The defendant, MM is a forensic patient under the Mental Health and Cognitive Impairment Forensic Provisions Act 2020 (NSW) ("the Act"). By summons filed on 23 February 2024, the Attorney General for New South Wales seeks an order under the Act extending the defendant's status as a forensic patient, (an extension order), for a period of 18 months.
The defendant appeared by his tutor Dr Katherine Pavlidis Johnson. I note that as a forensic patient the defendant is "a person under legal incapacity": s 3 Civil Procedure Act 2005 (NSW). As such, r 7.14 of the Uniform Civil Procedure Rules 2005 (NSW) requires the appointment of a tutor to carry on the proceedings. In the event, the defendant was present at the hearing (appearing by audiovisual link ("AVL")). The hearing was paused on occasion to allow him to speak with his solicitor with respect to the conduct of the matter. The defendant's tutor was also present at the hearing, also by AVL.
[2]
The proceedings brought by the Attorney-General
The defendant was, in May 2020, charged with aggravated sexual assault of a person under his authority, contrary to s 61J(1) of the Crimes Act 1900 (NSW). He was found unfit to be tried and a special hearing was held under the Act. At that hearing, Trail DCJ found that, on the limited evidence available, the defendant had committed the offence charged. Her Honour imposed a limiting term of 4 years commencing on 28 May 2020. This had the result of designating the defendant a "forensic patient", as defined in s 72 of the Act.
As a forensic patient the defendant was subject to periodic review by the Mental Health Review Tribunal ("MHRT"). Following a review, he was released during the currency of his limiting term, on 8 November 2023. He remained a forensic patient but was in the community subject to the conditions on his release imposed by the MHRT. Whilst in the community as a forensic patient the defendant is subject to the supervision of the Community Safety Program ("CSP").
The plaintiff's summons as originally filed sought an order that the defendant be subject to an interim order for the extension of his status as a forensic patient for three months together with orders appointing two qualified psychiatrists, registered psychologists or medical practitioners (or a combination of such persons) to conduct separate psychiatric examinations of the defendant; to furnish reports to the Court on the results of those examinations; and directing the defendant to attend those examinations. A preliminary hearing with respect to this interim relief was held before Sweeney J on 16 May 2024. On 21 May 2024, her Honour made orders in the terms sought, appointing two experts, and extended the defendant's status as a forensic patient for a period of three months from the expiry of his limiting term, which was on 27 May 2024: Attorney General for New South Wales v MM (Preliminary) [2024] NSWSC 599. That extension is therefore due to expire on 27 August 2024.
[3]
The relevant provisions
Forensic patients are dealt with under Pt 5 of the Act. The objects of Pt 5 of the Act are set out in s 69(1) as follows:
69 Objects
(1) The objects of this Part are as follows -
(a) to protect the safety of members of the public,
(b) to provide for the care, treatment and control of persons subject to criminal proceedings who have a mental health impairment or cognitive impairment,
(c) to facilitate the care, treatment and control of any of those persons in correctional centres or detention centres through community treatment orders,
(d) to facilitate the provision of hospital care or care in the community through community treatment orders for any of those persons who require involuntary treatment,
(e) to give an opportunity for those persons to have access to appropriate care,
(f) to protect the safety of victims of forensic patients and acknowledge the harm done to victims.
In general terms, Pt 5 provides for the review of forensic patients by the Tribunal and gives the Tribunal powers to make orders with respect to the patient's detention and release: s 81. Release may be either unconditional or subject to conditions. The conditions that can be imposed on a forensic patient are set out in s 85 of the Act.
Part 6 of the Act deals with the extension of a person's status as a forensic patient. Section 69(2) provides that the objects set out in s 69(1) extend to Pt 6 of the Act.
Section 123 gives standing to the plaintiff to apply for an extension order while s 121 gives the Court power to make an order. The circumstances in which an application can be made and requirements for the application are set out in ss 124 and 125 respectively and are met in the present case. The test for making the order is set out in s 122(1) which provides:
122 Forensic patients in respect of whom extension orders may be made
(1) A forensic patient can be made the subject of an extension order as provided for by this Part if and only if the Supreme Court is satisfied to a high degree of probability that -
(a) the forensic patient poses an unacceptable risk of causing serious harm to others if the patient ceases to be a forensic patient, and
(b) the risk cannot be adequately managed by other less restrictive means.
