Psychiatric evidence
28 Both Dr Allnutt, engaged by the Crown, and Dr Nielssen, engaged for the defence, interviewed the offender in the later part of last year and Dr Nielssen saw him again in June of this year. I have four reports of Dr Allnutt and three of Dr Nielssen, and it is apparent that both of them have given the case careful consideration. In the event, there is substantial agreement between them and it is unnecessary to examine their reports in detail.
29 When interviewed by the two doctors last year, the offender gave each of them an account of the killing which was not entirely consistent and which did not adopt all of what he had told police on the day of the offence. To both doctors he denied having met the deceased before. He told Dr Allnutt that the deceased had approached him with a knife, that he thought he was going to die, that he wrestled the knife off the deceased, and that he himself was stabbed before he left the scene.
30 He told Dr Nielssen that the deceased had come into the garage and punched him without any provocation on his part, that the deceased was holding a knife, and that he thought he was a "junkie" who was trying to "roll" him. He added that after the deceased hit him he was not sure what happened, but that he must have taken the knife from him and stabbed him. It will be noted that he told both psychiatrists that it was the deceased who initially had the knife. To Dr Nielssen he denied owning the knife and said that he had never previously carried a knife, although he kept one in his fishing tackle box.
31 He gave both psychiatrists an account, to which I have referred in reciting the agreed facts, that he had been drinking through the night preceding the killing and had not slept. That account is consistent with evidence not only that he was holding a bottle of beer when he went to the service station after the killing, but also that police who attended his unit found a large number of empty beer bottles at different locations within it. Moreover, he told Dr Allnutt that he had not been in contact with mental health workers around that time, and he told Dr Nielssen that he had been off his medication for "a few months". This is borne out by Medicare records of his supply of medication.
32 The experiences he described to his brother after his move to the flat at Kingswood point to the consequent deterioration of his condition. In that regard, I accept that it was he who removed the surveillance camera. No doubt, his condition also explains his being seen in possession of a knife a couple of weeks before the offence. These matters are indicative of what Dr Nielssen described as the development of a "paranoid belief that he was under threat …" The doctor also saw this as the reason for the collection of weapons found in his flat, but it may be that they were merely the pursuit of a hobby and had no aggressive or protective purpose.
33 Both doctors confirmed the diagnosis of schizophrenia, and Dr Nielssen also diagnosed substance abuse disorder. When interviewed by both of them last year, the offender denied any psychotic symptoms at the time of the killing. However, both doctors considered that the various accounts of his actions which he gave on that day were the product of delusional beliefs. Dr Nielssen noted that it was "not uncommon for people with chronic schizophrenic illnesses accused of serious offences to adhere doggedly to implausible explanations of events …" However, when he saw the offender again in June of this year, he found him to be "a little more open to the likelihood that he may have been irrationally suspicious and affected by symptoms in the period leading up to the offence".
34 Both doctors concluded that the defence of substantial impairment by abnormality of mind was available. In a report of 24 April 2009, Dr Allnutt expressed the view that, due to "underlying propensity to irrational thinking" the offender might have been more prone to misinterpreting events and less concerned about whether his reactions were right or wrong. In a report of 7 May 2009, he expressed the conclusion that the offender was suffering "symptoms of a mental illness at the relevant time", and he favoured "the likelihood that the information he provided to police and other witnesses in the material time following the alleged offence related to thought processes that he was experiencing at the time …"
35 In a report of 6 May 2009, Dr Nielssen expressed his conclusion in this way:
During the acute phase of the illness schizophrenia can give rise to an abnormality of mind that can have a significant impact on a person's perception of events, their capacity to judge right from wrong and their ability to control their actions. It is more probable than not that at the time of the offence Mr White was affected by persecutory beliefs that increased his perception of threat. The pattern of behaviour observed during his earlier acute episode suggests that he was also probably affected by irrational hostility that led to significant impairment in his capacity to judge right from wrong and to exercise self control.
Mr White's consumption of alcohol would not exclude the defence of substantial impairment because of the severity of his underlying mental illness and the exaggerated effect of alcohol on a person in an acute episode of schizophrenia.
36 In their final reports, the two doctors considered whether the offender might pose a danger to the community upon his eventual release. Dr Allnutt considered static and dynamic risk factors, and thought that he "probably falls into a group of individuals who are at moderate risk of future recidivism". He went on to say that he needed to undertake a number of "rehabilitation tasks", which he specified as follows:
ongoing consultation with a psychiatrist, with anti-psychotic medication;
"psychoeducation";
referral for drug and alcohol rehabilitation and abstention from alcohol;
vocational assistance; and
social skills training.
37 Of course, the offender has been under treatment for his condition while in custody and has maintained a course of medication. He told Dr Nielssen that he understood the need for long-term treatment, and said that he was "willing to accept medication given by long acting injection after his eventual release". He also expressed a determination to stay away from drugs and alcohol. Dr Nielssen noted that his acute symptoms were controlled through consistent treatment with anti-psychotic medication, and considered that he had predominantly "negative" symptoms, being "impairment in motivation, organisation, spontaneity and capacity for abstract thinking".
38 As for the future, Dr Nielssen had this to say:
With regards the risk of further offences, Mr White has mainly negative symptoms of schizophrenia, which are associated with a lower risk of serious violence. Moreover, he does not express any objection to treatment, including treatment by long acting injection.
Mr White also has the strong support of his brother and sister-in-law, who have provided him with accommodation and helped him to obtain a Housing Department flat. His family seem likely to provide him with support after his release.
He gave a spontaneous account of no longer needing to drink or abuse drugs, which is the main risk factor for further violence in patients with established schizophrenic illnesses. He seems to interpret advice in a literal way, which could translate to literal adherence to any parole conditions, such as the advice that he abstain from drinking and taking any kind of illicit drug.
Ideally, people with severe forms of schizophrenia who are charged with serious violent offences should be returned to the community via the secure hospital system and have their care monitored by the Mental Health Review Tribunal. However, there is no reliable mechanism to arrange this, especially for a person who is stable in custody, and it will probably be left to a parole officer to check on adherence to treatment and other conditions. Hence I recommend a relatively long period of parole.