R v Cummings

Catchwords: CRIMINAL LAW – murder – defence of mental illness – accused suffering from schizophrenia, substance use disorder and post-traumatic stress disorder – expert evidence unanimous that accused was suffering from mental illness at the time of the acts – expert evidence unanimous that accused could not reason with a moderate degree of sense and composure about whether her acts, as perceived by reasonable people, were wrong – special verdict of not guilty by reason of mental illness

Legislation Cited: Criminal Procedure Act 1986 (NSW)
Mental Health Act 2007 (NSW)
Mental Health and Cognitive Impairment Forensic Provisions Act 2020 (NSW)

Category: Principal judgment

Parties: Rex (Crown)
Lisa Marie Cummings (Accused)

Representation: Counsel:
S Oliver (Crown)
J Watts (Accused)
Solicitors:
Office of the Director of Public Prosecutions (Crown)
Legal Aid NSW (Accused)

File Number(s): 2024/00313031

Publication restriction: No

JUDGMENT

1. On 24 June 2025 Lisa Marie Cummings was committed from the Local Court at Coffs Harbour to this Court on a charge that on 22 August 2024 at Nambucca Heads she did murder Mark Anthony Myers. On 1 August 2025 the accused was arraigned before Hamill J and pleaded not guilty. On 3 October 2025, with the consent of both the Crown and the accused, his Honour ordered pursuant to s 132(1) of the Criminal Procedure Act 1986 (NSW) that the accused be tried by judge alone.

2. The trial was listed before me on 20 November 2025 at Coffs Harbour. The accused through her legal representatives indicated from the first mention of the charge in this Court that she did not deny having caused the death of the deceased but would contend that at the time she was relevantly affected by a mental health impairment within the meaning of s 4 of the Mental Health and Cognitive Impairment Forensic Provisions Act 2020 (NSW) (Mental Health Forensic Provisions Act) and that she was not criminally responsible for the homicide by the operation of s 28 of that Act.

Mental impairment defence

3. Sections 4 and 28 provide as follows, so far as relevant to this case:

4 Mental health impairment

(1) For the purposes of this Act, a person has a mental health impairment if—

(a) the person has a temporary or ongoing disturbance of thought, mood, volition, perception or memory, and

(b) the disturbance would be regarded as significant for clinical diagnostic purposes, and

(c) the disturbance impairs the emotional wellbeing, judgment or behaviour of the person.

(2) A mental health impairment may arise from any of the following disorders but may also arise for other reasons—

[…]

(c) a psychotic disorder

(3) A person does not have a mental health impairment for the purposes of this Act if the person’s impairment is caused solely by—

(a) the temporary effect of ingesting a substance, or

(b) a substance use disorder.

28 Defence of mental health impairment or cognitive impairment

(1) A person is not criminally responsible for an offence if, at the time of carrying out the act constituting the offence, the person had a mental health impairment […] that had the effect that the person—

(a) did not know the nature and quality of the act, or

(b) did not know that the act was wrong (that is, the person could not reason with a moderate degree of sense and composure about whether the act, as perceived by reasonable people, was wrong).

(2) The question of whether a defendant had a mental health impairment […] that had that effect is a question of fact and is to be determined by the jury on the balance of probabilities.

(3) Until the contrary is proved, it is presumed that a defendant did not have a mental health impairment […] that had that effect.

(4) In this Part, act includes—

(a) an omission, and

(b) a series of acts or omissions.

4. This being a judge alone trial, the question of fact arising under s 28 is to be determined by me on the balance of probabilities. The accused’s reliance upon s 28 arises from a report of Dr Andrew Ellis, psychiatrist, furnished to the accused’s solicitor on 11 May 2025.

5. Section 31 of the Mental Health Forensic Provisions Act is as follows:

31 Special verdict where defendant and prosecutor agree on impairment

The court may enter a special verdict of act proven but not criminally responsible at any time in the proceedings (including before the jury is empanelled) if—

(a) the defendant and the prosecutor agree that the proposed evidence in the proceedings establishes a defence of mental health impairment or cognitive impairment, and

(b) the defendant is represented by an Australian legal practitioner, and

(c) the court, after considering that evidence, is satisfied that the defence is so established.

