Joel Cauchi 'satanic control' claim not taken seriously by psychiatrist, Bondi Junction inquest told

Australia Broadcast Center

22-05-2025

Joel Cauchi expressing feelings of "being under satanic control" after ceasing his schizophrenia medication was "not taken seriously enough" by his treating psychiatrist, a panel of experts has told the Bondi Junction inquest.
The five experienced psychiatrists were called on by the court to provide their opinions on the treatment of Cauchi's mental health in the years leading up to the attack at the Westfield shopping centre in Sydney's east on April 13, 2024.
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Each doctor agreed Cauchi was experiencing psychosis when he went on a stabbing rampage, killing six people and injuring 10 others before being shot dead by NSW Police Inspector Amy Scott.
Psychiatrists Olav Nielssen, Edward Heffernan, Anthony Harris, Matthew Large and Merete Nordentoft were each asked to analyse Cauchi's treatment.
This included his first episode of psychosis as a teenager to when he was weaned off all forms of anti-psychotic medication in 2019 by his private psychiatrist, referred to as Dr A.
The court heard Cauchi was first admitted to the psychiatric ward of Toowoomba Public Hospital at the age of 17 after he was damaging doors and expressing concerns about being "possessed by demons".
Hospital records indicate Cauchi had also threatened someone, claiming he had a gun and had moved churches because he believed he was a prophet.
The panel agreed Cauchi's previous cannabis use likely contributed to his early onset of schizophrenia and "certainly made his symptoms worse".
Professor Large told the inquest that cannabis "is the most potent and proven cause of schizophrenia".
The inquest previously heard toxicology evidence suggested that Cauchi had been using cannabis in the days leading up to the attack.
The panel also accepted there were "clear sign" that Cauchi had chronic schizophrenia, including his father's history of psychotic illness and the ongoing presence of symptoms despite being medicated for several years.
The inquest heard Cauchi was discharged from the public system in 2012 while on a high dose of the drug clozapine — an anti-psychotic medication only prescribed when two other forms of medication fail to manage symptoms of psychosis.
All five psychiatrists agreed that it was "reasonable" for Dr A to reduce Cauchi's dose of clozapine when she first received him as a patient at her private clinic in order to find an "optimal dose" that would minimise the "unpleasant" side effects associated with the drug.
But they all disagreed with Dr A's decision to change Cauchi's diagnosis from chronic schizophrenia to first-episode psychosis, because she had assessed that her patient had been "well" for 16 years.
Dr A previously told the inquest that she weaned Cauchi off all anti-psychotic medication by 2019 based on guidelines for treating first-episode psychosis, not chronic schizophrenia.
The inquest heard that between September 2019 to February 2020, Dr A's clinic received multiple reports about Cauchi's health, which she did not consider psychotic.
Those included Cauchi telling the clinic about an obsession with pornography and his mother expressing concerns that her son was writing notes about being "under satanic control".
"When you collectively put them together, and I count nine different entries that were entries of concern, either insomnia or his mother suspecting symptoms … a change in behaviour, satanic control," Professor Heffernan said.
Professor Nordentoft said the concerns were "not taken seriously enough" and described this period as a "missed opportunity" to put Cauchi back on his anti-psychotic medication.
The inquest heard that at this stage, Dr A told Cauchi to restart his OCD medication but that he did not want to, and she didn't believe she could force him to.
"And I think this is where a more assertive approach in terms of encouraging restarting medication needs to be considered," Professor Heffernan told the court.
"It's very difficult when you have a voluntary patient … to change the course that has been in play for some time, and unfortunately it does involve having some hard conversations."
The inquest heard that by mid-2020 Cauchi had moved to Brisbane and had been discharged from Dr A's clinic.
On January 8, 2023, Cauchi called Queensland Police, saying his military collection, including "US army knives", had been taken from his room by his father, where a physical altercation then ensued at the family residence.
Professor Nordentoft said that if she had been called to this situation as a psychiatrist with knowledge of his background, she would have placed him under involuntary emergency care.
"It was a clear message he was psychotic and that he could be of potential dangers to others," she said.
The inquest continues.