Krishnabevi Alisher, the mother of Manmeet Alisher, outside court.
Krishnabevi Alisher, the mother of Manmeet Alisher, outside court.

We need to discuss mental illness and crime

THE case of Anthony O'Donohue, who killed Brisbane bus driver Manmeet Alisher with a petrol bomb in 2016, is tragic and terrifying on multiple levels.

It has shattered the family and friends of 29-year-old Alisher (also known as Sharma) who was much loved in the Indian community.

The journey of O'Donohue from an educated and productive man into one whose mind descended into psychosis and made him a stranger to reason is a terrifying insight into the darkness of insanity.

His fatal conspiratorial delusions are sobering for anyone who might have even fleeting encounters with the delusional.

And the fact that the best of treatment he accessed was unable to diagnose his eventually paranoid schizophrenia is a reminder of the limitations of our medical system, if not of medicine itself.

The light that Alisher brought to even strangers was shown in the impact statement of Lille Mina Gill, a passenger on the bus: "In our brief greeting, we had both been open and sincere, smiling at a brand new day, the kindness of strangers, and that uplifting feeling you get on a sunny spring morning.''

Manmeet Alisher was killed by mentally ill man Anthony O’Donohue.
Manmeet Alisher was killed by mentally ill man Anthony O’Donohue.

But, in the twisted and tormented mind of O'Donohue, that same smile was a conspiratorial smirk, confirming that the world was out to get him.

Who would ever have thought the mutterings of this delusional man could morph into a fiery assault that killed a good man and, had it not been for the bravery of a passing taxi driver, could very easily have killed 14 more?

But, even more worrying is how O'Donohue's unravelling sanity went undiagnosed and largely untreated for so long.

Judge Jean Dalton's ruling in the Mental Health Court that O'Donohue was "deprived of the capacity to know he ought not do the acts in relation to all the charges before the court'' and her summation are morbidly fascinating and frightening.

Four psychiatrists examined O'Donohue after his arrest. Three diagnosed paranoid schizophrenia while the fourth went for delusional disorder.

However, all four thought he had been ill for a long time, probably since 2003, when he started to have difficulties with his employer.

But because he could not recognise that he was ill, he attributed the difficulties to interference from his workmates.

He left his job, lost his girlfriend and as events in his life went badly his delusions and the list of those who thought were persecuting him grew.

He ended up homeless, destitute and friendless and in 2010 tried to killed himself and was diagnosed as psychotic.

But still he refused to believe he was ill and avoided treatment.

In 2011, he took a tyre lever to a police station and said he believed he would kill. He was made an involuntary patient and remained under treatment until December 2014.

Anthony O’Donohue, pictured being arrested, has been deemed unfit for trial, but has been locked up for at least 10 years in a psychiatric facility.
Anthony O’Donohue, pictured being arrested, has been deemed unfit for trial, but has been locked up for at least 10 years in a psychiatric facility.

He was treated with depot antipsychotic drugs, involving a deposit of slow release medicine under the skin.

Then (and the why is unexplained) the involuntary treatment order was revoked and he was prescribed tablets.

Still, he refused to believe he was mentally ill and was able to fool his psychiatrists that he was taking his drugs.

He was on a downhill mental slide that ended in a ball of flame at a Moorooka bus stop.

But this is not the first time in recent years that mentally ill people in Queensland have failed to take their medication with fatal results.

We had the similar case of Meing Huynh who eventually attacked people with knives in South Brisbane and was shot dead by police.

And there was Natalia Perry who had killed her own five-year-old son and then in 2002 killed her three-year-old nephew in Rockhampton after failing to take her medication.

I wondered then and I wonder now how people with serious mental issues that commonly involve symptoms of denial and who have been under involuntary treatment can be presumed willing and able to manage their own medication.

Some in the Indian community have claimed that O'Donohue gamed the system to escape justice but I don't think that can be sustained.

By ensuring O'Donohue is locked up for at least 10 years (at least) the court has protected the community while at the same time extending mercy to a man whose insanity made him incapable of reason.

However, we are entitled to wonder why he went undiagnosed for so long, why the involuntary treatment order was revoked, why he able to almost disappear into the community, and why he was trusted to manage his own treatment.

I don't underestimate the difficulty faced by psychiatrists or the burden faced by a health system under siege from burgeoning mental health problems.

And I understand that cunning and crazy are not incompatible

But, by definition, the system failed poor innocent Alisher, it failed O'Donohue, and it failed the community.

We deserve to know why.

Terry Sweetman is a Courier-Mail columnist.