6. The Crown arranged for the accused to be examined by Dr Kerri Eagle, psychiatrist, and obtained a report from her dated 4 September 2025. On the basis of the two expert reports, the accused and the Crown agreed, prior to trial, that the proposed evidence would establish a defence of mental health impairment. Paragraph (a) of the prerequisites in s 31 of the Act for a verdict of “proven but not criminally responsible” is therefore satisfied. Paragraph (b) is also satisfied as the accused has been represented by Mr Watts of counsel throughout the proceedings

7. As a result of the common ground between the parties, the trial has proceeded in a very abbreviated form. The Crown dispensed with an opening address and instead referred the Court to the Crown Case Statement dated 21 July 2025. The Crown tendered a Statement of Agreed Facts dated 4 November 2025, signed by the accused, by her counsel and by counsel for the Crown. The facts set out in that document substantiate the allegations in the Crown Case Statement. The Crown then tendered the report of Dr Eagle, whom the accused did not require for cross-examination. The Crown closed its case and the accused tendered the report of Dr Ellis. He was not required for cross-examination by the Crown. The Court received brief written submissions from Crown counsel in lieu of a closing address. Counsel for the accused likewise provided written submissions in closing.

Statement of Agreed Facts

8. Where the agreed facts incorporate assertions made by the accused about conduct of the deceased, I accept the fact that she made the relevant statements but do not make findings about the deceased’s actual conduct. The accused assertions about the deceased are evidence of her schizophrenic delusional perceptions rather than reliable claims about his behaviour and actions. Subject to that qualification, relying upon the statement of agreed facts I am satisfied beyond reasonable doubt of the following matters.

9. The accused was born 22 July 1989 and was aged 35 years in August 2024. Mark Anthony Myers was born 21 December 1961 and was aged 62 years at that time. He owned and occupied a dwelling house 14 Loftus Street, Nambucca Heads. Around July 2024, the accused moved into that address as a housemate.

10. On Thursday, 22 August 2024, at about 6.50 pm the body of the deceased was found in the driveway of a rural property at Darkwood, a locality on the Bellinger River, about 70 km north-west of Nambucca Heads via Bellingen. The body was wrapped in blankets, with electrical cord wound around the blankets, a purple towel also wrapped around the body, a yellow plastic bag over the deceased’s head and a surfboard bag enclosing the whole. One of the three men who came across the body, Mark Perkins, had previously resided at the Darkwood property where the body was found.

11. When police, including crime scene officers, were called to the location they observed that the deceased had sustained a laceration to the throat. A kitchen knife was protruding from his upper abdomen just below the rib cage with only the handle of the knife visible. Fingerprints taken from the body enabled police to identify it as that of Mark Anthony Myers whose address was ascertained to be 14 Loftus Street, Nambucca Heads.

12. At 2:00 pm the next afternoon, Friday 23 August 2024, police attended that address. The accused was the only person there. After the accused had initially stated that Mark Myers left "with a couple of blokes last night", she was informed that his body had been found and that his house was now a crime scene. The accused then volunteered to the detectives: "I did it. I killed him”. She was arrested and cautioned. She then said the following, as recorded on body worn video:

I went downstairs and got a cord and I put it over his neck and I strangled him. I dragged him off the lounge, towards the kitchen and I stabbed him. Then I wrapped the body, put into a surfboard cover and dragged him downstairs and put him in the car and drove it out to Darkwood. And the reason why I did that is cause this guy that lives out there, Mark Perkins, raped me and his name's, name’s Mark and I just had a massive meltdown and freaked out.

The accused went on to say that Mark Perkins had been her partner for 4 years during which time he had assaulted her and that a previous partner named Peter had also assaulted her.

