The defence of mental illness
26 The defence of mental illness arises to be considered in accordance with s 38 of the Mental Health (Forensic Provisions) Act. That section provides for a special verdict that an accused person is not guilty by reason of mental illness. It provides that if the evidence at the trial establishes that the person was mentally ill, so as not to be responsible, according to law, for his or her action at the time when the act was done, then, if it appears that the person did the act, but was mentally ill at the time a special verdict that the accused person is not guilty by reason of mental illness must be returned. If a special verdict of not guilty by reason of mental illness is returned, the Court may remand the person in custody until the making of an order under section 39 of the Act in respect of the person.
27 The onus of proof of a defence of mental illness rests on the accused, on the balance of probabilities (see Mizzi v Regina [1960] HCA 77; (1960) 105 CLR 659). The term 'mental illness' is not defined in the Mental Health (Forensic Provisions) Act. The test which must be considered when a defence of mental illness is relied on, is discussed in Regina v M'Naghton (1843) 8 ER 718. Mentally ill in this context means suffering from a 'defect of reason' or 'a disease of the mind', so that the accused did not know the quality and nature of the physical acts which she was doing, or alternatively, if she did know, that she did not know that what she was doing was wrong. There is no suggestion in this case that the accused did not know the quality and nature of the physical acts which led to Mr Vaughan's death. The defence was pressed on the basis that owing to her disease of the mind, she did not know that what she was doing was wrong.
28 It is the accused who must establish that she was suffering from a mental illness. In this case there is no issue that the accused was suffering paranoid schizophrenia at the time of the offence. What the accused must further establish is that at the time that she stabbed Mr Vaughan, because of that mental illness, while she caused his death, she did not understand that what she was doing was wrong.
29 In Regina v Porter [1933] HCA 1; (1933) 55 CLR 182 at 189-90, Dixon J of the High Court explained that the accused must prove that the disease, disorder or disturbance of the mind from which she was suffering, whether arising from some infirmity, temporary or of long standing, was of such a character that she was not able to appreciate the wrongness of the particular acts she was doing at the particular time. His Honour explained at 189 - 90:
The question is whether he was able to appreciate the wrongness of the particular act he was doing at the particular time. Could this man be said to know in this sense whether his act was wrong if through a disease or defect or disorder of the mind he could not think rationally of the reasons which to ordinary people make that act right or wrong? If through the disordered condition of the mind he could not reason about the matter with a moderate degree of sense and composure it may be said that he could not know that what he was doing was wrong. What is meant by "wrong"? What is meant by wrong is wrong having regard to the everyday standards of reasonable people.
30 In this case those questions must be answered having regard to the evidence as to the accused's outward conduct and the medical opinions which have been received.
31 I have outlined the opinions of the psychiatrists who examined the accused and who considered her medical history. Their opinions were consistent, namely that as a consequence of her mental illness, the accused was unable to understand that what she was doing was wrong and that the defence of mental illness is available to her. The experts' opinions, given the medical history on which it was based, were persuasive.
32 The evidence of the text messages which Mr Bowcott received; what the accused told him when she spoke to him on the phone shortly before 2 pm; what she told her mother shortly afterwards on the phone; what she said and was doing, when her mother arrived at her home; and how she behaved and what she said when spoken to by police officers and others at the scene, all support the conclusions which the psychiatrists reached. That evidence, too, suggested that the accused had a defect of reasoning resulting from the serious disease of the mind from which she suffers, with the result that she did not know that what she was doing to Mr Vaughan was wrong.
33 Section 37 of the Mental Health (Forensic Provisions) Act requires that consideration be given to the legal and practical consequences of a finding of mental illness, including the existence and composition of the Mental Health Review Tribunal constituted under the Mental Health Act 2007 and its functions with respect to forensic patients.
34 The effect of an order made under s 38 is that provided for in s 39 of the Mental Health (Forensic Provisions) Act, which provides:
39 Effect of finding and declaration of mental illness
(1) If, on the trial of a person charged with an offence, the jury returns a special verdict that the accused person is not guilty by reason of mental illness, the Court may order that the person be detained in such place and in such manner as the Court thinks fit until released by due process of law or may make such other order (including an order releasing the person from custody, either unconditionally or subject to conditions) as the Court considers appropriate.
(2) The Court is not to make an order under this section for the release of a person from custody unless it is satisfied, on the balance of probabilities, that the safety of the person or any member of the public will not be seriously endangered by the person's release.
(3) As soon as practicable after the making of an order under this section, the Registrar of the Court is to notify the Minister for Health and the Tribunal of the terms of the order.
35 In this case the accused sought no order for her release.
36 The role and responsibilities of the Mental Health Review Tribunal were recently described by Hall J in Regina v Coleman [2010] NSWSC 177, a description which I respectfully adopt. His Honour observed:
69 The legal and practical consequences of a finding that the accused is "not guilty on the ground of mental illness" may be shortly stated.
70 The statute which governs cases like this, namely, s.39(1) of the Mental Health (Forensic Provisions) Act, requires me to consider making an order that the accused be detained in such place and in such manner as the Court thinks fit until released by due process of law. In practice, this means not only that the accused remains in custody until a decision is made to release him, but also that he becomes what is known as a forensic patient and falls under the supervision of a body called the Mental Health Review Tribunal.
71 The Mental Health Review Tribunal consists of a president and his/her deputy, who must be a lawyer. It also consists of two other persons, one of whom must be a psychiatrist. The third member is a person who has suitable qualifications or experience for the task.
72 The Tribunal is required to review the accused's case as soon as practicable after an order is made for his detention in strict custody. The Tribunal may make orders as to his continued detention, care or treatment, or as to this release.
73 The Tribunal cannot make an order for the release of the accused unless it is satisfied that the safety of that person or any member of the public would not be seriously endangered by his release. The Minister for Health and the Attorney General may appear before the Tribunal, or make submissions to the Tribunal, in relation to the possible release of the accused.
74 Where an order for release is not made, the Tribunal orders result in continued detention, care and treatment in a place and manner specified by the Tribunal.
75 After the initial review, the Tribunal must, at least once every six months, again review the case and make orders as to the accused's continued detention, care or treatment in a hospital, prison or other place or as to his release.
76 If release is ordered, then it may be on conditions or it may be unconditional. If any condition is breached, or where the mental condition of the accused has deteriorated so that he may be a serious danger to others, a further order may be made by the Tribunal for his apprehension, care and detention.
77 The conditions which could be prescribed include matters such as living in a particular place, taking particular medication, appointments with health care professionals, enrolment in educational and therapeutic programmes, to ensure that the accused is properly cared for. Other than pursuant to any such release, the accused would remain, as I have said previously, in strict custody within one of the psychiatric institutions caring for forensic patients.
78 Security conditions (as necessary) are in place while the accused is detained in a hospital, prison or other place or if he is allowed to be temporarily absent from the place of detention.