Finch, Re [2009] QMHC 6

MENTAL HEALTH COURT CITATION: Re Finch [2009] QMHC 6 PARTIES: REFERENCE BY THE DIRECTOR OF MENTAL HEALTH IN RESPECT OF BENJAMIN VALENTINE FINCH PROCEEDING: No 272 of 2008 DELIVERED ON: 5 November 2009 DELIVERED AT: Brisbane HEARING DATE: 9 October 2009 JUDGE: Philippides J ASSISTING PSYCHIATRISTS: Dr F T Varghese Dr E N McVie FINDINGS AND ORDER: 1. That at the time of the alleged offences the subject of the reference, the defendant was suffering from unsoundness of mind as described in Schedule 2 of the Mental Health Act 2000 (Qld); 2. That the defendant be detained as a forensic patient at The Park High Security Program Authorised Mental Health Service; 3. Approval of limited community treatment confined to the grounds of The Park Centre for Mental Health for up to two hours twice per week, at the discretion of the authorised psychiatrist, on the following conditions: a. That the defendant remain under the escort of two health service staff members nominated by the authorised psychiatrist for the duration of the limited community treatment; b. That for the purposes of the limited community treatment he comply with the directions of the nominated staff members for the duration of the limited community treatment; and c. That the defendant not initiate contact with specified persons. CATCHWORDS: MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where defendant charged with attempted murder, assault occasioning bodily harm, torture, deprivation of liberty and acts intended to maim/disfigure/disable – whether defendant was of unsound mind as defined in Schedule 2 of the Mental Health Act 2000 (Qld) at the relevant time. Mental Health Act 2000 (Qld), Schedule 2 -- 1 of 5 -- 2 COUNSEL: Mr C Heaton for the Defendant Mr W Isdale for the Director of Mental Health Mr B Campbell for the Director of Public Prosecutions (Qld) SOLICITORS: Legal Aid Queensland for the Defendant Crown Law for the Director of Mental Health The Director of Public Prosecutions (Qld) [1] PHILIPPIDES J: Mr Finch is charged with a number of offences arising out of events that occurred on 8 December 2007. These comprise one count of acts intended to maim/disfigure/disable, one count of attempted murder, two counts of deprivation of liberty, one count of assault occasioning bodily harm and two counts of torture. [2] It appears that the defendant had an altercation with his mother on 8 December 2007. The defendant had been at his mother’s house and became agitated while watching a TV programme relating to police being assaulted and the court system. Initially, he began to verbally abuse his mother and uncle, stating that all police were corrupt and deserved what they got. He then proceeded to assault them, with a prolonged and violent physical attack ensuing. The defendant eventually fled and was subsequently located by the police and arrested. [3] The defendant was seen by Dr Hannah, consultant psychiatrist with the Prison Mental Health Service, on 21 December 2007, who described him as presenting with “blunted affect ++ … paranoid delusions regarding the mother poisoning him with tablets”. Dr Schramm saw the defendant on 1 February 2008 and noted that he deteriorated quickly into formal thought disorder with clear loosening of associations. When he reviewed him again later that month, Dr Schramm recorded that the defendant “seems to have for many years held poorly formed concerns surrounding the government monitoring him (and all citizens) via satellites, the Hubble telescope, injections of ‘plasma’ (as per plasma in TV)”. On 10 March 2008, the defendant was transferred to The Park Centre for Mental Health where he presently remains. Dr Tie [4] Dr Tie provided a report dated 5 December 2008, in which he supported a defence of unsoundness of mind in respect of all the charges. He also gave oral evidence augmenting his report and confirming his opinion. [5] Dr Tie noted that at the time of the events in question the defendant had been unmedicated. The defendant’s recollection of the events of the day in question was patchy. However, he was able to report to Dr Tie that, while watching the television, he became preoccupied with the idea that his mother wanted “to put me in gaol for the rest of my life”, and stated “I felt incredibly threatened – I thought I was going to be killed in gaol. I thought there was a conspiracy to put me in gaol.” [6] Dr Tie opined that the defendant met the DSM-IV-TR criteria for Paranoid Schizophrenia, observing that since 1997 the defendant had demonstrated the following features in his clinical presentation: prominent delusional themes, -- 2 of 5 -- 3 auditory hallucinations and formal thought disorder manifesting as disorganized speech. [7] Dr Tie had available to him discharge summaries from the Wolston Park Hospital in 1997, the Princess Alexandra Hospital for three admissions in 1999 and the Redlands Hospital for admissions in 2000, 2002 and 2003. He noted that at the time of the defendant’s first psychiatric admission he was noted to have a one month history of psychotic symptoms, including the belief that he had the powers of telepathy, that he could levitate and move objects by thinking, that he was receiving extra sensory phenomena through a hole in his head and that he did not exist in the world as commonly experienced. Dr Tie also noted that, with multiple psychiatric admissions over the subsequent five years, the defendant’s diagnosis had changed to one of Chronic Schizophrenia, and that recurrent psychiatric admissions to the Princess Alexandra Hospital and the Redland Hospital had been characterised by first rank symptoms of thought alienation, persecutory delusions, religiose delusions and delusions of reference. [8] Dr Tie’s conclusion that the defendant was suffering from a psychotic illness was based not only on the longitudinal history of his psychiatric condition since 1997, but also on many reviews of his mental state since his incarceration in December 2007 and the nature of his psychiatric presentation in the High Secure Inpatient Service since March 2008. Dr Tie commented on the persistence of a