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Otago Daily Times
30-04-2025
- Health
- Otago Daily Times
Call for 'urgent review' after mental health patient kills again
By Sam Sherwood The Chief Victims Advisor is calling for a Royal Commission of Inquiry into forensic mental health facilities after it was revealed a man who was ruled insane after killing someone two decades ago has killed again. RNZ has revealed a man who was made a special patient under the Mental Health Act after his first killing was recently found not guilty of murder by reason of insanity for a second time, after killing someone he believed was possessed. Releasing a person into the community after they have been designated a special patient requires the sign off of the minister of health, the attorney general and the director of mental health. The man was released more than a decade ago, and later had his status changed to being a patient under the Mental Health Act. Family want answers after mother killed At the time of his second killing, he was subject to a Community Treatment Order. RNZ is unable to publish details regarding either killings as the decision to lift name suppression has now been taken to the Court of Appeal, meaning the man and his victim can not be identified until the appeal has been determined. Chief Victims Advisor Ruth Money told RNZ the case was "my worst fear", adding she felt "physically sick" when she read the article today. "It's pretty hard to see how this could be any worse." Money wants an "urgent review" for any patient who has had their status changed. "Clearly something is seriously wrong with how these people have chosen to re-classify their status," she said. "It's getting to the point where we need a Royal Commission to find out what's happening in these facilities." Money said there would be many patients who had the correct classification. "But at this point I don't think the public can have any faith that the allocations or the classifications have been done safely. "We have got people killing members of the community who have been classified by the senior people in mental health as safe, clearly we have a significant problem because the community wasn't safe." Mental health patient Elliot Cameron pleaded guilty earlier this month to murdering Faye Phelps at her Christchurch home in October last year. Nearly three years ago, in June 2022, Hillmorton Hospital forensic mental health patient Zakariye Mohamed Hussein stabbed Laisa Waka Tunidau to death as she walked home from work. Hussein was on community leave at the time of the killing. RNZ revealed earlier this week that Phelps, and others who employed Cameron to do their gardening, were unaware he was actually a mental health patient who had been living at Hillmorton Hospital for many years. After RNZ's story about Cameron, Money wrote to director of mental health Dr John Crawshaw. In her email - seen by Phelps' daughter - Money wrote she was "both extremely concerned and outraged" to read about Phelps' death. "This is not the first time it has happened, but it needs to be the last." Money said she wanted to understand what support was being offered to Phelps' family, what he was doing to expedite the reports, and what support was being offered to Waka Tunidau's family. She also asked when the investigation of Canterbury District Mental Health Services - launched after Tunidau's murder - was going to be released. Money told RNZ she was "very concerned" from a victim's perspective about the "systemic issues" around victims of mental health patients. "This isn't the first innocent death at the hands of someone from this mental health facility, and it seems that we are waiting an inordinate amount of time for reports that have been promised that could have prevented unnecessary assaults." She wants Health New Zealand to commit to timelines so that the families are updated. "They need to be transparent with the care that is being offered to the families, but also the staff in these institutions. And importantly, there needs to be an urgent and long, lasting review and change so that this doesn't happen again," she said. "How many more people need to die? How many more victims do we need to create before systemic change happens? This must be prevented at all costs." In a statement to RNZ, Dr Crawshaw said he had replied to Money's email, and offered an opportunity to meet and discuss broader issues relevant to both their roles. He said reviews specific to serious events were undertaken by Health New Zealand. Dr Crawshaw's report investigates wider concerns about the mental health service provision in the Canterbury district of Health New Zealand. He said the investigation looks into the service at a systemic level: its general and clinical governance, its resourcing and overarching care model. "All of which take some considerable time to review, analyse and report." The broader review was scheduled to be completed mid-year, he said. 