On 12 February 2013 Jason Shepstone died after Ms Wilson inflicted serious burns when she poured boiling water over him. In October 2015, I found that she was unfit to be tried for his murder, she then suffering considerable ill health and having been diagnosed to be suffering moderate to severe depression, as well as a range of psychotic symptoms, PTSD, having cognitive impairment and her IQ falling in the range for mild intellectual disability: R v Wilson [2015] NSWSC 1538.
At a special hearing later conducted under the provisions of the Mental Health (Forensic Provisions) Act 1990 (NSW) before me as a judge sitting alone, I found that on the limited evidence available, Ms Wilson was not guilty of Mr Shepstone's murder, but guilty of manslaughter: R v Wilson (No 4) [2017] NSWSC 1730.
For that offence, in July 2018 I nominated a limiting term of 2 years, 6 months' imprisonment, commencing on 5 July 2018 and concluding on 4 January 2021 and referred Ms Wilson to the Mental Health Review Tribunal under s 24(1)(a) of the Mental Health (Forensic Provisions) Act. Ms Wilson was also granted bail pending orders being made under s 27 of that Act: R v Wilson (No 5) [2018] NSWSC 1077.
By an amended determination of 1 March 2019 the Mental Health Review Tribunal has reported to the Court under s 24(2) of the Mental Health (Forensic Provisions) Act, that it has determined that Ms Wilson is no longer suffering from a mental illness, but that she is suffering from a mental condition for which treatment is not available in a mental health facility. The Tribunal also advised that it had formed the opinion that Ms Wilson has not become fit to be tried: s 47(4). It also concluded that a mental health facility is not the appropriate environment for her condition to be treated and that the more appropriate form of treatment is that provided in the community by an aged care facility.
In April 2019, NCAT made a limited guardianship order for Ms Wilson in favour of the Public Guardian, which gives it custody of Ms Wilson, in order to carry out specified functions. They include deciding where Ms Wilson may live; what medical treatment she may receive; making "substitute" decisions about proposed medical treatment, if she is not capable of giving consent; and to authorise others, including ambulance service officers, to retrieve her to a place of accommodation or safety, over her stated objections, if necessary.
When the matter came on for hearing on 30 April 2019, as the result of steps already taken by the Guardian, Ms Wilson was an in-patient in a locked medical ward, at Shellharbour Hospital.
Section 27 of the Mental Health (Forensic Provisions) Act now requires the Court to consider the Tribunal's Determination and to make an order as to Ms Wilson's detention.
Annexed to an affidavit sworn by Mr Coulton, a solicitor employed in the office of the Director of Public Prosecutions, was an email from Dr Irvine, the Director of Medical Services at the Southern Illawarra Hospital Group, in which she advised that the ward where Ms Wilson is an inpatient at the Hospital is not a "private mental health facility", or a "declared mental health facility" under the Mental Health Act.
Dr Irvine also advised that the locked ward requires a staff swipe card for exit; Ms Wilson is there under a "coercive treatment order", to assist keeping her in the hospital environment; but that she is able to go on "gate leave" with a carer. What such leave involves, was not there explained, nor was who made the "coercive treatment order", but there is no issue between the parties that Ms Wilson is in hospital, as the result of steps taken by the Guardian.
Dr Irvine further advised that "The hospital staff feel that Ms Wilson is unsafe in the home environment and she remains here whilst a suitable care solution is found". Dr Irvine also said that she understood that Ms Wilson might be ordered to live in an aged care facility and that this might entail her staying in the hospital, until a suitable bed was found. She considered that the hospital was not the most appropriate environment for Mrs Wilson's care and so "consideration of early placement and suitable temporary alternatives need to be a priority".
The matter was adjourned part-heard without objection on Ms Wilson's application, in order that further evidence could be obtained as to what enquiries had been made about suitable care in an aged care facility. At the resumed hearing further evidence was led, including from the Public Guardian and from Dr Irvine, who gave oral evidence and was cross-examined.
Dr Irvine then confirmed that Ms Wilson would remain in the ward at the Hospital until an aged care placement in a locked ward was found for her and if the Court ordered her detention, she would remain in the Hospital, in accordance with that order.
[2]
The issue
The Court having received the Tribunal's Determination, there is no issue that it must now order that Ms Wilson "be detained in a place other than a mental health facility": s 27(b) Mental Health (Forensic Provisions) Act.
