Australia- Nine people stabbed including 9 month baby @ the Westfield Shopping Centre in Bondi Junction, suspect fatally shot, Sydney, 13 April 2024

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Sor Juana said:
How do you treat someone who doesn’t accept they’re ill?
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Sometimes it works if the treatment is court ordered, and the person is not able to flee. I worked at and inpatient crisis center. We would stabilize people om meds, discharge them with the meds, and find the full bottles in the trash outside the front door. They have the right to refuse the treatment, once they are not under involuntary commitment. The system is a mess, bottom line.
 
drsleuth said:
I fear it's just all talk SA. Its a "hot topic" atm, gotta be seen saying the right things :rolleyes:

Mental Health services in this country is woefully pathetic.

People reach out in crisis & get turned away all the time. Eventually they don't ask for help anymore.

You only need to browse the Coronial findings in every state to see how much mental health is represented.

All just my IMO & from my experience.
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We have the same problems in the USA. Except our psychotic people can buy and keep all the guns they want. Psychotic does not translate to stupid, either. They know what to say and what not to say to get released if they are picked up on a psych hold. It is very tough to work with this population.
 
Sor Juana said:
Even $120 for 6 sessions (totalling $720 annually) is quite generous, something many countries lack in their systems. The remaining $480, a gap payment, is much less than a fortnightly unemployment benefit. While it's undoubtedly challenging to afford on a tight budget, I believe it's not impossible, and one can manage it on a pay-as-you-go basis.
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Long-term mental health issues here, though nothing so far discussed on this thread - it's a wide field. btw, I'm neither crazy nor dangerous.

Maybe the occasional person can manage as you propose, but the huge majority I think not. I don't consider $120 for 6 sessions generous at all, but it does depend on what you're comparing with. Can you give some examples of these "many countries", please?

On top of the financial issues - 6 sessions is nothing, as somebody else pointed out. So, that $720 annually has to be paid in more years than one, most likely for most people.
MOO

Anyway, no thread on WS is going to solve the world's mental health crisis. It's a far too complex matter, needing multi-faceted, long-term solutions from experts in many fields IMO. Though input from those afflicted with mental health problems would undoubtedly be useful for experts, because you can't grasp everything if you haven't been in that situation IME and IMO.

RIP to all those victims killed in this awful stabbing.
Prayers/good thoughts to all those injured and to all families and friends of all victims.
 
Samara McPhedran, an expert on mass killing events, said every incident was different and the likelihood of the perpetrator also dying made it difficult to nail down a motive.

She agreed, however, that a person having schizophrenia did not mean they were likely to commit murder.

“When we look at homicide in general, even then relatively few murders are committed by people with severe mental illness,” she said.

Bouda also said that Cauchi walked up behind two of his victims in the back, not speaking to them or looking at them before delivering the fatal blows.

“The first woman was lining up in a queue to buy a coffee, he has come up behind her and stabbed her in the back,” crime editor Simon Bouda said.

“He stabbed another woman in the back, he is not even looking at them.

On Monday Mr Cauchi’s father speculated that he had targeted women because he wanted a girlfriend and was “frustrated out of his brain”.
 
dotr said:
Meanwhile..
torontosun.com

Man arrested after stabbing during televised church service in Sydney

A video on social media shows a man dressed in black approaching a cleric and appearing to stab him repeatedly.
torontosun.com torontosun.com
'In a screengrab from video posted to social media, a man stabs a cleric at Christ the Good Shepherd in Sydney on Monday, April 15, 2024.
SYDNEY — Police say a man has been arrested after reportedly stabbing a bishop and churchgoers in Sydney.'
View attachment 497281
Ws thread..
www.websleuths.com

Sydney stabbing rampage at Christ the Good Shepherd Church in Wakeley - 15 April 2024

"Sydney is rocked by another stabbing rampage with a priest and worshippers attacked at Christ the Good Shepherd Church." https://www.dailymail.co.uk/news/article-13309617/bishop-stabbed-Sydney-church.html
www.websleuths.com www.websleuths.com
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www.abc.net.au