'Multiple checks and balances' - minister In a statement, Minister for Mental Health Matt Doocey said he had been "very clear that we can and must do better to improve mental health and addiction outcomes and services in New Zealand". "Within mental health there is a range of services available that are focused on addressing the mental health and addiction issues that many people face. In addition, we have specialised forensic services who provide rehabilitation to special patients, with the aim of protecting the public and keeping patients safe. "As a result of rehabilitation, special patients may progress to a point where it is appropriate for their legal status to be reviewed. Before this occurs, there is a transition period where the person remains a special patient but is granted progressive community leave with clinical supervision and family or wider support. If the patient is progressing well, they may be granted extended periods of approved leave. Leave may have specific conditions applied regarding treatment required, or activities or movement in the community." Doocey said there were "multiple checks and balances in place when it came to special patient decisions. "These include the Director of Mental Health who gives advice and a recommendation, the responsible clinician and in some instances the Special Patient Review Panel and the Mental Health Review Tribunal. It is only at the end of this process that a person's status as a special patient may be reviewed. A change in status will only be granted if specified criteria, including public safety, are met. "Even when a person is changed from special patient status, they will usually progress to being a patient where care is provided under compulsory treatment orders. These orders are regularly reviewed. These are long standing processes used for many years and aligned with approaches used in countries similar to our own." He said the Mental Health Bill currently before Parliament would set out a new approach to the decision-making around change of status from special patient. "If passed, the Bill will establish a Forensic Review Tribunal responsible for determining long leave, reviewing the condition of these patients, and determining changes in legal status. "Any serious incident, particularly where someone is tragically killed, is a cause of very serious concern. That is why it is important that investigations and reviews are triggered and recommendations for changes to services are acted on." Labour mental health spokeswoman Ingrid Leary told RNZ it would be "inappropriate" to comment on either the Cameron case or the case involving the man found insane twice as they were each subject to review processes. "I would expect the reviews to look at systems and information gaps to see whether existing processes were followed and whether there are systems gaps that need to change. "Like everyone else, I want to ensure cases like this don't happen again and will keep close eyes as the reviews evolve." Leary said it was "premature" to suggest a full review into the mental health system. "While these cases are harrowing and deeply unfortunate it's important to allow the review process to occur and respond appropriately rather than taking a knee-jerk approach which might not actually lead to the best and whole solution based on all the evidence."
RNZ News
30-04-2025
- Health
- RNZ News
'Urgent review' needed after mental health patient commits second killing
Photo: RNZ The Chief Victims Advisor is calling for an "urgent review" of all mental health patients who have had their status changed, after it was revealed a man who was ruled insane after killing someone two decades ago has killed again. RNZ has revealed a man who was made a special patient under the Mental Health Act after his first killing was recently found not guilty of murder by reason of insanity for a second time, after killing someone he believed was possessed. Releasing a person into the community after they have been designated a special patient requires the sign off of the minister of health, the attorney general and the director of mental health. The man was released more than a decade ago, and later had his status changed to being a patient under the Mental Health Act. At the time of his second killing, he was subject to a Community Treatment Order. RNZ is unable to publish details regarding either killings as the decision to lift name suppression has now been taken to the Court of Appeal, meaning the man and his victim can not be identified until the appeal has been determined. Chief Victims Advisor Ruth Money told RNZ the case was "my worst fear", adding she felt "physically sick" when she read the article today. "It's pretty hard to see how this could be any worse." Money wants an "urgent review" for any patient who has had their status changed. "Clearly something is seriously wrong with how these people have chosen to re-classify their status," she said. "It's getting to the point where we need a Royal Commission to find out what's happening in these facilities." Ruth Money. Photo: Stephanie Creagh Photography Money said there would be many patients who had the correct classification. "But at this point I don't think the public can have any faith that the allocations or the classifications have been done safely. "We have got people killing members of the community who have been classified by the senior people in mental health as safe, clearly we have a significant problem because the community wasn't safe." Mental health patient Elliot Cameron pleaded guilty earlier this month to murdering Faye Phelps at her Christchurch home in October last year. Nearly three years ago, in June 2022, Hillmorton Hospital forensic mental health patient Zakariye Mohamed Hussein stabbed Laisa Waka Tunidau to death as she walked home from work. Hussein was on community leave at the time of the killing. RNZ revealed earlier this week that Phelps, and others who employed Cameron