Beckett, Re [2006] QMHC 17

MENTAL HEALTH COURT CITATION: Re Beckett [2006] QMHC 017 PARTIES: REFERENCE BY THE DIRECTOR OF MENTAL HEALTH IN RESPECT OF DORIAN BECKETT PROCEEDING: No 246 of 2005 DELIVERED ON: 9 November 2006 DELIVERED AT: Brisbane HEARING DATE: 6 November 2006 JUDGE: Philippides J ASSISTING PSYCHIATRISTS: Dr J F Wood Dr J M Lawrence FINDINGS AND ORDER: 1. That the defendant was not of unsound mind at the time of the alleged offences 2. That the defendant is fit for trial 3. That proceedings continue according to law CATCHWORDS: MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where defendant charged with unlawful wounding and attempted robbery whilst armed – where the defendant suffered from schizo- affective disorder – where evidence that defendant had injected amphetamine and consumed alcohol before the alleged offences – whether defendant of unsound mind as defined in Schedule 2 of the Mental Health Act 2000 (Qld) at the time of the alleged offences – where conflicting expert evidence as to whether defendant’s mental state affected by voluntary intoxication Criminal Code 1899 (Qld), s 27 Mental Health Act 2000 (Qld), Schedule 2 Re LIH [2002] QMHC 014, cited Re RKS [2004] QMHC 011, cited Re Hellmann [2006] QMHC 003, cited COUNSEL: Ms C Morgan for the Defendant Mr J Tate for the Director of Mental Health Mr G Cash for the Director of Public Prosecutions SOLICITORS: Legal Aid Queensland for the Defendant Crown Law for the Director of Mental Health The Director of Public Prosecutions (Qld) -- 1 of 5 -- 2 [1] PHILIPPIDES J: The defendant, Dorian Beckett, a 21 year old man, is charged with unlawful wounding and attempted robbery whilst armed. The defendant’s mental condition at the time of the alleged offences has been referred to this Court. [2] There is no dispute as to the facts of the alleged offences. [3] Both charges relate to events which occurred at 1.15 pm on 31 August 2005 near a Caltex service station at Mudgeeraba. The defendant approached the female complainant who was walking from her car, pointed a pocket knife at her and demanded that she give him the keys to her car. A struggle ensued in which the defendant stabbed the complainant in the finger, which later required suturing. The defendant ran off, pursued by an onlooker, and was arrested by the police soon after. [4] The defendant told police that on the morning of the day in question he had injected amphetamine. He told them that he had used about $500 worth. (However, he later told Dr Albrecht that it was closer to $100 and told Dr McVie he had used about a gram, mentioning that he purchased about $200 worth a couple of weeks before the incident.) In addition, he told police that he had drunk about one and a half bottles of vermouth. He repeated similar statements to Dr Albrecht and Dr McVie, telling them that he had bought two bottles, which he did not finish. He also told them that he had been to a pub that morning and had consumed several cans of beer. [5] The defendant’s diagnosis was initially schizophrenia, which was modified to schizo-affective disorder, in view of his depressive symptomatology and his numerous suicide attempts. The defendant’s condition is characterised by hallucination and delusion. He has been admitted to psychiatric hospitals in Tasmania on four occasions and has had four admissions in Queensland. The defendant also has a history of drug and alcohol abuse commencing at approximately age 15. [6] The defendant was referred in remand custody to the Gold Coast Hospital where he was treated by Dr Albrecht, who has continued to be his treating psychiatrist. The defendant had stopped taking his pharmacological medication at least one week prior to the offences. The defendant did not respond to a range of anti-psychotic medication, but has stabilised on Clozapine. [7] He had no prior history of violence, but does have a conviction for drunk and disorderly behaviour. [8] Dr Albrecht, who has provided a number of reports and gave oral evidence, supported a defence of unsoundness of mind. Dr Albrecht accepted that on the defendant’s account he appeared to have been seriously and substantially intoxicated. However, he was of the view that at the time of the alleged offences the defendant was deprived of all three capacities, because of the degree of his psychotic symptoms, which he considered were exacerbated by intoxication against the background of his underlying major psychotic disorder. -- 2 of 5 -- 3 [9] Dr Albrecht observed that the defendant’s recollection of the events of the day was patchy. He had no recollection of confronting the complainant and was unable to give an account as to his conduct. The defendant could recall walking through a park and subsequently