Bondi Junction killer threw up ‘red flags' after medication stopped
Joel Cauchi was exhibiting 'red flags' that he was relapsing months after he was taken off antipsychotic medication five years before he went on a horrific rampage through Westfield Bondi Junction, a psychiatrist has told an inquest.
An inquest is examining the events that led to Cauchi, 40, killing six people in Sydney's eastern suburbs on April 13, 2024.
Dawn Singleton, Yixuan Cheng, Faraz Ahmed Tahir, Ashlee Good, Jade Young and Pikria Darchia died and another 10 were stabbed by Cauchi before he was shot by police.
Cauchi, who grew up in Toowoomba in Queensland, was diagnosed with schizophrenia when he was 17 and was medicated until he stopped taking all psychotropic medication in June 2019.
His mental health and treatment is one of the issues being probed during the five-week inquest.
From 2001 to 2012, he was managed within the public mental health system with psychotropic medication and from 2012 until February 2020 he was treated by a private psychiatrist.
The inquest previously heard that his private psychiatrist, known as Dr A, had not sought a second opinion when she decided in 2018 to take Cauchi off clozapine - despite doing so when she had begun to gradually reduce his dose in 2015 after he complained of oversedation.
He took abilify to treat obsessive compulsive disorder until he was taken off the medication in June 2019.
A panel of five psychiatrists - Professor Matthew Large, Professor Anthony Harris, Professor Edward Heffernan, Professor Olav Nielsen and Denmark-based expert Professor Merete Nordentoft - on Thursday gave evidence to the court about Cauchi's care.
The court has heard that in a termination of treatment notice, Dr A described Cauchi as being treated for 'first episode psychosis' and he had no relapse for 'over 16 years'.
However, the panel of psychiatrists agreed that it was wrong to refer to him as suffering from 'first episode psychosis' and rather he had a chronic condition.
When asked by counsel assisting the coroner Peggy Dwyer whether it was a mistake to initially wean Cauchi off antipsychotic medication, Dr Nielssen told the court: 'Yes, in hindsight'.
'It appears to have been made very much with Mr Cauchi's wishes,' Dr Nielssen said.
Dr Large told the court that: 'We are all subject to outcome bias and hindsight bias.'
In late 2019, Cauchi's mother contacted his psychiatrist expressing concerns about his behaviour and a possible relapse.
She said: 'I have noticed a gradual decline in his condition' and she had a feeling he was 'hearing voices'.
She later told one of the nurses at the clinic that he had alluded in a note to being 'under Satanic control'.
Cauchi separately emailed the clinic asking to help him arrange a 'porn-free phone'.
He had initially agreed to go back on a low dose of clozapine however he later changed his mind.
His father Andrew, who the court heard had also suffered from mental illness, was adamant that he did not want his son to go on medication.
Professor Nordentoft said there were 'several red flags' which were raised by Cauchi's mother.
'I agree there are several red flags and I think the most important ones are the ones raised by his mother his knows the most about his condition,' Dr Nordentoft said.
Professor Heffernan agreed there were 'red flags' and Dr Nielsen said that Cauchi was clearly relapsing at that point.
The court was told that the risk of relapse for patients who discontinue anti-psychotic medication was 77 per cent at one year and 80 per cent after two years. While those who remained on medication, the risk of relapse was 10 per cent.
The inquest heard details of his teenage years when he developed psychotic symptoms.
In 2001, Cauchi's father had to move churches because Cauchi believed he was a prophet.
The court was told he went from a scholarship student to experiencing symptoms of psychosis in his final year of school.
He was verbally abusive and aggressive and threatened a person that he had a gun in his bag,
He was hospitalised in early 2001 after he was damaging doors at home, exhibited auditory and visual hallucinations, was paranoid and believed he had been possessed by demons.
