be little doubt, indeed it was not disputed, that Mark Lawrence remains a serious danger to the community in the absence of a Division 3 order. There is acceptable, cogent evidence of sufficient weight to persuade me to a high degree of probability that the decision first made on 3 October 2008 and subsequently confirmed on many occasions that in the absence of a Division 3 order Mark Lawrence remains a serious danger to the community should be affirmed. [154] As the Court of Appeal held in Francis, when the court affirms the decision, if supervision of the prisoner is sufficient to ensure adequate protection of the community then an order for supervised release should, in principle, be preferred to a continuing detention order. [155] The court is also required to consider practical matters under s 30(4)(b) as to whether or not a supervision order can be practicably managed by Corrective Services Officers to ensure protection of the community. Affidavits were filed regarding those matters and whilst they point to some difficulties none of them appear to be insurmountable. [156] The critical matter in this case is whether not Mark Lawrence is such a serious danger to the community that adequate protection of the community cannot reasonably be provided by a supervision order. In determining that question I shall address each of the matters set out in s 13(4) of the DPSOA which are relevant to this application. It is not necessary to repeat all of what I have previously set out. I have, however, taken it all into account. -- 35 of 41 -- 36 Reports prepared by the psychiatrists and the extent to which Mr Lawrence co- operated in the examinations by the psychiatrists [157] I have referred in detail to the reports prepared by Dr Grant and Dr Lawrence and need not repeat what I have already said. Mr Lawrence co-operated in their examinations for this review. Both of them have diagnosed him as suffering from paraphilia (sexual sadism) with an anti-social personality disorder and psychopathic traits. [158] Dr Lawrence has had the advantage of seeing Mr Lawrence over a very long period of time. She first reported on him in January 1985 when he had been charged with murder. He described in graphic detail his violent and deviant fantasies of the rape and murder of a girl which he acted upon. She was told of other violent and sexual criminal acts he had committed for which he had not been charged and of his continuing deviant fantasies reinforced by frequent masturbation. Disturbingly, he told Dr Lawrence that the best part of his fantasy was killing his victim by cutting her throat. She was then of the opinion that he was a very high risk of re-offending. [159] Dr Lawrence then prepared reports on Mr Lawrence for the purposes of annual reviews under DPSOA. Of particular concern in her report of 2 November 2009 were the analysis of the extremely different accounts of his upbringing which led her to the view that he was unreliable, his passionate expression of his innocence of the rape in jail, and his lying, which meant that relying on his uncorroborated statements was unwise. Dr Lawrence assessed his risk of recidivism as high. In her report of 16 May 2011 she expressed the strong opinion that he continued to present a very high risk of re-offending sexually and violently and that the harm that could be inflicted by any expression of his sadistic and homicidal behaviours could be extreme. [160] In Dr Grant’s first report of 6 August 2012, he expressed the opinion that Mr Lawrence’s release into the community carried considerable risk and that if he re-offended it could cause extreme harm to potential victims. He referred to the stresses that would attend Mr Lawrence’s release on a supervision order, his need to manage his sexual fantasies and his problems with his credibility and reliability in reporting his emotions and behaviour. He did not support Mr Lawrence’s release on supervision. [161] Mr Lawrence refused to be interviewed by Dr Lawrence for her report of 29 October 2012. [162] In her report of 31 October 2013, Dr Lawrence formed the opinion that his risk had been reduced to a moderate level particularly because of his therapeutic relationship with Dr Madsen which had led to a change of attitude combined with his compliance and achievement within the prison system. She expressed the opinion that his moderate risk could be managed by a supervision order. [163] In Dr Lawrence’s report for this review she thought that he had developed realistic plans for his release. She formed the opinion that his risk of re-offending had been reduced to moderate or even moderate to low. The most significant factor in terms of risk was the presence or absence of ongoing deviant sexual fantasies which he denied having. [164] In Dr Grant’s report for this review he expressed the opinion that the risk that Mr Lawrence represented was containable by a strict, detailed, intensive supervision order. The caveat was, however, that the soundness of this opinion depended on the -- 36 of 41 -- 37 extent to which Mr Lawrence’s assertion about positive change should be accepted given his past dishonesty and unreliability. [165] In his oral evidence Dr Grant accepted that a person with sadistic paraphilia which led to rape or murder was very dangerous if the paraphilia was not under control. [166] In his last report given after reading Mr Lawrence’s oral evidence, Dr Grant’s opinion was that a carefully applied, detailed supervision order combined with close individual therapy and supervision would have the effect of reducing the risk to low if he were released into the community, although a low threshold should be maintained and monitored such that he should be returned to custody if his risk was seen to be increasing. This was because the potential offence, if Mr Lawrence acted on his fantasies, would be catastrophic. Any other medical, psychiatric, psychological or other assessment relating to the prisoner [167] Mr Lawrence has been treated very effectively by Dr Lars Madsen on a fortnightly basis since June 2012. He has undoubtedly made progress since that treatment began. Dr Madsen’s reports on his treatment and assessment of Mr Lawrence are set out at length in these reasons. I need not repeat them. [168] When Dr Madsen first started his treatment of Mr Lawrence, he assessed him as an unreliable historian and at high risk of re-offending. He identified Mr Lawrence’s deviant sexual fantasy as a very strong fantasy involving the rape and murder of a woman who is in or may be taken to an isolated place. [169] Dr Madsen’s clinical judgment was that Mr Lawrence’s paraphilia was not curable but would be manageable if he disclosed the development of fantasies. However, Dr Madsen also recognised the difficulty faced that Mr Lawrence was aware that such disclosure might lead to his re-incarceration, an outcome he did not desire. Information indicating whether or not there is a propensity on the part of Mr Lawrence to commit serious sexual offences in the future [170] Of particular relevance to this consideration are the risk assessment tools used by Dr Lawrence and Dr Grant. According to the actuarial scales as assessed by Dr Lawrence in 2009, his risk of re-offending was high to very high. By contrast, Dr Grant originally assessed the risk as high reducing to moderate because of increasing maturation, some insight and improved self-esteem. However the risk of harm to potential victims was severe. The risk of Mr Lawrence’s re-offending as assessed by both psychiatrists reduced over time principally as a result of the individual treatment he received from Dr Madsen. Whether or not there is any pattern of offending behaviour on the part of the prisoner [171] Prior to 2000, Mr Lawrence committed a variety of violent and sexual offences whether in or out of custody or a psychiatric hospital. His offences usually involved sexual deviancy and violence to vulnerable people. [172] However in more recent years his behaviour in prison has been stable. He has been able to engage in a consensual sexual relationship with another prisoner. -- 37 of 41 -- 38 The efforts by the prisoner to address the cause or causes of his offending behaviour including whether he participated in rehabilitation programs [173] As well as the treatment by Dr Madsen already referred to, Mr Lawrence had earlier completed the High Intensity Sex Offender Treatment Program (HISOP) in 2007. Dr Madsen expressed the opinion that Mr Lawrence appeared to have gained some benefit from the HISOP but retained attitudes supportive of offending. Mr Lawrence completed the Sexual Offending Maintenance Program (SOMP) in 2013. [174] Mr Lawrence has made an effort to address the causes of his offending behaviour with Dr Madsen. Whether or not the prisoner’s participation in rehabilitation programs has had a positive effect on the prisoner [175] There was a report that after Mr Lawrence completed the HISOP he talked to another inmate about a desire to get out of prison and re-offend, a report he denied. Dr Lawrence suggested that as a result of the HISOP he had acquired jargon rather than truly acquiring underlying empathic and emotional understanding and acceptance of relevant concepts. It was reported that three months after the HISOP Mr Lawrence made inappropriate sexual advances to other prisoners, that he harboured hostility and a desire for revenge against a specific woman and had ongoing sadistic sexual fantasies against women. The exit report from SOMP referred to his entrenched thinking patterns. He responded to the exit report in a way that suggested that he completely misunderstood it and retained those entrenched thinking patterns. [176] However his participation in these programs and, in particular, the individual treatment by Dr Madsen has had a positive effect on Mr Lawrence. Mr Lawrence’s antecedents and criminal history [177] Mr Lawrence has a very serious criminal history from before he was an adult. I will repeat a brief summary. Between 1977 and 1980 he committed