The medical expert opinion evidence
- The Crown relied on two reports from Dr K. Eagle dated 20 November 2020 and 29 October 2021. Dr Eagle was asked to address the offender's diagnosis of mental illness, his mental state at and about the time of the alleged offending, whether the offender could be dissembling about experiencing auditory command hallucinations prior to the commission of the alleged offences and whether he had a defence of mental illness available to him. She was also asked to comment on a report of Dr Allnutt, which was not in evidence, but clearly related to the question of whether the offender had a defence of mental illness available to him. Given the pleas of guilty, following a complex procedural history, that is not an issue relevant to sentencing.
- The offender did not consent to a psychiatric assessment for the purpose of Dr Eagle's report. She did, however, provide a detailed summary of the offender's past psychiatric history and a summary of clinical records obtained from Royal North Shore Hospital, the Hills Clinic Hornsby, Justice Health, Hornsby Local Health District Medical Records, the St Leonards Clinic, Hornsby Medical Centre and Hornsby Foundation Medical Centre. Dr Eagle also provided a detailed summary of the Crown Case Statement and evidence, including various statements in the ERISP interview of the accused and other police evidence.
- Dr Eagle confirmed the offender's diagnosis of Schizophrenia Paranoid Type, which he has suffered since 2003. His illness had been characterised by relapses of psychosis causing delusions and hallucinations, negative symptoms involving social withdrawal, notwithstanding his high functional level academically. The offender's report that he had not been compliant with his antipsychotic medication prior to the offending conduct was consistent with a deterioration in his mental state at the time of the offending. Dr Eagle was of the view that it was unlikely the offender was fabricating his experience of auditory hallucinations but that he may be exaggerating the impact of them on his thinking and behaviour. Ultimately, she opined that at the time of the offending, "the offender was able to reason, and in fact did reason, with a moderate degree of sense and composure as to the moral wrongfulness of his actions, despite the presence of auditory hallucinations."
- In her second report dated 29 October 2021, Dr Eagle was asked to address inter alia whether the offender's mental illness contributed to the commission of the offences on 28 October 2018, and if so, how and to what degree. She was qualified with the Agreed Statement of Facts and noted that her opinion was based on the documentation provided to her without the benefit of a clinical psychiatric assessment.
- Dr Eagle noted that the offender had never required an acute in-patient psychiatric treatment for his illness and had maintained a high level of vocational and academic function despite his illness. She assessed him on the Static-99R actuarial risk assessment as being an average risk of recidivism.
- Dr Eagle acknowledged the limitation on her ability to form a reliable opinion regarding the degree of any contribution of his illness to the offending in the absence of a clinical assessment. Having regard to the degree of planning involved, she opined that his actions appeared "purposeful and goal directed". His motive appeared to be to engage in sexual activity with the victim. Further, there was no information to suggest that the offender's mental illness impacted on his ability to control his sexual interest in the victim.
- Dr Eagle opined that mental illness and mental disorders are common in the prison population. Given the progress since the offending in his treatment and assuming that he received ongoing antipsychotic treatment, she opined "his mental illness would appear to be unlikely to make a custodial sentence more onerous than the average offender."