13. The accused was taken to Macksville Police Station and entered into custody. She obtained legal advice before participating in an electronically recorded interview, in which she gave an account of events leading up to the homicide. Her account was interspersed with assertions that appeared to indicate a paranoid delusional state of mind. In summary, the accused gave answers to the following effect under police questioning:

(a) She met the deceased about a year previously. About a month or two prior to August 2024 she ran into him again and told him she was looking for a place to live. He offered for her to live with him as a paying housemate. She accepted and moved in immediately. (b) The accused told the deceased that her previous partner was Mark Perkins. The deceased said he knew Perkins and that he was previously "in the underbelly”. (c) She and the deceased started consuming "ice" together and she felt obligated, being under his roof, to engage in sexual acts with him, at his instigation. (d) In the days before she killed the deceased, he took her to see one of his friends named "Glenno" whom the deceased referred to as being "in the underbelly”. She said that the deceased on that occasion "basically told me quite a few things about ... all these murders and stuff like that and ... certain girls that he had come and do what he wants and stuff". (e) After that the accused asked her father if she could return to his house and he said no. She said she "felt trapped...and dad had no room for me, which meant I had nowhere to live, and walls were closing on me". (f) After she had moved into the deceased’s house he broke the door to the bathroom and hung a doona cover up in its place. She believed he broke the door so he could watch her in the shower. (g) On the afternoon of 22 August 2024 the deceased was seated in the loungeroom and playing with his penis on the outside of his clothing. This made her feel "uncomfortable". She said she “didn't even agree to that. But it was like ... I felt like I had to 'cause he was already doing that .., it felt like an ownership thing in the moment ...". She said "I just felt like what Mark Perkins had done to me". (h) She went to have a shower and whilst in the shower she decided to kill the deceased, motivated by past trauma and because she felt she was trapped. She said it was a "survival" thing.

14. The accused told police that, after her shower, she killed the deceased by strangulation and stabbing, describing those events in the same terms as were recorded on body worn video when she spoke to police at the time of her arrest. She said she was naked throughout the killing of the deceased and she described her actions as "kill or be killed". During the electronically recorded interview the accused repeated her description of having wrapped the body and placed it in the boot of the deceased’s car.

15. The accused’s further answers during the interview described her disposal of the body, as follows:

(a) She drove to a caravan park, borrowed $20 from a friend and proceeded to a petrol station to buy fuel. She then drove up the highway, stopped at another petrol station to buy refreshment and then made a further stop to see a friend at Raleigh, 28 km north of Nambucca Heads. She did not discuss with her friend what had occurred. (b) The accused then drove directly to Darkwood where she dumped the body, after which she quickly drove away back towards Nambucca Heads. She chose the property at Darkwood because she thought Mark Perkins lived there and "maybe subconsciously" to get the police to help her "link what's happened”. (c) While driving home, she thought at one point she was being chased by Mark Perkins, so she pulled into a driveway before continuing. (d) She was glad she did what she did as she hoped it would identify Mark Perkins, her friend at Raleigh, her previous intimate partner and others as being involved in drug supply, abduction and murder. (e) When she returned to 14 Loftus Street, she started cleaning up at the house. She washed a blanket and clothes that were associated with the killing and the removal of the body. (f) She last used methamphetamine (half a point) about an hour before killing the deceased but she only used it once a fortnight.

16. When asked "have you ever been diagnosed for any mental health issues?" she responded that she had been "picked up a few times in a delirious way (and) unfortunately I got taken then to the psych ward", adding that this was due to being drugged by Mark Perkins. Medical records for the accused from Coffs Harbour Mental Health Services show that she was detained under the Mental Health Act 2007 (NSW) at Coffs Harbour Hospital on seven separate occasions between February 2018 and September 2023. When she was last reviewed in September 2023 a diagnosis of schizophrenia was recorded as “active”.

17. Subsequent investigations by police confirmed that on 22 August 2024 at about 4:10 pm, the accused drove to the BP Roadhouse, Nambucca Heads where she made a fuel purchase. The staff member there said the accused was displaying erratic behaviour and movements and showing signs of being drug-affected or being mentally ill. Her friend at Raleigh confirmed that she came to his workshop at around 4:00 pm and obtained a cigarette. He described the accused as not being her normal self. She seemed very serious and hurried.

18. On the day following the homicide, 23 August 2024, the accused attended Anytime Fitness at Nambucca Heads and engaged in exercise at 10:00 am and again at 1.02 pm.

Forensic evidence and post-mortem examination results

19. After forensic examination of several items, DNA of the accused was developed from the following locations:

The electrical cord wrapped around the deceased’s body.

