Medical evidence.
35 Three experienced forensic psychiatrists were called to give evidence, Dr Westmore, on behalf of the Crown, and Drs Allnutt and Giuffrida, in the case for the accused. Each had reviewed the evidence in the Crown case, including the records of interview conducted by the police with the accused. Each had also seen Mr Jennings at some length. Each had access to the reports prepared by his colleagues; so that each was in a position, when giving evidence, to comment upon the views expressed by the other practitioners.
36 The history provided by Mr Jennings to Dr Westmore was similar to that given to Drs Allnutt and Giuffrida. Mr Jennings told Dr Westmore the following:
"... He told me the victim then tied him up with a rope. Mr Jennings said he had taken the rope with him. He said he and the victim had previously discussed this and it had been decided that he would take the rope with him.
He said the victim commenced performing oral sex on him. He stated, 'I started getting all freaked out, I heard some foot steps. I looked up and in the bushes there was a man and a wolf telling me to be careful, he might get you. I felt frightened and paranoid. I asked him (victim) to stop so I could collect myself.'
He continued stating, 'Then we talked for a bit because I had to calm myself down. I had to ask him to untie me before we talked. Then I tied him up after I collected myself and I started doing oral on him and he started doing oral on me. Then I heard the voices again, "I'm going to get you, I'm going to rape you." I felt him grabbing at me.'
He said, 'I went down and picked up my knife and I stabbed him and everything went all blank. I dropped the knife, picked up my stuff and run back to the unit.' In response to a question from me he told me his unit was about two hundred metres away.
I then asked him more about the reported voices. He said the voices were male and at first they were internal but then 'I thought it was coming from the visions I was seeing. It seemed like he was saying he was going to rape and bash me when he was grabbing at me.'"
37 Mr Jennings said that he had similar visions in the past. They had included a black man with a green outline, which he saw in circumstances where he would hear footsteps and would peak around corners. Dr Westmore noted that the history given to Dr Allnutt included an account of auditory hallucinations.
38 The account provided by Mr Jennings of his drug taking was again similar in the case of each doctor. He told Dr Westmore that on the evening he met Mr Vitale, he had taken three or four ecstasy tablets between 30 and 60 minutes beforehand, as well as "an eight ball" of amphetamines intravenously at about the same time.
39 Before moving to the diagnoses provided by each doctor, I should deal with one issue which arises in every psychiatric case. Diagnosis is, to a greater or lesser degree, dependent upon the history provided by the patient. It is therefore obviously important that the patient provides a truthful and accurate history. Doctors ordinarily look for corroboration of the history, or aspects of it. Here, there was no corroboration in the form of complaints to others of the visual and auditory hallucinations reported by Mr Jennings to each doctor. Mr Jennings provided the following explanation to Dr Westmore: (Exhibit H1, p10)
"He said he did not speak to others about these experiences because he did not want to be placed into a mental institution."
40 Nor did Mr Jennings disclose to the police the matters which he later related to the doctors. Yet each doctor said that he accepted that the symptoms as reported by Mr Jennings were genuine. A number of reasons were provided. First, the descriptions of symptoms given to each doctor were consistent, even though their examinations were spread over a number of months. Dr Giuffrida said that he would not have expected a person who was feigning mental illness to be able to reproduce that level of detail with such consistency.
41 Secondly, the symptoms as described by Mr Jennings, were very typical. Dr Westmore, for instance, said that he would not have expected a person who was not mentally ill to be able to describe the constellation of symptoms in the terms chosen by Mr Jennings, even if he had attempted to familiarise himself with various forms of mental illness.
42 Thirdly, each doctor said that it was not uncommon for a person suffering from mental illness not to discuss their symptoms, especially when questioned by the police. They may not do so, either through embarrassment, or because of anxiety associated with their condition. They may not feel comfortable discussing such issues with persons who are not treating them, or at least persons who were not doctors.
43 Each doctor who examined Mr Jennings is, as I have said, an experienced forensic psychiatrist. Each made the clinical judgment that the symptoms Mr Jennings reported were genuine. I accept that evidence. Whilst there were differences between each doctor as to the diagnosis of Mr Jennings' condition, there was also broad agreement on many issues. Dr Westmore believed Mr Jennings was suffering from a schizophrenic illness which had been precipitated and/or aggravated by his excessive use of illicit drugs. He considered, as an alternative diagnosis, a drug induced psychosis. Dr Giuffrida, on the other hand, diagnosed a drug induced psychosis, believing that there was insufficient evidence of deterioration in cognitive social and other aspects of personality to diagnose schizophrenia.
