Mental Health Stream - Review of supervision order - Supervision order no longer warranted - revocation of supervision order - Issue a certificate to apply to the Supreme Court of Tasmania to have the supervision order revoked.

Criminal Justice (Mental Impairment) Act 1999 (Tas); ss 21, 29A, 34, 35 and 37;

The decision has been anonymised for the purpose of publication

1. QKC is a 53-year-old man who resides in southern Tasmania. QKC has been subject to a supervision order since 2022 and has a diagnosis of schizophrenia, made over 20 years ago.
2. The index offending, which occurred on 4 November 2020, resulted in QKC being charged with eight counts of unlawfully injuring property, two counts of attempted carjacking and one count of dangerous driving contrary to ss 172A, 240 and 273 of the Criminal Code Act 1924 (the Code). On 18 November 2021, a jury found QKC not guilty by reason of insanity with respect to all charges.
3. On 11 February 2022 in the Supreme Court of Tasmania, the Honourable Wood J imposed the following supervision order for QKC pursuant to s 21(1) of the Criminal Justice (Mental Impairment) Act 1999 (the Act):

That you be subject to a supervision order pursuant to s29A of the Criminal Justice (Mental Impairment) Act 1999. > > You are released under the supervision of the Chief Forensic Psychiatrist on the following conditions:

4. You must comply with any directions as to supervision given by the Chief Forensic Psychiatrist or his or her delegate;
5. You must take medication and submit to the administration of medical, psychological or psychiatric treatment as determined by the Chief Forensic Psychiatrist or his delegate.
6. You must comply with directions of the Chief Forensic Psychiatrist or his or her delegate to address drug use, drug and alcohol counselling and treatment with services such as Alcohol and Drug Services, directions to comply with drug screen testing (including providing urine samples) in order to monitor your illicit substance use, and other counselling such as grief counselling.
7. You must not drive under any circumstances, for an indefinite period, subject to an order of the Supreme Court.
8. Since the initial imposition of the supervision order, the Tribunal has reviewed the supervision order on three occasions being 25 January 2023, 21 January 2024 and 14 January 2025. At the conclusion of first two hearings, the Tribunal determined that the supervision order was still warranted, and the conditions remained appropriate.
9. At the hearing conducted on 14 January 2025, the Tribunal determined that the supervision order was no longer warranted, and recommended the order be revoked and the defendant be released unconditionally.
10. The matter was listed for a review of supervision order hearing on 7 January 2026 and was conducted in the TASCAT hearing rooms in Hobart. Dr WK and case manager, BC attended by video link.
11. QKC did not attend the hearing. He was represented by counsel Ms Phillipa Jones of Tasmania Legal Aid. The Tribunal had before it a report from Dr WK and BC outlining QKC's diagnosis, originating offence, clinical update and recommendation in relation to the status of the supervision order. Ms Jones did not submit any written material.

1. The authority for the Tribunal to review a supervision order is found in s 37 of 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 principle in section 34 and have regard 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 conditionally or on the conditions specified in the recommendation. > > (5) If the Tribunal issues a certificate in respect of the revocation of a supervision 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.

2. In determining proceedings under Div 6 of the Act, the Tribunal is to apply the principle set out in s 34, namely that restrictions on the defendant's freedom and personal autonomy should be kept to the minimum consistent with the safety of the community. The Tribunal must also 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 recourses 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 court thinks relevant.