The top side of the knife handle that was protruding from the body.

The carry handle of the surfboard bag.

The exposed end of the purple towel wrapped around the body.

The end of the purple towel from under the surfboard bag.

20. A post-mortem examination of the deceased’s body established that the cause of death was stab wounds, in the context of neck compression. There were clear signs of ligature strangulation consistent with the accused’s description, including severe congestion of the upper half of the neck, face and head with a large number of associated petechial haemorrhages in the facial structures. The congestion in the neck was circumferential with a line of demarcation. An abrasion corresponded to the grey electrical cord. There were full-thickness contusions to the strap muscles of the neck. The larynx was significantly injured with fractures of the hyoid bone, suspected fractures of the right and left side of the thyroid cartilage and a displaced acute fracture of the cricoid cartilage. The base of the tongue showed a large number of contusions deep into the muscle.

21. The examination revealed three stab wounds. The first was to the left lower chest which passed through the left ventricle of the heart and into the lower left lobe of the lung. The second stab wound was to the left upper abdomen, just below the rib cage, within which a kitchen knife was still embedded up to the handle. The knife blade was 205 mm long and 40 mm wide. The wound track passed into the abdominal cavity, through the diaphragm and pericardium and into the right lower lung. The third stab wound was on the left side of the neck just below the angle of the jaw passing through the left jugular vein and ending at the C4 vertebra. This knife thrust left a sharp force injury to the bony projection of the vertebra and left vertebral artery.

22. From the agreed facts that I have summarised to this point, I am satisfied beyond reasonable doubt that the accused caused the death of the deceased by deliberate acts of strangulation and stabbing.

The accused’s personal background and psychiatric history

23. Consideration of whether the accused was mentally impaired at the time of the homicide must commence with a brief outline of her history as obtained by Drs Ellis and Eagle. Parts of that history were supplied by the accused herself during the doctors’ respective examinations of her, by Dr Ellis on 15 April 2025 and by Dr Eagle on 7 August 2025. She recounted to each doctor, in similar terms, events relevant to the emergence of psychiatric symptoms. What she told the doctors by way of personal background was generally consistent with statements obtained by police from her father and mother. There is no reason to doubt the accused’s personal and psychiatric history to the extent she was able to relate it.

24. Dr Ellis reviewed medical records of her presentations and treatment at Macksville and Coffs Harbour Hospitals between February 2018 and September 2023. Both doctors reviewed Justice Health records of her presentation and treatment in custody since 23 August 2024. I accept the accuracy of the doctors’ summaries of the records and the veracity of the observations and events set out in those records.

25. From the above-mentioned sources it is established that the accused grew up in the Nambucca Heads area. Her parents separated when she was two and from then she was raised by her mother. She attended school to the age of 16 and completed year 11. The accused commenced working while she was still at school and left in order to pursue employment. She left home at 17.

26. From the age of 18 the accused was in an intimate relationship for about five years with a man named Peter who was six years her senior. Peter was seriously violent towards the accused and introduced her to methylamphetamine. She commenced to use that drug from about age 21, in 2010. The relationship with Peter ended in about 2013 when she was 24.

27. The accused worked as a landscape gardener in her mid-twenties. She commenced a relationship with Mark Perkins in about 2015, at the age of approximately 26 years. He was a drug dealer and he introduced her to injectable methylamphetamine. During the approximately four years of the relationship Mark Perkins, also, was physically abusive. The accused believed he had raped her. The relationship ended in about 2020 when the accused was 31. She had one further serious relationship, for about 12 months, with a man who died as a result of a stroke while the relationship was ongoing.

28. In February 2018 the accused presented to Macksville Emergency Department accompanied by her then partner Mark Perkins, who described symptoms of “talking crazy”, expressing paranoid thoughts about people, hitting her head in the car and behaving irrationally. The accused admitted to using crystal methamphetamine. A likely diagnosis of drug induced psychosis was recorded. The accused was administered olanzapine (antipsychotic) and diazepam (sedative) and later discharged

29. In March 2018 and again May 2019 the accused was detained under the Mental Health Act 2007 (NSW) at Coffs Harbour Mental Health Unit. Subsequently, on 27 November 2019, she was diagnosed with schizophrenia. At that time she was treated in the community with antipsychotic medication and was not admitted to hospital as an involuntary patient.

