Doncaster, Re [2006] QMHC 6

MENTAL HEALTH COURT CITATION: Re Doncaster [2006] QMHC 006 PARTIES: REFERENCE BY THE DEFENDANT’S LEGAL REPRESENTATIVE IN RESPECT OF WARWICK ANDREW DONCASTER PROCEEDING: No 159 of 2005 DELIVERED ON: 14 June 2006 DELIVERED AT: Brisbane HEARING DATE: 8 June 2006 JUDGE: Philippides J ASSISTING PSYCHIATRISTS: Dr J F Wood Dr J M Lawrence FINDINGS AND ORDER: 1. That the defendant was of unsound mind at the time of the alleged offence as described in Schedule 2 of the Mental Health Act 2000 (Qld). 2. That the defendant be detained as a forensic patient to the West Moreton District Area Network Authorised Mental Health Service for involuntary treatment and care. 3. Approval of limited community treatment to commence immediately on the following conditions: (a) That he reside at a specified address or at an address approved in advance in writing by the authorised psychiatrist; (b) That he present to West Moreton Integrated Mental Health on 15 June 2006 at 1.30 p.m. and attend all follow up appointments and in-patient care as required by the authorised psychiatrist; (c) That he comply with the requirements of the authorised psychiatrist in relation to the taking of the prescribed medications and other treatment; (d) That he abstain from using alcohol and illicit drugs and co-operate fully in random medical tests for those substances as required by the authorised psychiatrist; (e) That he not drive a motor vehicle unless licensed and, further, unless he is permitted to do so by the authorised psychiatrist. (f) That he not possess any offensive weapons, and if -- 1 of 4 -- 2 in possession of same, he surrender them to the proper authorities; and (g) That he make no contact with the complainant unless one of Mr Doncaster’s parents is also present. CATCHWORDS: MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where defendant charged with assault occasioning grievous bodily harm – where psychiatric opinion indicated the defendant suffered from a mental illness – where evidence that defendant was intentionally intoxicated – whether state of mind resulted to any extent from intentional intoxication Mental Health Act 2000 (Qld), s 289, Schedule 2. COUNSEL: Mr C O’Meara for the defendant Mr J Tate for the Director of Mental Health Ms C Kelly for the Director of Public Prosecutions SOLICITORS: Carne Reidy Herd for the defendant The Crown Solicitor for the Director of Mental Health The Director of Public Prosecutions [1] PHILIPPIDES J: The defendant, Warwick Doncaster is charged with assault occasioning grievous bodily harm on 19 June 2004. The matter of his mental condition at the time of the alleged offence was referred to this court by his legal representative. [2] Dr De Leacy and Dr Butler both provided psychiatric reports and gave oral evidence. They both diagnosed the defendant as suffering from a mental disease at the time of the alleged offence, namely paranoid schizophrenia. The question that arises concerns the issue of intoxication and whether the defendant’s state of mind resulted to any extent from intentional intoxication for the purposes of the definition of “unsound mind” in Schedule 2 of the Mental Health Act 2000 (Qld). [3] The evidence indicates that on the day in question the defendant had gone to his uncle’s place to seek safety and to “chill out”. He had delusions that he was going to be harmed. He and his uncle fell into drinking beer and went to a hotel where more alcohol was consumed and they met a friend of the defendant. They then all went to the friend’s place and played pool. As a result of his delusions, the defendant misinterpreted a friendly tap on the head with a billiard cue by his uncle (to indicate that it was his turn) as the beginning of an assault. The defendant believed there was a threat of being killed and reacted to the danger he perceived by a frenzied attack on his uncle. [4] The evidence indicates that the defendant had consumed about 14 beers over the course of the day from 10.00 am. The extent of intoxication cannot be clearly determined, but there was general agreement that the likely range of blood alcohol level was between 0.05 and 0.15. The defendant had a history of paranoia -- 2 of 4 -- 3 associated with drug use. In addition, the defendant had in the 24 hours before the alleged offence taken some intravenous amphetamines, although both doctors were of the view that that did not result in intoxication at the relevant time. [5] In his report Dr De Leacy stated that it was likely that the defendant was suffering unsoundness of mind at the time of the incident; the defendant responding in a reflex manner to his delusions that he was in danger and going to be harmed. His oral evidence was that it was the defendant’s psychotic illness that made the defendant believe that he was under threat and in danger and not the effects of intoxication. Although he could not exclude intoxication from alcohol consumption as having a role, he was “reasonably confident” that the psychotic episode would have occurred without the intoxication. He expressed the opinion that the defendant’s mental illness was of such