The Court is not required to determine that "the risk of a person causing serious harm to others is more likely than not in order to determine that the person poses an unacceptable risk of causing serious harm to others": s 122(2). Furthermore, the Court must have regard to the matters set out in s 127(2) in addition to any other matters it considers relevant. Section 127(2) provides:
127 Determination of application for extension orders
…
(2) In determining whether or not to make an extension order, the Supreme Court must have regard to the following matters in addition to any other matter it considers relevant -
(a) the safety of the community,
(b) the reports received from the persons appointed under section 126(5) to conduct examinations of the forensic patient,
(c) the report of the qualified psychiatrist, registered psychologist or registered medical practitioner provided under section 125(b),
(d) any other report of a qualified psychiatrist, registered psychologist or registered medical practitioner provided in support of the application or by the forensic patient,
(e) any order or decision made by the Tribunal with respect to the forensic patient that is relevant to the application,
(f) any report of the Secretary of the Ministry of Health, the Commissioner of Corrective Services, the Secretary of the Department of Communities and Justice or any other government Department or agency responsible for the detention, care or treatment of the forensic patient,
(g) the level of the forensic patient's compliance with any obligations to which the patient is or has been subject while a forensic patient (including while released from custody subject to conditions and while on leave of absence granted under this Act),
(h) the views of the court that imposed the limiting term or existing extension order on the forensic patient at the time the limiting term or extension order was imposed,
(i) any other information that is available as to the risk that the forensic patient will in future cause serious harm to others.
[4]
The hearing
At the hearing the plaintiff relied upon a large volume of material contained in the affidavits of Ms Jennifer Tsui dated 23 February 2024 and 12 April 2024 and the affidavit of Ms Stephanie Breen dated 22 July 2024, together with associated annexures and exhibits. That material replicated the evidence before Sweeney J, with additional evidence post-dating the preliminary hearing. The additional evidence included the reports of the two experts appointed pursuant to the orders of Sweeney J. Both experts were cross-examined on behalf of the defendant.
The defendant relied on affidavits of Mr Callum Hair dated 15 May 2024 and Ms Jessica Smith dated 31 July 2024.
The background to the application, relevant assessments of the defendant up until the preliminary hearing were summarised by Sweeney J at [8]-[40]. Her Honour's reasons should be read together with these reasons.
The further evidence available at the final hearing before me is discussed below.
[5]
Further evidence: Dr Carollyne Youssef
Dr Carollyne Youssef, a forensic psychologist, was appointed pursuant to the orders made by Sweeney J. Dr Youssef interviewed the defendant for approximately two and half hours by AVL. She was provided with the documentary material then in existence and relied upon on this application. In her report she set out the defendant's background, developmental history and his history of criminal offending.
Dr Youssef reported that the defendant had reflected on his past alcohol use, blaming his prior partners on the basis they would often drink together or that he would drink "as he was stressed about their drug use or other stressors related to them". He told her he did not need a relapse prevention plan, stating "[it's] not going to happen … not going to go back … no one can stop it but myself". He said that he was not currently engaged in any services, but was waiting for an appointment with a psychologist through the Tamworth Aboriginal Medical Service ("TAMS"). (He had by the time of hearing had one session.) He told Dr Youssef that he did not need to engage with any other providers or programs, the change that he had made having been his "own hard work".
Dr Youssef noted that the defendant had been released to live with his mother but that there had been difficulties in residing there, in part due to the attitude of family members towards him based on his commitment to abstinence. I interpolate here that the defendant appears to have demonstrated insight into the risk the environment posed for him, the result of which was the arranging of temporary accommodation in a motel while waiting for his own public housing accommodation. In the event, the defendant moved into his own residence a matter of days before the hearing. (According to other evidence he was anticipated to move into his accommodation on 1 August 2024.) He told Dr Youssef his primary goal was to reconnect with his children. He had reconnected with some of them and was assisting them with abstaining from drug use.
