District Court New South Wales Medium Neutral Citation: R v Crispe (No 4) [2014] NSWDC 211 Hearing dates: 28 July 2014; 29 July 2014 and 9 October 2014 Decision date: 09 October 2014 Before: Cogswell SC DCJ Decision: I make a conditional order under s 39(1) of the Mental Health (Forensic Provisions) Act 1990 releasing Ms Crispe. Catchwords: CRIMINAL LAW - special verdict of not guilty by reason of mental illness - final orders following period of conditional release - forensic psychiatrist - proposed treatment plan - low risk of reoffending and good long term prognosis - protection of the offender and the community - conditions of release - issue of whether required to comply with medication prescribed Legislation Cited: Mental Health (Forensic Provisions) Act 1990, s 39 Family Law Act 1975 Category: Principal judgment Parties: The Crown Tricia Oi Foong Crispe, offender Representation: Mr P Thompson, Crown Mr S Schaudin, Offender File Number(s): 2012/000270941 Judgment 1Tricia Oi Foong Crispe was charged with a very serious offence. On 29 July 2014. I returned a special verdict that she was not guilty by reason of mental illness of that offence. I gave reasons for that verdict. It was in compliance with s 39(1) of the Mental Health (Forensic Provisions) Act 1990. I adjourned the proceedings to today and released Ms Crispe into the community subject to conditions, again under s 39 of the same Act. 2Today I need to determine what final orders I make under s 39 of that Act. It provides that I "may make such other order (including an order releasing the person from custody, either unconditionally or subject to conditions) as the Court considers appropriate." Importantly, s 39(2) goes on to provide that I am "not to make an order under this section for the release of a person from custody" unless I am satisfied "on the balance of probabilities, that the safety off the person or any member of the public will not be seriously endangered by the person's release." 3Mr Schaudin, who appears for Ms Crispe, has asked me to make an order releasing his client from custody subject to conditions. Those conditions are contained in a report from a consultant forensic psychiatrist Dr Richard Furst. The report was commissioned after the last adjournment. Dr Furst had given earlier opinions and is familiar with Ms Crispe. 4Dr Furst is a consultant forensic psychiatrist at the Long Bay Correctional facility. He saw Ms Crispe on 16 September 2014 and provided a report dated 7 October 2014, which became exhibit 3. Dr Furst was aware of the requirement that I cannot make an order unless I am satisfied about Ms Crispe's safety and any member of the public's safety. 5Dr Furst reviewed Ms Crispe's recent progress including living in stability with her mother and attending a Buddhist temple in Berala daily and engaging in very positive activities. Significantly, Dr Furst made this observation, "Ms Crispe has not taken any medication since November 2012, opting for supportive therapy and work in the Buddhist temple as an alternative to antidepressant and other psychotropic medications. Although this is unusual for someone with a severe depressive illness, Ms Crispe appears to have benefited and is no longer depressed." He noted that she had earlier reported adverse side effects from medications. 6Dr Furst noted that there were problems with respect to compliance with treatment recommendations including Ms Crispe not taking anti-depressant medications in his review of documents from the Auburn Community Health team. Dr Furst confirmed his diagnosis of major depressive disorder adding that there were "signs her condition is largely in remission". He also thought that she had "dependant and obsessional personality traits". 7Having reviewed Ms Crispe's progress, including her attendance at the temple and engagement with a Community Mental Health team, a lack of previous significant violence apart from the violence which this case is about along with the current support of her mother, Dr Furst concluded "that neither Ms Crispe nor any member of the community would be seriously endangered by her conditional release." Dr Furst went on to recommend a treatment plan containing seven components, adding that her treatment in the community should be reviewed on a regular basis by the Mental Health Review Tribunal. 8Dr Furst concluded that Ms Crispe "has gained considerably through her engagement and attendance on a daily basis" at the Buddhist temple and went on to express the opinion that "her risk of reoffending is low and she has a good long term prognosis." 9There was a report from the Auburn Community Mental Health team dated 4 September 2014. It referred to a community treatment order which had expired on 18 May 2014 "due to Ms Crispe's refusal to commence anti-depressant medication despite the psychiatrists' recommendation" but added that she "appears to have engaged well in maintaining a therapeutic relationship with her care coordinator" at the Mental Health team. 10The report noted that her care coordinator was on leave. It now appears that she no longer works at the facility. In any event, the report added that "Ms Crispe has been given contact names and numbers in case she requires support" over the following period of time. 11Evidently Ms Crispe had been seeing one or two psychiatrists as part of her community treatment order imposed by the Mental Health Review Tribunal on 19 November 2013, although Ms Crispe says not the one, Dr Kuljic, who is named in the order. 12Mr Schaudin says that his client has no difficulty accepting six of the seven conditions in Dr Furst's proposed treatment plan. She still baulks at any requirement to take psychiatric medication. She explained today, partly herself and partly through Mr Schaudin, that she does not trust putting the pharmaceuticals into her body. That is clearly an available point of view and one which may well be consistent with the lifestyle which she has very positively embraced through the Buddhist temple. 