to do their gardening, were unaware he was actually a mental health patient who had been living at Hillmorton Hospital for many years. After RNZ's story about Cameron, Money wrote to director of mental health Dr John Crawshaw. In her email - seen by Phelps' daughter - Money wrote she was "both extremely concerned and outraged" to read about Phelps' death. "This is not the first time it has happened, but it needs to be the last." Money said she wanted to understand what support was being offered to Phelps' family, what he was doing to expedite the reports, and what support was being offered to Waka Tunidau's family. She also asked when the investigation of Canterbury District Mental Health Services - launched after Tunidau's murder - was going to be released. Money told RNZ she was "very concerned" from a victim's perspective about the "systemic issues" around victims of mental health patients. "This isn't the first innocent death at the hands of someone from this mental health facility, and it seems that we are waiting an inordinate amount of time for reports that have been promised that could have prevented unnecessary assaults." She wants Health New Zealand to commit to timelines so that the families are updated. "They need to be transparent with the care that is being offered to the families, but also the staff in these institutions. And importantly, there needs to be an urgent and long, lasting review and change so that this doesn't happen again," she said. "How many more people need to die? How many more victims do we need to create before systemic change happens? This must be prevented at all costs." In a statement to RNZ, Dr Crawshaw said he had replied to Money's email, and offered an opportunity to meet and discuss broader issues relevant to both their roles. He said reviews specific to serious events were undertaken by Health New Zealand. Dr Crawshaw's report investigates wider concerns about the mental health service provision in the Canterbury district of Health New Zealand. He said the investigation looks into the service at a systemic level: its general and clinical governance, its resourcing and overarching care model. "All of which take some considerable time to review, analyse and report." The broader review was scheduled to be completed mid-year, he said. In a statement, Minister for Mental Health Matt Doocey said he had been "very clear that we can and must do better to improve mental health and addiction outcomes and services in New Zealand". "Within mental health there is a range of services available that are focused on addressing the mental health and addiction issues that many people face. In addition, we have specialised forensic services who provide rehabilitation to special patients, with the aim of protecting the public and keeping patients safe. "As a result of rehabilitation, special patients may progress to a point where it is appropriate for their legal status to be reviewed. Before this occurs, there is a transition period where the person remains a special patient but is granted progressive community leave with clinical supervision and family or wider support. If the patient is progressing well, they may be granted extended periods of approved leave. Leave may have specific conditions applied regarding treatment required, or activities or movement in the community." Doocey said there were "multiple checks and balances in place when it came to special patient decisions. "These include the Director of Mental Health who gives advice and a recommendation, the responsible clinician and in some instances the Special Patient Review Panel and the Mental Health Review Tribunal. It is only at the end of this process that a person's status as a special patient may be reviewed. A change in status will only be granted if specified criteria, including public safety, are met. "Even when a person is changed from special patient status, they will usually progress to being a patient where care is provided under compulsory treatment orders. These orders are regularly reviewed. These are long standing processes used for many years and aligned with approaches used in countries similar to our own." He said the Mental Health Bill currently before Parliament would set out a new approach to the decision-making around change of status from special patient. "If passed, the Bill will establish a Forensic Review Tribunal responsible for determining long leave, reviewing the condition of these patients, and determining changes in legal status. "Any serious incident, particularly where someone is tragically killed, is a cause of very serious concern. That is why it is important that investigations and reviews are triggered and recommendations for changes to services are acted on." Labour mental health spokeswoman Ingrid Leary told RNZ it would be "inappropriate" to comment on either the Cameron case or the case involving the man found insane twice as they were each subject to review processes. "I would expect the reviews to look at systems and information gaps to see whether existing processes were followed and whether there are systems gaps that need to change. "Like everyone else, I want to ensure cases like this don't happen again and will keep close eyes as the reviews evolve." Leary said it was "premature" to suggest a full review into the mental health system. "While these cases are harrowing and deeply unfortunate it's important to allow the review process to occur and respond appropriately rather than taking a knee-jerk approach which might not actually lead to the best and whole solution based on all the evidence." Sign up for Ngā Pitopito Kōrero, a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