being chased. He told Dr Albrecht that he thought he might have wanted to buy some drinks in a supermarket nearby. Fragmented and poor recollection is a feature of the defendant’s binge drinking. In this regard, I note that the defendant told Dr Albrecht that usually he “would remember things quite well” and said “when I hear voices I am ok with the memory” and “even on amphetamines”, but that when he binge drank he got “things mixed up, can’t remember things, and get all muddled”, “I get strange”. Dr Albrecht also observed that poor recollection was occasionally a feature of the defendant’s mental illness. [10] Dr Albrecht considered, from the information available to him, that the defendant was increasingly suffering from a range of auditory and visual hallucinations and had become increasingly distressed at his worsening psychotic symptoms, which he attempted to alleviate by drinking alcohol. [11] Dr Albrecht opined that “whatever [the defendant] would have come across on that day there would have been a more than 50% chance that [he] would have proceeded with whatever action he thought he might do (without any likely definite voluntary intent), and without being aware of the events at the time or the consequences, or being able to modify his behaviour, or to control or stop his behaviour”. He considered, on the grounds of the defendant’s account of having experienced a range of auditory and visual hallucinations for more than a month prior to the offences, that the intoxicants merely exacerbated his existing, underlying psychotic illness. He noted the cessation of medication at the time and stated that the defendant’s account needed to be seen in the context of his carrying a knife for his own protection based on paranoid delusional beliefs. [12] Dr Albrecht considered that: “the principal driving force behind his behaviour, especially as of the early parts of the day of the alleged events in question, was his emotional distress about the worsening paranoid and hallucinatory beliefs and experiences, including the actual psychotic symptoms cumulating later in drug and alcohol abuse (self-treatment), with the latter two in my clinical opinion not being the primary causal or contributing factors for his alleged behaviour, but being more related to exacerbating his psychosis, and being causal, and contributing to his lack of memory regarding the alleged events in question”. [13] Dr McVie in her report outlined the defendant’s mental illness as a severe, chronic, treatment resistant schizo-affective disorder, characterised by auditory and visual hallucinations, associated delusional beliefs, persecutory ideas and a history of depressive symptoms with multiple suicide attempts. She noted the defendant’s significant history of poly-substance abuse, mainly amphetamines and alcohol. She also observed that the defendant has required a lengthy, acute inpatient stay, eventually responding partially to the antipsychotic medication, Clozapine. -- 3 of 5 -- 4 [14] In respect of the events on the day in question, the defendant told Dr McVie that it was his birthday and that he had been trying to have a good time. She also noted that in the lead up to his birthday, the defendant was experiencing worsening auditory hallucinations and persecutory beliefs and observed that while there was “clear evidence of some intoxication”, the defendant had resorted to using the intoxicants in an attempt to self-medicate in order to diminish the distress he was suffering due to his hallucinations and persecutory beliefs. [15] Dr McVie concluded that the defendant’s schizo-affective disorder would have been sufficient at the time to deprive him of the capacity to know he ought not to do the act and possibly to deprive him of the capacity to control his actions. She agreed with the opinion of Dr Albecht that, based on the defendant’s treatment resistant psychotic illness and his description of his thoughts and psychotic experiences in the lead up to the alleged offences, the defendant’s mental illness in itself “may well have been sufficient” to deprive him of these capacities. [16] Dr Kingswell saw the defendant on 15 December 2005. Accepting that the defendant suffered from a chronic mental illness and was chronically hallucinated and deluded, Dr Kingswell nevertheless was unable to find evidence that those experiences or beliefs would, under normal circumstances, provoke the defendant to act as he did in demanding a person’s car keys. He considered it extremely unlikely that the defendant’s state of mind did not result to some extent from intentional intoxication or stupefaction. However, he was at pains to point out that he had initially provided an opinion for the purposes of whether the Director ought