With respect to the application, he expressed his discontent to Dr Youssef, stating that he is "not a fuckin forensic patient" and that he "didn't do anything wrong". I pause to note at this point, that this is somewhat different to what he told Dr Sathish Dayalan, whose psychiatric report dated 4 August 2023 was relied upon by the plaintiff. The defendant told Dr Dayalan, "I was intoxicated … I drank a lot of grog … I wasn't thinking right … I never want to go through something like this again"; "I don't do stuff like that. I don't know what came over me" and "I am a better man than that". There was, additionally, evidence at the trial that neighbours heard the defendant say, "I've done something horrible" and "kill me".
Dr Youssef reported on the defendant's time in custody. She noted he was made a special management area placement (SMAP) inmate, separating him from the mainstream prison population on the basis of his vulnerability. She noted he did not incur any institutional offences while in custody, but was moved from his unit for a short time due to concerns he was standing over and bullying other inmates. A behaviour support plan was commenced due to the defendant's conduct which was said to demonstrate "deficits in interpersonal skills, communication, [problem solving] and emotional regulation". Dr Youssef noted that while in custody the defendant had completed several programs including the EQUIPS Foundation, which is a general therapeutic program designed to target risk factors related to offending, conducted over 40 hours. I note he also undertook 14 sessions with a psychologist. MM reported to Dr Youssef that he had completed a couple of drug courses and that he had learnt to use his breathing when stressed stating that "now when I'm stressed, I just do tactic breathing". He was adamant that he did not need to plan for any possibility of relapse in the future.
With respect to the assessment of risk, Dr Youssef began by noting the limitations of risk assessment stating that it is not possible to accurately predict whether an offender will or will not reoffend. She also noted the fact that risk assessments assess risk generally and do not evaluate the likelihood of the commission of an offence resulting in serious harm.
Dr Youssef set out the results of the various risk assessment tools applied. This included the Static-99R which placed the defendant in the average risk category, relative to other male sexual offenders. Dr Youssef noted that in "routine samples with the same score, the 5-year sexual recidivism rate is between 2.7 and 3.7 per cent". Dr Youssef cautioned that the Static-99R does not measure all relevant risk factors with the result that the defendant's risk could be higher or lower, and further noted that the test does not discriminate in terms of the potential severity of any reoffending. In order to obtain greater insight into the risk Dr Youssef set out her assessment of the various risk and protective factors applied in accordance with other testing protocols.
Dr Youssef found that the defendant "does pose a risk of harm to others, which has the potential to be serious, if he ceases to be a forensic patient, and is not subject to any other type of protective order". Significant in this assessment is the defendant's cognitive deficit and a history which highlights "a proclivity for poor coping, intimacy deficits, poor general self-regulation, negative attribution bias, attachment deficits, and substance use". Dr Youssef endorsed the view that should alcohol use resume "it is highly likely that consumption will rapidly escalate and that severe problems will once again develop". Dr Youssef expressed the opinion that continuation of the defendant's status as a forensic patient would mitigate some of the risks identified. Also significant in this assessment is Dr Youssef's opinion that the defendant's "most robust protective factors stem from external regulations" and that contributing to his present stability is the support he receives from the CSP team and the National Disability Insurance Scheme ("NDIS").
In cross-examination, Dr Youssef gave evidence that alcohol has been a major contributor to the defendant's prior offending. She noted that, while there were other factors, alcohol was "by far … the significant one". She accepted that the index offence would not have occurred but for the defendant's high level of intoxication.
Dr Youssef agreed that in coming to her conclusions as to the risk of serious harm, the commission of prior offences involving the use of a knife and choking was significant. Absent those features the defendant's risk would drop to moderate on the particular risk assessment tool employed (the SARA-V3 risk assessment tool). I note there can be no criticism of Dr Youssef in her relying on a history provided to her which included offences involving a knife and choking. However, on this application the plaintiff ultimately accepted that, on review of the facts with respect to that event, the inference to be drawn was that the defendant was not sentenced on the basis that the event involved the use of a knife, but rather the facts on which he was sentenced simply alluded to him picking something up in conjunction with him uttering a threat. Dr Youssef, in re-examination, clarified defendant's use of any object that could be used as a weapon would be sufficient for her to maintain her opinion.