The only issue thus remaining between the parties is what specific order the Court should now make. The cases which the parties each advanced raise questions as to the proper construction of s 27.
[3]
The parties 'cases
The Crown contended that on the evidence the only order which the Court could now make, given the requirements of s 27, was that Ms Wilson be detained in a correctional facility. There is no issue that the Court can make such an order under s 27(b).
It was Ms Wilson's case initially, that the Court would order that she be detained in a locked aged care facility or medical ward. After Dr Irvine gave evidence, the order pressed was that she be detained in a locked aged care facility or medical ward at Shellharbour Hospital.
That the Court can make such an order was in issue.
[4]
The proper construction of s 27
Section 27 must be construed in its statutory context. I explained the statutory scheme in R v Wilson (No 5) [2018] NSWSC 1077. As I there discussed at [114] the construction question which has now arisen in that statutory context, must again begin with a consideration of the text of the section, that being "the surest guide to legislative intent", which must be considered in context, including the general purpose and policy of the provision, in particular the mischief it was intended to remedy: Alcan (NT) Alumina Pty Ltd v Commissioner of Territory Revenue (NT) (2009) 239 CLR 27; [2009] HCA 41 at [47].
Context must be regarded at this first stage and not a later stage and "it should be regarded in its widest sense". The natural and ordinary meaning of words and how they are ordinarily understood in discourse is important to the process of construction, but considerations of context and purpose recognise that, understood in its statutory, historical or other context, some other meaning may be suggested and if the ordinary meaning is not consistent with the statutory purpose, it must be rejected: SZTAL v Minister for Immigration and Border Protection (2017) 262 CLR 362; [2017] HCA 34 at [14].
A consideration of the consequences of competing constructions is also relevant: Cooper Brookes (Wollongong) Pty Ltd v Federal Commissioner of Taxation (1981) 147 CLR 297 at 321; [1981] HCA 26.
Section 27 provides:
"27 Orders Court may make following determination of Tribunal after limiting term is imposed
If a Court is notified by the Tribunal of its determination in respect of a person under section 24 (3), the Court may:
(a) if the Tribunal has determined that the person is suffering from mental illness or that the person is suffering from a mental condition for which treatment is available in a mental health facility and that the person, not being in a mental health facility, does not object to being detained in a mental health facility - order that the person be taken to and detained in a mental health facility, or
(b) if the Tribunal has determined that the person is not suffering from mental illness or from a mental condition referred to in paragraph (a) or that the person is suffering from such a mental condition but that the person objects to being detained in a mental health facility - order that the person be detained in a place other than a mental health facility."
In Director of Public Prosecutions (NSW) v Khoury (2014) 306 ALR 86; [2014] NSWCA 15, it was held that despite the word "may" used in the introductory words of s 27, the Court cannot decline to make an order under the section, after it receives a s 24(2) report from the Tribunal: at [23], [47], [58].
Thus it is common ground that at this point of the statutory process, the Court has no further power to order Ms Wilson's release, either conditionally or unconditionally. That is now a matter for the Tribunal under Part 5 of the Mental Health (Forensic Provisions) Act.
Rather, given what the Tribunal has determined, the Court must now order that Ms Wilson be "detained in a place other than a mental health facility": s 27(b). That is, in a place which is neither a "declared mental health facility", or "a private mental health facility".
There was finally no issue that it was possible for a s 27(b) order to specify a place other than a correctional centre, as the place where a person subject to a limiting term is to be detained.
The Crown's case was, however, that if the place was not a correctional centre, it had to be specified in the order and evidence led as to how it operates; how it physically and legally detains people; and whether it was prepared to police the detention ordered. That was because the Court had to be satisfied that it was a place at which a person could be "detained".
That was in issue.
It was Ms Wilson's case that in construing s 27, it must be borne in mind that in s 27(b) the Legislature did not, as it could have, require that the Court order that a person suffering from a mental condition for which treatment is not available in a mental health facility, be detained in a correctional centre. Rather, it is empowered to order that such a person be detained in "a place other than a mental health facility".
That term is not defined, but on the approach urged for Ms Wilson, the place at which she was to be detained did not have to be specified in the order. It would be sufficient to specify that it be a hospital or an aged care centre.
