Latest news with #MicheleCauchi
The Guardian
5 days ago
- Health
- The Guardian
Cauchi's mass murders put harsh spotlight on failings of mental health and police systems
Joel Cauchi's mother didn't appear before the coronial inquest examining her son's life and the day her son murdered six people at a popular Bondi Junction shopping centre. But her presence was often felt, taking shape in the form of notes she had written to his doctor or in a conversation with a police officer. One of the most striking moments of the inquest was when Michele Cauchi, now in her mid-70s, was filmed via body-worn video camera on a police officer. She was standing outside her tidy home next to blooming hydrangeas, explaining how her son – who spoke multiple languages and had a university degree – had been deteriorating since he stopped taking medication. 'I don't know how we're going to get him treatment unless he does something drastic,' she says. These moments painted a picture of a mother engaging in a Sisyphean struggle to get her son – then living with untreated schizophrenia – help. But she could keep pushing only so far. Person after person who gave painful evidence at the five-week inquest told a similar story of doing their best in a 'fallible system'. It crystallised into a key takeaway: the system is letting down people in a crisis, like Cauchi. Cauchi's attack and the severity of it was a rare occurrence. But the system's failure to pick up on his slide after he stopped taking his medication for treatment-resistant schizophrenia is sadly a familiar story. Psychiatrists who appeared as experts before the inquest said the vision when mental health asylums in Australia were dismantled in the 1970s was for community services to instead support those people in need. But Queensland psychiatrist Prof Edward Heffernan told the inquiry the planned funding for community services 'never really followed' the shift. Psychiatrists also told the inquest that services hadn't kept pace with population growth. Meanwhile, psychological distress was increasing across the population, and patterns of substance abuse and other modern stressors had made things worse. Ian Korbel, a psychiatrist not part of the inquest, tells Guardian Australia he once worked in a mental health outreach team that would respond to people in crisis. But that program stopped running in the mid-2000s. Korbel says the team that worked in Sydney's eastern suburbs used to check the beaches for people experiencing homelessness. Cauchi was reportedly sleeping rough there before the attack. Korbel says the faltering of services has resulted in the buck passing to police and the justice system. 'They're in the punishment business,' he says. 'They shouldn't respond to this, but the health system isn't resourced to respond to it.' Police are increasingly responding to such crises. The inquest heard that in New South Wales, police responded to 40% more mental health incidents in 2022 compared with four years earlier. Sen Sgt Tracey Morris told the inquiry: 'We will always look at [those incidents] from a policing lens. That may lead to charges and them going through the court system when [it's] effectively because of the mental illness.' Morris works as the mental health intervention coordinator in the Queensland police district where Cauchi's parents live, in Darling Downs. The day Cauchi's mother spoke to police, they referred Joel to her role – which helps people link in with health services – for a follow-up check. But the officer acting in her role while she was on leave missed the email. This moment to get Cauchi help was described by a psychiatrist at the inquest as a 'missed opportunity'. Fighting back tears, Morris told the court this was no reflection on that officer's capability, but a direct consequence of under-resourcing. At least four people should be doing her job in that particular police district, she said. One of the cruelest ironies of that under-resourcing issue came during the inquest in a blink-and-you-might-have-missed it-moment, where Morris said no one was covering her role while she was at the inquest for the week. She couldn't find anyone to backfill it. Matthew Morgan, an expert in policing mental health responses who lectures at the Australian Catholic University, says: 'The only people really to blame here is the government. If they're not going to invest in a proactive and responsive mental health system that can provide the community around-the-clock care … then the buck stops with them.' A recent report Morgan co-authored analysed Queensland coronial inquests into people fatally shot by police while experiencing a mental illness. Twenty-four people have been fatally shot in the state since 2008. There is a clear patten, he says. 'The state has really just failed them. 