The evidence concerning the accused's fitness to be tried
21 It is convenient to refer at this stage to the affidavit of Mr Velcic sworn on 15 April 2009, the relevant parts of which appear below:
I am an accredited specialist in criminal law and have had extensive experience in dealing with young persons.
I appeared for the young person in the Children's Court and in the Supreme Court.
I have had numerous conferences with the young person alone and with counsel.
The young person would provide basic instructions but would then ask questions indicating clearly that he did not understand my questions. The situation did not improve with time and with the assistance of the young person's Chaplain Lee Bromley.
I contacted Dr Nunn and spoke to him about the young person's mental health issues.
The inability to obtain instructions and the young person's mental health issues caused me to request a psychiatric report from Dr Nielssen.
It is my view that the young person does not understand the effect of the evidence against him and does not have the capacity to provide me or Mr Winch with instructions. It is my view that the young person does not have the ability to make his defence or to answer the charge.
I have read the reports of Dr Nunn and Dr Nielssen and agree with their opinions particularly in respect of the level of intellectual functioning of the young person.
22 It is apparent from the material which has been placed before me that the circumstances in which the accused spent his early years were highly unusual. Some insight into them is provided by Dr Nunn in his initial report. The following extract is taken from that report:
JH is a 16 year old boy of mixed Hungarian and Torres Strait Island ethnicity. …
JH's mother and father lived together for three years and other than a further brief relationship, JH's mother has lived with JH only in an exclusive and isolated relationship. JH describes spending the entire day with his mother watching television, looking after his fish, his car and train collection and going out to shops or restaurants where she would introduce him to European food, sometimes quite exotic food like caviar, despite their straightened financial circumstances.
JH's mother has a history of attempted suicide at the age of 15 years. JH described visiting the General Practitioner (GP) regularly with his mother who took JH to him to have him checked for signs of abuse after contact with his father with no effective outcome from his point of view. JH says that he told the GP and the DOCS workers that he would kill himself if he had to have maintained contact with his father.
…
His mother was on a pension for reasons which JH was unaware and was able to do only occasional casual work in cleaning or with a charity organisation. They were both, from JH's account, leading very socially isolated lives from both adults and children. JH describes his mother warning him that his father had been in the vicinity of their house and had actually taken up residence in the roof. His mother was continually preoccupied and distressed by the appearance of a tarpaulin on the roof, a manhole that was sometimes opened and sometimes closed, and food that was suspected to be poisoned, including teabags and milk. JH was concerned to liberate his mother from her distress about these things. He described the distress of his mother and the constant harassment by his father. However on each occasion that I tried to find out what he had actually observed, what stood out was the degree to which he was reliant upon his mother's description and interpretation of events. For example, when she described the manhole cover being moved it was always ascribed to his father being in the roof. The only events that JH describes in detail in relation to his father are the abuse that his father dealt out to him (whether this was in fact or in his psychotic experience).
Initially JH attended school and in each school setting he reports being bullied in relation to his colour. In his last year at school (Year 8), JH made allegations of sexual abuse perpetrated by other students. This came, I understand, after extensive involvement with the Family Court relating to contact with JH and his father and always referring back to alleged domestic violence and maltreatment. Unfortunately I have been unable to gain access to this material. However, I understand that contact was continued based upon directions of the Court. It was these directions together with the inability of DOCS to mount any effective case that JH cites as the reason he believed that no one believed him, or if they did believe him, they were unable to act. So far as I have been able to confirm neither DOCS nor the local doctor have at any stage seen evidence of the extensive abuse detailed by JH nor the rape of JH's mother, communicated to JH by her. JH reports having difficulty at school which was mainstream and not appropriate to his intellectual disability.
23 As I have said, Dr Nunn has been seeing the accused on a regular basis since his incarceration. In preparing his report, he had the benefit of being able to gain access to clinical case notes retained by Justice Health. Contained within that material were the observations made by four other psychiatrists who had reviewed the accused's situation since he has been in custody. The notes also included two separate assessments which had been made by a senior psychologist employed by the Department of Community Services, and various reports which had been prepared by the Serious Offender Review Panel.
24 In his report of 23 April, Dr Allnutt provided further details about the accused's attitude towards his father. The following extract is taken from that report:
He said ever since he was a child, he hated his father. He never wanted to be separated from his mother. He used to cry a lot when he was little. He said his father was a violent man. His father would make him bend over and his father would hit him across his buttocks with a belt. He would make him eat his own vomit (until age 8); he would force him to eat his food.