The place named in a s 27(b) order may not be a "mental health facility". That term is defined in s 3 to have the same meaning as it has in the Mental Health Act 2007 (NSW), where it is defined in s 4 to mean "a declared mental health facility or a private mental health facility". Whether a particular place is a "mental health facility" is thus a question of fact.
On the evidence of Dr Irvine, the locked ward of Shellharbour Hospital has not been declared to be such a facility. Her uncontested evidence thus establishes that it is a place which could be named in a s 27(b) order, if the evidence also establishes that a person can be "detained" there.
Despite Dr Irvine's evidence, that remained in issue.
The position is not the same in relation to aged care facilities. Dr Irvine was not asked whether the aged care facilities which have locked wards, to which she referred in her evidence, some of which are private and some public, have been declared to be a "mental health facility".
It follows that the evidence does not establish that any aged care facility which might be identified through the process Dr Irvine explained is being pursued, to find a suitable locked ward to which Ms Wilson can be admitted, is not a "mental health facility". Nor did Dr Irvine's evidence establish that any specific facility which may be identified is a place where Ms Wilson can be "detained".
The word "detained" is not defined in the Mental Health (Forensic Provisions) Act and must thus be given its ordinary meaning, which comprehends, but is not confined to a person being held in a custodial environment.
Its ordinary definition in the online Macquarie and Oxford Dictionaries, respectively are:
Macquarie Dictionary:
"detain
verb (t) 1. to keep from proceeding; keep waiting; delay.
2. to keep under restraint or in custody.
3. to keep back or withhold, as from a person.
Oxford Dictionary:
a. transitive. To keep in confinement or under restraint; to keep prisoner. spec. To place (a political offender) in confinement."
The meaning of the word "detain" thus involves the notion that someone is keeping someone else under restraint, custody or confinement.
If the Court ordered that Ms Wilson be detained in a correctional centre, as was common ground it was empowered to do under s 27(b), there is no issue as to the steps which will be taken to ensure that the order is complied with, with the result that Ms Wilson will be "detained". She will thereby have been lawfully ordered to be detained in a facility regulated by the Crimes (Administration of Sentences) Act 1999 (NSW): s 4(e).
That Act, it should be noted, makes provision for how an inmate is to be detained, including by transfer to a hospital or some other place, if the Commissioner of Corrective Services is of the opinion that it is necessary or desirable for the inmate to receive medical attention: s 24(1). On its face that would appear to encompass transfer to a mental health facility if medical attention could be provided there for a mental illness or condition.
The Mental Health Act regulates detention in a "mental health facility": s 12. Accordingly, if an order was made under s 27(a) that a person be detained in such a facility, there can also be no question as to how the Court's order would be complied with, with the result that the person would be detained at the facility.
Neither party suggested that some other legislative scheme regulated detention in places other than mental health facilities or correctional centres. Yet s 27(b) contemplates that the Court can also order detention at places "other than a mental health facility".
That aspect of s 27 must have work to do. Accordingly, as the Crown accepted, so long as the Court is satisfied that the place specified in its s 27(b) order is not a mental health facility and a place where a person can be "detained", the discretion to make the order can be exercised.
In Khoury Bathurst CJ and Basten JA did not discuss the meaning of the word "detained", but at [47] Basten JA observed by reference to State of New South Wales v TD [2013] NSWCA 32 at [35]-[46], that after a limiting term is imposed the Court is restricted "to determining the place in which he or she should be detained" and at [62], that "the remaining question is where the detention should occur, the options being in a mental health facility or some other specified place".
This latter observation supports the conclusion which I have reached as to the proper construction of s 27, which requires that if detention is to be ordered at a place other than a mental health facility or correctional centre, that place must be specified in the order.
In Khoury, Simpson J (as she then was) considered the meaning of the word "detained", noting at [139] that s 27 provides only for detention in either a mental health facility, or a place other than a mental health facility. Her Honour observed that "it has commonly been assumed that "a place other than a mental health facility" means, or at least includes, a correctional centre within the meaning of the Crimes (Administration of Sentences) Act". Her Honour also noted that whether that was correct did not, however, arise for determination.
It does arise for determination in this case and there is no issue now between the parties, that the statutory term includes a correctional centre.
Simpson J also observed at [140] that "detained" is not defined in the Act, but considered that the word "implies coercion of the kind supported by law enforcement authorities". Compulsory "detention" not being "ordinarily amenable to non-custodial residential facilities".