The inquest continues.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
ABC News
an hour ago
- ABC News
How creative writing can aid healing process to create happy ending
Renee Hayes was leading an "ordinary" suburban life when a back injury up-ended her plans, rendering her bed-bound. "I was an active 30-year-old who went from having a busy life to being stuck in bed for [six] months," she said. She had been working in a dental surgery in the Atherton Tablelands when one morning she woke in excruciating pain after a disc burst in her back. She tried countless options to manage the constant, chronic pain, but was ultimately unable to move or work, and the sudden changes in her life made it difficult to cope. "Anyone who has been in chronic pain knows it is incessant and it's very hard to escape from," she said. Hayes eventually found an escape in the written word. Initially, without a laptop, Hayes hand-wrote the first draft of her self-published fantasy trilogy, the Rim Walker series, while flat on her back. "After being stagnant for so long trying to heal, it felt like a gift and that I hadn't wasted that time," she said, reflecting on how writing gave her a fresh start. Now a published author of three novels, Hayes credits the creative writing process as a therapeutic outlet that allowed her to find joy again, despite the pain. "It helped me through an incredibly tough time mentally and physically and I no longer felt like I'd lost anything or life was punishing me." Creative writing expert Edwina Shaw isn't surprised. The writer, educator and tutor in the University of Queensland's creative writing department said the therapeutic benefits of writing went far beyond the stereotypical journalling exercise. "It's about using the craft of writing to create something beautiful from the pain, trauma or loss someone has suffered," she said. She said research had shown that the process of handwriting was very calming on the body and a subduer of our stress systems, while creativity was "a natural calmer of the vagus nerve". She said writing could help to avoid internalising powerful emotions such as anger, which was associated with experiences of grief or trauma. "We need to separate ourselves from what's happening in our lives and reframe the way we think about it," she said. "Creative writing can help us do that, whether writing a poem, a song, a novel or even writing comedy." That was singer-songwriter Greta Stanley's experience when she lost her home and contents in the December 2023 flood that ripped through Far North Queensland. "Songwriting was a big part of my healing process, 100 per cent," Stanley said. At the time, she felt lost, anxious and completely overwhelmed, was trying to manage a debilitating autoimmune disease and write her third album. Stanley said she tried meditation, reiki healing, a therapist and even a visit to a psychic to help her manage her mental health and chronic pain, but songwriting was the most cathartic outlet. Stanley, 27, said using the lyrics as a tool to express herself on the album about navigating mental health gave her hope. "The album has definitely been my way of putting all the noise and stuff going on in my head, into something that makes sense for me." But creative writing expert Ms Shaw said the writing did not have to be an autobiographical piece to be effective, and acknowledged that for some, that would be too confronting. "Sometimes life is too close or too hard to write about it as yourself, so you can invent a character … and give your experience to someone else … change the ending." Canberra-based widow Emma Grey took that approach in her novel after the death of her husband Jeff. "I found incredible comfort in writing about grief and it was a very cathartic process for me." She said using writing to navigate the trauma of losing her husband allowed her to manage the myriad of feelings that would creep up, often without warning, and channel them into something "useful". The Last Love Note, her novel written while grieving, sold more than 100,000 copies in the United States alone, becoming a beacon of hope for many who had lost loved ones, Grey said. "I have since been inundated with messages from around the world from readers sharing their stories of loss and how my novel helped them through tough times," she said.