1. Within the clinical report received by the Tribunal on 19 December 2025, Dr WK outlined the following:
   1. [QKC's] mental health has been stable over the past year, with no positive symptoms consistent with his past history of illness (i.e., delusions, hallucinations or passivity experiences). He has chronic negative symptoms of schizophrenia (mainly poverty of ideas, affective blunting, lack of motivation, social isolation) and likely cognitive symptoms (i.e., impaired memory and learning).
   2. [QKC] is currently prescribed antipsychotic medication administered by long-acting injection (paliperidone 100mg/month). He reliably attends for his antipsychotic medication administration. He is also prescribed opioid substitution therapy (Buvidal 96 mg) through ADS [Alcohol and Drug Service] and has engaged well with their team.
   3. Over the past 12 months [QKC] has transitioned a change of case manager from [UX] to [BC]. He has remained consistently engaged throughout and has shown the ability to form a collaborative therapeutic relationship with his new clinician. [QKC] has also been supported by [SC] (clinical psychologist) through quarterly appointments. His participation remains amiable but superficial, with negative symptoms identified as the primary impediment to more intensive psychological therapy. That is, [QKC] rarely engages beyond agreeable monosyllabic responses.
   4. [QKC's] attitude to services has been positive. He has expressed his appreciation of the externally supported structure afforded by his case management. He responds well to highly consistent routines, attending his appointments at the same day and time. Occasionally he runs late or requires a reminder but has not expressed or demonstrated any opposition to engagement since his engagement with CFMHS [Community Forensic Mental Health Service] commenced.
   5. [QKC] has not expressed any negative attitude to the SO. He has opined that the supports provided by CFMHS provide helpful structure and reassurance. He has expressed concerns that without these supports his mental health would likely deteriorate.
   6. [QKC] returned a single positive urinary drug screen on 5 February 2025. He has consistently told CFMHS that has not knowingly use [sic] methamphetamine for at least two years and has not been observed at any point in the past year to be drug affected. Given his historical candour about substance use, it is plausible that he has unknowingly smoked methamphetamine given to him by associates in the community. He gives an increasingly sophisticated explanation of how methamphetamine impacts his mental health and worsens his illness and has expressed growing determination to remain abstinent from methamphetamine use.
   7. He has been accepting of psychoeducation regarding the hazards of smoking cigarettes given to him without knowing their contents. He acknowledges the detrimental impact of methamphetamine on his mental state and has consistently expressed his intention to sustain abstinence.
   8. In the absence of a Supervision Order, [QKC] is likely to remain engaged with CFMHS, given his expressed satisfaction with the service. Concerns which might arise in such an event include the risk of relapse into drug use, which will remain a chronic risk given his history and recent positive UDS [urine drug screen] and have historically been a key factor associated with his psychotic relapse. That said, that is the longest period of confirmed (i.e., biochemical screening) abstinence since my care of [QKC] commenced, and I consider that his likelihood of relapse diminishes as he becomes more adapted to a life free from drug use.
   9. Were [QKC's] Supervision Order to be revoked, he would remain under the care of CFMHS until adequate support in an alternative service, either primary care or civil mental health service is established. Furthermore, endeavours to secure some sort of NDIS support of his health care continue. The absence of NDIS support is not considered an impediment to [QKC's] recovery or suitability for SO revocation, as he has demonstrated a consistent alliance with mental health services, independent of any external support, and consistently expresses his intention to continue this engagement for the foreseeable future.
   10. The Supervision Order currently adds little clinical benefit to [QKC's] management. His illness is in a stable state of remission and in the absence of illicit substance use, he is anticipated to remain in remission for the foreseeable future.
   11. Following consultation with the MDT [multidisciplinary team], CFMHS remain unanimously agreed that the provisions of the SO are excessively restrictive given [QKC's] level of compliance and available alternatives. CFMHS respectfully recommends that [QKC] transitions to voluntary treatment with ongoing case management from our team and psychological input with a focus on psychoeducation and social integration.

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

1. In conjunction with her written evidence, Dr WK gave evidence at the hearing confirming that she has been QKC's treating psychiatrist since 8 February 2024 and last reviewed him on 18 December 2025.
2. Dr WK told the Tribunal QKC, diagnosed with schizophrenia, had "a great 12 months" since last review and that he continues to engage consistently with the Community Forensic Mental Health Service, attends all appointments, complies with all recommendations and requests made of him including urine drug screening, taking medication and presenting for clinical reviews.
3. There had been no clinical indication of relapse of illness in the review period.
4. The Tribunal accepts both the oral and written expert evidence that QKC has a well-established diagnosis of schizophrenia and that his mental illness is currently being well managed.

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

1. At the hearing, Dr WK gave evidence that QKC is drug free and psychologically well. Dr WK said that QKC had a greater recognition of his mental illness and the relationship particularly of methamphetamine use to his illness and that he clearly identifies that the use of methamphetamines precipitates relapse of his symptoms.
2. Dr WK told the Tribunal that QKC can list his symptoms of psychosis and that he has a good relationship with his case manager. Dr WK reiterated that QKC was compliant with his supervision order and that the order was not enhancing his access to care or reducing his risk in any discernible way.
3. Dr WK gave evidence that should QKC come off the supervision order and be a voluntary patient he had the capacity to make decisions about his treatment and wider lifestyle and physical health. Dr WK said that, should a certificate be granted to recommend the supervision order be revoked, and the order was indeed revoked, the plan was for the treating team to continue working with QKC in his voluntary capacity to gradually put things in place to graduate his eventual transition to primary care, independence and autonomy.
4. When addressing whether the QKC would, if released be, likely to endanger another person or other person generally, Dr WK evidence was that QKC's risk of relapse and risk of criminal offending is almost always contingent on his use of drugs. QKC's abstinence from drugs is the key factor that will impact his health and also his vulnerability to offending. Dr WK indicated that QKC is not using illicit substances and that his mental health was stable. Relevantly, as noted in [15] above, Dr WK said that QKC had greater recognition of the relationship between illicit drug use and relapse.
5. The Tribunal accepted the evidence of Dr WK and is satisfied that, if released from the order, QKC is not likely to endanger another person or persons generally.