For Ms Wilson it was submitted that her Honour's conclusion was incorrect, while the Crown relied on this observation to support its argument that detention in a hospital or aged care facility cannot be ordered, unless the place is specified and the evidence establishes that a person can be "detained" there.
For Ms Wilson reliance was placed on Johnson J's observations in State of New South Wales v Windle (No. 3) [2017] NSWSC 727 at [179]-[185], where his Honour had to consider the provisions of s 10(1A)(b) and (2) and s 25B(2)(b) of the Crimes (High Risk Offenders) Act 2006 (NSW). They have the effect that the operation of an extended supervision order will be suspended whilst a person "is in lawful custody whether under this or any other Act or law".
Johnson J accepted that "a person detained in a mental health facility under the Mental Health Act 2007 is "in lawful custody … under … any other Act or law": at [182]. His Honour also observed at [183]-[185]:
"183 The term "lawful custody" is not defined in the High Risk Offenders Act. The term "custody" is not to be narrowly confined: Eatts v Dawson (1990) 21 FCR 166 at 178-9. It is clear that involuntary detention under mental health legislation may be sufficient to found a writ of habeas corpus: Antunovic v Dawson (2010) 30 VR 355; [2010] VSC 377 at 376-380 [99]-[113], 395 [196]; White v Local Health Authority [2015] NSWSC 417 at [78]. The concept of "lawful custody" is not confined to custody or detention for penal or punitive purposes. Involuntary detention in cases of mental illness is non-punitive in character: Chu Kheng Lim v Minister for Immigration (1992) 176 CLR 1; [1992] HCA 64 at 28 [24]; Re Woolley; Ex parte Applicants M276/2003 [2004] 225 CLR 1; [2004] HCA 49 at 24-25 [58].
184 I accept the Plaintiff's submission that, whilst the Mental Health Act 2007 uses the terminology of "detain" and "detention", the concept of involuntary detention involves "custody" given the restraint on liberty which flows from the authority to detain conferred by law. An involuntary patient under the Mental Health Act 2007 is given into the custody of the mental health facility and is not free to leave. This approach is supported by the decision of the Court of Appeal in Graham v State of New South Wales [1989] NSWCA 89.
185 Accordingly, I accept that any detention of the Defendant under the Mental Health Act 2007 will constitute lawful custody so as to suspend the operation of the ESO for the period of such lawful custody. In making orders on 26 May 2017, I utilised the approach adopted by Davies J in State of New South Wales v Cruse (No. 2) at [122] and State of New South Wales v Boatswain at [114] by including a notation (in Order 5) concerning the way in which s.10(2) High Risk Offenders Act would operate in the circumstances of the present case."
Davies J reached similar conclusions in State of New South Wales v Boatswain [2014] NSWSC 1446 at [114].
In my view, consistently with Johnson J's approach in Windle, the Court's detention order under s 27 must have the result that there be a restraint imposed on the person's liberty, the place specified in the order being one from which he or she will not be free to leave. That requires evidence upon which satisfaction can rest, that the place specified, will provide such restraint.
Reliance was also placed on TD, where in issue was whether detention after a limiting term had been imposed under the then entitled Mental Health (Criminal Procedure) Act 1990 (NSW), had deprived TD of her liberty and whether, nevertheless, she had made out the elements of the tort of false imprisonment.
That arose for consideration in circumstances where Wood J had first ordered under s 24(1)(a) that TD be detained at Mulawa Correction Centre. After receipt of the Tribunal's determination, in June 2002 Wood J ordered that "in accordance with s 27 of the said Act" that TD "be taken to and detained in a hospital": at [69]. There was no issue that the s 27 order was valid and effective in its terms, requiring as it did that TD be detained in a hospital: at [70].
Section 27 then provided:
"Orders Court may make following determination of Mental Health Review Tribunal after limiting term is imposed
If a Court is notified by the Mental Health Review Tribunal of its determination in respect of a person under section 24 (3), the Court may:
(a) if the Tribunal has determined that the person is suffering from mental illness or that the person is suffering from a mental condition for which treatment is available in a hospital and that the person, not being in a hospital, does not object to being detained in a hospital - order that the person be taken to and detained in a hospital, or
(b) if the Tribunal has determined that the person is not suffering from mental illness or from a mental condition referred to in paragraph (a) or that the person is suffering from such a mental condition but that the person objects to being detained in a hospital - order that the person be detained in a place other than a hospital."
