Inside psychiatrist's 'chat therapy' which replaced the powerful drugs that kept Joel Cauchi sane - as she is SLAMMED by experts for taking him off his vital medication

Daily Mail​

18-05-2025

An expert criminologist has slammed the psychiatrist who took Joel Cauchi off his schizophrenia medication - and then told the inquest into the Bondi Junction Westfield massacre that her decision had nothing to do with his deadly rampage.
Dr A treated Cauchi for eight years and told an inquest this week that he was not psychotic when he stabbed six people to death.
She said his actions were 'likely due to his sexual frustrations and hatred towards women', although she backtracked the following day after her comments sparked anger and disbelief.
Now criminal psychologist Dr Tim Watson-Munro has blasted her comments and said she is 'kidding herself' about her 'chat therapy' treatment of Cauchi's condition.
The Bondi Junction inquest has previously heard 'clear and unanimous' expert psychiatric evidence that Cauchi was 'floridly psychotic' when he stabbed the 16 victims.
Dr Watson-Munro said this was a tragedy for both the families of the victims and for the family of Cauchi.
He stressed he did not wish to personally attack Dr A, and was focusing on the professional views she had expressed.
But he said it was patently obvious that Cauchi was 'drowning in psychosis' when he launched his rampage.
Queensland -based Dr A, who has run several psychiatry businesses, told the Bondi Junction inquest that Cauchi was not psychotic and did not take medication as it was 'not necessary'.
Despite offering her 'sincere apologies' and saying the massacre 'devastated me personally', Dr A insisted Cauchi could not have had a psychotic episode at the time of the 2024 murders.
She said his psychosis had previously exhibited as extreme disorganisation to the point he couldn't put 'two words together', and he therefore wouldn't have had the ability to launch his attack.
'That was nothing to do with psychosis,' the psychiatrist told the NSW Coroners Court.
'He couldn't have organised himself to do what he did. I think it might have been due to his frustrations, sexual frustration, pornography and hatred towards women.'
In under three minutes on the afternoon of April 13 last year, Cauchi, 40, murdered Dawn Singleton, 25, Jade Young, 47, Yixuan Cheng, 27, Ashlee Good, 38, Pakria Darchia, 55, and Faraz Tahir, 30.
Five were female shoppers at Westfield Bondi Junction and one a male security guard.
Cauchi also injured 10 more with his US military knife, before he was confronted and shot dead by NSW Police Inspector Amy Scott.
Dr Watson-Munro stressed he had never professionally examined Cauchi, but said he took issue with Dr A's claim that he didn't need medication.
Cuachi had been on powerful antispychotic medication - clozapine and aripiprazole - to treat his schizophrenia for 18 years before he stopped taking them completely in 2020.
'That is all well and good if the person if not psychotic, but if someone is floridly psychotic and out of touch and deteriorating?' said Dr Watson-Munro.
'He was living in his car, had lost contact with his family ... was totally dishevelled and shambolic.
'He was obviously having issues about not having a relationship. I have read that treatment with antipsychotic drugs has side effects such as the impact of libido.
'Wanting to come off the medication and have a go at life is a separate issue and his parents were sufficiently concerned.
'But the evidence would suggest he had a well-established and documented schizophrenic illness.
'And we end up with this enormous tragedy.'
Cauchi was taking 550mg of clozapine for 10 years under the care of public health doctors when he transferred to Dr A's private clinic in February 2012.
Dr A has in the past promoted several types of therapy to treat patients, including 'dialectic therapy' where patients and therapists discuss their mental health.
Dr Watson-Munro dismissed those treatments as 'chat therapy' for people with personality disorders or anxiety, but not effective for people with schizophrenia.
The inquest heard Dr A worked with Cauchi to see if his symptoms, including a lack of joy or motivation, were caused by his schizophrenia or clozapine's side effects.
Dr A embarked on a plan to lower Cauchi's clozapine dose, and his mother Michele agreed to support him through the gradual reduction.
But in 2019, his mum became concerned Cauchi was suffering a schizophrenic relapse, after coming off his medication, when he said he was under Satanic control.
He also had extreme OCD, compulsively used pornography and his gait - his walking style - had changed, she said.