'There's just lots of patterns of sporadic treatment, lack of follow-up care, and then the police get blamed for their criminalising and sometimes lethal response to such situations.' The inquest heard there had been multiple improvements in crisis response since police spoke to Cauchi and his mother in January 2023. Police can connect with health professionals to get advice on incidents, and there are co-response models where healthcare workers respond to call-outs alongside police. Those changes – as Peggy Dwyer, counsel assisting the coroner, pointed out in the inquest – have come after multiple inquiries, internal police and government reports and coronial inquests. All make a similar recommendation: health professionals should respond to mental health crises, not police – at least not alone. Joining calls for this change are families whose loved ones have been shot dead by police while they were suffering a psychosis. One of the loudest recent voices has been Judy Deacon, the mother of Jesse, who police shot dead in Glebe in 2023 after reports he was self-harming. But co-responder models have not been rolled out nationwide, despite recommendations to do so. The leading model in NSW, known as Pacer, operates in just 20 of NSW's 57 police commands. During the inquest, Dwyer asked Dr Brendan Flynn, the executive director of the mental health branch of NSW Health: 'Why has there not been an expanded Pacer across NSW where sufficient demand is demonstrated, when this report came out almost four years ago?' Flynn responded: 'It's a resourcing issue. It would require new funds, and that's a matter primarily for government.' Later Dwyer asked: 'Is there a risk that we just then get stuck here for another four years where there's no rollout of more supports?' Flynn replied: 'I hope very much that's not the case.' Even if a version of Pacer were rolled out across NSW, Korbel says, more work needs to be done. 'Nowhere in Australia do we fund mental health as we should,' he says. 'NSW is the worst. It gives 5% of its health budget to mental health.' Korbel says that figure 'would need to be doubled at least' to match similar programs in countries such as England and Canada. Investment in health services can save money in the long term. Prof Olav Nielssen, a Sydney-based psychiatrist who appeared before the inquest, spoke about a supported housing charity he works at. It supports people revolving between hospital, prison and the homeless sector. He estimated the cost of having people in supported housing was a tenth of what it would otherwise cost having them bouncing around a network of hospitals, prisons and other institutions. He said NSW had 'plans' to have 70 of these beds but that there should be 1,000 to meet the need. Elizabeth Young, the mother of Jade Young, a victim of the stabbings, appeared before the inquest and described her 47-year-old daughter's murder as the 'stuff of nightmares'. She also described it as the result of 'years of neglect' within the mental health system. 'It seems to me that my daughter and five others were killed by the cumulative failures of numbers of people within a whole series of fallible systems.' In Australia, the crisis support service Lifeline is 13 11 14. In the UK and Ireland, Samaritans can be contacted on freephone 116 123, or email jo@ or jo@ In the US, you can call or text the National Suicide Prevention Lifeline on 988, chat on or text HOME to 741741 to connect with a crisis counselor. Other international helplines can be found at
Daily Mail
22-05-2025
- Health
- Daily Mail
Psychiatrist who took Bondi Junction killer Joel Cauchi off his anti-psychotic medication and ignored his mother's concerns about his deteriorating mental state is unmasked
The psychiatrist who took Bondi Junction killer Joel Cauchi off his antipsychotic medication and failed to listen to his mother's repeated concerns about his declining mental state has been unmasked. Queensland psychiatrist Dr Andrea Boros-Lavack can finally be identified as the specialist who treated Cauchi and weaned him off his powerful medication. His mother, Michele Cauchi, contacted Dr Boros-Lavack's clinic seven times to tell them that her son's troubling schizophrenic symptoms were returning, but her fears were dismissed. Cauchi was still off his drugs when he went into a 'florid psychotic state' and killed six people in his bloody rampage through the Westfield Shopping Centre in April 2024. Dr Boros-Lavack's treatment has come under fire after the details were revealed at the inquest into the massacre, but until today her identity has been kept secret by a legal gag. Now Daily Mail Australia can identify her, and also reveal that her treatment was questioned at another inquest into the death of a 45-day-old baby. Dr Boros-Lavack is a medical entrepreneur who - along with her former juice salesman husband - opened a 'luxury' psychiatric clinic in Queensland which went belly up within four years. This was just three years after a Tasmanian Coroner's inquest found that Dr Boros-Lavack had given professional advice that an infant was safe to be in his mother's care. Five days later the child was dead from inflicted brain injuries. On Thursday afternoon, the NSW Coroner's Court released Dr Boros-Lavack's name and her colleagues who had treated Cauchi and testified at the inquest into Bondi Junction Westfield massacre. The medical witnesses treated Cauchi at Dr Boros-Lavack's now defunct Toowoomba Clinic west of Brisbane, where he was eased off Clozapine - the last resort anti-psychotropic drug which had successfully controlled his chronic schizophrenia for years. The clinic went into voluntary financial administration just 20 days after Cauchi's rampage, which one witness in the inquest believed was an entirely avoidable tragedy. Suppression orders on Dr Boros-Lavack and her colleagues' names expired at the conclusion of the psychiatric expert panel evidence component of the State Coroner's inquest into last year's Westfield tragedy. The inquest is investigating what led up to the deaths of Dawn Singleton, 25, Jade Young, 47, Yixuan Cheng, 27, Ashlee