Contrary to the s 27 order, TD was for a period in July 2002 held in a prison in a cell which was not a "hospital" as then defined in the Dictionary to the Mental Health Act, albeit the adjoining cell had been declared to be such a hospital: at [68].
The State conceded that TD's detention for the period in question in the cell in which she had been held was thus unlawful, there being no lawful order or authority justifying such detention and the statutory scheme for detention of inmates and offenders not then operating with respect to TD: at [75].
For Ms Wilson it was contended that like the order made in TD, it was unnecessary for the order to specify a particular aged care centre at which she would be detained. All that s 27 required was that a place of detention be specified in the order and the Tribunal having already determined that it would be more appropriate for her to be placed in an aged care facility, making an order that she be detained at such a facility, was sufficient. Further, to conclude otherwise, would not pay necessary regard to what the legislative scheme intended.
I am satisfied that this cannot be accepted.
In TD, there was no question as to the validity of the order that TD be "detained in a hospital". But that order was made at a time when s 27(a) provided for such detention, as s 27(a) now does in respect of orders for detention at a mental health facility. It was not an order under s 27(b), that TD be detained in a place "other than a hospital", as is here in issue.
Section 27 was amended in 2007 to replace the reference to "hospital" with "mental health facility", reflecting what was then enacted in the Mental Health Act. As explained in the Second Reading Speeches, this was the culmination of an extensive consultation and review process, to take mental health services in a new direction: New South Wales Legislative Assembly, Parliamentary Debates (Hansard), 22 November 2006 at 4611.
Section 27 is thus now concerned with the detention order which should be made, following the Tribunal's determination as to whether the person in question is suffering from a mental illness or mental condition for which treatment is available in a mental health facility.
Whether or not such treatment is available, the Court must still order the person's detention. The place of detention must now either be a mental health facility, or some other place. In the case of an order under s 27(b) order, the place specified will be influenced both by the conclusions reached by the Tribunal in its Determination, about the nature of the person's illness or condition and the treatment it requires and the what the evidence led establishes.
As I have explained, detention in mental health facilities which may be ordered under s 27(a), is regulated by statute. Detention in hospitals and aged care centres is not so regulated and accordingly, in my view, if a s 27(b) order is to be made, as well as being satisfied on the evidence that the place specified in the order is not a "mental health facility", the Court must also be satisfied that it is a place where a person can be "detained".
That must be resolved on the evidence.
[5]
Does the evidence establish that Ms Wilson can be "detained" in the locked ward at Shellharbour Hospital or in the locked ward of an aged care facility?
Dr Irvine's evidence was that Ms Wilson was admitted to the locked medical ward at Shellharbour Hospital, as the result of steps taken by the Public Guardian, after her bail was continued by the Court in 2018 and the Tribunal's determinations were made in 2019.
The functions specified in the Guardianship order do not include the function of detention, but they do include functions which permit the Guardian to take steps to ensure that Ms Wilson is restrained; that she remains in the locked ward where she has been admitted; and that she is returned to the ward, should she leave it unaccompanied.
Ms Elliott, the Principal Guardian for the NSW Public Guardian, is currently responsible for Ms Wilson. In her letter she explained the circumstances in which Ms Wilson was admitted into Shellharbour Hospital for treatment for her physical and mental comorbidities. Ms Elliott also explained how the treatment Ms Wilson has there received has resulted in a position where her acute medical issues have been resolved, to the point where she understands that Ms Wilson can now be transferred to an aged care facility.
Ms Elliott also explained that under the guardianship order, the Public Guardian has the power presently to authorise others to return Ms Wilson to a place of safety, should she leave the locked ward and refuse to return. The exercise of that power would depend on notification by hospital staff after less coercive measures had failed to result in her return, on satisfaction that there was a risk to Ms Wilson, if she did not do so.
Ms Elliott also said that she was supportive of the proposal that Ms Wilson be transferred to a suitable aged care facility, which the Hospital proposed.
Dr Irvine's evidence confirmed that Ms Wilson remains admitted in the locked ward at the Hospital, the Guardian having accepted the advice of her treating medical team, that she is incapable of caring for herself at her home. Dr Irvine also said that her cognitive condition continues to decline.
On Dr Irvine's evidence, while it is possible that Ms Wilson might elude staff and leave the locked ward, given the number of those who visit the ward, that has not occurred and if it did, steps would be taken by hospital staff to return her to the ward. That would include, if necessary, police involvement.
