[2013] AATA 309
General information, not legal advice.
Administrative Appeals Tribunal of Australia
2013-05-15
Original judgment source is linked above.
...[T]he prisoner having previously equipped himself with a length of metal pipe, namely the shower rail which he had torn from the wall and broken into a manageable piece, confronted Mr Lee, the first officer who opened the door. He says himself he punched Mr Lee. There was some use of the metal rod. Prison Officer Shaw came in to assist. He was knocked unconscious while attempting to tackle the prisoner. He sustained an injury to both arms, a fracture of his right wrist, severe bruising of his left arm and various other injuries. Officer Honeysett, also coming in to assist, was threatened by the prisoner, but not actually stuck, but finally engaged in a tug of war to retrieve the metal rod from the prisoner's grasp. The prisoner was then restrained.
The assaults on the three officers are themselves serious. The effects physically and psychologically upon, at least Mr Shaw, were themselves serious. He gave evidence that he is still undergoing counselling and he said he suffered a fracture of his wrist. Mr Lee described himself as being unable to return to full duties for seven weeks or so. Of course the severity of injury is not necessarily determinative of the severity of sentence, but it is certainly a factor to be taken into account. ...
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During the course of the trial and I assume it is still before me there was tendered a report from Professor Greenberg, as well as the report of Dr Andronkashvi, which indicates that the prisoner does have some psychological difficulties. He appears to be suffering from depression. Whilst he was fit to plead and continued to be fit to conduct his case, it was obvious that there is a rigidity of thought and without expressing any unqualified lay-diagnosis, the appearance at least of paranoia, to which Professor Greenberg referred. ...[2]
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I should also say this, that [the Applicant], with his perceptions of what [is] going on around him, probably represents a difficult prisoner to manage, but he is nonetheless entitled, as he claims himself, to be treated in accordance with the law. ... For his part, he should understand that sometimes, regardless of how fervently he believes something to be the case, he is at times wrong and his perceptions as to the way in which he is being treated, are not necessarily accurate.[3]
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The injury to the victim was substantial. ... The records of the Liverpool Hospital indicate there to be a laceration in the anterior chest wall with x-rays disclosing a left haemothorax from which blood was aspirated. The victim required further treatment. It is noted he was stabbed four times, two in the chest area, one in the lower limb, and one in the right arm. He subsequently required treatment by way of thoracotomy, repair of the left ventricle and pericardium, repair of a laceration to the left hemidiaphragm and suturing of wounds to the left lower lung and the right upper lung.
Medical reporting from Dr S Raj Sundaraj of 30 January 2007 notes that at that time the victim continued to be troubled with very severe pain in the left anterolateral chest area with some left medial leg numbness and weakness. In his view the victim suffered neuropathic pain to the left chest, pleuritic pain, left leg saphenous nerve neuropathic pain and some clinical depression. He continued to receive treatment, including psychiatric treatment and support in respect of pain management.
Dr F Noore initially noted the victim to suffer post traumatic stress disorder and major depression which required treatment and medication. By September 2007 it was noted there had been significant improvement in relation to the depressive illness but the symptoms of PTSD continued to some extent. It was felt he required continuing medication.
Reports of a psychologist, Mr Parish, were also provided. They noted there had been some improvement in the victim's condition as at February 2008, although the victim continued to experience some significant psychological difficulties, which required continuing treatment. A victim's impact statement is before me. As I have said, it seems there were serious mental and psychological injuries to the victim, as well as the physical injuries. Because of his injuries the victim has been unable to work for a lengthy period of time and apparently suffers from post traumatic stress disorder to the extent he is unable to place himself in some situations because of his fear and lack of trust. I have no doubt the effects upon him have been severe. ...
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[In regard to a submission by the Applicant's counsel that the Applicant had "good prospects of rehabilitation"] there is a medical report under the hand of Dr David Greenberg, dated 4 September 2008 relating to his assessment of the offender by way of psychiatric assessment. He had apparently previously seen him in 2002 on two occasions, and on 29 July 2004. He obtained information from the offender's medical records at Justice Health and had the benefit of his earlier observations of the offender. He recorded the offender to be Hepatitis C positive with no physical symptoms at this time. He noted some history of alcohol abuse, but a denial of any need for treatment for that abuse. A long history of substance abuse was recorded from early adolescent times but he told Dr Greenberg he had not abused any substances in the past year and denied he was in any need for treatment for drug use.