Good, 38, Pakria Darchia, 55, and Faraz Tahir, 30, and that of Cauchi. In under three minutes on the afternoon of April 13 2024, Cauchi, 40, used a Ka-Bar military knife to murder the five shoppers and one security guard, and injure ten others. Dr Boros-Lavack, who set up a private medical clinic with her MBA graduate businessman husband Richard Lavack, initially told the inquest that Cauchi was not psychotic. Instead, she said that stabbing to death six people was 'likely due to his sexual frustrations and hatred towards women'. The inquest heard that after Dr Boros-Lavack took Cauchi off Clozapine in 2019, his mother contacted the psychiatrist seven times about her son's troubling behaviour. Mrs Cauchi's concerns were sparked by her son leaving notes around the family home saying he was under the control of Satan or demons, and the fact his gait had changed, he had extreme OCD and compulsively viewed pornography. Dr Boros-Lavack's assertion that it was Cauchi's misogyny that lay behind the Westfield rampage rather than any psychosis drew gasps in the courtroom. Counsel assisting the inquest Dr Peggy Dwyer SC challenged her, suggesting she held that view 'because you don't want to accept, yourself, the failings in your care of Joel'. Despite offering her 'sincere apologies' and saying of the murders she was 'sharing the pain, it has devastated me personally', Dr Boros-Lavack replied: 'I did not fail in my care of Joel and I refuse – I have no error on my behalf.' However, in the witness box the following day, Dr Boros-Lavack withdrew the misogyny diagnosis as speculation rather than a clinical assessment. 'It was conjecture on my part and I shouldn't have speculated four years later after I completed his treatment,' she told the court. Dwyer, who described Dr Boros-Lavack as 'the treating psychiatrist, who weaned Mr Cauchi off his medication' asked the opinion of another medical witness. Dr Dwyer put it to a registered nurse referred to as RN3, who had also attended to Cauchi: 'Is it your view that if Joel had remained medicated and mentally well, he would not have been capable of committing this terrible travesty?' 'I think so,' the nurse replied. 'Yes.' Asked if more follow-up should have been done on his condition after moving on from clinical care, RN3 said 'It's very, very hard. 'People do get lost (in) follow up. With hindsight, things could have been done differently, with reflection.' Dr Boros-Lavack is promoted on health websites as having 'a special interest in the treatment of schizophrenia' and being 'well-versed in various therapeutic approaches, including cognitive behavioral therapy, dialectical behavior therapy, and supportive psychotherapy'. Criminal psychologist Dr Tim Watson-Munro told the Mail that these were mostly 'chat therapies' for people with personality disorders or anxiety. The inquest heard that Dr Boros-Lavack treated Cauchi from 2012 to 2020. For 15 years, Cauchi took Clopazine, considered the psychotropic drug of last resort to control severe 'treatment-resistant' form of schizophrenia. Cauchi's father Andrew also had the illness, the doctor told the inquest, and the condition was likely hereditary. In 2019 Dr Boros-Lavack let him come off Clozapine after Cauchi expressed a strong desire to do so to alleviate the resulting lack of joy or motivation, and a blunting effect. He also wanted to enjoy a sex life with women, and side effects of his medication included sexual dysfunction and deterioration of libido. Dr Boros-Lavack rediagnosed Cauchi with 'first episode' schizophrenia, deeming it safe for him to cease taking Clozapine. When Mrs Cauchi raised the alarm on the return of her son's schizophrenic symptoms, such as hearing voices, Dr Boros-Lavack prescribed another drug, Abilify, which he did not take. Andrew Cauchi would later take away his son's collection of knives, including the Ka-Bar style of military weapons with which Joel killed, only to have a deluded Joel report his dad to police for 'theft'. At the inquest, Dr Boros-Lavack acknowledged Mrs Cauchi's concern for her son but it did not come from any position of medical expertise, describing her as 'a beautiful, beautiful mother but she is not a psychiatrist'. Since the financial collapse of their Toowoomba Clinic, Dr Boros-Lavack and her husband have continued to run a medical practice, the Mi-Mind Centre in South Toowoomba. The couple, who live in a $1.3m house at Preston, between Toowoomba and the Lockyer Valley, previously worked in New Zealand although Andrea is originally from Hungary. Mr Lavack was a flight systems centre manager at the Massey University School of Aviation on New Zealand's North Island and CEO of Squish Drinks, which pioneered a hisbiscus-based fruit drink. In 2020, after fundraising 'many millions' the Lavacks opened the $9million Toowoomba Clinic offering 'top service, luxury beds, facility already planning to expand in early 2021'. Local media quoted the psyhciatrist as saying, that 'the first patient discharged from the Toowoomba Clinic walked out the doors in October 2020 with tears in her eyes. 