range of persecutory delusions expressed by the defendant in relation to his mother during the defendant’s period in The Park. [9] Dr Tie opined that in relation to all the charged offences the defendant was deprived of both the capacity to know that he ought not do the act and the capacity to control his actions. Dr Kovacevic [10] Dr Kovacevic also considered that the defendant was of unsound mind at the relevant time. He was of the opinion that the defendant suffered from acute Paranoid Schizophrenia, but offered a slightly different view in respect of the question of deprivation of capacity, opining that the defendant’s deprivation of capacity was confined to the capacity to know that what he was doing was wrong. In his report, Dr Kovacevic stated: “Reports that Mr Finch refused to call a taxi and that he decided to wait several hours before leaving the residence (this is described in Miss Finch’s statement to the police) could be indicative that he knew that what he did was wrong and made an effort to avoid a discovery. However, he was very paranoid in a more general sense, believing in particular that his mother was setting him up with the police. He also believed that there was a conspiracy against him. Therefore aforementioned behaviour is not inconsistent with a paranoid psychotic state. In summary, it is my opinion that Mr Finch should be able to avail himself of the defence of unsoundness of mind by virtue of the deprivation of the capacity to know that he ought not to do the act. The deprivation of this capacity was directly related to his mental disease.” -- 3 of 5 -- 4 Dr Sundin [11] Dr Sundin in her report of 8 May 2009 also supported a defence of unsoundness of mind for all of the charges. She also noted that historically, there was good collateral material of the defendant having demonstrated on multiple occasions, first-rank psychotic symptoms of delusions (paranoid, religiose, delusions of reference), auditory hallucinations and formal thought disorder, consistent with the diagnosis of chronic Schizophrenia, Paranoid type, as defined in the DSM-IV-TR. She observed that: “With the passage of time, it is clear that his symptoms have certainly persisted for more than six months and have been associated with deterioration in inter-personal, social and occupational achievement. At the time he attacked his mother and uncle he appears to have been acting on the delusional belief that his mother was about to collude with the police to place him in gaol where he would remain for the rest of his life. To some contemporaneous examiners he spoke of feeling under threat from his mother as a result of this belief. His mother appears to have been the focus of his attack, which in itself was sustained. He does not appear to have demonstrated any level of calm or composure throughout this period and it seems likely that he had lost the capacity to control his actions. There is no clear explanation for the attack upon his uncle; I suspect that he may have been caught up inadvertently in Mr Finch’s psychotic/paranoid fixation upon his mother. In the months after these events Mr Finch continued to demonstrate first rank symptoms of a florid psychotic episode and it has taken considerable therapeutic intervention to bring his condition into partial remission. I note that the flag has been raised for Schizo-affective Disorder from 1999 but I consider this an unlikely diagnosis. Therefore with regard to Section 27 of Criminal Code, I consider that his chronic psychiatric condition present since 1997 with the acute exacerbation in December 2007; is sufficient to meet the definition of disease of the mind such that Mr Finch meets the criteria for unsoundness of mind.” [12] In respect of the issue of deprivation of capacity, she favoured the view of Dr Tie, stating: “… I am of the opinion that Mr Finch was deprived of the capacity to know that he ought not to do the act and given the collateral material from his mother in which she reports that the attack went on for a three-hour period, it would suggest that he was also deprived of the capacity to control his actions.” -- 4 of 5 -- 5 Findings and orders [13] The clinical evidence from all the reporting psychiatrists is to the same effect, that the defendant suffered from a mental illness at the time of the alleged offences, namely paranoid schizophrenia. I note that none of the reporters considered that intoxication was an issue in respect of the defendant’s state of mind. On the basis of the evidence I am satisfied that as a result of that mental illness the defendant was deprived, at least, of the capacity to know that he ought not to do the acts in question. Accordingly, I find that the defendant was of unsound mind at the material time within the meaning of Schedule 2 of the Mental Health Act 2000 (Qld). [14] The update report of Dr Morris, consultant psychiatrist at The Park, indicates that the defendant continues to retain some concerning delusional ideation in respect of his mother. It is apparent that the defendant has significant ongoing treatment needs. The gravity of the charged offences, the treatment requirements of the defendant and the need to protect the community, demonstrate that a forensic order is clearly required. It is also evident that limited community treatment should be quite constrained at present. [15] I order that the defendant be detained as a forensic patient at The Park High Security Program Authorised Mental Health Service. I approve limited community treatment confined to the grounds of The Park Centre for Mental Health for up to two hours twice per week, at the discretion of the authorised psychiatrist, on the following conditions: 1. That the defendant remain under the escort of two health service staff members nominated by the authorised psychiatrist for the duration of the limited community treatment; 2. That for the purposes of the limited community treatment he comply with the directions of the nominated staff members for the duration of the limited community treatment; and 3. That the defendant not initiate contact with the specified persons. -- 5 of 5 --