Live moment: Sydney church stabbing being investigated as 'terrorist act', authorities say

At least two police officers have been injured as large crowds clashed with authorities following the stabbing of a bishop during a live-streamed church service in Sydney's south-west last night.
www.abc.net.au www.abc.net.au

It's been looked at as a terrorist attack :mad:
 
nhmemorymaker said:
Brothers or cousins??
I have a number of friends with lost or dead sons and daughters. Some with a couple or a few....
Their lives full of pain.
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brothers both adopted at 3 and 4 years old - schizophrenia in their biological Dad
and lives full of pain is right, at some point you have to save yourself
 
I'm glad the parents are willing to speak, but I wish it was in a more dignified environment for them. Some information that is filtering out is important (if it's factual of course).

There are lots of familiar patterns here, coming off meds when he was doing well (clue, it's the meds that are allowing you to do well......). As Dotta says, schizophrenia is a life-long condition, people need constant monitoring and likely a certain amount of medication.

As has been said, there is a problem with compliance and insight with some patients. Patients and doctors need to work together to get the right balance and right meds.

In my opinion (schizophrenia in the family and many years of nursing including psychiatry), patients' personalities, intelligence, insight and regard for others play a very significant part in how the disorder plays out. While they are well they need to be educated about their illness and how it can be managed.

One of the great difficulties with schizophrenia is that mental health professionals have to rely a lot on self-reporting by the patient. Some patients do lie a lot about their symptoms and seek to manipulate to get off meds, get off a section, and to carry out bad acts. You need to look at the whole picture of how that individual is functioning in life and interacting with others to really see what is going on.

I think the episode where Cauchi himself called the police to complain about his father taking his knives away is incredibly telling. A staggering lack of insight into how people might see him. The lack of social skills and "nerdiness", probably some mild autism there too. I'm sure his father was 100% right that his life was at risk. I'm sure local police there fully expected this man to commit a violent offence. Was there any follow-up?

Being young, fit, male, non-compliant with treatment, a drug-user, loving knives, parents afraid he will kill them - just a couple of risk factors and red flags there !- a psychiatrist should always have had oversight of him and sectioned him when necessary. He's an obvious high-risk patient.

I'm not surprised to see evidence of planning, IMO the move to an affluent area of Sydney was to attack "high value victims" and to make sure he was noticed all over the world. Same old, same old MO of all these pathetic and repulsive murderers. I really hope people do not brush this under the carpet as just an expression of schizophrenia. Of course it makes life difficult but the vast majority of patients make valiant efforts to help themselves and not to be a burden to their families and society.

The perpetrator made a lot of very poor, arrogant and selfish choices about his problems. Chiefly IMO adding drugs into his life massively raised the risk of violence Small risk of violence in schizophrenia unless drugs and alcohol are involved | University of Oxford.
He chose to inflict his anger at the way life had been so unfair to him on utterly innocent people in the most savage of ways. IMO.
 
RosalindaA said:
Interesting about the knife sharpening (if accurate), Calocane went one better and carried a knife-sharpener with him in his rucksack. Again. this level of premeditation and criminal mindset is not consistent with psychotic violence, but with psychopathy. And the escort advertising, I wonder if that was a lure to entrap women victims to kill them?
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I agree, a psychopath who happened to have schizophrenia. He collected large hunting knives and reported his father to police because he hid the knives, he wanted to meet up with gun owners, imo, he was planning to kill, it was an 'episode' which picked the time and the place, but he planned it. JMO
 
investikater said:
Bravo
"All too often I see "mental health struggles" being used as a synonym for drug abuse." - Drives me nuts!!!

Keeping in mind I am certainly not an expert: as far as I know, people with organic, genetic and idiopathic schizophrenia generally don't seek out drugs, especially stimulant and hallucinogenic drugs.

However something like half of schizophrenics abuse drugs.

That seems paradoxical until you remember illegal drug use is strongly linked to inducing psychosis and schizophrenia.
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My brother's schizophrenia was diagnosed way before he began using drugs.