sexual assaults on children, three boys and one girl. He escaped from custody and committed an offence of attempted armed robbery, in company, of a taxi driver. While detained as an involuntary mental health patient he committed a serious crime with another patient against a vulnerable female patient and was convicted of manslaughter on the basis of diminished responsibility. He has been convicted of rape in prison. The risk that Mr Lawrence will commit another serious sexual offence if released into the community [178] The risk that Mr Lawrence presents must be measured against the potential for him to commit an offence and the consequence for a victim if the potential materialises. The consequence of his committing an offence has been aptly characterised as catastrophic. [179] His paraphilia means that there is always a risk that he will have violent sexual fantasies of raping and killing a woman. -- 38 of 41 -- 39 [180] If he allows himself to indulge in violent sexual fantasies and masturbates to those fantasies, members of the community, particularly vulnerable women, will be at serious risk from him. [181] The method of obviating that risk is for him to recognise triggers that may cause him to have thoughts which could develop into such a fantasy and use strategies to prevent the fantasy from developing. He is aware that if he starts to develop such fantasies he must inform his psychologist or supervising Corrective Services officer. He also knows that if he does so he is likely to be returned to prison. That is a real disincentive to disclosure and to the necessary honest and open recording of his fantasies. It would be in these circumstances in his interests not to disclose the development of a fantasy. There is a real risk, therefore, that he would not make the necessary disclosure. [182] The psychiatrists’ reports were, to a large extent, based on his own reports of his internal thinking and masturbatory habits. While there are some matters capable of being corroborated by external information, others are not. The question of the credibility of the information supplied by Mr Lawrence is in the end a matter for the judge to determine. As the Court of Appeal held in Attorney-General (Qld) v Lawrence:16 “Where the nature and extent of the risk, and therefore the assessment of the issue of adequate protection, depends in a material way upon a prisoner’s account to an expert witness, it is the Court, not an expert, which must make the necessary findings about the truthfulness of the account. The experts’ opinions on the issue may be helpful, but they cannot be determinative.” [183] There were a sufficient number of inconsistencies in his accounts as to various matters for me to entertain doubt as to his credibility and finally to conclude that where his version was the only evidence, it lacked the honesty and reliability necessary for me to be able to accept it. I shall give some examples of matters that serve to undermine his credibility and reliability. [184] The information Mr Lawrence gave as to his upbringing to various professionals while he was in prison was quite different from the information given to Dr Lawrence by his sister in 1985. His version of his upbringing was self-serving in that it presented him as a victim of a brutal and sexually violent environment as a child after the age of seven and as a teenager. There was no independent confirmation of the story he told about his upbringing and the only collateral information contradicted it. [185] Mr Lawrence was initially frank in expressing his lack of empathy for victims of his offences when he committed them and in the aftermath. More recently he has expressed empathy for the victims of his offences and others affected by him but it must be doubted whether that empathy is real. It is more likely that it is expressed as a learned response and not actually expressed as a true response. All of the medical professionals have noted on occasion his apparent indifference to the consequences to others of his crimes. He continues to deny that he raped a vulnerable fellow prisoner notwithstanding two jury verdicts of guilty and his second conviction being upheld in the Court of Appeal. [186] Dr Madsen referred to internal contradictions in the history Mr Lawrence gave as to when he stopped masturbating to deviant fantasies with at one extreme suggesting, Dr Madsen concluded, that he had his fantasies under control for as much as seven years before 16 [2014] QCA 220 at [88]. -- 39 of 41 -- 40 November 2012; that is, in 2005. Dr Madsen expressed reservations about whether Mr Lawrence was being honest with him. By late 2015, Mr Lawrence told Dr Madsen that he experienced deviant sexual fantasies infrequently and denied ever masturbating to them. [187] In 2009, he told Dr Lawrence that he had had no deviant sexual fantasies since 2006 and masturbated only once a week. He told Dr Lawrence in October 2013 that he masturbated once or twice a week but was starting to get bored with it and