He then added that his father put poison in his cereal. He said he had found poison in his cereal. He said he first saw his father pour poison into his cereal when he was about age 5. He recalled it was "blue stuff". From age 10 he started flushing his cereal down the toilet.
Last year he said his father started poisoning not only his cereal but his food as well. He said the food tasted like poison. When he was younger it was the blue stuff but he alluded to different poison at this stage.
In the beginning of 2007 he started taking food home to show his mother. She told him it smelt like poison. He could also smell poison in it, he said. After each visit with his father, he lost weight and she would have to take him to a doctor. His mother, he said used to tell the doctor that he was being poisoned but the doctor never said anything about that. He would gain weight after he came back from living with his father.
He believed that his father was poisoning him because his father hated him and his mother and because his father was planning to kill him and his mother. He said his father used to spy on them; he would drive past their house, at night he would be on the roof trying to listen to what they were talking about; he used to hide inside their garden on occasions; on some occasions he had seen him and on other occasions only his mother had seen him; he heard his father up on the roof; he could hear his father walking around.
He had two cats and they would hiss when his father was around. On occasions he heard somebody jumping over the gate. He and his mother knew that his father was planning to kill them. He said that when he was smaller he had heard his father say "I'm going to kill you". He estimated he had heard his father say this when he was about 8 to 10 years of age. When he and his mother went outside the house they would see footprints in the dirt.
His mother used to talk about how horrible his father was. She told him that prior to his birth his father had raped her twice. His mother told him this for the first time that she had been raped by his father when he was 5 or 6 years of age. He said also at 5 or 6 years of age he had seen his mother with bite marks all over her body. His mother told him that prior to his birth she had been pregnant with another child and that his father had shoved a rod up her vagina and raped her and killed the baby. She said that if his father had not done that he would have had an older brother. His mother told him that his father had tried to so the same thing when his mother was pregnant with the defendant. He said that his mother told him his father tried to rid of the defendant when she was pregnant with him. She said she kept what he did a secret because she told him it was too bad to tell. His father was really a bad person and the Courts would never listen to he (sic) and his mother about how bad his father was. He then added "I really hated my dad".
25 Dr Allnutt then expressed the following opinion about the accused's mental condition:
By the time that the alleged offence occurred the defendant had been living with his mother for 14 years, during a period of development and high dependence and a period of significant vulnerability to influence. The evidence suggests to me that from a relatively young age he has believed that his father was a bad man, and violent towards him and his mother; that his father was poisoning him; that his father had raped his mother; his father had prevented his other sibling from being born by violent means; had attempted to kill him in utero; he was also of the view that his father was plotting to kill he (sic) and his mother. These beliefs were further compounded by the influence of his mother, and in the absence of any significant others to challenge them, significantly influenced his thinking process to the extent that he maintained them with a significant degree of conviction; so that at the material time that the alleged offence occurred he manifested persecutory delusions that related to his father, auditory hallucinations and ideas of external control such as receiving telepathic messages from other people and would be regarded as suffering from psychosis. In addition to this the defendant was of a young and vulnerable age, immature and was intellectually impaired, and would be regarded by most psychiatrists as meeting the legal definition of having a "disease of the mind".
Psychosis is a mental illness and impacts on an individual's capacity to make rational interpretations of their environment. It also is a condition that impacts on a person's capacity to appreciate that they have lost that capacity. Psychosis is a condition that affects reasoning capacity and thus at the material time of the alleged offence as a consequence of the disease of the mind he manifested a defect of reason. Intellectual impairment, immaturity and his social circumstances would only serve to compound these difficulties.
I do not, however, believe that his defect of reason was of a nature and severity that it impacted on his capacity to know the nature and quality of his actions. His account suggests an understanding that the person who was being harmed was his father and that weapons such as axes and knives could kill or seriously harm his father if utilised on his father.
I am, however, of the view that his capacity to understand the wrongfulness of his actions was significantly impaired. The information suggests that he is a relatively isolated young child with limited external social contacts. He would have been highly influenced by his mother, his values and opinions and particularly his regard for his father. It appears that the defendant had developed a strong sense of commitment and loyalty to his mother probably in the relative absence of external challenges to his belief system; this probably shaped the content of his developing delusions and perceptual interpretations as his mental illness emerged over time, to include themes of his father as persecutor; and this subsequently led him to conspire with his mother to kill his father.