30. In April 2020 the accused was admitted to Coffs Harbour Mental Health Unit for four days. She was considered to have suffered a relapse of schizophrenia in the context of non-compliance with medication and misuse of cannabis. Her symptoms were alleviated with antipsychotic medication.

31. On 3 May 2021 the accused came to the attention of police when behaving erratically and running into traffic. She was taken by police to Coffs Harbour Mental Health Unit but was discharged after assessment. Similar conduct on 24 May 2021 again caused police to take the accused to the Mental Health Unit. She displayed thought disorder with persecutory and paranoid delusions, including an expression of belief that police were chasing her because she was in possession of a USB containing evidence that tended to incriminate them.

32. In June 2023 the accused broke into a private house and was found there having a shower. Upon the attendance of ambulance officers she expressed the delusional belief that one of them was her mother. She was observed responding to auditory hallucinations and purporting to talk to God. The accused tested positive to methylamphetamine. An injection of strong sedative was necessary to enable her to be transferred to Coffs Harbour Hospital, where she was treated with oral antipsychotic medication. On this occasion the accused remained an involuntary patient for at least 16 days.

The accused’s description of psychiatric symptoms since her mid-20s

33. On examination by Dr Ellis on 15 April 2025 the accused gave the following description of her mental state experiences since her mid-20s. Her report of symptoms is consistent with the record of her hospitalisations and treatment and it supports the longstanding diagnosis of schizophrenia.

34. First, she described to Dr Ellis auditory hallucinations. Over the preceding six years she was “hearing a voice” on most days for about 50% of the day. The voice would give mundane commands concerning her everyday activities but would also make derogatory and abusive comments. The accused was frightened by the voice. Secondly, the accused described ideas of reference. She believed things were being communicated by the television concerning herself and her family. Thirdly, the accused described paranoid beliefs, such as a belief that people and cars were following her. The accused told Dr Ellis that the incidence of these three types of mental experiences was increased by her use of methylamphetamine. Fourthly, the accused reported intrusive memories, anxieties and nightmares relating to traumatic events earlier in her life.

35. The accused told Dr Eagle that for years she could not tell the difference between voices she heard and real voices. She said she commenced hearing voices in the period between her two long relationships, which was in about her mid-20s, and that they were “really bad” when she used illicit substances.

The accused’s account of psychosis at the date of the homicide

36. The accused told Dr Ellis that she was not taking any psychiatric medication at the time of the homicide but was smoking about 0.5 g of crystal methyl-amphetamine daily. She described to both Dr Ellis and Dr Eagle specific manifestations of her psychotic symptoms immediately proximate to her killing the deceased. She said she believed the deceased was selling drugs to both of her ex-partners, Peter and Mark Perkins, and that the three of them would arrange to drug and rape her (paranoid beliefs). The voice told her throughout the day that she would be killed and that “if you don’t kill him, he will kill you” (auditory hallucinations). She saw a program on television called “Kill or be killed” and thought this was further evidence that the deceased was trying to rape and kill her (ideas of reference). Eventually, on 22 August 2024 the voice told her specifically to take an extension cord and strangle the deceased, which she did.

37. The accused gave Dr Eagle a very similar account of auditory hallucinations from the night before the homicide. She said the voice was telling her that the deceased and others “were going to rape and kill” her and that she must “kill or be killed”. She was also affected by referential ideas, believing that the television was giving her the same message. The accused told Dr Eagle that she chose the place where she left the deceased’s body because she believed Mark Perkins lived there and she was “trying to get the cops to go there so they knew why – they were trying to hurt me”.

38. Both Dr Ellis and Dr Eagle reviewed the electronically recorded police interview with the accused, conducted on 23 August 2024. They found that her longer answers displayed disorganisation of speech and of thought, albeit she was able to describe her actions of killing the deceased and moving his body. During the interview she frequently expressed fears that she would be raped by the deceased and other men. Dr Eagle noted that during the interview the accused did not appear to be responding to unseen stimuli, or distracted. She was able to converse logically with the police about routine matters and identify her movements for them, on a map. However, she described persecutory ideas and beliefs that others were involved in the conspiracy to rape and kill her.

