Attorney-General for the State of Queensland v Fisher [2025] QSC 284

• [4] On 14 September 2018 the respondent pleaded guilty and was convicted of one count of indecent treatment of a child under 12 as well as two counts of entering a dwelling with intent.
• [5] He received a head sentence of three years and six months. His full-time release date, after taking into account time already served, was 22 November 2020.
• [6] Before his release, the Attorney-General applied for orders under s 13 of the DPSOA. An order made under that section can:

(a) require that a respondent be detained in custody for an indefinite term for control, care or treatment, or

(b) release a respondent from custody subject to the mandatory statutory requirements and other conditions considered appropriate by this Court (a supervision order).

• [7] On 26 August 2020 the matter came on for hearing.[1] The Attorney-General submitted that the respondent was a serious danger to the community and that adequate protection for the community could be ensured by the making of a supervision order. As not all the expert evidence had been collected at that time, the application was adjourned and a date for final hearing was set. Upon receipt of that further evidence the Attorney-General's attitude evolved consistent with the opinion of the various experts.
• [8] In another review hearing the respondent's capacity to engage in the proceedings was raised. That led to substantial delay and an order, on 24 May 2021, referring that issue to the Queensland Civil and Administrative Tribunal. Further delay ensued until 9 May 2022 when a QCAT member declared that the respondent did not have the capacity to engage in these proceedings and the Public Guardian was appointed as the respondent's guardian for, among other things, these proceedings.
• [9] I need not set out all the reasons for the delay that followed that appointment. It is enough to say that the respondent's mental condition and his attitude to treatment together with the conflict of the opinions of the court appointed psychiatrists and the Prison Mental Health Service psychiatrists contributed substantially to the length of time needed to conclude this matter.
• [10] When this matter was first listed for hearing in 2020 the opinions of the court appointed psychiatrists - Dr Arthur and Dr Brown - may be summarised in this way:

• Exhibitionism (displaying consistent elements);

Drug Induced Psychosis (historical diagnosis with a differential of Schizophrenia); and

Cognitive Impairment (currently unexplored - "secondary to his psychiatric condition, due to the effects of substance use or as a consequence of chronic self-harm in the form of headbanging_._")

Mixed Antisocial and Emotionally Unstable Personality Disorder;

Substance Use Disorder (alcohol, cannabis and other substances);

Psychotic Disorder (probable, most likely Schizophrenia or Organic Psychotic Disorder, secondary to substance use);

Exhibitionism Disorder, Paedophilic Disorder or other Paraphilic Disorder (unclear, yet consistent with the Respondent's offending profile).

• [11] Since the first reports were provided, there has been no change of any substance in the assessments made by the psychiatrists in the many reports which have followed the originals.
• [12] When this matter came before me on 20 February 2023 I observed:

"The Attorney General applies, in the alternative, for orders under section 13 of the Dangerous Prisoners Sexual Offenders Act 2003 for a continuing detention order or a supervision order. The evidence called on behalf of the Attorney General is consistent. A supervision order would not be the appropriate order to make today. But the evidence called by the Attorney General is also consistent with the conclusion that appropriate treatment of the respondent might lead to a situation where a supervision order was the appropriate order to make. The problem that has become apparent is that the respondent has been incarcerated for over two years now and has not received any treatment for many months.

The three consulting psychiatrists all agree that he needs treatment. They all agree that treatment, properly administered, would lessen the risk that he might pose. And if appropriate treatment were given, he might be in a position to be the subject of a supervision order. Notwithstanding all of that material having been available to the relevant authorities, no treatment has been afforded since, I think, the middle of last year, and at the moment there is no proposal that treatment be afforded as suggested by the consulting psychiatrists. The doctor who had been dealing with the respondent in prison is no longer engaged by the government.

Associate Professor Karunakaran gave evidence by telephone this morning, having read the reports and having listened to the evidence, to the effect that Mr Fisher should be assessed as soon as possible, with a view to treatment commencing. He also gave evidence that there is or are problems with accommodating these requirements within the government system, and that it might require the intervention of the Chief Psychiatrist. I'm not satisfied that it is appropriate to make a continuing detention order in the face of the evidence given today. It is certainly not appropriate to make a supervision order today. I am minded to adjourn these proceedings then for some time in order that the assessment and commencement of treatment can be undertaken as soon as possible.