ABC News
4 hours ago
- ABC News
WA woman unable to legally undergo IVF in home state became 'reproductive refugee'
As a professional woman in her 30s who was not yet sure if she wanted to have children, Jane* decided to freeze her eggs to give her future self the choice. Four years later, she decided the time was right. But when Jane went back to the fertility clinic, she was told she could not use her frozen eggs for in-vitro fertilisation (IVF), the most common type of assisted reproductive technology. Why? Because she was a single woman who did not have reproductive health problems. And because she lived in Western Australia. While every state and territory in Australia has its own laws concerning IVF, WA is the only one that still rules out an unpartnered woman from accessing the procedure unless a doctor deems her to have reproductive problems (along with other restrictions against same-sex couples). "To my shock and surprise … I was not eligible to access my own eggs and use them for the final stages of IVF and that's because I was not classified as 'sub-fertile'," Jane told the ABC's Life Matters program. "I think part of the hurt, disappointment and frustration is that it's the 21st century. "In other parts of Australia women who are not partnered are able to access IVF, and yet in WA, because I chose to do it unpartnered, I was pretty much being discriminated against." WA laws allow IVF for women who can't conceive due to medical reasons, but explicitly excludes age as a valid reason. "The only option within WA that was offered to me was to undergo several rounds of intra-uterine insemination … which would still cost thousands of dollars per round and has a relatively low success rate," Jane said. Intra-uterine insemination is when sperm are inserted directly into the uterus, so in that scenario Jane — who was now in her late 30's — would not be using her frozen eggs which were four years younger — equating to healthier and likely more fertile. She was told the success rate of that procedure at her age at the time was 10 to 15 per cent per round, compared to an estimated success rate with IVF of 40 per cent. Jane searched for other options and found one — sending her eggs, and herself, to another state to undergo IVF. "That in itself was a challenge because the clinic in WA indicated they would only transfer my eggs to another fertility clinic interstate that was part of the same chain of clinics, so I was limited in my choice,' she said. She was lucky and found a clinic, and a fertility specialist, willing to assist her on the east coast. But the experience of travelling to an unfamiliar place without her support network to undergo the procedure made her feel like a "reproductive refugee". "When you're going through something as life-changing as IVF, it makes a challenging situation even more difficult," she said. It was also expensive. "I would estimate the costs of the egg freezing plus having to go interstate to undergo IVF would be in excess of $20,000," Jane said. "And there was no guarantee it would work." Jane said what made the whole process "rather harrowing" was that the clinic in WA told her to keep the transfer of her eggs interstate, and the procedure, "very quiet". Stephen Page, one of the nation's leading fertility lawyers and secretary of the Fertility Society of Australia, said nothing Jane or the clinic did was illegal. "Number one, Jane is the owner. Number two, under the constitution you have freedom of interstate trade, commerce and intercourse," he said. "And number three, in Western Australia there are restrictions about moving donor eggs, donor sperm and donor embryos, you need permission of the Reproductive Technology Council — but these eggs, her eggs, were not donor eggs, so she had full freedom to move them," he said. "But the Western Australian legislation is quite clear, that if you act outside your licensing conditions then the clinic can lose its WA licence [and] the clinician can commit an offence." Mr Page, along with many other experts and individuals, has long been calling for the legislation in WA to be updated — and while the state government said it had done much work on this, no changes have yet been made. In January 2018, the then newly-elected Labor government announced an independent review of WA's assisted reproductive technology (ART) and surrogacy legislation. The report, by associate professor Sonia Allan, found the laws discriminatory on the grounds of sex and relationship status, leading to the government to introduce the Human Reproductive Technology and Surrogacy Legislation Amendment Bill 2018. WA Premier Roger Cook was health minister in 2019 when the bill failed to pass the upper house after Liberal MP Nick Goiran gave one of the longest filibuster speeches in the state parliament's history, succeeding in delaying a vote on the laws. The bill then languished in parliament as attention turned to voluntary euthanasia before the COVID pandemic came along and up-ended most plans. In 2021, WA Labor won a historic victory, giving the party total control of both houses — yet even in those four years nothing was done. And despite Labor's strong result in the March 2025 election, the upper house now includes five crossbench MPs who could wield some influence, and Mr Goiran is also still in the chamber. But the government insists the legislation is important. "Reviews have highlighted that the current laws have prevented people from fulfilling their desires to create a family and also resulted in Western Australians having to travel interstate and overseas to access ART services," a government spokesperson responded to questions from the ABC. They insist new legislation is in development. "The bill will support more WA families and individuals to be able to access IVF and surrogacy to start or expand their families in line with other Australian jurisdictions." Jane's journey with IVF has been successful. She is now 30 weeks pregnant and due to have a girl. "It's really important to me that she grows up and she has bodily autonomy and reproductive freedom," Jane said, overcome by emotion when talking about her daughter's future. "Access to assisted reproduction should be open to solo parents by choice, gay singles and couples, widows, women who have survived domestic violence and still want to have kids but outside a partnership. "I urge the WA government to really make updating these laws a priority. *We have changed Jane's name to protect her identity, at her request.
