DMM, Re [2004] QMHC 2

SUPREME COURT OF QUEENSLAND CITATION: Re DMM [2004] QMHC 002 PARTIES: REFERENCE BY THE DIRECTOR OF MENTAL HEALTH IN RESPECT OF DMM PROCEEDING NO: 0094 of 2003 DELIVERED ON: 12 March 2004 DELIVERED AT: Brisbane HEARING DATE: 12 March 2004 JUDGE: Wilson J ASSISTING PSYCHIATRISTS: DR J M Lawrence Dr J F Wood FINDINGS AND ORDERS 1. That at the time the alleged offences were committed, the defendant was suffering from unsoundness of mind as described in schedule 2 of the Mental Health Act 2000 (Qld) 2. Order that the defendant be detained as a forensic patient at Royal Brisbane Hospital and Royal Women's Hospital and District Authorised Mental Health Service for involuntary treatment and care; 3. Approval of limited community treatment in the nature of unescorted day leave on and off the grounds of the hospital at the discretion of the authorised psychiatrist on the following conditions: a) That he abstain from using alcohol and illicit drugs and make himself available and co-operate fully in random medical tests for those substances, as required by the authorised psychiatrist; b) That he return to the ward at the times specified by the authorised psychiatrist and otherwise comply with the requirements of the authorised psychiatrist. CATCHWORDS: MENTAL HEALTH – DECLARATION OR FINDING OF MENTAL ILLNESS OR INCAPACITY – where the defendant charged with entering a dwelling with intent to commit an indictable offence and child stealing – where defendant suffers from hydrocephalus – whether the Court ought to make a forensic order with provision for limited community treatment – where all parties agree that such an order should be made – where defendant has no ties to the jurisdiction and no place of abode – whether Court should approve limited community treatment in the nature of more -- 1 of 4 -- 2 than overnight leave. Mental Health Act 2000 (Qld), schedule 2 COUNSEL: Mr D Shepherd for the defendant Mr J Tate for the Director of Mental Health Mr P Rutledge for the Director of Public Prosecutions SOLICITORS: Legal Aid Queensland for the defendant The Crown Solicitor for the Director of Mental Health The Director of Public Prosecutions [1] WILSON J: DMM [“the defendant] has been charged with entering a dwelling with intent to commit an indictable offence and child stealing on 4 May, 2002. I am satisfied that at the time of the alleged offences he was suffering from unsoundness of mind as described in Schedule 2 of the Mental Health Act 2000. [2] These are very serious offences. The defendant was born on 5 October 1968, so that he is presently aged 35 years. He suffers from hydrocephalus and there is, on the one view of the evidence, an organic psychosis associated with it. He lives in Griffith in New South Wales with his parents. From the material before the Court it seems that he is not subject to any management plan at present. [3] He has been on bail and apart from one or two incidents in or about August 2002 he has complied with the reporting conditions of that bail. He has been co-operative with assessments for the purposes of the present proceeding and he has attended Court today voluntarily. [4] Dr Fama assessed him in April 2003. In his report he said this: "[D] does not require extended hospitalisation. However, since he has no place of abode, save the family home in Griffith, and since he has not hitherto had any psychiatric treatment, if he comes to be determined of unsound mind then he would best be placed in a local Brisbane psychiatric unit for initial care. His reported offences were serous and I think he may well need a maintenance and preventive program, including supportive counselling, rehabilitative measures, and the prescription of a long-term anti-psychotic medication, such as Risperidone". [5] Dr Matthew Large, a psychiatrist and visiting medical officer in Griffith, New South Wales, has more recently assessed the defendant. He said this: "As I don't believe he needs any specific medical treatment, I would see no indication for him having a Community Treatment Order, as defined by the Mental Health Act in New South Wales. Some protection to the community might be conferred by him having a regular assessment. This could quite possibly be performed by a General Medical Practitioner. At present he has a local doctor, Dr [A]. I am uncertain of whose responsibility this would be. While he is in the premises of his parents they would be in the best position to monitor his mental state. Unfortunately, [D] is not particularly -- 2 of 4 -- 3 happy living with his parents so this may not be a particularly suitable long-term option." Dr Large had said earlier: "He has little in the way of symptoms that would be likely to respond to anti-psychotics and I don't believe it is an essential part of his management. It might be a reasonable thing to do to try a low dose of an atypical anti-psychotic such as Zyprexa or Solian at some point". [6] It was common ground amongst the counsel appearing in this case for the defendant, for the Director of Public Prosecutions and for the Director of Mental Health that a forensic order should be made for the defendant's detention to the Royal Brisbane Hospital and Royal Women's Hospital and District Authorised Mental Health Service, and a draft order was put before the Court. [7] It was clearly envisaged that there be an initial period of inpatient admission to allow assessment and it was anticipated that there would be an application to the Mental Health Review Tribunal for approval for him to move out of Queensland. In fact, arrangements had been made with the Mental Health Review Tribunal for an application to be heard on 23rd March, which is only about 11 days away. [8] There was then debate as to the terms of limited community treatment during the period of his being a forensic patient at the Royal Brisbane Hospital. The draft order which was put before the Court provided for unescorted day leave on and off the grounds of the hospital during the period of his inpatient admission followed by more than overnight limited community treatment to commence at the discretion of the authorised psychiatrist. There were various matters of concern in relation to the proposed more than overnight limited community treatment. In particular, the defendant has no ties in Queensland and he presently has nowhere to go if given more than overnight limited community treatment. In these circumstances, there is, I consider, a palpable risk of his taking flight and returning to New South Wales. [9] I am conscious of the need to give the treating psychiatrists flexibility and for this Court not to be too prescriptive in the terms of limited community treatment. Nevertheless, the situation is this, as I see it. Dr Fama considers that up to a fortnight will be needed for the inpatient assessment. A date has been obtained from the Mental Health Review Tribunal for a hearing within that time. In those circumstances, I am not prepared to approve more than overnight limited community treatment. That matter can be brought before the Mental Health Review Tribunal in 11 days time, after there has been some assessment at the Royal Brisbane Hospital. [10] Accordingly, the forensic order I make is in these terms. That the defendant be detained as a forensic patient in the Royal Brisbane Hospital and Royal Women's Hospital and District Authorised Mental Health Service for involuntary treatment and care. I approve limited community treatment in the nature of unescorted day leave on and off the grounds of the hospital at the discretion of the authorised psychiatrist on the following conditions: -- 3 of 4 -- 4 a. That he abstain from using alcohol and illicit drugs and make himself available and co-operate fully in random medical tests for those substances, as required by the authorised psychiatrist; b. That he return to the ward at the times specified by the authorised psychiatrist and otherwise comply with the requirements of the authorised psychiatrist. -- 4 of 4 --