With respect to the allegation of choking, the police facts before me in relation to this incident reveal an allegation, including a choking. It was pointed out on behalf of the plaintiff that the conviction of the defendant was after a hearing, resulting in uncertainty as to what particular facts were proved in establishing the charge of assault occasioning actual bodily harm. The only allegation of actual bodily harm contained in the facts was bruising to the neck which was said to be the result of the defendant grabbing the complainant in that area. While there is a degree of uncertainty, it is highly likely in those circumstances that conviction for actual bodily harm was based on a grabbing of the neck.
Dr Youssef accepted that the defendant's risk of committing a sexual offence was lower than his risk of committing an interpersonal violence offence. She also accepted any risk, presented by the defendant, was lower should he abstain from alcohol and have stable accommodation. She accepted that, with the defendant having moved into his own accommodation, receiving support with respect to day-to-day living and with engagement in psychological treatment and occupational therapy, his risk was reduced. She, however, raised a concern that the defendant continue to engage with these supports noting that the defendant could not be compelled to utilise such services provided through the NDIS.
[6]
Further evidence: Ms Lisa Zipparo
Ms Lisa Zipparo is a clinical neuropsychologist, appointed pursuant to the orders made by Sweeney J. Ms Zipparo provided a detailed report dated 11 July 2024. She saw the defendant for approximately two hours. In her report she set out the defendant's history and summarised the content of the various reports and other documentary material she had received. She set out the results of her neuropsychological assessment, in which she found, in summary, that the defendant has "severe impairments in most areas of cognitive functioning", with his results across various domains in either the borderline or, more predominantly, the severely impaired range. Ms Zipparo applied the Static-99R risk assessment tool which, consistent with the Dr Youssef's results, indicated an "average" risk of sexual re-offending. Like Dr Youssef, she said this is "generally equivalent to the average rate of sexual reoffending in the overall population of individuals convicted of sexually motivated offences". Ms Zipparo went on to observe that about half the individuals within the average risk category will transition to a below-average risk "within a year or two after appropriate support and treatment".
Ms Zipparo also applied a structured professional judgment risk assessment tool called the ARMIDILO-S which is designed specifically for use with individuals with intellectual impairments who have either offended sexually or displayed sexually offensive behaviour. Ms Zipparo set out her assessment of the various risk factors and protective factors in accordance with that tool.
Based on her assessment, Ms Zipparo assessed the defendant as having a "moderate to high risk of any reoffending and a moderate risk of sexual reoffending if he ceases to be a forensic patient".
Ms Zipparo recommended continuation of the defendant's forensic status in order to manage his risk of causing serious harm to others. This was on the basis of her conclusions as to the defendant's absence of insight into his cognitive impairments and need for treatment, together with a long history of treatment non-compliance suggesting a need for mandated treatment to address the defendant's past trauma and drug and alcohol issues.
In cross-examination Ms Zipparo explained the aetiology of the defendant's cognitive impairment, explaining that its nature was such that she would not expect an improvement in his cognitive functions "in any substantial way". She also agreed that alcohol was the biggest risk factor, but that frontal lobe damage on its own leads to "impulsivity, inhibition, poor insight, poor decision-making" which were things which needed to be managed because "they are not going to [go] away".
Ms Zipparo gave evidence that, as a result of the defendant's deficits, strategies and routines would take longer than normal to learn and implement, leading to her recommendation to extend his status as a forensic patient. Positively, she observed that he had been working hard to implement what he had learnt including strategies for managing his anxiety. She said that he had demonstrated the capacity to learn and change but that "he is going to need longer than normal" to make what he has learnt part of his normal routine. In that vein, Ms Zipparo indicated that she would like to see established relationships with a drug and alcohol counsellor and a therapist dealing with past trauma.
Ms Zipparo gave evidence that the defendant required more than the 10 hours a week support presently allocated to him under the NDIS. Her evidence was, however, that even with these supports in place she remained concerned as to his risk in the absence of established relationships with counsellors of the kind referred to immediately above.
[7]
The defendant's treatment under the current order
The most recent MHRT decision is that of 9 February 2024, conducted pursuant to the obligation to review patients at intervals of six months: s 78(d) of the Act. The previous conditions were maintained, subject to some relatively minor changes. The effect of the conditions is to put in place a case manager with whom the defendant is to have contact weekly, with a face-to-face meeting at least once a month. There are conditions in relation to where he may live, essentially requiring the case manager to approve his accommodation. The conditions prohibit the use of alcohol and drugs and provide for random testing to detect the use of alcohol. Of significance on the application are the following conditions:
"6. [MM] is to participate in any psychological treatment, education, training, rehabilitation, recreational, therapeutic or other programs which his case manager asks him to attend.