to approve leave prior to a determination as to bail, and that he had not had the opportunity to observe and interview the defendant that others had had. Was the defendant of unsound mind? [17] In determining whether the defendant was of unsound mind at the time of the alleged offences, the Court must determine whether he was deprived by a mental disease of at least one of the three capacities referred to in s 27 of the Criminal Code 1899 (Qld) and if so, whether the defendant’s state of mind resulted to any extent from intentional intoxication, so that a finding that the defendant was of unsound mind is precluded by Schedule 2 of the Mental Health Act 2000 (Qld). The words “state of mind” referred to in the definition of “unsound mind” in Schedule 2 are to be understood in terms of a mental disease resulting in loss of any one of the three separate capacities: (Re LIH [2002] QMHC 014, Re RKS [2004] QMHC 011, Re Hellmann [2006] QMHC 003). [18] There is no doubt that the defendant has a severe chronic mental disorder that was present at the time of the alleged offences and characterised by chronic hallucinations and delusions. [19] The difficulties presented in this case arise from a lack of available history concerning the defendant’s thinking and conduct in respect of the alleged events and from the evidence of significant intentional intoxication. -- 4 of 5 -- 5 [20] As to the evidence of intoxication, while that arises solely on the defendant’s self report, there being no independent evidence to substantiate the extent and nature of it, I see no compelling reason to reject the defendant’s reports. There is some inconsistency in his reports as to the quantity of amphetamine he used, but he consistently reported that he had used amphetamine prior to the alleged offences and that he had consumed between one and two bottles of vermouth. The evidence therefore points to a quite significant degree of intoxication. [21] While I accept that the defendant’s mental disorder may of itself have deprived the defendant at least of the capacity to know he ought not to do the acts the subject of the charges, I am unable to be satisfied on the balance of probabilities that such a conclusion can be reached on the state of the evidence before the Court. [22] Dr Wood accepted that the defendant’s psychosis could well have deprived him in accordance with the views expressed by Dr Albrecht and Dr McVie, but was concerned at the apparently significant degree of intoxication and considered that that may well have contributed to or even determined his behaviour on the day in association with his disturbed psychotic behaviour. [23] Dr Lawrence’s clinical opinion was that, in the circumstances of the present case, intoxication must have played some part in the defendant’s behaviour and that there was a gap in marrying up the symptoms of the defendant’s mental illness at the relevant time and his behaviour, in the absence of the factor of intoxication. This reflected the opinion of Dr Kingswell, who also identified the difficulty of reaching a firm conclusion as to unsoundness of mind, given that the offending took place in the context of considerable intoxication from amphetamines and alcohol taken on the occasion of the defendant’s birthday. [24] I observe that both Dr Albrecht and Dr McVie struggled in linking the defendant’s actions on the day in question with the symptoms of the defendant’s illness. Dr Albrecht’s oral evidence was that it was difficult to understand why the defendant acted as he did unless one placed his actions in the context of a history of becoming uncontrollable in his behaviour when psychotic. Dr McVie opined that one possible explanation for his actions was his anxiety for his safety and hence his use of the knife. She acknowledged however, that “the [defendant’s] actions in themselves don’t suggest deluded thinking. The actions in the context of his long term history is what suggests a deluded thinking”. Some additional weight is given to the opinions of Drs Albrecht and McVie by the fact that the defendant apparently demanded the keys to the complainant’s car although he cannot drive and has no licence. [25] However, in the circumstances of this case where there is evidence of substantial intoxication and unsatisfactory evidence linking the defendant’s conduct with deprivation due solely to his mental illness, I am unable to conclude unsoundness has been shown to the requisite degree. Accordingly, I find that the defendant was not of unsound mind at the relevant time. [26] The defendant is fit for trial. I order that the proceedings continue according to law. I grant leave to the parties to use the experts’ reports before the Court in further proceedings. -- 5 of 5 --