The accused’s mental state since arrest

39. In the days immediately after arrest the accused acknowledged drug misuse but denied any mental health problems or symptoms. Over the next month, while review by a mental health nurse was pending, her behaviour demonstrated psychiatric disorder. On 23 September 2024 she was noted to be irritable and suspicious, expressing intricate beliefs of being followed and being set up with harm coming for her. She had ongoing delusional beliefs of being targeted by an “underbelly” community and was fearful for her life, believing she had found a chip with highly classified information and she was being set up on the murder charge and targeted. In early October 2024 she was floridly psychotic with no insight and was refusing to take the olanzapine that was prescribed for her.

40. Dr Eagle’s review of Justice Health records showed that on 22 October 2024, after two months on remand at Silverwater Women’s Correctional Centre, a psychiatry registrar reported to the Mental Health Review Tribunal as follows:

[She has] an established diagnosis of schizophrenia, evidenced by serious thought disorder characterised by tangential thoughts. She was delusional believing she was involved with “underbelly” characters and could not talk about this. Ms Cummings had mood disturbances characterised by irritability and low threshold for intrusion. She is guarded and suspicious in her presentation and characterised by refusing to answer questions. [She is] sexually disinhibited and was touching fellow inmates [at Silverwater].

41. The accused was transferred from Silverwater to the Forensic Hospital at Malabar on 21 October 2024. Dr Ellis is the Clinical Director Forensic Mental Health for New South Wales, with overall clinical responsibility for patients under the care of Justice Health, the health service for inmates in the custody of Corrective Services. He approved the transfer of the accused to the Forensic Hospital as a correctional patient and that order was independently confirmed by the Tribunal. On reception at the Forensic Hospital it was recorded that the accused had severe thought disorder, “delusional thoughts and still believed [the deceased] was involved in the underbelly”. The thought disorder improved on antipsychotic medication but the delusions persisted.

42. By the time of Dr Ellis’ examination of the accused on 15 April 2025 she described ongoing auditory hallucinations, although they were not present at that date. She continued to report beliefs of persecution, reference from the media and delusions of interference with her thought processes. Dr Ellis considered that she had partial insight into these psychotic symptoms but that they had not fully resolved.

Conclusions of Drs Ellis and Eagle

43. Dr Ellis concluded in his report that the accused meets the recognised criteria for diagnoses of schizophrenia, substance use disorder (currently in remission in a controlled environment) and post-traumatic stress disorder. With respect to the interaction between the accused’s misuse of drugs and her psychotic symptoms, Dr Ellis expressed following opinion:

Although her symptoms are likely significantly exacerbated by, and may have been precipitated by, the use of stimulants (crystal methamphetamine) this is not the likely sole cause. She continues to experience attenuated symptoms while substance free and on antipsychotic treatment. She has experienced the lengthy symptoms that are unlikely to be explained by drug use alone. There is no evidence she is feigning the condition.

[…] It is likely that substances have been used as a form of self-medication for her psychiatric symptoms. Paradoxically this has likely worsened those symptoms in the longer term.

44. From Dr Ellis’ diagnosis of schizophrenia at the time of the homicide and from his description of her symptoms, all of which I accept, the three criteria of a mental health impairment, as prescribed in s 4(1) of the Mental Health Forensic Provisions Act, are established on the balance of probabilities. Turning to the effect of that mental health impairment upon the accused at the time when she killed the deceased, Dr Ellis is of the view that she likely knew the nature and quality of her acts (s 28(1)(a), “in that she was using lethal means of strangulation and stabbing of the deceased in order to kill him”. However, Dr Ellis considers that she is not likely to have been able to know that her actions were wrong, to reason with a moderate degree of sense and composure about her actions (s 28(1)(b)).

45. Expanding his opinion about par (b) of the mental impairment defence, Dr Ellis said the following:

She believed that she was in immediate danger, had no way of leaving the situation or contacting others for help and was experiencing significantly disorganised thought process, distracted by hallucinations and having a fearful response to the symptoms that would have impaired her ability to reason with any level of composure about the situation. She had a history of schizophrenia prior to the offence, and when in custody was rapidly diagnosed with this condition. Her presentation in the police interview indicates disorganised thought process and likely delusional thinking (persecutory beliefs about the deceased and others, “spiritually psychic”).