Otago Daily Times
29-04-2025
- Otago Daily Times
Man found not guilty of murder by way of insanity for second time
By Sam Sherwood of RNZ A man ruled insane after committing a high-profile killing more than two decades ago has gone on to kill another person. The case, which is shrouded in secrecy, occurred "against a backdrop of apparent significant failures in the mental health system", a High Court judge says. RNZ can exclusively reveal the man - who was made a special patient under the Mental Health Act after his first killing - was recently found not guilty of murder by reason of insanity for a second time after killing someone he believed was possessed. To be released into the community after being designated a special patient, requires the sign off of the Minister of Health, the Attorney General and the Director of Mental Health. The man was released more than a decade ago, and later had his status changed to being a patient under the Mental Health Act. At the time of his second killing he was subject to a Community Treatment Order. Health NZ confirmed to RNZ an external review of the care the patient received leading up to their offending was under way. Mental Health Minister Matt Doocey said he had been told about the case by health officials, but declined to comment further. The man and the victim's family have lost a bid for name suppression in the High Court. In declining suppression, Justice Karen Grau said while the decision had been "very difficult", public interest must prevail. "There is rightly a high degree of public interest in learning of the circumstances in which a person who has been released into the community under the supervision of mental health services has gone on to kill again," she said. RNZ is unable to publish details regarding either killings as the decision to lift name suppression has now been taken to the Court of Appeal, meaning the man and his victim can not be identified until the appeal has been determined. However, RNZ can report the man has a long history of mental health issues. After the brutal killing more than 20 years ago, he was found not guilty of murder by reason of insanity. A judge ordered that he be detained in a special secure unit and not freed without the health minister's authority. The latest killing In her ruling, Justice Grau said that in the weeks leading up to the second killing, the man's mental health was "rapidly declining". He was admitted to a mental health facility following an altercation with a relative. About a week later he was released. He had issues with a relationship that he was in and was using cannabis. Court documents reveal the second killing occurred when he stabbed a person to death. He later told an associate he had killed the victim. Asked why, he said the victim was "possessed". "I had to do it." Police later found the victim dead. When the man was later found by police and told he was under arrest for murder, he said: "Yes, I know". In ruling the man was insane for a second time, the judge said there was no question that he was responsible for the killing. Two health assessors' reports had been ordered to address his fitness to stand trial, and whether he had a possible defence of insanity. Both report writers assessed him as being fit to stand trial and as having an available defence of insanity. Justice Grau said he was "mentally impaired" and suffered from a longstanding diagnosis. The Crown agreed the only reasonable verdict was that of "act proven but not criminally responsible on account of insanity". In her judgement, the judge addressed the victim impact statement. There was "shock, disbelief, and grief" in relation to the victim's death. The offending was described as a "cruel and heartless act". "The whanau feels that the mental health system has failed." The judge said the criminal charge "could not unpick what has happened in the system and what could and should have done, but it is hoped that answers will come, both for the whanau and for the wider community". The defendant was described as a "caring person when he was well". But, at the time of the killing he was "clearly unwell". 'Acutely unwell' As part of the court process, the man was assessed by two psychiatrists - Dr Justin Barry-Walsh and Dr Greg Young. The reports concluded he had suffered a relapse and was "acutely unwell" when he killed the victim. Dr Barry-Walsh interviewed the man twice. After the first interview, his opinion was that the man was "actively psychotic", with cannabis use likely contributing to the relapse. During the short period of time between when he was released from hospital and the killing, his mental health deteriorated. "In Dr Barry-Walsh's view, [the defendant] was suffering from a disease of the mind and would have a defence of insanity. Nothing suggested he was unable to know the nature and quality of his actions, but he was unable to reason that they were morally wrong. He believed his life was threatened and that he had to kill [the victim]." Dr Young's conclusions were the same. "Dr Young considers [the defendant's] actions were motivated by his delusions and associated aggressive emotional state that commonly accompanies severe paranoia. He too considers [the defendant] would have been incapable of knowing his acts were morally wrong." Because of the court's finding, the man was not convicted, but was made a special patient under the Mental Health Act again. Dr Young said that, for the defendant, the delusions he suffers from are real. Justice Grau asked the psychiatrists whether the risk reduced with age. "Dr Barry-Walsh has said it is the case that the risk of violence can decrease as a person ages, but the rate at which people age is individual. A level of risk may still be elevated long into the future, but if ageing is quicker, then the risk may reduce. Age also affects illness so that presentation may change. Age then is a factor, but it can't be relied on as reducing risk." 