This evidence establishes, I am satisfied, that Ms Wilson is currently restrained in the locked ward. She is not free to return to her home, where she was earlier bailed to reside, even if she wishes. That has resulted from the Guardian's exercise of the functions granted by NCAT, on medical advice, because of Ms Wilson's deteriorating condition and the Hospital's response to the exercise of the Guardian's functions.
On Dr Irvine's evidence, it is also apparent that ward is no longer the best place for Ms Wilson's detention, but nor clearly, is a correctional centre, given the evidence of her deteriorating condition.
Ms Wilson does not have the means herself to pay for placement at an aged care facility and so, on Dr Irvine's evidence, the result is that it falls to the Hospital and her medical team to identify a suitable placement. But none has yet been identified.
Even though no legislative scheme regulates detention at the Hospital, On Dr Irvine's evidence, account will be taken of the Court's s 27 order in finding such a placement for Ms Wilson, if it be made and in the meantime, the Hospital would adhere to the order. That unchallenged evidence must be accepted. Necessarily, even when the Court orders that a person be detained in a correctional centre or mental health facility, enforcement of its order depends on actions taken by employees of the State.
Dr Irvine's evidence reflects that those involved in caring for Ms Wilson in the Hospital and identifying a suitable placement are employees of the State. On Dr Irvine's evidence, they have been awaiting the Court's order, before finalising any placement.
Dr Irvine's evidence was that a suitable aged care facility may not necessarily be a public facility and that a facility's ability and willingness to provide the detention which the order proposed for Ms Wilson would require, will be a part of the process of identification of a suitable locked facility. Dr Irvine could not speak on behalf of such facilities, but understood that a locked ward at a suitable facility would provide greater security than that currently provided on the Hospital's locked ward.
On that evidence I am satisfied that there are public aged care facilities where Ms Wilson conceivably could be ordered to be "detained".
If Ms Wilson were to be detained at a private facility, however, enforcement of the proposed order would necessarily depend on the co-operation of the facility, there being no statutory scheme which imposes relevant obligations on such a facility.
That being the case, I am not satisfied that this aspect of Ms Wilson's proposed order is one which the Court can make under s 27(b), the aged care facility at which Ms Wilson is to be detained not there being specified. The result is that there is thus no evidentiary basis for satisfaction that any aged care facility to which she might be transferred is either a "mental health facility", or a place where she can be "detained".
In my view, under this statutory scheme, which I will further discuss below, those are matters about which the Court must be satisfied, before an order under s 27(b) is made. They simply cannot be left to those who are seeking a suitable placement for Ms Wilson, no matter how well intentioned it may be accepted that those persons are, or how difficult Ms Wilson's circumstances, undoubtedly, are.
[6]
Ms Wilson's current position
The nature of Ms Wilson's considerable physical and mental health conditions were discussed in my earlier judgments. She is a "forensic patient" as defined in s 42 of the Mental Health (Forensic Provisions) Act, even though she was released from custody on bail under the Court's s 24 order: s 42(a). Her conditions of bail will thus be revoked, when the s 27 order is made.
Once the Court has made an order under s 27(b) for Ms Wilson's detention, s 45(1)(b) will then require the Tribunal to again review Ms Wilson's case "as soon as practicable", that provision appearing in Part 5 of the Act. The objects of that Part are those specified in s 40, which provides:
"40 Objects
The objects of this Part are as follows:
(a) to protect the safety of members of the public,
(b) to provide for the care, treatment and control of persons subject to criminal proceedings who are suffering from a mental illness or mental condition,
(c) to facilitate the care, treatment and control of any of those persons in correctional centres through community treatment orders,
(d) to facilitate the provision of hospital care or care in the community through community treatment orders for any of those persons who require involuntary treatment,
(e) to give an opportunity for those persons to have access to appropriate care,
(f) to protect the safety of victims of forensic patients and to acknowledge the harm done to victims."
Section 46 will also thereafter require the Tribunal to again review Ms Wilson's case, at any time, but at least every 6 months. On a s 46 review the Tribunal may order her continued detention, or her release: s 47(1).
It follows that even if an order of the kind for which Ms Wilson contends is not now made, the Tribunal can give effect to its determination that Ms Wilson should be treated in an aged care facility, when one is located.