It seems to me that his prospects for rehabilitation are not good and depend to a large extent upon his being compliant with medication and attending for treatment in respect of mental health problems to which I shall refer.
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Dr Greenberg reached a diagnosis of psychotic disorder with a query of schizophrenia and a query of drug induced psychosis (in remission) and also of alcohol and substance abuse. He thought him to have a personality disorder with anti-social and paranoid traits. In his opinion the offender suffers from a psychotic mental illness although the exact diagnosis was not clear.
He recorded that following the offender's release from custody in April 2006 he was referred to the Mildura Community Health Service for further follow-up care but was not compliant with psychiatric medication for two or three months prior to his current criminal offence. At the time of assessment he noted the offender to be treated with medication and to display no evidence of acute psychotic symptoms such as hallucinations or delusions, but noted him to continue to have some paranoid ideation and tended to have limited insight into his mental illness and the need for psychiatric treatment. He thought it unclear as to the role his mental illness played in the offence but thought it possible that mental illness played some part in the offence on the basis that he had discontinued his anti-psychotic medication two or three months prior to the offence. He thought him at high risk for further acts of violence.
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In relation to mental health issues I note he was considered fit to plead following receipt of psychiatric reports of Drs Westmore and Allnutt, and thus a fitness hearing was not considered necessary. It seems that since he has again been on prescribed medication his behaviour has modified, although it still appears he lacks insight into his mental health issues. On the last occasion on release from prison he ceased his medication.
It seems to me that in the light of his psychiatric problems and his need for continuing medication and assessment that I should find special circumstances as it appears to me that he will require a long period of supervision and rehabilitation and thus I am satisfied I should vary the statutory ratio in accordance with that finding of special circumstances.
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The offender is presently thirty-six years of age. He did not give any evidence before me and I am reliant upon the medical material tendered on his behalf in relation to any psychiatric condition. As I have said, it seems that if he continues to take his medication his mental condition stabilises, although he clearly lacks some insight into the mental health issues and on that basis it is difficult to assess his understanding of the seriousness of the offence which he has committed. ...
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It's not for me any more. It's never brought anything good into my life. I don't see any benefit. I want the good things in my life. I used to take drugs to numb me from life, now I want to take part in life. I want to be part of something bigger than me. I want to get a job, smile and laugh, look after the people who are important to me.
He had paranoid ideas, but there was no evidence of any overt delusional beliefs. His insight was poor with regard to his mental illness. He claimed there was nothing wrong with him and he feels that he did not need psychiatric treatment.
[The Applicant] was clear during the clinical interview in May 2012 that he did not believe that he is mentally ill and feels that he has been wrongly diagnosed. ... In a conversation on 15 October 2012 [the Applicant] disagreed with the diagnosis of Schizophrenia and thought that he was being punished for his beliefs by having his medication increased. ... He continues to maintain that he is not mentally unwell and that the medication is not of any assistance to him. ...
In Long Bay Hospital, other patients would warn you about not admitting to anything to the psychiatrists in case you would end up on medications, dribbling from the mouth and everything. I was afraid of being made to take medications. Even before I went there, other inmates told me that the doctors would medicate me because of my violent past.
I assaulted the Corrective Services Office[r]s in 2002 because they check your door each night and yet it seemed like the officers were waking me up on purpose. I complained often to the officers because it felt like I wasn't getting sleep at all - and in the end I lashed out.
[The Applicant] recalled that the offence took place in 2006, and that he was released from custody approximately six months prior. He said that during this time he was "living rough" near Campbelltown. He said he was not in a relationship, not working, and not having any regular contact with his daughter. He told me that he was not in receipt of psychiatric medication, because his prescription ran out, for two to three months leading up to the offence. He told me that he was meant to have contact with the Mildura mental health team, but did not as he was not residing there. He said he was disconnected from his family during this time. He recalled smoking cannabis and drinking alcohol at weekends, but denied any history of regular intoxication.
I asked [the Applicant] about his mental health during the time leading up to the offence, to which he replied, "I wasn't in a good way ... I was hearing the voices and that ... it was pretty rough". [The Applicant] recalled feeling unsafe, stating "I couldn't trust anyone". He stated, "I was suspicious of everybody", including family and friends. He described widespread ideas of persecution and believed that various people wanted to harm him. His description of hearing "voices" was consistent with that illustrated above. He recalled feeling confused, irritable and distressed during this period.