'A very difficult decision' The victim's family requested permanent name suppression for the victim. Both psychiatrists supported name suppression for the man. Dr Young said the likelihood the defendant may need placement in aged residential care in the future would be a "difficult matter" if his name was not suppressed "because of the stigma involved". "He considers that, in future, if [the defendant] is seeking an ordinary life, that would be more in reach if he has name suppression." Justice Grau said that while she had the "utmost sympathy" for the whanau, she was unable to grant suppression. "I have found this decision a very difficult one, and I must say, it is one that I make most reluctantly," she said. She said she had declined name suppression because the defendant's name and details had already been reported in the past, and because this was a case where the public interest in open justice must prevail. "There is rightly a high degree of public interest in learning of the circumstances in which a person who has been released into the community under the supervision of mental health services has gone on to kill again." The judge said it was a case where the man had killed another person while suffering from mental illness "against a backdrop of apparent significant failures in the mental health system". "These are matters that the public has an interest and an entitlement to know about." The man also posed an "ongoing and serious risk to public safety", and the public had a "legitimate interest in knowing the identity of a person who poses such a risk". "That includes people in the future, with whom [the defendant] might be placed, and I refer there to Dr Young's comments about the potential for aged care in the future. I also note that there are victims of [the defendant's] previous homicide who have a very real and very legitimate interest in knowing that this has happened again." Review under way In a statement to RNZ, the director of mental health Dr John Crawshaw said they were limited in what they could say regarding the case as there was ongoing legal action and name suppression in place. Dr Crawshaw confirmed there were specific processes set out under the Criminal Procedure Act and the Mental Health Act that must be followed when the status of a special patient is reviewed or changed. "The thresholds for decision making under the act are long standing. These processes are always followed." When a patient was moved from special patient status they were frequently subject to continued compulsory treatment orders, Dr Crawshaw said. "The Ministry of Health has provided information to the Minister of Mental Health about some aspects of this case under the no surprises principle, but it has not provided a formal briefing. The event and investigations all began prior to the current Minister's time in office." Doocey said his office had received some information under the no surprises principle. A Health NZ spokesperson said an external review of the care the patient received leading up to their offending was in progress.
Otago Daily Times
29-04-2025
- Otago Daily Times
Released patient kills for second time
By Sam Sherwood of RNZ A man ruled insane after committing a high-profile killing more than two decades ago has gone on to kill another person. The case, which is shrouded in secrecy, occurred "against a backdrop of apparent significant failures in the mental health system", a High Court judge says. RNZ can exclusively reveal the man - who was made a special patient under the Mental Health Act after his first killing - was recently found not guilty of murder by reason of insanity for a second time after killing someone he believed was possessed. To be released into the community after being designated a special patient, requires the sign off of the Minister of Health, the Attorney General and the Director of Mental Health. The man was released more than a decade ago, and later had his status changed to being a patient under the Mental Health Act. At the time of his second killing he was subject to a Community Treatment Order. Health NZ confirmed to RNZ an external review of the care the patient received leading up to their offending was under way. Mental Health Minister Matt Doocey said he had been told about the case by health officials, but declined to comment further. The man and the victim's family have lost a bid for name suppression in the High Court. In declining suppression, Justice Karen Grau said while the decision had been "very difficult", public interest must prevail. "There is rightly a high degree of public interest in learning of the circumstances in which a person who has been released into the community under the supervision of mental health services