had difficulty maintaining an erection. In October 2015, he told Dr Lawrence that he had not masturbated for some time, giving her the impression that it was for more than a year because he had difficulty getting an erection using whatever stimulus he was using. [188] He told Dr Grant in August 2012 that he had not had any violent sexual fantasies for a long time but then admitted having thoughts of raping and killing for “about a minute” if he saw some violent stimulus on television. He said he masturbated about once a week. [189] One matter about which he was likely to be telling the truth was that he found it difficult to maintain an erection and masturbate to non-deviant fantasies, such as having consensual sex with a fellow prisoner or with a woman with whom he had been corresponding in prison. This had led him to discuss this with his general practitioner the possibility of being prescribed erectile dysfunction medication such as Viagra. He thought that he was experiencing sexual dysfunction because his testosterone levels had dropped. Those levels have decreased but are still within the normal range. Dr Lawrence expressed the firm view that he should not be prescribed Viagra, a view with which I completely agree. The prescription of such a drug to an offender with such a violent, deviant paraphilia would be likely to overwhelm any control he has over his sexual drives. [190] On the other hand, if he finds it, as he says he does, very difficult to maintain an erection and obtain sexual satisfaction from non-deviant fantasies, and if this has concerned him sufficiently, as it has, to discuss inappropriate medication with his medical practitioner, then it appears likely that he will be tempted to use deviant fantasies to enable him to maintain an erection and masturbate with the consequent reinforcement of his paraphilia leading him to act out those sadistic fantasies as he has in the past. If he is no longer in prison he will have the time and opportunity to indulge his fantasies without being observed or checked. The danger is obvious. No degree of supervision outside the prison environment could be so intense and constant as to be able to prevent this occurring. The only safeguard is disclosure by him. [191] If he does not disclose the development of fantasies it is quite likely that it would not be apparent to any person supervising him. It is therefore the case that the fantasies could develop without anyone becoming aware of it until he acted on those fantasies with disastrous consequences for the protection of the community. [192] Further, the stresses and frustrations that Mr Lawrence would undoubtedly experience after his release from a custodial environment have been identified as likely triggers. He is institutionalised and the routine, structure and predictability of prison is safe and easily negotiated by him. He has work in prison which he enjoys and makes him feel valued. This would be most unlikely to be replicated outside the prison environment. In spite of his denials, it is my view that this is likely to make him frustrated and angry and therefore more vulnerable to using sexual fantasies to elevate his mood and make him feel more powerful. -- 40 of 41 -- 41 [193] Mr Lawrence has been distrustful and suspicious, has taken offence at personal slights and been prone to anger over many years. He is aware that if he reveals that he is developing deviant fantasies, this could lead to return to prison, an outcome he is desperate to avoid. [194] This lack of trust in professionals and his suspicious querulousness was amply demonstrated in his oral evidence where he expressed disagreement with various statements made by Dr Madsen, Dr Lawrence and Dr Grant. This is of particular concern given that he would have to be fearlessly honest with Dr Madsen for him to be safely managed on a supervision order. I do not accept that he would be honest in these circumstances, given his demonstrated history of lying and suspiciousness and his knowledge that such disclosure would be likely to return him to prison. The need to protect the members of the community from that risk [195] The risk to members of the community from Mr Lawrence is obvious and must be measured not only against the risk posed of his re-offending but also the risk posed by his re-offending; that is, of very serious, potentially fatal, harm. The need to protect the community from that risk is said by s 30(4)(a) of the DPSOA to be the paramount consideration. I am persuaded that the only way to protect the public from the risk posed by Mr Lawrence is to affirm the decision that he is a serious danger to the community in the absence of a Division 3 order and for him to be subject to a continuing detention order. Orders 1. The decision made on 3 October 2008 that Mark Richard Lawrence is a serious danger to the community in the absence of a Division 3 order is affirmed. 2. Mark Richard Lawrence is ordered to continue to be subject to the continuing detention order. -- 41 of 41 --