[The Applicant] told me that he did not consume any illicit substances or alcohol on the day of the offence. He commented, "I needed to get some money so I went to try and rob a security guard and ended up stabbing him, I hurt him very bad ... I was becoming a danger to everybody and myself ...". On further exploration of his mental state at this time, [the Applicant] commented, "to tell you the truth, I don't remember exactly what was going on", and he said he was unable to recall his exact thought processes. He stated, "I doubt I even knew what I was doing".
Whether [the Applicant] is likely to take his medication upon release into the community.
During my assessment [the Applicant] noted his intention of remaining complaint (sic) with psychiatric medication in the future, including upon his release into the community. I understand that he is currently prescribed oral antipsychotic medication. Given [the Applicant's] clinical picture, history of non-compliance, and his severity of past relapses of psychotic symptoms, in my view it would be pertinent to commence injectable long-lasting antipsychotic medication, if [the Applicant] consents. In my view this would decrease the likelihood of future non-compliance and hence relapse.
If [the Applicant] continues to use his medication in the community, what is his likelihood of reoffending?
In my opinion [the Applicant's] psychiatric management should include antipsychotic medication, as discussed above, and I also believe that additional facets of management would be of benefit. I believe that [the Applicant] would benefit from: assertive input from mental health services; regular review by a psychiatrist and case worker; psychological therapy to include psychoeducation, and input addressing areas such as emotional recognition, emotional regulation, adaptive coping strategies, and offending behaviour; abstinence from illicit substance and alcohol use; formal drug and alcohol rehabilitation; and social assistance reintegrating into the community and family network. In my opinion, it is reasonable to conclude that the entirety of this psychiatric management plan would mitigate [the Applicant's] risk of reoffending.
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Recidivist Assessment
The progress [the Applicant] has made since the commission of the offence.
On the basis of the information currently available, it appears that [the Applicant's] clinical presentation has stabilised significantly since 2006, with regards his mental health, levels of irritability and aggression, overall insight, and ability to regulate his emotions.
The likelihood of [the Applicant] reoffending.
In considering [the Applicant's] violence risk it is evident that in (sic) he manifests a number of risk factors that are associated with future violence.
[The Applicant] exhibits historical (also referred to as static risk factors), including: significant previous violence; engaging in violence from a young age; relationship instability; employment problems; substance use problems; major mental illness; and prior supervision failure.
It appears, particularly over recent months, that [the Applicant] has exhibited a significantly lower loading of dynamic risk factors (factors associated with violence in the present time), including: his stabilised mental health and absence of psychotic symptoms; lack of irritability; stability of emotions; lack of negative attitudes; willingness to comply with psychiatric medication; and improving insight into his mental illness.
[The Applicant's] risk of recidivism can only accurately be appraised whilst also considering his environment and the support and management around him. As already mentioned, in my opinion it is reasonable to conclude that appropriate psychiatric management (as delineated above) will likely mitigate his risk of engaging in future violent behaviour. Should this not be available, however, and a scenario developed whereby [the Applicant] becomes non-compliant with psychiatric medication, falls out of contact with family supports, disengages with mental health clinicians, uses illicit substances, and his environment generally becomes more unstable, in my opinion the likelihood of him engaging in violent behaviour will be significantly increased.
The seriousness of the offence should he re-offend.
On the basis of the information currently available, in my opinion it is reasonable to suggest that there is a reasonable likelihood of [the Applicant] engaging in serious violence should he re-offend.
The nature of the risk to the Australian community should [the Applicant] re-offend.
In my view, should [the Applicant] re-offend there is a reasonable likelihood that he will engage in violence towards others. As already discussed, I believe this violence risk will be mitigated by assertive management strategies.
I think there is, yes, indeed. As I've illustrated in my report, in my opinion [the Applicant] does, indeed, suffer with a severe mental illness by the name of paranoid schizophrenia. Certainly, based upon my assessment and review of the collection of material available, I think that dates back some years. In my opinion, there certainly is a link between [the Applicant's] symptoms of mental illness and his aggressive behaviour and I've certainly tried to illustrate that in my report. I also believe there is a link between his severe mental illness and also his offending behaviour.
