Sydney Stabber Had Untreated Schizophrenia, Highlighting Mental Health Care Gaps

Sydney stabbing killer had untreated schizophrenia, exposing Australia's inadequate mental health system that failed to provide continued care, leading to his psychotic break.

The murder spree in which a shopping mall in Sydney claimed six lives and injured many over April 13 glaringly shows the gap in Australia's mental health setup. The victim, Joel Cauchi, was diagnosed with full-blown schizophrenia at the age of 17 and became quite responsive to medication for several years, but has since stopped taking the medications exceedingly.

On the list of lifelong mental illnesses, schizophrenia is at the top, which requires constant care and medication to treat symptoms such as hallucinations, delusions, and disorganized behavior. Specialists are of the opinion that if untreated, such a disorder could exacerbate and develop into an acute psychotic state, which is what apparently transpired with Cauchi.

“He was homeless, without any real support, and shortly thereafter, in a very acutely psychotic state," noted Patrick McGorry, University of Melbourne Professor in the area of youth mental health. "It is definitely a matter of disease, mental illness which is either undertreated or poorly treated."

Cauchi's parents have claimed that the boy had been successfully treated for 18 years, then gradually he refused to take his medication with a doctor's approval when he was convinced that he was doing well. The next stage was living away from his residence in transit vehicles and hostels, with irregular contact with family members.

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According to mental health professionals, a completely inadequate system was in place in Australia that did not allow providing rehabilitation treatment for patients having unmanaged complex needs like Cauchi. Many are rejected from emergency rooms during busy hours when they are not ill enough; none of the other places exist.

"You would have a system of follow-up care if you had cancer or some severe physical illness," said Anthony Harris, who is the head of the Vienna Medical School Psychiatry. "With a mental illness as severe as that, I guess there is nothing for people to even bat their eye."

We have seen the tragedy reopen the can of worms of the need for reform to prevent a psychotic breakdown capable of such tragic results, as lives are at stake. As one of the experts said, "The national problem of violence against women is a much wider issue. Most probably, this is just a manifestation of that issue."