has gone on to kill again," she said. RNZ is unable to publish details regarding either killings as the decision to lift name suppression has now been taken to the Court of Appeal, meaning the man and his victim can not be identified until the appeal has been determined. However, RNZ can report the man has a long history of mental health issues. After the brutal killing more than 20 years ago, he was found not guilty of murder by reason of insanity. A judge ordered that he be detained in a special secure unit and not freed without the health minister's authority. The latest killing In her ruling, Justice Grau said that in the weeks leading up to the second killing, the man's mental health was "rapidly declining". He was admitted to a mental health facility following an altercation with a relative. About a week later he was released. He had issues with a relationship that he was in and was using cannabis. Court documents reveal the second killing occurred when he stabbed a person to death. He later told an associate he had killed the victim. Asked why, he said the victim was "possessed". "I had to do it." Police later found the victim dead. When the man was later found by police and told he was under arrest for murder, he said: "Yes, I know". In ruling the man was insane for a second time, the judge said there was no question that he was responsible for the killing. Two health assessors' reports had been ordered to address his fitness to stand trial, and whether he had a possible defence of insanity. Both report writers assessed him as being fit to stand trial and as having an available defence of insanity. Justice Grau said he was "mentally impaired" and suffered from a longstanding diagnosis. The Crown agreed the only reasonable verdict was that of "act proven but not criminally responsible on account of insanity". In her judgement, the judge addressed the victim impact statement. There was "shock, disbelief, and grief" in relation to the victim's death. The offending was described as a "cruel and heartless act". "The whanau feels that the mental health system has failed." The judge said the criminal charge "could not unpick what has happened in the system and what could and should have done, but it is hoped that answers will come, both for the whanau and for the wider community". The defendant was described as a "caring person when he was well". But, at the time of the killing he was "clearly unwell". 'Acutely unwell' As part of the court process, the man was assessed by two psychiatrists - Dr Justin Barry-Walsh and Dr Greg Young. The reports concluded he had suffered a relapse and was "acutely unwell" when he killed the victim. Dr Barry-Walsh interviewed the man twice. After the first interview, his opinion was that the man was "actively psychotic", with cannabis use likely contributing to the relapse. During the short period of time between when he was released from hospital and the killing, his mental health deteriorated. "In Dr Barry-Walsh's view, [the defendant] was suffering from a disease of the mind and would have a defence of insanity. Nothing suggested he was unable to know the nature and quality of his actions, but he was unable to reason that they were morally wrong. He believed his life was threatened and that he had to kill [the victim]." Dr Young's conclusions were the same. "Dr Young considers [the defendant's] actions were motivated by his delusions and associated aggressive emotional state that commonly accompanies severe paranoia. He too considers [the defendant] would have been incapable of knowing his acts were morally wrong." Because of the court's finding, the man was not convicted, but was made a special patient under the Mental Health Act again. Dr Young said that, for the defendant, the delusions he suffers from are real. Justice Grau asked the psychiatrists whether the risk reduced with age. "Dr Barry-Walsh has said it is the case that the risk of violence can decrease as a person ages, but the rate at which people age is individual. A level of risk may still be elevated long into the future, but if ageing is quicker, then the risk may reduce. Age also affects illness so that presentation may change. Age then is a factor, but it can't be relied on as reducing risk." 'A very difficult decision' The victim's family requested permanent name suppression for the victim. Both psychiatrists supported name suppression for the man. Dr Young said the likelihood the defendant may need placement in aged residential care in the future would be a "difficult matter" if his name was not suppressed "because of the stigma involved". "He considers that, in future, if [the defendant] is seeking an ordinary life, that would be more in reach if he has name suppression." Justice Grau said that while she had the "utmost sympathy" for the whanau, she was unable to grant suppression. "I have found this decision a very difficult one, and I must say, it is one that I make most reluctantly," she said. She said she had declined name suppression because the defendant's name and details had already been reported in the past, and because this was a case where the public interest in open justice must prevail. "There is rightly a high degree of public interest in learning of the circumstances in which a person who has been released into the community under the supervision of mental health services has gone on to kill again." The judge said it was a case where the man had killed another person