7. In particular [MM] is to attend the Tamworth Aboriginal Medical Service as directed by his case manager and participate in such programs offered by the Service, including its Drug and Alcohol program, as recommended by his case manager. [MM] is also to attend the Centrecare Men's Behavioural Change program as directed by his case manager."
There is no evidence that any counselling has been put in place beyond one session with a psychologist arranged through TAMS. This is despite the plaintiff's application being based on the need for such treatment. This issue is discussed further below.
In its reasons for its 9 February 2024 orders, the MHRT referred to the evidence before the Tribunal and observed:
"Overall, the CSP considers that he has demonstrated self-directed compliance with the conditions of his order, engagement with supports and services and has started making progress towards establishing positive lifestyle. He has also been accepted into the Tamworth Aboriginal Medical Service to access the alcohol, tobacco and other drugs support service. He has also been accepted into the men's behavioural change program and attended the first session on 22 January 2024. The program supports men who used abusive and controlling behaviour towards their partners or family members to change their behaviour. He has also started work on a casual basis mowing lawns and undertaking general garden maintenance and would like to start his own business."
It was noted that on the defendant's release from prison in November that many of the courses were in holiday shutdown but were expected to restart. That does not, of course, explain the lack of progress to date.
Further evidence was obtained by the plaintiff in preparation for the hearing, including records relating to the administration of the conditions attaching to the defendant's status as a forensic patient. Those records showed the defendant had been tested for alcohol consumption with no use detected. It should be noted that quite apart from the negative testing, no suggestion was made that the defendant has at any stage since his release, relapsed into alcohol use and I find positively that he has not.
A case note dated 19 June 2024 indicates the defendant had been accessing support workers three days a week. It would appear this is a reference to support provided through the NDIS. The note indicates a psychologist or counsellor was being sought to assist the defendant with his then "tumultuous housing situation", reference being made to the consumption of alcohol and cannabis at that location. The inference to be drawn is that no psychological counselling was then in place. The note indicates the defendant was attending the TAMS Alcohol, Tobacco and Other Drugs Services "as needed". Is unclear as to what, in practical terms, this means.
Records of phone conversations between the defendant (at times with his NDIS support worker) and the CSP team were tendered. Those notes are demonstrative of the defendant's resolve to remain crime free. They include references to an altercation with a nephew to which the defendant responded by attending police to obtain an apprehended violence order. There is also a report of an altercation between the defendant and his son in the context of the defendant attempting to assist his son to cease his use of crystal methylamphetamine ("ice"). It was reported the defendant, on this occasion, used breathing techniques to calm himself and "did not even think about having a drink". The note also reported the defendant's concerns with respect to, and desire to dissociate himself from, the home environment as a result of the use of drugs and alcohol on the premises.
The notes also make reference to the support being provided through the NDIS, a matter which is discussed below.
[8]
The defendant's evidence - his NDIS plan
The defendant relied on an affidavit of Ms Jessica Smith, the coordinator of supports at Little Blue Wren, the defendant's NDIS provider. (The NDIS plan was also annexed to an affidavit of the defendant's solicitor.) She deposed that she has contact with the defendant on an "as needs" basis, currently seeing the defendant approximately two or three times a week. The defendant has a weekly schedule pursuant to which support workers are available to him on Mondays, Wednesdays and Thursdays between 9am and 1pm, with some variability depending on the defendant's needs. The support offered provides access to the community, assistance with attending appointments, compliance with legal obligations and securing and maintaining housing. With regard to the latter, Ms Smith deposed that the defendant had been allocated a two-bedroom public housing unit in Tamworth, and was to move into that property on 1 August. It was confirmed at the hearing that he had, in fact, moved into the premises.
