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.
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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