While there was no appearance on behalf of the relevant authority today, the prima facie view I have formed is that the absence of treatment has been to the detriment of the respondent, and should he not receive appropriate treatment in the near future, that that also would be a considerable detriment to the respondent, as it would preclude further favourable consideration of any application for a supervision order."

• [13] Although there were further delays, the respondent was eventually provided with some treatment, but its nature was, as Mr Tate described it, "opaque". A brief description of the respondent's circumstances is contained in Dr Brown's report of 31 July 2025. She said:

"Mr Fisher's case is rather complex, in that his mental illness and mild cognitive difficulties are associated with his offending risk and his ability to adhere to supervision in the community.

In 2023, Mr Fisher was prescribed antipsychotic medication and he was compliant with this for a period of months in depot form. He then ceased this medication and his mental state worsened.

In 2024 he was referred back to the Prison Mental Health Service and commenced on oral Lurasidone (antipsychotic). He ceased this in late September 2024 and again his mental state deteriorated.

In the past year Mr Fisher has presented as disinhibited and inappropriate towards female staff, sexually preoccupied (upset without a girlfriend, missing out on sex due to imprisonment and upset when he had sexual side effects preventing masturbation), disorganised in thoughts and behaviours, expressing bizarre ideas, (including that he had access to a diamond mine, that he had millions of dollars and that he knew the Attorney General), paranoid and combative towards other prisoners (worsened when he ceased medication), unrealistic and grandiose in terms of future goals and plans (building a granite house, making jewellery, working as a welder or other skilled employment), drug seeking (cannabis, cocaine, opiates), and rejecting of supervision (ankle bracelet, precinct housing, case management).

Despite these various symptoms and behaviours Mr Fisher was not considered to require involuntary treatment under the Mental Health Act by the treating mental health service. He is therefore unmedicated and insightless into his mental disorder, treatment needs and the legal complexities of his situation."

• [14] Both Dr Arthur and Dr Brown assess the respondent's unmodified risk of future serious sexual offending as in the "high" risk category compared to the general recidivism rate of sex offenders. The chief risk is exposure and sexual assault of a female child or adult. According to Dr Brown any such offending would most likely be an opportunistic and impulsive act of exposure with masturbation and would involve a female child who may or may not be known to the respondent. He might also offend against adult females. Dr Brown said: "The most likely risk scenario remains the same. Without the structure and supports of the prison environment, Mr Fisher's presentation is likely to deteriorate as it has in the past."
• [15] All three of the reporting psychiatrists are of the opinion that the respondent's risk of future serious sexual offending is unlikely to be reduced, or reduced to an acceptable level, at this time. Each of them was of the view that it was unlikely that he could comply with the restrictions of a standard supervision order and so, such an order would not significantly reduce the risk of sexual offending.

• [16] The three court appointed psychiatrists were broadly of the same view about treatment of the respondent when they provided their most recent reports.
• [17] Dr Simpson says:

"Previously psychiatrists Dr Brown and Dr Arthur have expressed similar views to myself that Mr Fisher requires ongoing and sustained psychiatric treatment and care under involuntary treatment, given he clearly lacks insight into his mental health condition and therefore sees no need for treatment. It is unfortunate that little seems to have changed since his last hearing.

The crux of the matter appears to be this: Mr Fisher requires a comprehensive management plan that incorporates robust mental health treatment and support in the community if he is to have any chance of successfully transitioning to community living under a Supervision order. In my opinion that requires a period of care in a psychiatric rehabilitation unit such as SMHRU or The Park High Secure inpatient service where his needs can be thoroughly evaluated when he is not in a custodial setting. This would also allow better assessment of his adaptive living skills and capacity to function independently in the community which he needs to be able to do in order to manage in the precinct, as well as identify any other issues which would heighten his risk of relapse. Without this occurring then I am concerned that Mr Fisher's progress is at an impasse and he will remain stuck in custody."