[7]
The Tribunal's amended s 24 Determination
In determining what order the Court should make, there is no issue that Tribunal's determination must be taken into account.
Section 24 of the Mental Health (Forensic Provisions) Act required the Tribunal to determine whether or not Ms Wilson:
1. was suffering from mental illness, or
2. was suffering from a mental condition for which treatment is available in a mental health facility and, where the person is not in a mental health facility, whether or not the person objects to being detained in a mental health facility.
"Mental condition" is defined in s 3 to mean "a condition of disability of mind not including either mental illness or developmental disability of mind".
In its amended Determination the Tribunal accepted the common view of the psychiatrist Dr Bradbury and Dr Korbel of the Community Forensic Mental Health Service, that "the main component of Ms Wilson's presentation was the mental condition of her vascular dementia rather than the mental illness which is at present in remission because it is unprovoked". That was the basis for its conclusion that a mental health facility is not the appropriate place for her condition to be treated and that the more appropriate form of treatment is that provide in the community by an aged care facility.
Under the heading "Determination", the Tribunal said that it had inferred that Ms Wilson objected to being detained in a mental health facility. It made no order that Ms Wilson be detained in an aged care facility, but it has power to make such an order under s 47(1) of the Mental Health (Forensic Provisions) Act.
[8]
The orders finally pressed cannot be made
As I have explained, the Crown contended that the Court should order that Ms Wilson be detained in a correctional centre. Given the Tribunal's amended Determination and the evidence I have discussed, I am satisfied that such an order should not be made.
The Tribunal concluded that Ms Wilson would best be placed in an aged care facility. Since its amended Determination, as I have explained, further relevant events have occurred, which necessitated her admission to the locked medical ward at the Hospital. Those developments and the evidence of her deteriorating cognitive condition, support the conclusion that an aged care facility is the best place for her to be detained in the long term, but no suitable facility has yet been identified.
The orders finally pressed for Ms Wilson were:
"Ms Wilson be detained in a locked aged care facility or medical ward at Shellharbour Hospital".
As I have explained, the evidence establishes that Shellharbour Hospital is not a "mental health facility" as defined and is a place where Ms Wilson can be "detained.
Given that Ms Wilson, elderly and infirm as she otherwise is, is suffering ongoing cognitive decline, that reflecting the deteriorating vascular dementia to which the Tribunal referred and no suitable aged care facility where she might be detained yet having been identified, I am satisfied that the order which should justly be made under s27(b), is that she be detained at the locked ward of the Hospital.
While it must be accepted that this is not, given all that I have discussed, I am well satisfied that it cannot accept that the Court's discretion should be exercised to require that Ms Wilson be detained in a correctional centre, notwithstanding the limiting term which I imposed upon her. That conclusion rests on the Tribunal's determination that the state of her mental illness and mental conditions require that she be treated in an aged care facility and that it did not conclude that she should be detained in a correctional centre as it, undoubtedly, could have.
Given the other evidence I have discussed and s 27(b) permitting, as the Crown accepted, that the Court may order that Ms Wilson be detained in the Shellharbour Hospital, so long as it is satisfied that the evidence established that the locked ward there is a place where she can be "detained', I am satisfied that this is what I should order, in proper exercise of the Court's discretion.
That order will permit the search Dr Irvine explained for a suitable aged care facility for Ms Wilson to be pursued, while she is detained in the locked ward of the Hospital. On her evidence it appears likely that by the time that her case is again reviewed by the Tribunal, a suitable facility will have been identified for Ms Wilson, s 45(1)(b) requiring that the Tribunal again review Ms Wilson's case "as soon as practicable", after the Court's s 27 order is made.
Given all of these circumstances, I will direct the Registrar to refer this judgment to the Tribunal, so that it may give Ms Wilson's case its urgent consideration.
[9]
Orders
For these reasons, I order that:
1. Ms Wilson's bail is revoked.
2. Ms Wilson be detained in the locked ward at Shellharbour Hospital where she is presently admitted.
[10]
DISCLAIMER - Every effort has been made to comply with suppression orders or statutory provisions prohibiting publication that may apply to this judgment or decision. The onus remains on any person using material in the judgment or decision to ensure that the intended use of that material does not breach any such order or provision. Further enquiries may be directed to the Registry of the Court or Tribunal in which it was generated.
Decision last updated: 10 May 2019