while suffering from mental illness "against a backdrop of apparent significant failures in the mental health system". "These are matters that the public has an interest and an entitlement to know about." The man also posed an "ongoing and serious risk to public safety", and the public had a "legitimate interest in knowing the identity of a person who poses such a risk". "That includes people in the future, with whom [the defendant] might be placed, and I refer there to Dr Young's comments about the potential for aged care in the future. I also note that there are victims of [the defendant's] previous homicide who have a very real and very legitimate interest in knowing that this has happened again." Review under way In a statement to RNZ, the director of mental health Dr John Crawshaw said they were limited in what they could say regarding the case as there was ongoing legal action and name suppression in place. Dr Crawshaw confirmed there were specific processes set out under the Criminal Procedure Act and the Mental Health Act that must be followed when the status of a special patient is reviewed or changed. "The thresholds for decision making under the act are long standing. These processes are always followed." When a patient was moved from special patient status they were frequently subject to continued compulsory treatment orders, Dr Crawshaw said. "The Ministry of Health has provided information to the Minister of Mental Health about some aspects of this case under the no surprises principle, but it has not provided a formal briefing. The event and investigations all began prior to the current Minister's time in office." Doocey said his office had received some information under the no surprises principle. A Health NZ spokesperson said an external review of the care the patient received leading up to their offending was in progress.
RNZ News
29-04-2025
- RNZ News
Man found not guilty of murder by way of insanity twice after two separate killings
Photo: RNZ A man who was ruled insane after committing a high-profile killing more than two decades ago has gone on to kill another person. The case, which is shrouded in secrecy, occurred "against a backdrop of apparent significant failures in the mental health system", a High Court judge says. RNZ can exclusively reveal the man - who was made a special patient under the Mental Health Act after his first killing - was recently found not guilty of murder by reason of insanity for a second time after killing someone he believed was possessed. To be released into the community after being designated a special patient, requires the sign off of the Minister of Health, the Attorney General and the Director of Mental Health. The man was released more than a decade ago, and later had his status changed to being a patient under the Mental Health Act. At the time of his second killing he was subject to a Community Treatment Order. Health NZ confirmed to RNZ an external review of the care the patient received leading up to their offending was underway. Mental Health Minister Matt Doocey said he had been told about the case by health officials, but declined to comment further. The man and the victim's family have lost a bid for name suppression in the High Court. In declining suppression, Justice Karen Grau said while the decision had been "very difficult", public interest must prevail. "There is rightly a high degree of public interest in learning of the circumstances in which a person who has been released into the community under the supervision of mental health services has gone on to kill again,' she said. RNZ is unable to publish details regarding either killings as the decision to lift name suppression has now been taken to the Court of Appeal, meaning the man and his victim can not be identified until the appeal has been determined. However, RNZ can report the man has a long history of mental health issues. After the brutal killing more than 20 years ago, he was found not guilty of murder by reason of insanity. A judge ordered that he be detained in a special secure unit and not freed without the health minister's authority. In her ruling, Justice Grau said that in the weeks leading up to the second killing, the man's mental health was "rapidly declining". He was admitted to a mental health facility following an altercation with a relative. About a week later he was released. He had issues with a relationship that he was in and was using cannabis. Court documents reveal the second killing occurred when he stabbed a person to death. He later told an associate he had killed the victim. Asked why, he said the victim was "possessed". "I had to do it." The police later found the victim dead. When the man was later found by police and told he was under arrest for murder, he said: "Yes, I know". In ruling the man was insane for a second time, the judge said there was no question that he was responsible for the killing. Two health assessors' reports had been ordered to address his fitness to stand trial, and whether he had a possible defence of insanity. Both report writers assessed him as being fit to stand trial and as having an available defence of insanity. Justice Grau said he was "mentally impaired" and suffered from a longstanding diagnosis. The Crown agreed the only reasonable verdict was that of "act proven but not criminally responsible on account of insanity". In her judgement, the judge addressed the victim impact statement. There was "shock, disbelief, and grief" in relation to the victim's death. The offending was described as a "cruel and heartless act". "The whanau feels that the mental health system has failed." The judge said the criminal charge "could not unpick what has happened in the system and what could and should have done, but it is hoped that answers will come, both for the whanau and for the wider community". The defendant was described as a "caring person when he was well". But, at the time of the killing he was "clearly unwell". As part of the court process, the man was assessed by two psychiatrists - Dr Justin Barry-Walsh and Dr Greg Young. The reports concluded he had suffered a relapse and was "acutely unwell" when he killed the victim. Dr Barry-Walsh interviewed the man twice. After the first interview, his opinion was that the man was "actively psychotic", with cannabis use likely contributing to the relapse. During the short period of time between when he was released from hospital and the killing, his mental health deteriorated. "In Dr Barry-Walsh's view, [the defendant] was suffering from a disease of the mind and would have a defence of insanity. Nothing suggested he was unable to know the nature and quality of his actions, but he was unable to reason that they were morally wrong. He believed his life was threatened and that he had to kill [the victim]." Dr Young's conclusions were the same. "Dr Young considers [the defendant's] actions were motivated by his delusions and associated aggressive emotional state that commonly accompanies severe paranoia. He too considers [the defendant] would have been incapable of knowing his acts were morally wrong." Because of the court's finding, the man was not convicted, but was made a special patient under the Mental Health Act again. Dr Young said that, for the defendant, the delusions he suffers from are real. Justice Grau asked the psychiatrists whether the risk reduced with age. "Dr Barry-Walsh has said it is the case that the risk of violence can decrease as a person ages, but the rate at which people age is individual. A level of risk may still be elevated long into the future, but if ageing is quicker, then the risk may reduce. Age also affects illness so that presentation may change. Age then is a factor, but it can't be relied on as reducing risk." The victim's family requested permanent name suppression for the victim. Both psychiatrists supported name suppression for the man. Dr Young said the likelihood the defendant may need placement in aged residential care in the future would be a "difficult matter" if his name was not suppressed "because of the stigma involved". "He considers that, in future, if [the defendant] is seeking an ordinary life, that would be more in reach if he has name suppression." Justice Grau said that while she had the "utmost sympathy" for the whanau, she was unable to grant suppression. "I have found this decision a very difficult one, and I must say, it is one that I make most reluctantly," she said. She said she had declined name suppression because the defendant's name and details had already been reported in the past, and because this was a case where the public interest in open justice must prevail. "There is rightly a high degree of public interest in learning of the circumstances in which a person who has been released into the community under the supervision of mental health services has gone on to kill again." The judge said it was a case where the man had killed another person while suffering from mental illness "against a backdrop of apparent significant failures in the mental health system". "These are matters that the public has an interest and an entitlement to know about." The man also posed an "ongoing and serious risk to public safety", and the public had a "legitimate interest in knowing the identity of a person who poses such a risk". "That includes people in the future, with whom [the defendant] might be placed, and I refer there to Dr Young's comments about the potential for aged care in the future. I also note that there are victims of [the defendant's] previous homicide who have a very real and very legitimate interest in knowing that this has happened again." In a statement to RNZ, the director of mental health Dr John Crawshaw said they were limited in what they could say regarding the case as there was ongoing legal action and name suppression in place. Dr Crawshaw confirmed there were specific processes set out under the Criminal Procedure Act and the Mental Health Act that must be followed when the status of a special patient is reviewed or changed. "The thresholds for decision making under the act are long standing. These processes are always followed." When a patient was moved from special patient status they were frequently subject to continued compulsory treatment orders, Dr Crawshaw said. "The Ministry of Health has provided information to the Minister of Mental Health about some aspects of this case under the no surprises principle, but it has not provided a formal briefing. The event and investigations all began prior to the current Minister's time in office." Mental Health Minister Matt Doocey said his office had received some information under the no surprises principle. A Health New Zealand spokesperson said an external review of the care the patient received leading up to their offending was in progress. Sign up for Ngā Pitopito Kōrero, a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
