Psychiatrist defends decision to wean Joel Cauchi off medication

ABC NEWS (Australia)

Joel Cauchi's last primary psychiatrist before the Bondi Junction Westfield attack, has defended her decision to wean the schizophrenic off all forms of anti-psychotic medication. A coronial inquest heard the doctor lowered Cauchi's mental health diagnosis shortly after receiving him as a patient from the public system.

Transcript

00:00This person was Joel Couchy's primary psychiatrist for about an eight year period when he lived in

00:08Toowoomba, so from 2012 to 2020 when he was eventually discharged from the clinic and at

00:14that point was taking no form of anti-psychotic medication. We heard he initially came from the

00:20public health system where they had already begun lowering his dosage of Clozapine which was a high

00:27level of schizophrenia medication which he was taking for what was he he was diagnosed with

00:33treatment resistant schizophrenia which meant he had trialed two other forms of medication which

00:38didn't appear to work so he's put on a higher level of Clozapine. Now shortly after receiving

00:44him as a patient the inquest heard the psychiatrist decided to continue lowering his dosage of that

00:50drug based on meetings that she had with him monthly and keeping in strong communication with

00:56his mother who we heard was a reliable source of information about what Joel Couchy's condition

01:02was like and whether or not he was at risk of relapsing but we heard shortly after he became

01:08her patient the psychiatrist decided to re-diagnose his type of schizophrenia from one that was chronic

01:15to a first episode schizophrenia which in in essence changed exactly the threshold that he needed to

01:23continue to be lowering his dosage and eventually taking off all forms of anti-psychotic medication

01:29and she continued to do that over a number of years until we got to 2019 when he was completely

01:35off all forms of medication. The inquest had seen clinical notes by the psychiatrist who also asked for

01:42second opinions from Couchy's initial psychiatrist in the public health system both agreeing that he should

01:47for the rest of his life remain on some form of anti-psychotic medication but of course that seemed

01:53to change over the years as she said she saw an improvement in his physical and mental well-being.

01:59We heard today that Couchy had finished a degree and achieved a distinction degree of arts in Chinese

02:06language and continued to so increased cognitive functions as that dosage was reduced and eventually he was

02:15taking off that medication as well as a medication he was taking for his obsessive compulsive disorder

02:21but in those emails and the letters sent we saw that there was no plans to take him off it whatsoever

02:27but she then changed her mind over the years what she said getting to know him and that was despite

02:32what the inquest heard was some concerns raised after he was completely taken off his medication in 2019

02:38by his own mother who was worried about the fact that he had become irritable untidy and that was

02:43because he was started to live with himself we she's still continuing to give evidence today he's

02:49psychiatrist but we do know from previous hearings that after this period Joel Couchy had moved to

02:55Brisbane and had stopped all communication with this clinic was eventually discharged we heard yesterday

03:01that's the point where they believe he became lost to regular check-ups on his mental health

03:13you

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