intensity that it would on the balance of probabilities have deprived him of his capacity to know that what he did was wrong. He was of the same opinion with respect to the deprivation of the defendant’s capacity for control. [6] Dr Butler in his report stated his opinion that the presence of mild to moderate alcohol intoxication did not contribute to the presence of a mental disease, but considered it was possible that it contributed to the deprivation of the defendant’s capacity to know that he ought not have committed the act “through impairment of ability to make choices when confronted with a perceived deadly assault. Similarly the intoxication could have impaired his capacity to understand what he was doing during the commission of the alleged assault”. On that basis he formed the view that on the balance of probabilities it was likely that intentional intoxication did to some extent contribute to the deprivation of at least one of the relevant capacities. [7] Dr Butler was more equivocal in his oral evidence, moving to the view that “the mental disease in itself … in isolation, would be enough to deprive him of one or more [capacities]”. His oral evidence as to the two capacities referred to in his report was that “if one took away the fact that he was intoxicated, I think he would still have been deprived of the [capacities].” [8] Dr Butler also gave evidence that, the delusional ideas which the defendant had at the beginning of the day developed so that during the course of the day he misinterpreted things that his uncle said and did. His uncle became incorporated into his delusional thinking so that he believed that his uncle was part of a conspiracy to harm him. Dr Butler was asked by Dr Lawrence, one of the assisting psychiatrists, whether it was probable that intoxication had played a part in that development. However, Dr Butler was unable to provide a clear answer, observing that the more the defendant had to do with his uncle during the day the more that he was misinterpreting his uncle’s behaviour. [9] It is fair to say, as Dr Wood, the other assisting psychiatrist observed, that “Dr Butler had somewhat changed from his report [where he] didn’t support unsoundness, more towards the position of supporting unsoundness, emphasizing perhaps more that he was unable to rule out the participation of intoxication”. In the final result the highest that Dr Butler put the contribution of alcohol in the deprivation of any relevant capacity was “somewhere between possibility and probability”, but he could not be completely unequivocal about even that. -- 3 of 4 -- 4 [10] In advising the court, Dr Wood noted the qualification in Dr Butler’s oral evidence and the movement away from the views expressed in his report. Dr Lawrence however took the view that on the evidence before the court intoxication did contribute on the balance of probability to the deprivation of the relevant capacities. [11] While the matter is not without difficulty, I am satisfied on the balance of probabilities that the clinical evidence on the whole indicates that the defendant’s delusions, which developed in the course of the day to incorporate the defendant’s uncle, were such that he was deprived at least of the capacity to know that he ought not do the act alleged and that that deprivation did not result from intoxication. I therefore find that the defendant was of unsound mind at the time of the alleged offence as described in Schedule 2 of the Mental Health Act 2000 (Qld). [12] The clinical opinion clearly indicates is that a forensic order is appropriate in this case. The defendant has been charged with a serious offence. He has a mental illness which requires ongoing management, in circumstances where his history suggests lack of insight, substance abuse and poor compliance. [13] I order that the defendant be detained as a forensic patient to the West Moreton District Area Network Authorised Mental Health Service. [14] I approve limited community treatment pursuant to s 289 of the Mental Health Act 2000 (Qld), to commence immediately on the following conditions: 1. That he reside at a specified address or at an address approved in advance in writing by the authorised psychiatrist; 2. That he present to West Moreton Integrated Mental Health on 15 June 2005 at 1.30 p.m. and attend all follow up appointments and in-patient care as required by the authorised psychiatrist; 3. That he comply with the requirements of the authorised psychiatrist in relation to the taking of the prescribed medications and other treatment; 4. That he abstain from using alcohol and illicit drugs and co-operate fully in random medical tests for those substances as required by the authorised psychiatrist; 5. That he not drive a motor vehicle unless licensed and, further, unless he is permitted to do so by the authorised psychiatrist. 6. That he not possess any offensive weapons, and if in possession of same, he surrender them to the proper authorities; and 7. That he make no contact with, the complainant and the victim of the alleged offence, unless one of the defendant’s parents is also present. -- 4 of 4 --