The Medical Evidence
28Dr Adam Martin examined the Accused on behalf of the legal representatives of the Accused. Dr Olav Nielssen examined the Accused on behalf of the Crown.
29The reports of Dr Martin have identified, in some detail, the Accused's history with respect to mental illness and disorder. It is not necessary to recite these matters in detail in this judgment. It is sufficient to note that, in Dr Martin's first report of 27 July 2011, he expressed the opinion that the Accused was probably not fit to stand trial. It should be borne in mind that the charges in relation to which Dr Martin was then expressing an opinion were different to those before the Court today. On one view of it, they are more straightforward as to the nature of the allegations against the Accused. They arose out of what was said to be a very serious but, it would seem, single incident of violence towards the Accused's then partner.
30Thereafter, Dr Nielssen, on 1 November 2011, expressed the opinion that the Accused was unfit to be tried, in particular upon the basis of his refusal or inability to respond to the charges, and what seemed to be an inability to provide reliable instructions to his legal representative about how to present his case. Again, I observe that Dr Nielssen was addressing the District Court charges, and not the present set of charges.
31His Honour Judge Keleman SC found the Accused unfit to be tried on 21 November 2011, and referred the Accused to the Mental Health Review Tribunal.
32Thereafter, Dr Andrew White, psychiatrist with Justice Health, examined the Accused at the request of the Mental Health Review Tribunal for the purpose of its then forthcoming inquiry. On 10 January 2012, Dr White reported on that examination, and indicated that he applied directly the elements of the Presser test. Dr White expressed the opinion that, on balance, the Accused was unfit to be tried for the District Court matters. Dr White's main concern was the Accused's ability to follow proceedings, and that that would impact on his ability to understand the substantial effect of evidence given against him. Dr White observed that the Accused's ability to cope with stress would lead to an issue of unfitness as outlined in Kesavarajah v The Queen.
33The Mental Health Review Tribunal then conducted an inquiry on 27 January 2012. The Tribunal was constituted by its then President, the Honourable Greg James AM QC, Dr Peter Shea, psychiatrist, and Mr John Haigh.
34In its determination of 14 March 2012, the Tribunal referred to the reports of Dr Martin, Dr Nielssen and Dr White. The Tribunal indicated that there was some confusion as to the Accused's precise charges. The Accused seemed to understand that the then relevant charges related to what was said to be an altercation with his partner, but he was of no assistance as to the other charges. The "other charges" I take to be the present charges, which were at that time before the Local Court but, since August 2012, have been before this Court.
35As I have already noted, the Tribunal concluded that the Accused was unfit to be tried, and was unlikely to become fit to be tried within the next 12 months.
36Dr Adam Martin provided a further report dated 21 March 2012, which followed an examination of the Accused at the MRRC on 7 March 2012. Once again, Dr Martin sought to apply the Presser test. It would seem that Dr Martin, at that stage, was still confining his inquiry to the matters before the District Court. However, even with that more straightforward set of charges, Dr Martin concluded that, given the Accused's responses to his questions relevant to the Presser test, it was difficult to reach any conclusion other than the Accused was probably unfit to plead or to stand trial. There had been no apparent progress in his condition and, according to the Accused's subjective account of his symptoms, in some ways he appeared to have worsened.
37Dr Martin concluded that it was highly unlikely that the Accused's level of understanding of the Court process was likely to change materially, regardless of which medication he was prescribed.
38The most recent medical evidence before the Court is the report of Dr Martin of 28 August 2012. Dr Martin examined the Accused on 23 August 2012 at the Long Bay Hospital. Dr Martin observed that the Accused had two separate sets of charges and understood, by that time, that the inquiry fixed for today was to take place in the Supreme Court.
39Accordingly, Dr Martin's examination of the Accused on 23 August 2012 was undertaken for the current set of charges as well as, indirectly, the District Court matters.
40In this report, Dr Martin concluded that the Accused appeared to have difficulty concentrating and understanding concepts, even when explained fairly basically. Dr Martin was not convinced that the Accused was then likely to be able to understand satisfactorily the legal process or to be able to make a reasoned defence, challenge evidence or instruct his defence team adequately.
41Dr Martin's impression was that the Accused was unlikely to be fit to stand trial, and his assessment was that that was unlikely to change even with ongoing antipsychotic treatment. Dr Martin formed the view that the Accused was probably of borderline intelligence only, and that this impacted upon his level of understanding of the Court process as well.