"[13] It is my opinion that a recrudescence of his psychotic symptoms will increase his unmodified risk of recidivism due to worsening judgement, heightened disorganisation and impulsivity. Given his lack of insight and voluntary status, it is unlikely that he will accept a referral to Community Mental Health Services or engage meaningfully in treatment if released.

[14] I am not comforted by cross-sectional assessments and opinions of my junior colleagues in the Prison Mental Health Services, particularly when more senior clinicians such as Dr Longhitano have observed ongoing evidence of chronic psychosis."

"It therefore remains my view, given the risks and mental health symptoms described, that Mr Fisher will require a period of assessment and rehabilitation in a secure hospital environment. In my view he would meet criteria for use of the Mental Health Act.

He should be established on depot antipsychotic medication. He could then have a gradual transition to the community to suitable supported accommodation (NDIS), so as to manage his ongoing treatment and risk management needs. A combination of a QCS supervision and treatment / management under the Mental Health Act is likely to be required."

The attitude which had previously been exhibited by Prison Mental Health Service altered in the middle of this year. Dr Longhitano gave evidence at the hearing on 14 August this year. While he was not employed in Prison Mental Health Service he had acted in consultant positions with the Service several times and was familiar with this case. In an email about the respondent sent before the hearing he said:

"Mr Fisher was transferred to hospital under a Recommendation for Assessment (RA) completed by Karola Hoffmann at PMHS on 24 July 2025.

He was admitted to Townsville's Adult Acute MH Unit on 29 July and placed on a TA by the receiving team, consultant psychiatrist, Dr Joanne Holdaway on the 30th July. The team confirmed the diagnosis of paranoid schizophrenia and started him on an IM Long-Acting Medication, namely aripiprazole 400 mg monthly.

He received two doses of the treatment and was observed as settled in his behaviour with no overt psychotic symptoms on the 31st July. His physical health examination and blood tests were unconcerning and his urine drug screen negative.

He was therefore returned to custody under the care of PMHS at TCC. [...]

I am of the opinion that Mr Fisher's mental state can safely and effectively be monitored by PMHS in corrections under a TA. His mental state is expected to stabilise within the next several weeks and up to two months following the re-commencing of a LAI antipsychotic agent. He may require a new period of brief hospital admission monthly, to ensure safe administration of the medication under the MHA, if he were to continue to refuse voluntary administration in custody or in the community."

• [20] The approach outlined in the passage above was not accepted as a complete solution by Dr Simpson. In her report of 8 August 2025, she said:

"Ultimately this new material does not alter my opinion from 2020 in any meaningful way.

I remain of the view that Mr Fisher has a chronic untreated psychotic illness, namely Paranoid Schizophrenia and he has been largely unmedicated for the last 7 years whilst in custody, although has had some periods when he was receiving medication, although it [is] unclear how adherent he was.

In my opinion this psychotic illness, untreated, increases Mr Fisher's risk of recidivism in the community across all offending as a result of both positive symptoms (grandiose delusions and persecutory ideas) and negative symptoms (disorganisation, poor planning, poor judgement, impulsive decision making and amotivation).

As noted in the IOMS notes Mr Fisher has engaged in altercations with other prisoners when experiencing paranoia and this is in the structured prison environment in the absence of other significant stressors that he would be facing if he were in the general community. Intermittently he has voiced delusional material and ideas, usually of a grandiose nature, but these seem to fluctuate.

I would speculate that his symptomatology is far more extensive than the mental health notes would suggest as his reviews have usually been relatively short and he is motivated to avoid treatment so is unlikely to disclose concerns to them. When he has been seen by others for longer periods such as the reporting psychiatrists, he is unable to contain those symptoms and has expressed more significant psychopathology."