MR TREMELLING: Since 2006 until the present, [the Applicant] has no prison offences compared with the significant history of behavioural problems whilst in custody prior to that, such as what we've just seen. How do you explain this change?
DR ADAMS: First of all, certainly, yes, in terms of the information I've seen, including the account [the Applicant] gave me, that was exactly the history that I gleaned of there - there seemed to be a change upon his incarceration in 2006. In my view, I think there are a number of possible reasons for that change. I think, if we think about mental illness first of all, certainly from my assessment and review of the information it appears that [the Applicant's] mental health has improved during those years. That appears to be in the context of [the Applicant's] newfound compliance with psychiatric medication. It appears to have occurred in the context of his more regular follow up with Mental Health Services, certainly over recent years. It also seems to have occurred in the context of quite assertive input from psychological services with the VOTP program, input from other services within the correctional environment offering support. You would also possibly suggest that that was also set in the context of abstinence from illicit substance use, although, certainly, [the Applicant] denied using any illicit substances. I have to say, I haven't seen any corroborative information of that. In my view, I see all those things as, certainly significant factors leading to the stabilisation of his presentation, stabilisation of his mental health and also as a result that vastly decreased frequency and intensity of aggression since 2006.
During my assessment, in my opinion [the Applicant's overall level of insight was reasonable, in particular he acknowledged his longstanding mental illness, was aware of the pathological basis of his symptomatology, noted the benefit of psychiatric medication, and noted his willingness to comply with antipsychotic medication and contact with mental health services in the future.
MR KIKKERT: Dr Adams, did you have any information before you that suggested that [the Applicant] was - that [the Applicant], in his interviews on May 2012 and October 2012, that he wasn't being truthful in the information that he provided to his mental health professionals?
DR ADAMS: No. At the time of my assessment, certainly I was aware of this information, but certainly I wouldn't interpret that - what I think we're seeing is an inconsistency between his account and the collateral information. Certainly I wouldn't interpret that in terms of the constructive truth, and I could expand on that if you would like me to.
DEPUTY PRESIDENT: Yes, please?
DR ADAMS: Certainly - again, just to highlight, I think perhaps what we're seeing is an inconsistency between the account that [the Applicant] gave to me at the time of my assessment and the description of his presentation towards the end of last year. Certainly when [the Applicant] - when I assessed [the Applicant], he did give an account that his mental health had been stable and improved for certainly longer than is indicated in the collateral information. From a psychiatric perspective, I wouldn't see that as unusual, and I wouldn't personally see that in [the Applicant's] case in terms of the truthfulness of his account. I think what's important here is to look at the entries of Dr Chew and Dr Fay at around that time, his treating psychiatrists in the prison, and they actually indicated the possibility of his relapsing mental state. For me, from a psychiatric point of view, that's the important bit. I think - and this is my hypothesis - that what might have been happening there is that - we know his medication was being decreased. From review of this information, to my mind his mental state was worsening slightly. What happens with psychosis is that, as your symptoms get worse - your delusions, hallucinations and thought disorder - often, hand in hand with that, one's level of insight decreases, and by insight there I mean the understanding that what you're experiencing is indeed illness. So perhaps, when [the Applicant] was seen in May, et cetera, last year, and he was saying, "I don't have an illness," that's actually what we're seeing: we're seeing a slight relapse of his mental state. And that is related to his level of insight as opposed to the constructive truthfulness.
(1) Australia has a sovereign right to determine whether non-citizens who are of character concern are allowed to enter and/or remain in Australia. Being able to come to or remain in Australia is a privilege Australia confers on non-citizens in the expectation that they are, and have been, law-abiding, will respect important institutions, such as Australia's law enforcement framework, and will not cause or threaten harm to individuals or the Australian community.
(2) A non-citizen who has committed a serious crime, including of a violent or sexual nature, and particularly against vulnerable members of the community such as minors, the elderly and disabled, should generally expect to be denied the privilege of coming to, or to forfeit the privilege of staying in, Australia.
(3) In some circumstances, criminal offending or other conduct and the harm that would be caused if it were to be repeated, may be so serious, that any risk of similar conduct in the future is unacceptable. In these circumstances, even other strong countervailing considerations may be insufficient to justify not cancelling or refusing the visa.
