Supervision order - Nature of mental impairment - Endanger another person - Adequate community resources for treatment and support - Compliance with order - Recommendation to revoke supervision order.

Criminal Justice (Mental Impairment) Act 1999; ss 30, 34, 35, 37.

The decision has been anonymised for the purpose of publication.

1. QEC is a 48 year old woman who resides in [a Tasmanian town] where she lives with her mother, or her partner.
2. In 2011 QEC was charged with grievous bodily harm for stabbing her brother with a knife in the context of alcohol intoxication and family tension.
3. QEC was found unfit to stand trial and "a finding could not be made that she was not guilty." The Supreme Court ordered that QEC be released under the supervision of the Chief Forensic Psychiatrist subject to the following conditions:
   1. She is to reside only at places directed by the Chief Forensic Psychiatrist or his or her nominee.
   2. She is to attend appointments or take part in programs and attend counselling as directed by the Chief Forensic Psychiatrist or his or her nominee or officer of the Forensic Mental Health Service.
   3. She is to abstain from the consumption of alcohol and the use of illicit substances.
   4. When and if required by the Chief Forensic Psychiatrist or his or her nominee or any officer of the Forensic Mental Health Service, she is to provide blood, urine or other bodily samples in order to monitor her use of alcohol and substances.
   5. She is to keep the peace towards [name of a person].
   6. She is not to initiate contact with [name of a person] directly or indirectly without the written permission of the Chief Forensic Psychiatrist or his or her delegate.
4. The supervision order has been reviewed by the Tribunal (including the former Mental Health Tribunal) on an annual basis since it was ordered. From 2013 to 2021 the Tribunal determined the supervision order was still warranted. When reviewed in 2022, 2023 and 2024 the Tribunal determined that the supervision order was no longer warranted and recommended the supervision order be revoked.
5. QEC has taken no action to apply to the Supreme Court to have the Supervision orders revoked.
6. On 14 May 2025 the Tribunal conducted a review of the supervision order for QEC and after hearing evidence determined to issue a certificate.

1. The hearing was conducted in Hobart with Dr WK consultant forensic psychiatrist and UX case manager attending in person. QEC did not attend the hearing.

1. The Tribunal's power to review a supervision order is in s 37 of the Mental Health Act 2013 (the Act):

37. Review of persons detained under forensic orders > > (1) A forensic order is to be reviewed under the Mental Health Act 2013 by the Tribunal within 12 months after the order was made and at least once in each period of 12 months afterwards. > > (2) In reviewing a forensic order, the Tribunal is to apply the principal in section 34 and have regards to the matters set out in section 35(1). > > (3) If the Tribunal, on review, determines that a forensic order is no longer warranted or that the conditions of the order are now inappropriate-

(a) the Tribunal must issue the defendant with a certificate to that effect; and

(b) the defendant may apply immediately, despite any other provisions of this Act, to the Supreme Court for discharge, revocation or variation of the forensic order.

(4) If the Tribunal issues a certificate in respect of the discharge of a restriction order, the certificate may include the recommendation of the Tribunal that, should the order be discharged-

(a) a supervision order or treatment order be made in respect of the defendant; or

(b) the defendant be released either unconditionally or on the conditions specified in the recommendation.

(5) If the Tribunal issues a certificate in respect of the revocations of a supervision order, the certificate may include the recommendation of the Tribunal that, should the order be revoked-

(a) a treatment order be made in respect of the defendant; or

(b) the defendant be released either unconditionally or on the conditions specified in the recommendation.

(6) If the Tribunal, on review, issues a certificate in respect of the variation of the conditions of a supervision order, the certificate may include the recommendations of the Tribunal as to what conditions should be included in the order.

(7) If the Tribunal, on review, determines that a supervision order should be revoked and that, instead, a restriction order should be made in respect of the defendant, the Tribunal is to-

(a) recommend to the Secretary of the responsible Department in relation to the Mental Health Act 2013 that he or she make an application under section 30(1) for the revocation of the supervision order and the making of the restriction order; and

(b) provide a copy of that recommendation to the defendant.

1. In determining proceedings under Division 6 of the Act, the Tribunal is to apply the principle set out in s 34, namely, the principle that restrictions on the defendant's freedom and personal autonomy should be kept to the minimum, consistent with the safety of the community and have regard to the matters set out in s 35(1) which are as follows:

(a) the nature of the defendant's mental impairment or other condition or disability; and

(b) whether the defendant is, or would if released be, likely to endanger another person or other persons generally; and

(c) whether there are adequate resources available for the treatment and support of the defendant in the community; and

(d) whether the defendant is likely to comply with the conditions of a supervision order; and

(e) other matters that the Tribunal thinks relevant.

