This week a 51 year old male school teacher was sitting on a seat at a bus stop in the Sydney suburb of Camperdown, waiting for a bus when a psychotic 29 year old man emerged from a block of apartments holding a twenty centimetre kitchen knife. In a completely unprovoked attack, he stabbed the schoolteacher numerous times, bringing about his death.
A young woman tried to stem the victims bleeding and the attacker turned on her, but another resident armed himself with a baseball bat and forced this man to drop the knife, whereupon other residents subdued him and held him until the police arrived.
There was a further incident when he was later put before a court. The attacker jumped from the dock and tried to escape, causing additional police and Sheriffs officers to run to the court and apprehend him. The magistrate learned that this killer was taking five types of medication, some of which were described as anti psychotic drugs. He was remanded in custody.
At a time when the public are at risk from radicalized Islamic zealots seeking martyrdom by indiscriminate killing of complete strangers, we also have the problem of those suffering severe mental illness who refuse to take their medication and threaten public harm - as this killing clearly illustrates.
How the law system reacts is quite predictable. This man will be held on remand and subjected to a psychiatric evaluation. The DPP will eventually announce that he is unfit to stand trial because of mental illness and he will be forcibly detained in a hospital - " Until he is deemed safe for release "!
No doubt his drug dependency will be strictly maintained while he is in care and he will revert to being a rational human being, and our hospital system is vastly overloaded and under stress. In due course - when he has behaved in a "normal "manner for a period of time - he will be approved for "day release " and may even find employment. It seems inevitable that eventually all forms of restraint will be removed.
A century ago we had medical facilities which some referred to as "Lunatic Asylums ". They were certainly grim places little different from the prison system and that was where those deemed a danger to the public were incarcerated. The need to trim the health budget saw them closed with the quaint idea that mental health could be better served by clinics in the community, but sadly these did not eventuate. The care of the mentally ill was dumped back onto the public hospital system, which is not not ideally suited for that task.
The majority of mental health sufferers do achieve near normalcy with modern medication - just as long as they continue to take it, and that is the glaring deficiency in today's mental health regime. Families and loved ones constantly despair that those within their care have discontinued the vital medication prescribed and they are powerless to force them to comply. This is not a task for the police and the hospital system can not intervene. The entire health system is paralysed - until a law is broken - and then the damage is too late to repair.
What is missing is an intervention mode. Usually a psychiatric patient is released on the condition that he or she resides with a carer. A medication lapse negates the condition which led to release within the community and on advice that medication has stopped that patient should be taken back into care - until the medication routine has again been reestablished.
It is highly likely that this Camperdown stabbing involves medication cessation. The missing link in psychiatric stability seems to be intervention to ensure that the medication regime is being maintained. Put that power into the carer's hands - and many more tragic incidents such as Camperdown may be avoided !
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