(4) Australia has a low tolerance of any criminal or other serious conduct by people who have been participating in, or contributing to, the Australian community only for a short period of time. However, Australia may afford a higher level of tolerance of criminal or other serious conduct in relation to a non-citizen who has lived in the Australian community for most of their life, or from a very young age.
(5) Australia has a low tolerance of any criminal or other serious conduct by visa applicants or those holding a limited stay visa, reflecting that there should be no expectation that such people should be allowed to come to, or remain permanently in, Australia.
(6) The length of time a non-citizen has been making a positive contribution to the Australian community, and the consequences of a visa refusal or cancellation for minor children and other immediate family members in Australia, are considerations in the context of determining whether that non-citizen's visa should be cancelled, or their visa application refused.
8. Taking the relevant considerations into account
(1) Decision-makers must take into account the primary and other considerations relevant to the individual case, noting that there are differing considerations for visa holders and visa applicants as articulated in Parts A and B. Separating the considerations for visa holders and visa applicants recognises that persons holding a substantive visa will generally have an expectation that they will be permitted to remain in Australia for the duration of that visa, whereas a visa applicant should have no expectation that a visa application will be approved.
(2) In applying the considerations (both primary and other), information and evidence from independent and authoritative sources should be given appropriate weight.
(3) Both primary and other considerations may weigh in favour of, or against, refusal or cancellation of the visa.
(4) Primary considerations should generally be given greater weight than the other considerations.
(5) One or more primary considerations may outweigh other primary considerations.
(1) In deciding whether to cancel a person's visa, the following are primary considerations:
Protection of the Australian community from criminal or other serious conduct;
The strength, duration and nature of the person's ties to Australia;
The best interests of minor children in Australia;
Whether Australia has international non-refoulement obligations to the person.
(1) In deciding whether to cancel a visa, other considerations must be taken into account where relevant. These considerations include (but are not limited to):
Protection of the Australian community from criminal or other serious conduct
9.1 Protection of the Australian community
(1) When considering protection of the Australian community, decision-makers should have regard to the principle that the Government is committed to protecting the Australian community from harm as a result of criminal activity or other serious conduct by non-citizens. Remaining in Australia is a privilege that Australia confers on non-citizens in the expectation that they are, and have been, law abiding, will respect important institutions, and will not cause or threaten harm to individuals or the Australian community.
(2) Decision-makers should also give consideration to:
9.1.1 The nature and seriousness of the conduct
(1) In considering the nature and seriousness of the person's criminal offending or other conduct to date, decision-makers must have regard to factors including:
j) Where the offence or conduct was committed in another country, whether that offence or conduct is classified as an offence in Australia.
9.1.2 The risk to the Australian community should the person commit further offences or engage in other serious conduct
(1) In considering whether the person represents an unacceptable risk of harm to individuals, groups or institutions in the Australian community, decision-makers should have regard to the principle that the Australian community's tolerance for any risk of future harm becomes lower as the seriousness of the potential harm increases. Some conduct and the harm that would be caused if it were to be repeated, is so serious that any risk that it may be repeated may be unacceptable. In making this assessment, decision-makers must have regard to, cumulatively:
He seems to have difficulty with containing his violent outbursts and perhaps particular difficulty with figures of authority.
I would see it as a fairly robust management plan for his community management. I mean, certainly from the psychiatric and perhaps, if you like, a risk management point of view I think there are a number of key issues there which, you know, I would highlight. The first, of course, is the point 27 where it stipulates that he must undergo psychiatric assessment, counselling, medical assessment and other medical treatment. Certainly, as I've suggested in my report, I think [the Applicant] would benefit from regular follow up from Mental Health Services regularly by a psychiatrist, case worker and so on and I could expand upon that if you'd like me to but, certainly, that is touched on there which I think is critical. I think the other important issues for [the Applicant's] case is that the stipulations for psychological follow up, again, and I've highlighted some of the things there I think he would benefit from ongoingly and also I note that it's stipulated he should have engagement with VOTP maintenance psychologist which I think, again, aiding in the transition into the community, certainly with [the Applicant] in mind, would be of a lot of benefit. I think, so that sort of covered the psychiatric and the psychological aspects of it. I think also that very importantly in there are aspects from a social management point of view, if you like, in terms of employment, although you didn't directly point me to that bit but I just flicked over it on page 8. Also in terms of his level of surveillance and follow up which is also critical. What will also be critical for his community management will be communication between all of these parties. There will need to be a line of communication, for example, between Mental Health and parole for this, what I deem to be, a robust management plan to work.