ABC News
5 hours ago
- ABC News
SA researchers expand baby heel-prick screening to help find rare conditions
When Max was three days old, he was diagnosed with a rare and life-changing condition called phenylketonuria, commonly known as PKU, through a newborn blood screening test. The condition is one of more than 30 which can currently be detected in newborns through heel-prick blood samples to help identify and treat serious health conditions early. Now, researchers in South Australia are working to expand the screening program to detect more than 600 genetic conditions. PKU is an inherited blood disorder which can affect how the body processes protein and can eventually lead to serious health problems if left untreated. "[It's] actually the condition that started the whole newborn screening program in the 1960s," explained South Australian researcher Professor Karin Kassahn. "It's one of the metabolic conditions where the body can't process protein, phenylalanine in particular [which is] a certain amino acid, in the way it usually would … so by picking this up at birth, then the diet can be modified." The heel-prick test method was developed by American microbiologist, Dr Robert Guthrie, whose niece was diagnosed with PKU at 13 months — too late to prevent early brain damage. Since 1960, the program has been rolled out across much of the world as a routine test for newborns — and expanded to be able to accurately and quickly detect more than 30 conditions. Twins, Max and Blake, underwent the screening as newborns. Their parents, Hannah and Robert Macbeth, had no idea PKU existed when Max was first diagnosed. "We'd never heard of it," Ms Macbeth said. "We kind of cried about it until it kind of realistically hit us and we went, 'You know what, we can manage this. We've caught it early'." Mr Macbeth said he was worried his son would have to follow a restricted diet for life. "We're quite a barbecuing family so we love our meats and that sort of thing and entertaining," he said. Thanks to early detection and intervention, Max's protein levels are closely monitored with weekly at-home prick tests, and he uses a medication to help lower his blood phenylalanine levels. "We're very lucky," Ms Macbeth said. "We could have been in all sorts of dramas for him because it can be pretty serious if left undiagnosed." Untreated, PKU can lead to irreversible brain damage and intellectual disability, neurological conditions such as seizures and tremors, and problems with behaviour, emotions, development and health. But for now, things are looking positive. "He'll live a relatively normal life, he might just be a bit different with food at school and stuff," Ms Macbeth said. "It's just managing it and it's quite easy at the moment … he's a happy little soul," Mr Macbeth added. The couple said they thought expanding the testing program would be "brilliant". "If we can do testing that picks up these things when they're little and there are things we can put in place to help reduce [the risk of] something happening in the long run or causing a bigger issue, then we would be mad not to do it," Ms Macbeth said. Professor Kassahn is the principal investigator on the NewbornsInSA study which is combining genomics and metabolomics in a bid to detect more treatable conditions, earlier. "Many of the conditions we screen for are rare, so individually people will probably not have heard of many of them — cystic fibrosis and PKU are probably the more familiar ones, but collectively they actually constitute quite a significant health burden," she said. "They are the primary cause of childhood admissions to hospital and also ongoing health problems. "Early detection allows early intervention and treatment, and just as the current program has really saved thousands of lives, we're hoping by expanding on that program … we can make a difference to the health outcomes for these babies." The researchers are looking for conditions including immune deficiencies, conditions of metabolic dysregulation, congenital deafness, and neurological conditions. Professor Kassahn said the study collaboration between SA Pathology, the Women's and Children's Hospital and the University of Adelaide was "well underway" with 250 families already enrolled, out of their target of 1,000. The team has already made some significant findings — with early intervention now in place for those families to help treat or manage their rare diagnoses. "We've issued five of what we call a 'high chance report' and those would have otherwise been undetected," she explained. "Those families are being managed through the clinical teams at the Women's and Children's Hospital." She said eligible families are still able to take part in the study with enrolment via the NewbornsInSA website.