1. Dr WK filed a report with the Tribunal dated 8 May 2025, and gave oral evidence at hearing.
2. Dr WK stated that QEC has had minimal engagement with the Community Forensic Mental Health Service (CFMHS) in the last couple of years, "other than to accommodate ad hoc reviews and accept liaison with Legal Aid representatives."
3. Dr WK stated she has not had opportunity to meet with QEC, despite numerous attempts to do so. Dr WK noted QEC has some continuity of engagement with her general practitioner, whom she attends periodically for her physical health. QEC also has some minimal contact with her case manager UX.

Section 35(1) (a) - the nature of the defendant's mental impairment or other condition or disability

1. At hearing, Dr WK stated QEC has a mild intellectual disability. She has a complex trauma history and some anxiety and panic attacks, but no major diagnosis of mental illness.
2. In her report Dr WK stated:

[QEC] has a long history of emotional dysregulation and behaviour disturbance characterised by interpersonal conflict and impaired problem-solving. She has previously reported anxiety and panic symptoms. She does not have major mental illness and is not prescribed psychiatric medication.

3. At hearing Dr WK confirmed QEC's intellectual functioning has been previously assessed as mild and noted that QEC was "assessed regarding seizures of unknown cause but disengaged from specialist medical follow-up."
4. Based on the medical evidence before us, we find QEC has a disability, which is a mild intellectual disability.

Section 35(1)(b) whether the defendant is, or would if released be, likely to endanger another person or other persons generally.

1. Dr WK stated there is nothing to suggest that QEC is likely to endanger another person or person generally. She considered the risk of her doing so is low and noted QEC has not offended since the index offence. Dr WK noted QEC has no contact with her brother.
2. Dr WK indicated in the past alcohol use has been a long-standing problem and correlated with increased risk of QEC's offending. Dr WK stated QEC has not been observed to be intoxicated for several years and there is no evidence that QEC has come to the attention of Tasmania Police or the community. In her report Dr WK states:

We are reassured that [QEC] has avoided police contact for several years and there has been no report of disruptive or otherwise concerning behaviour related to intoxication.

3. UX stated that QEC has weathered personal stressors over the last 12 years including the death of a partner and has managed these stressful events appropriately. UX indicated QEC is well supported by her mother, and her current partner.
4. Based on the evidence before us, we are satisfied that QEC, if released from the supervision order, is not likely to endanger another person or other persons generally.

Section 35(1)(c) - whether there are adequate resources available for the treatment and support

1. In her report Dr WK stated that QEC had been under the supervision of the CFMHS for the last 12 years. Dr WK stated the CFMHS has adequate resources available to treat and support QEC, however the issue is that QEC is not prepared to engage with CFMHS, except occasionally. Dr WK noted that given QEC's lack of engagement and the fact she is reasonably self-sufficient, the CFMHS is limited in what it can do.
2. Further, Dr WK stated that as QEC does not have a mental illness, she does not require treatment from the CFMHS.
3. Dr WK opined that QEC's support needs would be more meaningfully met by community disability services and indicated an attempt had been made to get funding for supports under the National Disability Insurance Scheme (NDIS), but this was not successful. We heard QEC is now content to be independent of support services.
4. Dr WK indicated that the supervision order allows for the ability to detain QEC at an approved facility under the Mental Health Act (2013) but there is little to no prospect of this needing to occur.
5. We are satisfied there are adequate resources available for the treatment and support of QEC by CFMHS however it is QEC's wish not to engage. Further, we take into account Dr WK's opinion, that:

Essentially there is nothing that CFMHS can offer to further optimise her recovery and our involvement in her care is nominal.

6. We also note that QEC is willing to receive treatment and support from her general practitioner, whom she attends periodically.

Section 35(1)(d) - whether the defendant is likely to comply with the conditions of a supervision order;

1. Dr WK opined that it was expected that QEC would comply with the conditions of the supervision order in a similar way in which she had over the last 12 years and that ongoing limited contact would be had with the CFMHS, that is primarily ad hoc contact with her case manager.
2. UX indicated that QEC has told her she wants to avoid further conflict and recognises that the avoidance of conflict is important. We are satisfied QEC has not initiated contact with her brother; appears to be keeping the peace and has not come to the attention of police and "is getting on with her life".
3. We find QEC is complying with the conditions of the supervision order, albeit, having minimal engagement with CFMHS.

Section 35(1)(e) - Other matters the Court thinks relevant

1. Dr WK's recommendation is that QEC be discharged from the supervision order. We note this would be the least restrictive of QEC's freedom and personal autonomy. We further note Dr WK states:

For many years the Supervision Order has had negligible utility with respect to [QEC's] clinical and risk management.

2. We have been told it is QEC's consistent expressed wish for the supervision order to be revoked, and if a certificate is issued by the Tribunal, it is QEC's intention to get legal representation to pursue this matter in the Supreme Court.

1. Applying the principle in s 34 of the Act and having regard to the matters in s 35(1)(a) - (e) inclusive of the Act, the Tribunal is satisfied on the evidence that the supervision order is no longer warranted and issues a certificate. The Tribunal recommends should the supervision order be revoked, QEC be released unconditionally.