From age 14 to age 19 he was a ski racer---and even trained with the US Olympic team as Giant slalom racer when he was 18. So he did no drugs in those years and only a beer now and then.

It wasn't until after he was diagnosed, at 20, and on medications that he slowly began messing with cocaine, LSD and stuff like that. The meds made him feel listless and foggy and he hated that feeling.
 
RosalindaA said:
I feel for the murderer's family here too, I have no doubt that they have had a tough time with their son over the years, mental illness/drug abuse or both is incredibly hard on relatives, eventually sometimes they have to cut ties to preserve their own safety and sanity.
Unfortunately this then results in the person wandering about, causing problems, moving on with no-one keeping eyes on them as they deteriorate. And of course. they hardly ever self-refer to services, especially if they are using drugs.
Teenagers often start off with cannabis (because it's so harmless!!) which can trigger schizophrenia. I feel thankful I grew up at a time when I was taught at school that all illegal drugs were harmful. As a first-degree relative of a schizophrenic I was later grateful that I hadn't played russian roulette with my own brain, It truly sickens me that "milder drugs" are promoted as a lifestyle option to people when the clinical evidence is absolutely clear.

Psychiatrists should routinely test patients for illicit drug use, especially youngsters at first onset.

I think the pathway in this case (and Calocane's) is a downward spiral with all these factors in play, drugs, mental illness, personality disorders, social disconnection leading to these outbursts of hate. To stab a baby before you then murder the mother comes from extreme desire to inflict maximum suffering, like the school shooters. Because they feel bad....

Looking at the police inspector (a young, blonde pretty woman like the other two victims named), I wonder if he would have raised his knife to a male officer? Thank God she was armed and able to shoot him, otherwise I have no doubt he would have killed her.
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Reportedly, he did raise his knife at her right before she shot him.
 
Finding the right drug regime is so hard. It took about a year to get right. I take only two meds- I'm open about it in a setting, like here, where people have had grace and courtesy. I was on lithium and endep, nil side effects except weight gain- even with balanced diet and exercise. I found in my bipolar support group that another drug was effective for migraines too. I don't get side effects from either medication, very pleased.
However, I'm lucky, with Bipolar 2, I don't hear voices or get psychosis, but certainly impaired thinking and I made decisions which were not good. At the time of diagnosis, I had also had a PRN or as needed seroquel- for panic attacks or sometimes I'd be unable to control an emotion, ugh don't miss that, but would absolutely knock me out. I don't use it, but for people who do- I can see why the turn to illicit drugs. There are other medications that have significant side effects- the injections and tablets- significant weight gain (which can lead to other co-morbid conditions), and excessive drowsiness.
I note that the perpetrator was incredibly thin, so I'm curious to see his toxicology.
The coroner will have recommendations, one or two of which will be about mental health.
The lingering question(s) that has come up in this thread is the use of compliance and non-compliance.
This is the most difficult and ethical issue. How can this have been prevented? Why did so many people die because of one man? What is the precedence of previous rampage killings in Australia where mental health was the causation? (I actually didn't find that many studies).
Lastly, the coroner will also enlist an independent panel of experts who will also have an opinion. The hearing is going to take a sig amount time to prepare for and take months to investigate.
A 40 year study of homicide by people with schizophrenia was done by researchers from Macquarie uni but on the Russian Federation. (3.0%).
Stats here:
Schizophrenia is a complex brain disorder, which affects between 150,000 and 200,000 Australians.

pubmed.ncbi.nlm.nih.gov

Rates of homicide and homicide associated with severe mental illness in NSW between 1993 and 2016 - PubMed

The fall in conviction for homicide offences in the last 24 years has not been matched by a reduction in NGMI homicide verdicts. More assertive treatment of emerging psychosis and comorbid substance use disorders, and improved continuity of care of chronic psychosis might prevent some homicides.
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov
www.betterhealth.vic.gov.au

Schizophrenia

People with schizophrenia do not have 'split personalities' and they are not intellectually disabled.
www.betterhealth.vic.gov.au www.betterhealth.vic.gov.au
 