• [21] At the hearing on 14 August this year there was a further realignment of the view of Prison Mental Health Service. Dr Longhitano gave evidence which exposed the possibility that a different approach might be taken, and that the respondent could be admitted to a SMHRU.
• [22] This possibility was explored with each of the court appointed psychiatrists who were broadly in favour of the respondent being admitted to a SMHRU for assessment and treatment subject to various conditions. The hearing was adjourned for that process to take place.
• [23] At a further hearing on 30 September, I was informed that:

(a) the respondent had been accepted into the SMHRU on 16 September,

(b) the respondent's transfer to the SMHRU was arranged for 30 September 2025 subject to the Court agreeing that the continuing detention order would cease, and

(c) a draft supervision order had been sent to the court appointed psychiatrists.

"The supervision order appears adequate to manage prisoner Fisher's risk of sexual recidivism. I believe that the conditions relating to his community mental health management are relevant, as the presence of a psychotic illness is a significant risk factor for recidivism.

My understanding of the Secure Mental Health Rehabilitation Unit is that it provides a safe and structured environment with 24 hour clinical support for people with persistent disabling symptoms of mental illness."

"As previously outlined in my written evidence to the Court, I am of the opinion that admission to a SMHRU whilst also subject to supervision order is the most appropriate option to address Mr Fisher's complex mental health and risk management needs. ... I confirm that the draft supervision order conditions are appropriate."

• [26] So that the respondent could begin treatment immediately I made an interim supervision order on 30 September.

• [27] The DPSOA requires that I give detailed reasons in these circumstances. The basis for my reasoning is set out in the evidence summarised above. The unanimous view of the experts was that, if the interim order were made permanent, then that would provide appropriate protection and treatment.
• [28] I am satisfied that the various opinions of the court appointed psychiatrists, and the other longitudinal evidence provides acceptable and cogent evidence of sufficient weight to justify the imposition of an order under Part 2 Division 3 of the DPSOA. It was not contested that the respondent is a serious danger to the community in the absence of such an order. It was also common ground that if the respondent were to be subject to a continuing detention order, then he could not receive the treatment necessary to deal with his condition. That attitude is supported by all the expert evidence.
• [29] The proposal that the respondent be made subject to a supervision order which contains conditions requiring him to live at the SMHRU Townsville and that he submit to assessment and treatment satisfies the requirements of the DPSOA with respect to protection of the community and provides a means by which the respondent may be able to return to the community after the conditions in the supervision order have been met.
• [30] I will make a final supervision order for a term of ten years with the same conditions as the interim order.

Originating application for Division 3 orders filed.

Preliminary hearing heard by Martin J. Drs Brown and Simpson are appointed.

Review before Davis J. Mr Fisher's capacity to engage in the proceeding is raised as an issue.

Review before Davis J where Legal Aid submits that it is experiencing significant difficulty in obtaining instructions from Mr Fisher.

The matter is reviewed seven times over this period (4 December 2020, 18 December 2020, 5 February 2021, 5 March 2021, 19 March 2021, 16 April 2021, 30 April 2021).

Williams J refers the matter to QCAT to determine the issue of Mr Fisher's capacity.

QCAT hearing regarding Mr Fisher's capacity. QCAT finds that Mr Fisher lacks capacity for complex matters. Office of the Public Guardian appointed as litigation guardian, to be reviewed in two years.

The matter is reviewed seven times over this period (12 May 2022, 26 May 2022, 23 June 2022, 20 July 2022 (in chambers), 31 August 2022, 12 October 2022 (in chambers), 8 November 2022 (in chambers).

Final hearing of the matter before Martin SJA. The Division 3 proceedings are adjourned to 29 May 2023 for review.

The matter is reviewed before Martin SJA. The applicant submits affidavit material foreshadowing the need for preparation of further expert reports. The matter is adjourned to 12 July 2023 for review.

The matter is listed for review 16 times over this period. On each occasion the parties make contact prior to the review date seeking that it be vacated, and a new review date be set.

The matter is reviewed and listed for final hearing on 14 August 2025.

Final hearing of the matter before Martin SJA. The matter is adjourned to 30 September 2025 for review.

[1] A concise chronology of events from the filing of the application until the final hearing is contained in the attachment to these reasons.