'When we asked, "Is something wrong?" she replied "I'm just so sad to be leaving".' The clinic offered a 'holistic approach' with psychiatry 'and a full array of treatments', with plans for an 'an exercise physiologist, massage therapist, an onsite gym, a qualified diversionary therapist with an art room and a consulting dietitian'. But by May 2024, the centre financially collapsed and local media reported that 'patients were left in limbo'. On May 3 a public notice was issued that the company had entered an external voluntary administration. That collapse came years after Dr Boros-Lavack was named in the findings of a 2017 inquest held in Hobart into the death of a seven-week old baby. The baby died on November 28, 2012 - five days after Dr Boros-Lavack had assessed the baby's mother as competent to make medical decisions for the child. The baby boy died from severe head trauma, a post mortem detecting a severe brain injury, fractured skull, multiple rib fractures, and fractures to both femurs and his right pelvis. The findings note that the child's mother didn't protect the boy as she should have done, but that she was subject to the violence and control of her partner. 'Child Protection Services did not protect (the boy) as it had a duty to do. If it had undertaken its duty under the Act in accordance with correct practice and procedure, (his) death would not have occurred,' the Coroner concluded.
Daily Mail
13-05-2025
- Health
- Daily Mail
Joel Cauchi's psychiatrist to return for second day of grilling after claiming 'no error' in her treatment of the Bondi Junction mass killer despite his mother's grave concerns about his deteriorating mental state
A psychiatrist who treated the Joel Cauchi will step into the witness box for a second day of heated testimony after denying any failings despite weaning him off antipsychotics. Joel Cauchi, 40, armed himself with a pigging knife in April 2024 when he fatally stabbed six shoppers at Sydney 's Westfield Bondi Junction and injured 10 others. The psychiatrist who treated him in Queensland for eight years testified at an inquest into the tragedy on Tuesday, saying Cauchi had never been psychotic after she helped him stop his antipsychotic medications - clozapine and aripiprazole - in mid-2019. 'What would you say to the suggestion that you refuse to accept that Joel was psychotic on the 13th of April (2024) because you don't want to accept yourself the failings in your care of Joel?' counsel assisting Peggy Dwyer SC asked. 'I did not fail in the care of Joel. I refuse - I have no error on my behalf,' the psychiatrist said. Cauchi had been diagnosed with schizophrenia as a teen and had been successfully treated for more than two decades. After the psychiatrist weaned Cauchi off the two antipsychotic drugs in July 2019, his mother, Michele, contacted the psychiatrist's private clinic seven times raising concerns about possible signs of relapse. This included that he was leaving notes around the house about Satanic control, experiencing extreme obsessive-compulsive disorder and was not sleeping well. Cauchi also sent an email saying that he had developed an obsession with pornography, the NSW Coroners Court was told. The psychiatrist - who cannot be legally named - said these were viewed as possible signs of a early relapse but later assessments found that he was not psychotic. Cauchi was having trouble sleeping because he was up watching pornography, she said. His other symptoms stemmed from stressors including a fear he had caught an STD after sleeping with a prostitute, the coroner heard. Expert psychiatric evidence filed in the inquest has said Cauchi was 'floridly psychotic' at the time of the Bondi Junction attack. However, the psychiatrist also rejected this. She said Cauchi could not have organised the stabbing spree if he was experiencing symptoms of schizophrenia as this was something he was mentally unable to do. 'It might have been to do with frustration, sexual frustration, pornography and hatred towards women,' she said. 'That is my opinion.' Earlier in the inquest, the officer-in-charge of the police investigation Detective Chief Inspector Andrew Marks said Cauchi did not appear to be targeting women during the attack. On Tuesday, the psychiatrist told the court there would not be any difference if Cauchi had taken antipsychotic medication after July 2019. She testified she had never seen Joel 'acutely unwell' nor any signs of 'any relapse (or) any issues of safety'. The psychiatrist grew irritated with Dr Dwyer's questions around her initial diagnosis of Cauchi in 2012, telling her to 'move on'. She insisted she believed he had first-episode schizophrenia, rather than chronic schizophrenia, because he had remained symptom-free while medicated. But a 2012 letter discharging Cauchi from the public system - which was shown to the court - appeared to contradict this. 'It appears that Joel may appear to experience some positive symptoms with fluctuating severity,' it read. 'However Joel denies such symptoms.' Discharging Cauchi to his Toowoomba general practitioner after he relocated to Brisbane, the psychiatrist said there was nothing she could do to follow up. 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. The psychiatrist accepted this. She earlier issued a tearful apology to the families of the victims, Cauchi and those affected by the attacks. Her life and health had also been personally impacted by the incident, she said. In early 2020, near the start of the COVID-19 pandemic, Cauchi moved to Brisbane when he was completely cut off from psychiatric care. His rampage at the Westfield shopping centre in 2024 was brought to an end after he was shot dead by NSW Police Inspector Amy Scott. On Wednesday, the psychiatrist will return for a grilling by lawyers of those who died during the attacks.