13However, the condition proposed by Dr Furst is compliance "with psychiatric medication as prescribed by her treating psychiatrist". She appears not to have a treating psychiatrist because the community treatment order has expired. She will be allocated one by the community mental health team. 14I regard it as important she comply with any requirement of a qualified psychiatrist that she should take medication. She of course may discuss the need for such medication and the effects upon her with such a psychiatrist and may persuade him or her that it is not required. The legislation under which I am required to determine this case today leaves no doubt about the fact I am "not to make an order under this section" releasing Ms Crispe unless I am satisfied there will be no serious danger to her safety or the safety of any other members of the public. 15I have to realistically bear in mind two factors here. One is there has been a history of mental health issues and mental instability with Ms Crispe, obviously at the time of this offence but before then as well. The second factor is that acting with a very compromised mental health condition she stabbed her estranged husband a number of times. That clearly raises the question of the safety of members of the public. 16If a psychiatrist treating Ms Crispe forms the opinion she must take some medication, then I would regard it as important that she comply with that condition. For those reasons I am going to include Dr Furst's recommendation in a conditional release order. Dr Furst does not direct that she must take medication, only that she complies with any psychiatrist's prescription of medication. 17Mr Thompson, who appears for the Director of Public Prosecutions, also asks that a condition of her release be that Ms Crispe continues to comply with an apprehended violence order issued against her and for the benefit of her estranged husband and two children. He also proposes a condition that Ms Crispe continue to reside with her mother and she not approach or attempt to approach her estranged husband or either of her children except in compliance with any order made under the Family Law Act 1975. 18I regard those proposed additional conditions as reasonable; indeed they promote consistency between my orders and orders made by other courts sitting in other jurisdictions. I checked with Mr Schaudin regarding the requirement that she continue to live with her mother and he said that is an acceptable condition. 19For the reasons I have given I make an order under s 39(1) of the Mental Health (Forensic Provisions) Act 1990 releasing Ms Crispe from custody subject to the following conditions: (1)She remains under the care of the Auburn Community Mental Health Service or such other community mental health service which succeeds that service with a view to ongoing case management. (2)She attends appointments with any allocated case manager or delegate on a regular basis, probably fortnightly in the first instance. (3)She attends appointments with any allocated treating psychiatrist or delegate on a regular basis, probably second monthly in the first instance. (4)She complies with psychiatric medication as prescribed by any treating psychiatrist, possibly a further trial of a suitable antidepressant medication such as Valdoxan (Agomelatine), 25 milligrams orally at night. (5)She complies with psychological therapy to deal with her adjustment to the breakdown of her marriage, lack of access to her children and her offending behaviour. (6)She continues to receive support from the nuns and other mentors at the Lingyen Mountain Temple. (7)She engages in social, occupational and vocational rehabilitation as deemed necessary by her case manager, preferably with a view to helping her re-enter the workforce as a music teacher. (8)She complies with the terms of the apprehended domestic violence order made at the Local Court in Burwood on 13 August 2014. (9)She continues to live at [home address]. (10)She not approach, attempt to approach or contact Phillip Crispe, Ronan Crispe or Quinton Crispe except in compliance with any order under the Family Law Act 1975. HIS HONOUR: Mr Schaudin would you just check the names of the children, the spelling, Ronan and Quinton? SCHAUDIN: Yes. HIS HONOUR: Mr Schaudin, Mr Thompson, what else do I need to do? SCHAUDIN: Subsection (3), I don't know if you need to make the order that the Registrar notify the Minister for Health and the Tribunal. 20In accordance with s 39(3) of the Act, I direct the Registrar to notify the Minister for Health and the Mental Health Review Tribunal of the terms of order. SCHAUDIN: I don't know if it's necessary but perhaps a copy of Dr Furst's October report could go with your order to the Mental Health Review Tribunal. HIS HONOUR: Also exhibits 3 and 4. Mr Schaudin's suggested it and I think it's sensible Mr Thompson. THOMPSON: I agree your Honour, thank you. 21I direct my associate to provide a copy of exhibits 3 and 4 to the Registrar for the Registrar to include copies of those in the Registrar's notification to the Minister for Health and the Tribunal. HIS HONOUR: I will give the papers to my associate to put in the Court file. Ms Crispe, you have heard the orders which I have made, I don't expect you to agree with all of them but you have heard the reasons I have given for making the orders. What I will do is this; my associate will type up the orders over the next half hour. I will impose on Mr Schaudin to come back at an agreed time and he will be given to pass on to you, a copy of the orders and one for Mr Thompson as well. You have heard me read them out; I don't think I need to say any more. Dr Furst is very optimistic about your progress, you are obviously making a very good effort toward your rehabilitation and healing and I congratulate you on that and encourage you to keep going. I have had to make orders in accordance with the law and the public interest about medication and I have given my reasons for having to do that. I am confident you will continue in your very satisfactory progress, so good luck. Mr Schaudin, it's a long list to type out for my associate, so not before 12.15. Thank you both for your assistance in this case, I've been greatly assisted. ********** 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: 09 December 2014