She contacted Dr A's clinic seven times to voice her concerns.
The inquest heard that at first Dr A accepted Mrs Cauchi's concerns at 'face value' and prescribed her son aripiprazole, but then the doctor felt she had erred on the side of safety.
Cauchi did not take the medication, and was not psychotic, Dr A claimed. She added that Mrs Cauchi was 'a beautiful, beautiful mother but she is not a psychiatrist'.
Dr Watson-Munro was taken aback by the comment and told Daily Mail Australia there were 'some real pearlers' in Dr A's testimony.
On Tuesday, senior counsel assisting the inquest Dr Peggy Dwyer SC asked Dr A: 'What would you say to the suggestion that you refuse to accept that Joel was psychotic on 13 April because you don't want to accept, yourself, the failings in your care of Joel?'
The psychiatrist replied: 'I did not fail in my care of Joel and I refuse – I have no error on my behalf.'
Dr Dwyer suggested she could have made a phone call.
'You could have done that, you just couldn't charge for it,' Dr Dwyer said, which the psychiatrist accepted.
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'It was conjecture on my part and I shouldn't have speculated four years later after I completed his treatment,' the psychiatrist said.
Criminal psychologist Dr Tim Watson-Munro said a medical system which let Joel Cauchi fall through the cracks when he deperately needed treatment was to also blame for the loss of 7 lives, including Cauchi's (above)
Barrister Sue Chrysanthou SC, representing the families of Ashlee Good, Jade Young and Dawn Singleton, described Dr A's testimony on Tuesday as 'shocking evidence to me and my clients' and 'contrary to all the expert evidence'.
Daily Mail Australia spoke with Cauchi's shattered parents this week, who refused to lay blame.
Cauchi's parents stressed that there was only one person who needed to apologise.
'My son let us down,' Mr Cauchi said.
But Dr Watson-Munro said it was not just Cauchi to blame, but a medical system which let a severely mentally ill man fall through the cracks when he deperately needed treatment.
What does it take to strip a psychiatrist of their licence?
By Harrison Christian
Psychiatrists can be held accountable if found negligent over a patient who went on to commit a violent crime - but it's unlikely to cost them their licence.
If a psychiatrist fails to take steps over client posing a serious risk, they could face disciplinary action by the Australian Health Practitioner Regulation Agency (AHPRA), or a civil claim, or both.
But stripping the psychiatrist of their licence would be an 'extreme outcome', even after even disciplinary action by AHRPRA, said Bill Madden, adjunct Professor at the Australian Centre for Health law Research.
The more likely result would be suspension or that they're made to undertake supervision, he said.
But he said they can face civil court legal action over perceived failures of care or a failure to sound the alarm when threats are made.
He said the most prominent case is a landmark 1976 case when Prosenjit Poddar warned his therapist he would kill fellow student Tatiana Tarasoff - and then he did.
The Supreme Court of California then ruled mental health professionals have a duty to reveal patient threats, and Mr Madden said it's the same in Australia.
'Ordinarily there's a doctor-patient relationship of confidentiality,' he said.
'Doctors are not normally permitted to release information, but the exception is where there is a serious (and perhaps imminent) danger to another person.'
In the code of conduct for Australian doctors, there are provisions for doctors to breach confidentiality if a patient makes a specific or even a general threat.
Mr Madden recalled a civil court claim after NSW's Morning Base Hospital discharged mentally ill patient Phillip Pettigrove who went on to kill his friend.
While there are a few reported legal cases in Australia, civil claims are usually resolved out of court, limiting information available, Mr Madden said.
'They're all pretty rare, but there may be some scrutiny of situations by coroners, or civil cases that are made but often not reported, or disciplinary cases by AHPRA or the Medical Board,' he added.
In the 2017 Victorian inquest into the death of Adriana Donato, the coroner scrutinised the response of James Stoneham's psychologist to a threat he made to harm an unnamed person.
Under questioning, it was revealed Stoneham may have made reference to Adriana and admitted his plan.
The coroner recommended a change to Victorian law, lowering the requirements for a breach of client confidentiality.