Sydney Morning Herald
12-05-2025
- Health
- Sydney Morning Herald
Killer's mum pleaded for help, but dad haunted by ‘demons' too, Bondi Junction stabbing inquest told
He was on a second smaller dose of Abilify, a second medication used to treat his obsessive-compulsive disorder. Cauchi was diligent with his medication and he never missed appointments. The nurse said the man was anxious about 'relapsing' into illness. 'He didn't want to get unwell, and he was very conscientious,' the nurse said. 'He had anxiety around it. He wanted to get support and make sure he did the right thing.' The nurse was monitoring Cauchi as the centre slightly reduced his Clopine dose around 2016-17. Cauchi was feeling better physically and mentally, and noticed boosted energy levels and improved capacity to study, the nurse told the court. He reported no hallucinations or violent tendencies. Cauchi, under the care of his psychiatrist at the same centre, completely came off Clopine in mid-2018. He began refusing to take Abilify in June 2019. Both nurses who gave evidence on Monday said they had never seen a patient go off Clopine and not transition to a replacement anti-psychotic. But Cauchi, by late 2019, was completely unmedicated for the first time in 15 years. Just weeks later, however, Cauchi's mother contacted the centre and said her son's behaviour was changing in terrifying ways. 'I know you thought that it wasn't having any effect, but I have noticed a gradual decline in his condition,' Michele Cauchi wrote in November 2019. 'I have a feeling he is now hearing voices. 'I would hate to see him have to go back into hospital after 20 years of being stable on medication. I would love to see him being able to live successfully, independently, and doing as well as he was a year ago when he first moved out of home.' Over the phone, Michele Cauchi told one of the centre's nurses that her son's notes said he was 'under Satanic control from religious beings'. Further, he was showering compulsively, had taken on a strange 'gait', and was wearing layers of clothing to stop himself getting sick. Cauchi was also fixated on pornography, and emailed the centre asking if they could help him get a phone or internet provider that would prevent him from accessing pornography. The following day, on November 21, 2019, Cauchi's nurse spoke to Joel's father, Andrew, over the phone. A clinical note, detailing their conversation, shows Andrew Cauchi did not want his son to go back on the medicine. 'Information given to his father, who became adamant that he did not want his son to go on medication as it will kill him,' the note reads. 'Father spoke that he himself had been traumatised by demons when awake and hears voices and is not on medication.' The Cauchi family are very religious, and the inquest has heard Andrew Cauchi has mental health problems. The doctors and nurses treating Cauchi urged him to go back on medication, but he did not want to. In February 2020, Cauchi was preparing to move to Brisbane. It would have taken him far from his family and Toowoomba. Cauchi's worried mother called again, telling centre that her son's unit was filthy, he was uncharacteristically swearing, and she feared he would become homeless if he moved to Brisbane. But one month later, in March, Cauchi was discharged and was out on his own and no one had the power to force him back onto his medication, the inquest heard. 'Don't you think the clinic should have followed up with Joel after March 2020 to ensure he found a new psychiatrist?' barrister for some of the victims' families, Sue Chrysanthou, SC, asked one nurse. 'That would have been ideal,' the nurse said. Cauchi could not be forcefully medicated unless detained under the Mental Health Act. That could happen only if he posed an imminent threat to himself, the inquest has heard. 'It's not something Joel could have been forced to do. His rights are taken into consideration,' one nurse told the inquest on Monday. Cauchi, in 2020, had multiple run-ins with police and his parents, including over a growing fixation he developed for military knives. By March 2024, the fears of Cauchi's mother had borne out; he was homeless and sleeping on a beach in Sydney. One month later, he would take one of his large military knives and kill six people in Bondi Junction Westfield before being shot dead by a NSW Police inspector.