44 Dr Giuffrida, however, acknowledged, as indeed did Dr Allnutt, who's views I will deal with shortly, the force of Dr Westmore's argument which relied upon two matters. The first was that the symptoms of visual and auditory hallucinations had persisted after arrest and were still present in April this year, that is, some fourteen or fifteen months after the incident, and after the cessation of drugs. If the psychosis of Mr Jennings were entirely drug related, you would not have expected symptoms to persist for that long. Secondly, the symptoms of auditory and visual hallucinations had abated, when appropriately treated with anti-psychotic medication, but had returned when that medication was reduced. Again, that suggested an underlying condition.
45 Both Dr Westmore and Dr Giuffrida reached the view that Mr Jennings met the requirements of the M'Naghten test for mental illness. Dr Westmore, in his first report, said this: (Exhibit H1)
"I believe that Mr Jennings was on the balance of probability suffering from an acute psychotic illness at the time the homicide occurred. My preferred diagnosis is that he suffers from a paranoid schizophrenic illness and that that illness was either precipitated and or aggravated by his use of illicit drugs.
I believe he suffered a disease of the mind, namely a schizophrenic illness which was present at the time of the homicide and which would have totally deprived him of his capacity to know that he ought not to do the act.
It is likely that Mr Jennings would have understood that he would have got into trouble from a legal perspective because of his behaviour but at the time the incident occurred I think it is probable that he was acting under delusional beliefs in relation to the victim and that as a consequence he was totally deprived of his capacity to consider his behaviour with a moderate degree of calmness and rationality."
46 In his second report, Dr Westmore elaborated: (Exhibit H2)
"I however think the preferred defence is that of mental illness. I believe he was suffering from a defect of reason caused by a disease of the mind which totally deprived him of the capacity to know, again in a moral sense, that what he did was wrong. He had a psychotic illness which was precipitated or aggravated by illicit drug use."
47 Dr Giuffrida reached the same view. In his report of 27 July 2005, he said this: (Exhibit 2, p2)
"I am however in full agreement with Dr Westmore that Mr Jennings was suffering from a psychotic illness at the time of the offence which was characterised by florid auditory and visual hallucinations and the consequent delusional ideas that constituted a disease of mind giving rise to defect of reason such that Mr Jennings did not know that what he was doing was wrong."
48 Dr Allnutt, on the other hand, favoured a diagnosis of substance induced psychosis. He accepted that Mr Jennings was impaired by reason of "a disease of the mind". However, he did not believe he was so impaired as to lack insight into the wrongfulness of his actions. He readily acknowledged that the defence of substantial impairment by reason of abnormality of mind was open to him.
49 In cross examination, Dr Allnutt agreed that there was no bright line separating, on the one hand, someone who was mentally ill, according to the M'Naghten test, and someone who was substantially impaired. It was a spectrum. The views held by Drs Westmore and Giuffrida were, to use the words of Dr Allnutt, "in the same patch" as his own view. They differed only in their conclusion as to which side of the line was appropriate. The following exchange with the Crown encapsulated the difference in view: (T65/66)
"Q. Doctor, do you accept that Mr Jennings had a genuine belief at the time he picked up that knife that this man represented some danger to him?
A. Now that is a very good question. Yes. I think he did genuinely believe it at the time. He genuinely believed at the time that he was at risk from this person.
Q. And that belief derived from his delusional thinking?
A. That's correct.
Q. And yet you say he still had the capacity to reason about the rightness and wrongness with a moderate degree of composure?
A. That's where I - when you invoke Porter, that is where it becomes very difficult to make the distinction. What I am saying is had he stopped, had he stopped and thought, he probably would have - in my view he probably would have been able to work out that he was misinterpreting, but his anxiety was such that he didn't stop to think. And that then could very well be Porter.
Q. But how can a man whose having acute delusional beliefs stop and think about them?
A. Because as I said, they do it every day. They stop and think about all kinds of things."
50 However, with great respect to Dr Allnutt, I prefer the views of Drs Westmore and Giuffrida. I accept that it was probable that Mr Jennings, although understanding what he was doing, was so disabled by disease of the mind, that he did not know that what he was doing was wrong.