00:00Well, there are 26 draft recommendations on the table after an extensive process involving
00:07police, the victims' families and many different experts who gave evidence to this inquest.
00:13The council assisting, Dr Peggy Dwye SC, has made submissions which largely focused on
00:18the mental health sector.
00:20There were clear signs that Joel Couchy was experiencing chronic schizophrenia in the
00:24lead up to this attack.
00:26He was unmedicated and he was also experiencing homelessness after moving from Queensland
00:31to New South Wales.
00:33Dr Dwye has told the court that there's very little controversy about the need for reform
00:37and more investment in community-based treatment options for people with chronic mental illness,
00:44including long-term and short-term accommodation solutions.
00:48Dr Dwye has said that this follows decades of underinvestment and a move towards deinstitutionalisation
00:55which began from the 1960s.
00:58And she's used some figures to highlight the decline in services.
01:01The court's been told that in 1991 there were about 1,100 short-stay beds in the four main
01:08inner Sydney hostels which provided people with things like meals but also psychiatric care.
01:14And now there are fewer than 300 temporary beds and only two of those places offer walk-up
01:19psychiatric care.
01:21One of the draft recommendations goes to that decline in services.
01:25And it's that the New South Wales Health Department should serve as the lead agency in advising
01:30the government about the decline in services and how to address it.
01:35We've also heard today about Joel Couchy's specific treatment in Queensland.
01:39Between 2012 and 2020 he was under the care of psychiatrist Dr Andrea Barros Lavac.
01:46And the court's been told that during much of that period he received good care but towards
01:50the end he was weaned off his anti-psychotic medication.
01:54The court's been told that there were missed opportunities, largely in the form of some
01:59concerns that were being expressed by his mother about what she saw to be his deteriorating
02:04mental health.
02:06When the psychiatrist gave evidence earlier this year she suggested that Joel Couchy was not
02:10psychotic during this attack and that he might have been motivated by malice or a hatred towards
02:16women.
02:17Dr Barros Lavac resiled from that position but the counsel assisting has told the court that
02:22that evidence was defensive and the response suggested a lack of insight.
02:27The court will continue to hear these submissions over two days this week.
02:31After today it will return on Friday for more closing submissions.
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