He describes at the material time believing that he was doing the right thing; while he might have had some faculty for knowledge of the wrongfulness of his actions, possibly in the sense of the objective wrongfulness (that is that other people might see what he had done was wrong which explains the attempts that they made to hide the evidence initially) from a subjective perspective he believed that he was acting in a manner that was in his and his mother's interests and that it was morally right; his delusions, hallucinations and referential experiences providing him with that justification (thus an irrational justification).
I do not believe that, given his intellectual impairment, psychosis and immaturity (age) at the material time of the alleged offence, that he would have been capable of reasoning about the wrongfulness of his actions with a moderate degree of sense and composure and thus he would have available to him a defence of mental illness . (emphasis added)
26 I referred earlier to the fact that Mr Velcic sought an opinion from Dr Nielssen concerning the state of the accused's mental health. Dr Nielssen, in a report dated 19 September 2008, expressed his opinion in the following terms:
The diagnosis of schizophrenia is made on the basis of JH's account of typical symptoms of schizophrenia and what seemed to be a delusional belief regarding abuse at the hands of his father, the corroborative provided by JH's treating psychiatrist and the Justice Health medical records and JH's presentation at the recent interview.
JH's grievance against his father was thought to have been based on information provided by his mother that was incorporated into a delusional system, as the history elicited was that JH had not been in the care of his father since he was three years old. He also expressed the bizarre belief that he had lost the ability to read as a result of abuse by his father.
At the time of the recent interview there appeared to be some doubt about JH's fitness for trial. He understood the name of the charge and was able to provide an account of the events. He was also able to give an account of symptoms of mental illness, although he did not appear to recognise that he had been mentally ill. There is a chance that JH's condition will improve sufficiently within the next twelve months for him to be considered fit for trial.
I believe that JH has the defence of mental illness available to him. He has an early onset schizophrenic illness that has resulted in a defect of reason in the form impairment in intellectual function and a shared delusional belief about his father. His immature emotional development and low intelligence, and the influence of his mother with whom it appears he shared a delusional belief regarding his father prevented him from realising that his actions in killing his father were morally wrong.
27 Dr Allnutt had already concluded in his report dated 1 March 2009, that the accused "presents with limited intellectual capacity". He also found that "he suffers from a chronic psychotic disorder. The differential diagnosis would include schizophrenia, schizoaffective disorder with shared delusions". Nevertheless, having considered the Presser test, he concluded that "I believe at this stage the [accused] should be regarded as fit to stand trial. His mental state could fluctuate given that he has a mental illness and he could become unfit".
28 Dr Nunn in his initial report diagnosed the accused as suffering from paranoid schizophrenia, major depression with melancholia and as having an intellectual disability. In that report Dr Nunn also made the following observations concerning the question of the accused's fitness to be tried:
My basic concern is one of his capacity for comprehension as an independent, autonomous individual without reference to his mother's world view. There are a number of lesser, but nevertheless significant, challenges to his comprehension as well.
Firstly, there is the matter of his intellectual level which, though not comprehensively assessed, remains reliably assessed, placing him in the mild disability range with IQ between 57 - 73 and lower than 99% of other young people his age at a 95% confidence interval. …
He was functioning cognitively, some 12 months after the offence and four months prior to the proceedings now before the Court, at a functional level between seven and eight years of age. It is still possible, that he understands at a cognitive level what he is charged with and what the proceedings are about. It is even possible that over the coming years his intellectual level will improve into the borderline disability range. I am unable to say what his cognitive level was at the time of the offence, except to make the obvious observation that it is unlikely to have been higher than either of these measures. However, it should also said that the capacity to repeat back basic instructions and to say what people have said to him over and over again does not necessarily constitute comprehension or understanding. JH has an intact memory. He can therefore repeat back what he has been told. Most of the questions used to assess Presser are in danger of assessing the presence of language and the presence of memory without any serious appreciation of the development of understanding.
There is the matter of his mental illness, which, in and of itself, does not alter his ability to understand the charges against him, his memory of the events (delusionally perceived or otherwise) leading up to these hearings, the proceedings of the Court and his capacity to express his own wishes and to instruct counsel. He is, as far as I have been able to ascertain from him, more able to do this now that at the time of the offence.
…
There is the matter of his social and emotional development, which when he came into custody was that of a much younger child who had not effectively separated from his mother and remained in the preschool/early infancy school level (i.e. lower than his cognitive development). He was socially isolated, naïve, and non-interactive with peers until the last few months prior to his transfer when he began to make substantial progress and gain some social and emotional confidence. He displayed many of the features of an extremely socially deprived and isolated boy with even some features more typical of autism, which remitted with time away from mother and with other people in detention. It is possible, that he now understands at a social and emotional level what he is charged with and what the proceedings are about. It is probable that over the coming years his social and emotional level will improve to, or above, his cognitive level (i.e. out of the disability range of social and emotional development).