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

1. QKC remains residing in private accommodation that has caused some concern for the treating team. He lives with a lady who takes care of him, but she does not have a formal carer role. At times there have been concerns that there may be some financial unfairness or exploitation through this relationship. The treating team have actively assisted QKC to assertively find alternate accommodation, but he has explicitly declined as he is satisfied with his current circumstances and does not want to be relocated into supported living. QKC has told the treating team he feels safe in his current accommodation.
2. Dr WK told the Tribunal that in applying the principles of the recovery model they will support QKC in his decision to stay in his accommodation and the team are proactively considering how best to support QKC as he progresses to possibly not being under the supervision order and to support him to ultimately disengage from the forensic service to be managed by primary care. Dr WK told the Tribunal that this plan may involve other services such as NDIS in the future to support QKC's access to care.
3. Dr WK told the Tribunal that QKC attends a general practitioner in the community who supports QKC with his general medical care. Dr WK said the core constituents that are required to allow QKC to live autonomously are currently in place.
4. The Tribunal accepts Dr WK's evidence and finds there are adequate resources allocated to QKC for his treatment and support in the community.

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

1. This criterion may only be relevant where the Tribunal is considering the suitability of a supervision order as an option over another type of order, such as a restriction order. Notwithstanding that, the Tribunal did have regard to the likelihood of compliance with a supervision order and noted the following evidence of Dr WK:
   1. The treating team were not aware of any breach of conditions of the supervision order save for early 2025 when QKC returned a positive drug screen. This was addressed by Dr WK in her report and summarised at 10(f) above. Dr WK said the team were accepting of QKC's explanation because in the past if he had used substances he would disclose this quite openly to the treating team.
   2. Dr WK told the Tribunal that QKC had not presented as intoxicated at either appointments at the clinic or at ad hoc reviews. For the remainder of 2025 all of QKC's urinary drug screens returned as negative.
2. QKC's case manager BC told the Tribunal that QKC comes into the service weekly for assessment. Over the last 12 months there had been more disruption at his accommodation than previous years but with assistance QKC has been able to resolve the household issues that have arisen during the review period.
3. On the evidence before the Tribunal, we are satisfied that QKC has complied with the conditions of the supervision order throughout this review period.

Section 35(1)(e) - other matters the court thinks relevant

1. In considering the principle in s 34 of the Act, the Tribunal is to apply the principle that the restrictions on QKC's freedom and personal autonomy should be kept to the minimum consistent with the safety of the community.
2. It was Dr WK's evidence that the supervision order no longer has a role to play in the management of QKC as he is willing to do everything the order requires of him.
3. Ms Jones acting for QKC submitted that the Tribunal can be satisfied that it is appropriate that the supervision order is no longer warranted and should make a recommendation that it be revoked.
4. Ms Jones submitted that QKC's mental health is stable, and he is living a life that is meaningful to him, he has his daily routine and has accommodation where he would like to remain. Ms Jones said QKC has demonstrated that if any problems arise at his accommodation he presents to the treating team for support for problem solving these situations.
5. Ms Jones submitted further that QKC is compliant with the order and has a good relationship with the treating team.
6. In making its determination the Tribunal must consider s 34, that is any restrictions on QKC's freedom and personal autonomy are limited to no more than what is absolutely necessary to ensure community safety.
7. Dr WK made it very clear in her evidence that the supervision order added little clinical benefit for QKC. On the evidence, QKC has told the treating team he understood the link between illicit substance use and a relapse of his mental illness. QKC's mental illness is now in a state of remission, and he is now abstinent from using illicit substances.
8. It was also the view of the multidisciplinary team of the CFMHS that the provisions of the supervision order are excessively restrictive given QKC's level of compliance and available alternatives.

1. It is Dr WK expert opinion that QKC's mental state is stable and his mental illness is in remission. QKC has demonstrated compliance with treatment and compliance of the conditions of the supervision order over the past year.
2. The Tribunal is satisfied, on the evidence, that in the absence of a supervision order QKC will continue to be agreeable to treatment from the Community Forensic Mental Health Service and Drug and Alcohol Services and that QKC is motivated to remain abstinent from illicit substances.
3. The Tribunal placed weight on the evidence of the treating team and their support for revocation of the supervision order as, in their opinion, the order is excessively restrictive and does not add any clinical benefit given QKC's level of compliance.
4. The Tribunal had determined that the supervision order is no longer warranted, and a certificate should be issued in respect of the order and the defendant be released unconditionally.