Attorney-General v James Aaron Ramirez (No 2) [2018] NSWSC 1305

Supreme Court New South Wales

Medium Neutral Citation: Attorney-General v James Aaron Ramirez (No 2) [2018] NSWSC 1305 Hearing dates: On the papers Date of orders: 01 August 2018 Decision date: 22 August 2018 Jurisdiction: Common Law Before: Lonergan J Decision: See paragraph [8]. Catchwords: MENTAL HEALTH – forensic patient – application for interim extension order – defendant with schizoaffective disorder – grandiose delusions regarding attractiveness to women – threshold requirements – unacceptable risk of causing serious harm to others Legislation Cited: Mental Health (Forensic Provisions) Act 1990 (NSW) Sch 1 Cases Cited: Attorney-General of New South Wales v James Aaron Ramirez [2018] NSWSC 662 Category: Principal judgment Parties: Attorney-General of New South Wales (Plaintiff) James Aaron Ramirez bht Sophie Tsatsimas (Defendant) Representation: Counsel: A Rose (Plaintiff) K Stares (Defendant)

Solicitors: Crown Solicitor's Office (Plaintiff) Legal Aid NSW (Defendant) File Number(s): 2018/67942

Judgment 1. On 1 August 2018, I determined that the Defendant should remain the subject of an order extending his status as a forensic patient. The orders I made were as follows: 1. Pursuant to cl 10 and cl 11(1) of Sch 1 of the Mental Health (Forensic Provisions) Act 1990 ("the Act"), the defendant be subject to an interim extension order commencing from 5 August 2018 for a period of 28 days unless renewed by further order of the Court or until the proceedings are finally determined, and 2. Liberty is granted to the plaintiff to write to the court for the purpose of seeking that a renewal of the interim extension order be made by consent in Chambers prior to the expiry of the 28 days period, and 3. In the event that consent is not reached by the parties with respect of the renewal of the interim extension order, the parties may seek to restore the matter to the list. 1. These are my reasons for making those orders. 2. On 14 May 2018, having considered the evidence then tendered, I concluded that it was appropriate to grant the interim orders extending the defendant's status as a forensic patient (including that the defendant be thoroughly assessed by two psychiatrists): Attorney-General of New South Wales v James Aaron Ramirez [2018] NSWSC 662. 3. Available to me on the court file at the time of considering whether to make a further extension commencing on 5 August 2018 were the reports of these two assessments, Dr Kerri Eagle, Forensic Psychiatrist dated 25 July 2018 assessed the defendant on 6 July 2018 and Dr Adrian Keller, Psychiatrist, assessed the defendant on 23 June 2018. 4. Each report analysed some of the background material, previous psychiatric presentations and opinions and diagnoses, as well assessing the defendant's current state of illness and his risk of further sexual offending if no longer a forensic patient. 5. Dr Eagle formed the view that the defendant has a schizoaffective disorder and a severe substance use disorder, and that he does pose a risk of causing serious harm to others in the future if he ceases to be a forensic patient. She outlined her reasons for reaching this view in some detail on page 20 of her report. She described the nature of the risk of harm to others being a risk of sexual reoffending or sexually disinhibited behaviours or aggressive behaviours, as well as potential threats and intimidation as a result of his severe treatment-resistant mental illness, his substance use disorder and his lack of insight into his illness. 6. The report of Dr Keller takes the view that the diagnosis is schizophrenia with a differential diagnosis of schizoaffective disorder, characterised by the presence of multiple bizarre, grandiose delusions, hallucinations and formal thought disorder. He also noted polysubstance abuse. He is of the view that the defendant poses a risk of causing serious harm to others if he ceases to be a forensic patient because of his history, as well as the dynamic risk factors of ongoing clinical symptoms and persistent poor insight into his mental health, combined with substance misuse issues. 7. These additional two opinions, combined with the evidence I examined for the purposes of the initial interim order, support an order extending the defendant's status as a forensic patient from 5 August 2018 for 28 further days.