I am not sure that JH understands that he is not being tried for defending himself and his mother against what he and she believed (as one person) at the time was a persecutory and abusive father, from whom they could gain no legally sanctioned respite, despite trying to do so on multiple occasions. He does not understand the difference between killing someone and murdering someone. I do not believe JH will enter any plea that he believes will not be in his mother's interests, irrespective of whether or not it is in his own interests. He has never been truly convinced by anything that I have said in relation to him having a mental illness … In that sense, he does not have a very basic insight to inform the capacity to decide upon the defence he will rely upon and his judgment is deeply clouded still by the continuing influence of his very troubled mother .
He does, however, have the capacity to make his version of the facts known to his counsel and the Court. I understand that defendants do not necessarily have to do what is in their own interests and that the Court is not obliged to ensure that they do what is in their own interests. My difficulty lies in the fact that JH is cognitively, emotionally and socially a minor, with the co-attendant range of vulnerabilities and emotional dependencies, in a relationship with a parent who has very distorted views of reality and an entirely undue influence upon his beliefs. As such, I am concerned that he will necessarily, because of his lack of insight, not do what is in his best interests in relation to acknowledging his illness, his need for treatment, his need to seek a defence based upon the illness and his response to treatment.
As can be seen, any individual matter relating to JH's fitness has elements lacking precision when assessing them and which, taken alone, might not remove the presumption of fitness. Taking all of these issues into account together (i.e. an intellectually impaired, hitherto extremely socially isolated, emotionally vulnerable, mentally ill young man who has been cared for and cosseted away by a mentally ill mother who, even still, continued to have a determinative emotional currency in his beliefs and decision making), it seems unlikely that he is fit to stand trial. He is able to comprehend little more than whether he will be punished for killing his father or not and whether what is decided in relation to him will make it better or worse for his mother. (emphasis added)
29 At my request, and with the concurrence of counsel, the three psychiatrists met together to discuss the accused's case. In a supplementary report, which is dated 16 April 2009, Dr Nielssen expressed the following opinion:
I confirm the opinion expressed in my previous report that JH has the chronic mental illness schizophrenia on a background of a learning disorder and subnormal intelligence. The acute symptoms of schizophrenia are currently in remission, to the extent that he has been able to withdraw from treatment with antipsychotic medication. However, according to Dr Nunn's observations he still holds overvalued ideas about his father's abusive behaviour and does not fully understand why he is being held in custody.
The further reports and your observations confirm the opinion expressed in my previous report, that JH is unfit for trial.
JH is able to answer questions about the nature of his charges, the general nature of the proceedings and the roles of the participants in an adversarial trial. However, his level of understanding is superficial and he does not recognise that he was ever mentally ill and is unable to provide reliable instructions regarding the role of mental illness in his offence .
Like many people with low intelligence JH is quite suggestible and is eager to please by agreeing with propositions put to him, even if he does not fully understand what he has been told. I believe his intellectual function is at such a low level that he would be unable to understand much of what was said in court … and would be unable to provide ongoing instructions based on an understanding of what was said in court or on legal advice put to him in the simplest of terms.
JH's condition is unlikely to improve sufficiently within the next twelve months for him to be considered fit for trial. (emphasis added)
30 Dr Nunn's supplementary report, is relevantly, in the following terms:
Dr. Allnutt, Dr. Nielssen, and Dr. Nunn met for approximately one hour. A number of points of consensus were clear. All three agreed that JH suffered from a psychotic illness of long standing which is best described as paranoid schizophrenia. After some discussion about the nature of the psychological testing done all three agreed that JH suffers from an intellectual disability. All three agreed that there were unique circumstances about his upbringing, his relationship with his mother and her mental condition that had a strong bearing on the circumstances surrounding the crime. Dr. Nielssen and Dr. Nunn agreed that a boy of this age, with this intellectual level and with his diagnosis, in the unique circumstances of his life, rendered him unfit for trial.
The disagreement between Dr. Nielssen and Dr. Nunn on the one hand and Dr. Allnutt on the other focused on the Presser criteria and the nature of understanding. Dr. Nielssen made the point that the intellectual level, contributed to by a mental illness, was sufficient in his view to remove the presumption of fitness. The rest of the discussion was a systematic review of the Presser criteria with a discussion between Dr. Allnutt and Dr. Nunn.