OptimusLime said:
Finding the right drug regime is so hard. It took about a year to get right. I take only two meds- I'm open about it in a setting, like here, where people have had grace and courtesy. I was on lithium and endep, nil side effects except weight gain- even with balanced diet and exercise. I found in my bipolar support group that another drug was effective for migraines too. I don't get side effects from either medication, very pleased.
However, I'm lucky, with Bipolar 2, I don't hear voices or get psychosis, but certainly impaired thinking and I made decisions which were not good. At the time of diagnosis, I had also had a PRN or as needed seroquel- for panic attacks or sometimes I'd be unable to control an emotion, ugh don't miss that, but would absolutely knock me out. I don't use it, but for people who do- I can see why the turn to illicit drugs. There are other medications that have significant side effects- the injections and tablets- significant weight gain (which can lead to other co-morbid conditions), and excessive drowsiness.
I note that the perpetrator was incredibly thin, so I'm curious to see his toxicology.
The coroner will have recommendations, one or two of which will be about mental health.
The lingering question(s) that has come up in this thread is the use of compliance and non-compliance.
This is the most difficult and ethical issue. How can this have been prevented? Why did so many people die because of one man? What is the precedence of previous rampage killings in Australia where mental health was the causation? (I actually didn't find that many studies).
Lastly, the coroner will also enlist an independent panel of experts who will also have an opinion. The hearing is going to take a sig amount time to prepare for and take months to investigate.
A 40 year study of homicide by people with schizophrenia was done by researchers from Macquarie uni but on the Russian Federation. (3.0%).
Stats here:
Schizophrenia is a complex brain disorder, which affects between 150,000 and 200,000 Australians.

pubmed.ncbi.nlm.nih.gov

Rates of homicide and homicide associated with severe mental illness in NSW between 1993 and 2016 - PubMed

The fall in conviction for homicide offences in the last 24 years has not been matched by a reduction in NGMI homicide verdicts. More assertive treatment of emerging psychosis and comorbid substance use disorders, and improved continuity of care of chronic psychosis might prevent some homicides.
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov
www.betterhealth.vic.gov.au

Schizophrenia

People with schizophrenia do not have 'split personalities' and they are not intellectually disabled.
www.betterhealth.vic.gov.au www.betterhealth.vic.gov.au
Click to expand...
BBM : So very true.

It's a real catch 22 situation with the side effects. Medication adjustment is best dealt with by a psychiatrist ( of course there is a hefty cost ) v's GP when trying to find what works for them . GP's are great at maintenance & rpt scripts, once stabilised IMO

In my experience people stop taking their meds for many reasons : because they have " no feelings" - they say they are like a zombie etc, weight gain is a big one, run out & can't get a Dr's appointment, cost, because they fell good & don't think they need them, itinerant life style, they get stolen.....so many reasons.
 
www.sbs.com.au

'Significant improvement' in baby's condition, as coronial inquiry into Bondi attack announced

The condition of the nine-month-old baby whose mother died in the mass stabbing at a Bondi Junction shopping centre on Saturday has improved from critical to serious, NSW's health minister said.
www.sbs.com.au www.sbs.com.au

NSW Health Minister Ryan Park said he was told on Monday morning the baby's condition had changed from critical to serious.
"That's a big change and a significant improvement," he said.

Park said he was hopeful the baby could be moved out of intensive care and into a ward in the coming days.
 
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EXCLUSIVE Sydney church stabbing: Teen accused of stabbing Bishop Mar Mari Emmanuel allegedly 'waited for livestream to begin' before he launched his terror attack at Christ The Good Shepherd Church - as parents reveal their horror: 'Crazy'​


www.dailymail.co.uk

Teen accused of stabbing bishop allegedly 'waited for livestream'

The 16-year-old boy allegedly stabbed Bishop Mar Mari Emmanuel, 53, during his sermon at Christ The Good Shepherd Church in Wakeley, in Sydney's west, on Monday night.
www.dailymail.co.uk www.dailymail.co.uk
 
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