[…] [Her] main reason for using lethal force was her immediate fear for her own safety based upon delusional beliefs. […] Her behaviours after killing the deceased indicate a disorganised plan to dispose of the body, very limited actions to conceal her involvement and waiving of rights to undertake a police interview whilst in a disorganised mental state. This is consistent with a mental health impairment operating at the time of the offence and immediate aftermath.

46. Dr Eagle’s conclusions are substantially to the same effect. She concurs in the diagnoses of schizophrenia and substance use disorder, the latter being in remission in a controlled environment. Dr Eagle stated the following in her report:

Schizophrenia is a severe psychiatric condition and a psychotic disorder. Ms Cummings was experiencing a relapse of psychosis resulting in auditory hallucinations, referential ideas and persecutory delusions at the time of the alleged offending. Relapses of psychosis can distort a person’s ability to appreciate what is real and what is not real. On that basis Ms Cummings had a temporary or ongoing disturbance of thought, mood, perception and memory that would be regarded as significant for clinical diagnostic purposes, and impaired her emotional well-being, judgment and behaviour.

47. That expression of opinion, which I accept, further supports my finding on the balance of probabilities that the s 4(1) criteria of a mental health impairment at the time of the homicide are established. Dr Eagle concurs with Dr Ellis that the impairment was not caused solely by the temporary effect of ingesting a substance, or by her substance use disorder. Although Dr Eagle accepts that methylamphetamine intoxication would have worsened the accused’s symptoms of psychosis and may have precipitated a relapse, the accused continued to experience psychotic symptoms well beyond the period of intoxication and withdrawal and for several months after treatment on medication had commenced in custody.

48. Dr Eagle is also of the opinion that the accused “appeared to be aware of the physical quality of her actions at the time of the Index Offences”, noting that she was “aware she had killed the deceased and could describe her actions in strangling and stabbing” him (par(a) of the prescribed conditions of the mental health impairment defence in s 28(1)). However, Dr Eagle has reached the same conclusion as Dr Ellis that par (b) of the defence is satisfied. Dr Eagle makes an analysis very similar to that of Dr Ellis regarding the way in which the accused’s mental health impairment would have prevented her from reasoning with a moderate degree of sense and composure about whether her acts, as perceived by reasonable people, were wrong.

Orders

49. The three requirements of s 31 are satisfied in the present case. As to par (c), I am satisfied on the balance of probabilities regarding the factual premises upon which the opinions of Drs Ellis and Eagle are founded and I accept the doctors’ conclusions to the same standard of proof. On the balance of probabilities I find that when the accused carried out the deliberate acts that directly caused the death of the deceased, she had a mental health impairment that had the effect that she did not know that her acts were wrong; that is, she could not reason with a moderate degree of sense and composure about whether the acts, as perceived by reasonable people, were wrong. The Court’s verdict follows accordingly.

50. On the charge that Lisa Marie Cummings did murder Mark Anthony Myers on 22 August 2024 at Nambucca Heads the verdict of the Court is:

Proven but not criminally responsible.

51. The following are the orders of the Court, to be entered forthwith:

1 Order pursuant to ss 33 and 34 of the Mental Health and Cognitive Impairment Forensic Provisions Act 2020 that Lisa Marie Cummings be detained at the Forensic Hospital, Malabar, or at such other place as determined by the Mental Health Review Tribunal, until released by due process of law.

2 Order pursuant to s 34 of the Mental Health and Cognitive Impairment Forensic Provisions Act 2020 that Lisa Marie Cummings is referred to the Mental Health Review Tribunal.

3 Direct the Registrar to notify the Minister for Health of these orders within 7 days.

4 Direct the Registrar to notify the Mental Health Review Tribunal of the verdict and these orders and to provide to the Tribunal a copy of the Court’s reasons for judgment and the exhibits within 7 days.

5 Direct the Registrar to notify Justice Health of the verdict and these orders and to provide to Justice Health a copy of the Court’s reasons for judgment and exhibits within 7 days.

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