Ms Smith indicated that the defendant's deficits resulted in difficulties with planning, decision-making and goal setting. In her opinion, he requires support in relation to anger management, financial management, medical management and in maintaining his tenancy. On this basis she has submitted a request for additional NDIS funding for the defendant for "home and living". Her aim is for the defendant to receive more comprehensive assistance in relation to his self-care and to ensure that his social and therapeutic needs are more effectively met. Based on her experience, she anticipates that the defendant will receive an increase in funding but said she did not know if it would extend to "home and living" funding. She also indicated it was proposed to make a guardianship application.
Ms Smith noted that the defendant had attended his first appointment with a psychologist from TAMS on 22 July 2024, having been on the waitlist for about eight weeks.
[9]
Consideration
Without wishing to oversimplify matters, the question as to the risk posed by the defendant appears to me to come down to the risk that he will relapse into alcohol abuse. While there was evidence that interpersonal difficulties continued while the defendant was in custody and not consuming alcohol, the risk that the defendant will have difficulties of that nature while not affected by alcohol, does not, having regard to his history more generally, rise to the point where it could be assessed as giving rise to an unacceptable risk of serious harm.
The risk of the defendant committing a personal violence offence is, essentially, the product of the risk of him becoming intoxicated, him committing a personal violence offence and that personal violence offence causing serious harm. In the event that the defendant does become intoxicated, the risk of him committing a personal violence offence is very high. The risk of serious harm from such an event is more difficult to predict. Without wishing to trivialise the various acts of violence committed by the defendant, the consequences of those acts have not risen above actual bodily harm. That is not to say that something more than actual bodily harm is required to establish "serious harm": see Attorney General of New South Wales v Kereopa (No 2) [2017] NSWSC 928. The nature of any injury sustained as a result of an assault will often involve, at least to an extent, a degree of happenstance. That is, for the purposes of looking forward, the consequences of some of the defendant's past acts of violence could have been significantly more grave. Of course, this remains a very different level of risk when compared with a person with a history of intentionally inflicting grave harm. The risk of the defendant causing serious harm as a result of a personal violence offence is significantly attenuated by comparison.
The risk of the defendant committing a sexual offence absent intoxication seems to me to be very low, probably negligible. Even intoxicated, the index offence appears to have been a "one-off". Acknowledging that to be the case, the facts of the offending suggest that, in the event the defendant should again become intoxicated to the extent that he was, there is a prospect of him engaging in serious criminal conduct that would otherwise not have been expected.
As I have said, central to the defendant's risk is the risk he will return to the consumption of alcohol. The defendant in this regard has made, impressive progress. Whether it be as a result of the defendant's incarceration for what was by far the longest period he has experienced (his longest previous incarceration being for two months in 2000), the commission of an offence which the evidence suggests he may have difficulty reconciling with his own sense of self; the realisation that alcohol has caused and will continue to cause harm to himself and others; or a combination of these or other reasons, it is plain that the defendant has made a strong commitment to abstinence. His choice to move away from family who did not understand his choice, his attempts to assist two of his sons with their addictions, and his response to his conditional liberty more generally, all suggest he has redefined himself as a man who does not use alcohol or drugs. It is, as I remarked at the hearing, impressive progress.
Suggestions that the defendant "lacks insight" must, in my view, be tempered by the knowledge that the steps he has taken clearly demonstrate a keen awareness of the dangers of alcohol for him, and those around him. That said, the lack of insight referred to was primarily a reference to a concern that the defendant underestimates the risk of relapse, and the potential benefit of supports that may prevent this.
The risk of relapse must be understood in the context of the evidence that the defendant consumed alcohol every day from a young age until his incarceration in 2020 at the age of 51 (presumably excluding time he had previously been in custody). While the defendant has not consumed alcohol for a period in excess of four years, other than for the last nine months of that time he has been in custody. While nine months is not an insignificant period of abstinence in the community, in context it is a relatively short period given the defendant's long history of alcohol misuse. The plaintiff's submission that it is still "early days" has some force.
The risk of relapse is significant in the case of anyone suffering a long standing addiction. The defendant's position is further complicated by the impact of his cognitive impairment. The evidence in this regard from Dr Youssef was that:
"[MM's] neurocognitive impairment indirectly impacts on his risk by affecting other dynamic risk factors, such as his poor coping, impulsivity, compromised executive dysfunction and self-awareness."
