DL Re [2007] QMHC 18

MENTAL HEALTH COURT CITATION: Re DL [2007] QMHC 018 PARTIES: AN APPEAL BY DL AGAINST A DECISION OF THE MENTAL HEALTH REVIEW TRIBUNAL PROCEEDING NO: No 0184 of 2007 DELIVERED ON: 6 November 2007 DELIVERED AT: Brisbane HEARING DATES: 6 November 2007 JUDGE: Philippides J ASSISTING PSYCHIATRISTS: Dr J M Lawrence Dr F T Varghese FINDINGS AND ORDERS: 1. Appeal dismissed. 2. The decisions of the Mental Health Review Tribunal dated 13 July 2007 and 5 October 2007 are confirmed. CATCHWORDS: MENTAL HEALTH – CONFINEMENT AND RESTRAINT OF MENTALLY ILL PERSONS AND SIMILAR ORDERS – GENERALLY – where the Mental Health Review Tribunal confirmed an involuntary treatment order in respect of the appellant on two occasions – where the appellant submitted that the involuntary treatment order should be revoked as he did not need to be in a high secure setting, wanted to live closer to his family and does not believe himself to be a danger to anyone else or himself – where the appellant suffers from schizophrenia – where the appellant has no insight into his mental illness and treatment needs – whether the decision of the Mental Health Review Tribunal to confirm the involuntary treatment order should be revoked Mental Health Act 2000 (Qld), s 14, s 191 COUNSEL: D Shepherd for the appellant J Tate for The Director of Mental Health SOLICITORS: Legal Aid Queensland for the appellant Crown Law for The Director of Mental Health [1] PHILIPPIDES J: The appellant appeals against two decisions of the Mental Health Review Tribunal confirming an involuntary treatment order ("an ITO"), namely, decisions of 13 July 2007 and 5 October 2007. -- 1 of 2 -- 2 [2] The grounds of appeal, in relation to the first appeal, are that whilst the appellant agreed to treatment he did not feel that he needed to be in a high secure setting and wanted to be permitted to reside closer to his family in Mount Isa. The additional grounds of appeal in relation to the further decision of the Tribunal are that the appellant does not believe that he is a danger to anyone else or himself. [3] The appellant was charged on 3 March 2007 with murder and robbery. He was granted bail on 8 June 2007 and then transferred to the high secure unit of The Park Centre for Mental Health ("The Park"). He was placed on an ITO on 11 June 2007. [4] In its reasons of 17 August 2007, the Tribunal set out in considerable detail the background to the diagnosis of the schizophrenia which the appellant has. There is no basis to call into question the diagnosis and counsel for the appellant conceded as much. [5] The Tribunal considered the application of the criteria under s 14 of the Mental Health Act 2000 (Qld) and on the review of the ITO in its further reasons of 5 October 2007 considered again whether the treatment criteria continued to apply and also had regard to the matters set out in s 191 of the Act. [6] Clearly the appellant does require treatment in relation to his mental illness. That has been provided to the appellant and is available at The Park high secure unit where he currently is. I am satisfied that there can be no fault in the reasoning of the Tribunal in relation to the application of the relevant criteria. [7] Because the appellant has no real insight into his mental illness or into the need for treatment there is a real risk that if he were not the subject of an ITO he would cease medication and therefore there would be a serious deterioration in his situation. [8] The appellant lacks the capacity to consent to treatment because of his lack of insight and in those circumstances there is no less restrictive way of ensuring that he receives appropriate treatment. He has indicated that he does not see the improvement which has progressed as being associated with his medication. He has also indicated that he does not accept either that he has a mental illness or that there is a need for ongoing treatment. And the evidence of the treating psychiatrist is that there is a high risk of absconding in the circumstances. [9] The Tribunal also had regard to the appellant's psychiatric history (there is a longstanding history of psychiatric illness), his social circumstances and his response to treatment and willingness to continue treatment, which I have dealt with. The difficulty really stems from the appellant's lack of insight into his illness and his treatment needs and in those circumstances the treating team is left with very little alternative but to continue along the present lines of treatment. [10] In those circumstances, I consider that the decision of the Tribunal both in relation to the first and the second appeal cannot be impeached. I am also satisfied that the relevant criteria are met. [11] The appeals are dismissed and the decisions of the Tribunal are confirmed. -- 2 of 2 --