Sins, reflections, and directions: A Tasmanian case study

Dr David Tuck1

1Forensic Mental Health Service (Tas), Hobart, Australia

 

This case study discusses a 54 year old male, with a long-documented diagnosis of schizophrenia. Currently, (at the time of submitting the present abstract), he is remanded in custody awaiting sentencing having recently been found guilty of arson after his insanity defence was rejected by the trial jury.

This individual, with one historical conviction for violence, set fire to the civil mental health centre where he had been receiving outpatient psychiatric treatment. Less than three weeks prior to this event, he had been discharged from an involuntary inpatient admission to the Royal Hobart Hospital’s Department of Psychiatry.

The individual’s complex delusion system involves a belief that doctors, pharmaceutical companies, and the mental health system have been conspiring against him, poisoning and experimenting on him, and trying to change his sexual orientation. Although disordered, the patient made various efforts to communicate these conspiracies to others, and even presented to the police station requesting assistance in the days prior to the offence. Since his arrest eighteen months ago, the patient has been cared for in Tasmania’s secure forensic mental health facility, and has only partially responded to antipsychotic medication. His delusions remain unwavering.

Having now been found guilty of arson, with his insanity defence rejected, this individual is awaiting sentencing – however, each of the options for sentencing present unique dilemmas to the future provision of clinical care, rehabilitation, and reintegration of this man. Although therapeutic targets are clearly evident, significant sentence-specific barriers to treatment exist.

This presentation will review the individual’s relevant history, the particulars of the arson offence, the developments at his trial, and the formulation for his future management.


Biography:

Dr David Tuck is a Clinical Psychologist, working for the Tasmanian Health Service as the acting Clinical Coordinator for the state’s Forensic Mental Health Service. Dr Tuck’s current research interests are in personality assessment, criminal offending profiles, malingering and psychopathy.