And further:
"Whilst there is no evidence that alcohol-induced [neurocognitive deficit] is directly related to risk of sexual or violent offending behaviour, the condition can cause various deficits that together can create a situation where [MM] may be less able to control his impulses, regulate emotions, and make sound decisions, thereby increasing the likelihood of engaging in offending behaviour."
A similar view was expressed by Ms Zipparo.
While significant progress has been made it must be borne in mind that he has had only one session with a psychologist. Proposed occupational therapy has not yet commenced. There does not appear to be regular drug and alcohol counselling in place.
It is highly regrettable that this application should be made by the plaintiff, in large measure on the basis of these needs, in circumstances where the supports said to be required have not been put in place over the nine months the defendant has been in the community. There is some force in the defendant's submission that extension of the order to mitigate risk is not warranted as no inference can be drawn that the making of an order will result in the provision of therapy for past trauma and drug and alcohol counselling. Against this, however, is the fact that, perhaps somewhat belatedly, psychological counselling has commenced. While there are concerns that it may not be sufficiently specialised, it is a start. While drug and alcohol and psychological support might be thought to be obvious interventions in a case such as this, and perhaps should have been commenced earlier, I would expect that the opinions of the court appointed experts and these reasons will have the effect of causing these measures to be put in place within a relatively short time.
Further, it is noteworthy that it is considered that greater support should be provided to the defendant under the NDIS and that, while this funding has been applied for, it had not yet, at the time of the hearing, been approved. There is limited evidence before me as to the extent of any additional services that might be provided, with the result that I can only proceed on the basis of the level of support the defendant presently receives, and the opinion of those providing that support which is that greater support is required.
Significantly, the defendant had moved into his accommodation only a matter of days before the hearing. While this is a positive step, he is yet to establish any routines. It is to be recalled that the defendant's only experience of living in the community, and not abusing alcohol, is the nine months that have elapsed since his release. He has, in that time, not been in a domestic relationship, a circumstance he identified as, in the past, placing him under stress and leading to the consumption of alcohol. He has a dearth of pro-social relationships, these essentially being provided by NDIS support workers and his supervision under the CSP.
The matter is somewhat finely balanced. The defendant has, as I have been at pains to point out, made great strides. What makes his progress so significant is, of course, his history. The length of that history which encompasses essentially a lifetime of alcohol abuse remains highly relevant. Having regard to that history, his particular deficits and the considerations set out in s 127(2) discussed above and in the reasons of Sweeney J, I am of the view that the defendant poses an unacceptable risk of causing serious harm to others if he ceases to be a forensic patient.
While there are other supports available to the defendant, particularly through the NDIS and a proposed application for a guardianship order, I accept the views of both Dr Youssef and Ms Zipparo that an extended order is the least restrictive means available to adequately manage the defendant's risk. While the defendant is currently positively engaged with the NDIS, that is in the context of his abstinence. In the event that that abstinence is threatened, the defendant's past response to supervision and support suggest that mandated intervention is likely to be necessary.
The plaintiff sought an order for 18 months. At the hearing it became apparent that the primary utility of the order is to enable the establishment of therapeutic relationships and stability in the community. It is not clear why 18 months should be necessary to establish these relationships. Further, the recent resolution of the defendant's housing situation suggests a shorter period of time will be sufficient to ensure the defendant positively habituated in his new setting. I regard 12 months as a sufficient period for the extension of the order.
[10]
Orders
I make the following orders:
1. Pursuant to ss 121 of the Mental Health and Cognitive Impairment Forensic Provisions Act 2020 (NSW), the defendant's status as a forensic patient is extended for a period of 12 months from today, 16 August 2024.
2. Access to the reports of the two court appointed experts is to be provided to the defendant's treating team.
3. Access to the Supreme Court's file in respect of any document shall not be granted to a non-party without leave of a Judge of the Court and if any application for access is made by a non-party in respect of any document, the parties are to be notified by the Registrar so as to allow them an opportunity to be heard in relation to the application for access.
[11]
DISCLAIMER - Every effort has been made to comply with suppression orders or statutory provisions prohibiting publication that may apply to this judgment or decision. The onus remains on any person using material in the judgment or decision to ensure that the intended use of that material does not breach any such order or provision. Further enquiries may be directed to the Registry of the Court or Tribunal in which it was generated.
Decision last updated: 16 August 2024