On Wednesday 20th December, 38yr old Julie Seed from Adelaide was allegedly killed in a knife attack by Sean Dunk, a 30yr old mental health patient. A colleague of Julie Seed was also seriously injured in the same attack and is in hospital after surgery to save her life. Mr Dunk was arrested at the scene of the incident and has been charged with murder and attempted murder. It is already widely reported he had been a mental health inpatient at the Royal Adelaide Hospital and was discharged only two days prior to the attacks. His lawyer has already informed the court they will seek reports in to this “capacity” to commit the offence and whether he is fit to stand trial – they are exploring a MH defence and he is now remanded in to secure mental health custody until March 2024.
This is an utter tragedy, no doubt about it – two apparently unprovoked attacks leading to death and serious injury. I can only think how much the victims’ families are suffering, especially as discussion begins about the fact Mr Dunk was discharged from hospital only two days before. We don’t yet appear to know what kind of inpatient order was used. Media reports simply say “mental health detention order” but South Australian law has three types of order in ‘civil’ admission, imaginatively known as level 1, level 2 and level 3 orders.
- Level 1 order – detention for up to 7 days
- Level 2 order – detention for up to 42 days, renewable once for a further 42 days.
- Level 3 order – detention for up to 12 months, but successive orders can be made, allowing for long-term detention.
South Australian mental health law also allows for a range of community treatment orders which can be applied after someone’s discharge and we do not yet know whether they were in play here. In fact, there’s an awful lot we don’t yet know about Mr Dunk and his healthcare background. South Australia Health has stated their will be an independent inquiry in to healthcare decisions, the state’s Chief Psychiatrist stating they will be looking at decisions taken to examine whether mistakes were made or lessons should be learned and a psychiatrist from outside South Australia will oversee that. But it’s currently Thursday and the poor victims were only attached yesterday, within 48-hrs of discharge. It’s impossible to know much and it will all come out during criminal proceedings and the healthcare review, in 2024.
THE WORST OF ALL TRAGEDIES
Of course, those closest to the victims will be in unbearable pain and confusion, not to say anger which is entirely natural – I can’t imagine what they must be going through. It must be amongst the worst kind of tragedy because of its randomness. Social media has of course gone in to overload with almost all comments labelling the South Australia mental health system a ‘disgrace’ or a ‘joke’, with almost everyone implying the fact of these attacks means the decision to discharge must have been wrong and that the attacks were preventable. Now, it may be the case we learn in due course that mistakes were made and the attacks were preventable – goodness knows, we saw an inquest in Northern Ireland only last week where a coroner said exactly that, “entirely preventable” if the police and mental health services had done their job according to law. So I’m not saying this wasn’t preventable or that it shouldn’t be examined.
What I am saying however is nobody really knows what’s going on and that early calls about preventability are premature – let the investigators and reviewers investigate and review and then we’ll know. It got me mulling over what people might be thinking to call so early that this was preventable: the media coverage was factually limited about overall background and nothing specific about what was known to the mental health staff who took the decision to discharge him. Beyond the fact of the detention order existing and his recent discharge, we don’t know anything at the of me writing this. So are those leaping to judgement saying, for example, no-one who has been in a mental health hospital under a detention order can ever be released in case this happens? – my sense of things is no-one really believes that is necessary, possible or justified because we know it would lead to thousands of people spending their lives in institutions without justification. But if we’re not saying that, what are we saying?
If we accept some mental health patients are going to be discharged from hospital back to the community to get on with their lives, including with community support, then we accept by definition there has to be a process to decide which patients are discharged along with when and how. That means, by definition, there is scope for the decision-makers to get things wrong and it then comes down to things like risk assessment and mitigating, supportive factors on release.
FOR INSTANCE
Let’s imagine a woman in her late twenties, admitted to hospital because of self-injury and bipolar disorder after a traumatic teenage / early adult period. She’s never hurt anyone else or been in trouble with the police before and as her condition improves she reaches a point where she feels safe to leave and take on responsibility for her life and her ongoing self-care, all the clinicians agree and nothing points towards her harming anyone. How do we justify keeping her detained indefinitely, just to ensure she doesn’t randomly hurt anyone?
Repeat that story with a narrative which includes her making threats to further self-injure, to harm her family who got her “sectioned” and several previous convictions for violence involving bladed weapons and you very suddenly have a very different set of circumstances which may well justify a different decision to be taken. My point in this latest tragedy is that no-one really knows what’s gone on, other than the clinicians who were involved in the discharge and perhaps the police who are starting to investigate this.
In due course, the courts in South Australia, including the criminal courts for the prosecution process already underway and the Coroners court for the inquest process which will follow Julie Meed’s death will be full of such detail, will hear all of the detail and background and it will eventually become clear. I’m perfectly prepared to learn mistakes were made but we can’t know that now. So calling about preventability, whilst understandable, is premature and it doesn’t help. It only reinforces ideas that all patients subject to the kinds of orders in use here must be dangerous and must remain detained. It’s more nuanced than that – otherwise you might as well just call for nineteenth century asylums to be reinstated and lock up everyone for life.
My heart goes out once more to the victims, their families and friends. Regardless of anything, this is the worst of all tragedies.
RESOURCES
Should you wish to read more about South Australian mental health law or the interface between mental health and emergency services, here are some resources –
- Mental Health Act 2009 (SA)
- Code of Practice 2010 (SA)
- Mental Health and Emergency Services MOU 2010 (SA)
Winner of the President’s Medal,
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All opinions expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2023
I try to keep this blog up to date, but inevitably over time, amendments to the law as well as court rulings and other findings from inquests and complaints processes mean it is difficult to ensure all the articles and pages remain current. Please ensure you check all legal issues in particular and take appropriate professional advice where necessary.
Government legislation website – www.legislation.gov.uk
Mental Health Cop 