MR TREMELLING: From today there's been evidence from [the Applicant's] brother, ["T"], and his other siblings outlining their willingness to undergo or demonstrate their commitment to undergo psycho-education with Area Mental Health Services. They are aware that he'll be released on parole and the breach provisions that can bring him back into custody and they are also aware of the options of contacting mental health services, and they also expressed a willingness to understand community treatment options that can be followed up at the end of his parole period so that [the Applicant] can be managed in the community with relevant breach provisions. How would you describe the adequacy of that family support?
DR ADAMS: As you've described it, I would say that's certainly adequate. You could even suppose this is more than adequate. You know, it's excellent. From a psychiatric perspective, there is a good body of evidence to suggest that family therapy - and some of the things there you were touching on in terms of family psychoeducation, family support - a support network understanding [the Applicant's] illness, what happens when things go wrong and what to do. There is a good body of evidence to suggest that that will prevent relapse, and certainly in [the Applicant's] case, I think that certainly makes sense. It seems to me that, going back, what I understand of [the Applicant's] case, that's one of the large factors which was perhaps absent prior to this most recent incarceration.
MR TREMELLING: What might happen if [the Applicant] didn't have access to his medication?
DR ADAMS: In my opinion, there's a significant likelihood that [the Applicant's] mental state would worsen. He would suffer a relapse of psychotic symptoms, and they will certainly deteriorate.
The strength, duration and nature of the Applicant's ties to Australia
9.2 Strength, duration and nature of the person's ties to Australia
(1) Reflecting the principles at 6.3, decision-makers must have regard to:
whether the person arrived as a young child, noting that: 1. Less weight should be given where the person began offending soon after arriving in Australia; and 2. More weight should be given to time the person has spent contributing positively to the Australian community. 2. The strength, duration and nature of any family, social and/or
employment links with Australian citizens, Australian permanent
residents and/or people who have an indefinite right to remain in
Whether Australia has international non-refoulement obligations to the person
We acknowledge with thanks receipt of your letter of inquiry dated 16th April 2013 seeking information on appropriate services available in the Kingdom of Tonga for a patient who is on an anti-psychotic medication as well as information on appropriate supporting programme which are inplace to support an unemployed patient diagnosed with schizophrenia.
At the outset, Tonga does not have a social welfare programme in place to financially support citizens who are unemployed. Inview of this, an unemployed patient will have to be financially supported by immediate family members and to some extend by extended family members or the community in general. Such support are voluntary and are in the form of providing accommodation, food, clothes, immediate needs, including medical services as required.
Tonga does not have a Disability support pension programme.
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... I overlooked to mention that it is a common knowledge of Tongan hospitals to be in short of or not to have appropriate supplies of appropriate medicine/medication as per demand and as per emergency cases requirements. Inclusive in these short supplies are anti-psychotic medication for patients diagnosed with schizophrenia.
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I certify that the preceding 121 (one hundred and twenty-one) paragraphs are a true copy of the reasons for the decision herein of Deputy President S E Frost.
.....[sgd].............................................................
Mr S Kikkert, Department of Immigration and Citizenship
[1] G documents, Exhibit R1, page 120 - 121
[2] G documents, Exhibit R1, page 122
[3] G documents, Exhibit R1, page 124
[4] G documents, Exhibit R1, pages 113 -114
[5] G documents, Exhibit R1, pages 115-118
[6] Transcript (extract), 30 April 2013, P-4, line 44 - P-5, line 7
[21] Transcript (extract), 30 April 2013, P-19, lines 4-17
[23] Transcript (extract), 30 April 2013, P-4, lines 27-34
[24] Transcript (extract), 30 April 2013, P-14, lines 25-27
[25] Transcript (extract), 30 April 2013, P-6, lines 1-22
[29] Transcript (extract), 30 April 2013, P-17, line 19 - P-18, line 4
[31] See [10] and [11] of these reasons
[32] G documents, Exhibit R1, page 125
[33] G documents, Exhibit R1, page 122