Knife attack in Sydney: Stabber Joel Cauchi suffered from schizophrenia and dropped out of treatment | World news

No one can know the mind of Sydney mall killer Joel Cauchi, but psychiatrists say one underlying cause of his rampage is clear: He had schizophrenia, went off his medication and dropped out of treatment.

People walk at the Westfield Bondi Junction shopping center on Community Reflection Day as it reopens to the public for the first time following the stabbing attacks that left several people dead at the mall in Sydney, Australia (REUTERS)

Since the knife attack at Bondi Junction on April 13, in which five women and a male security guard were stabbed to death and another 12 injured, the search has been on for an unfathomable motive, including a nine-month-old girl.

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Cauchi’s parents have said that their son was diagnosed with schizophrenia at the age of 17 and was successfully treated for about 18 years.

Schizophrenia, a serious mental disorder, can cause hallucinations, delusions and disordered behavior. It requires lifelong treatment.

New South Wales Police Commissioner Karen Webb said it was “obvious” to her and investigators that Cauchi, 40, had targeted women and avoided men, sparking a media debate about misogyny in Australia.

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Prime Minister Anthony Albanese described the gender split among the victims as “worrying” and vowed to do more to combat violence against women, citing the toll of one woman dying every week at the hands of a man they knew.

“But we will never know what was going on in the minds of the perpetrator of these acts,” said Professor Ian Hickie, co-director of health and policy at the University of Sydney’s Brain and Mind Centre.

“Ordinary people are trying to impose a rational explanation,” he told AFP. “The most obvious is the irrational mind of the perpetrator.”

The recurrence of the mental illness itself cannot necessarily explain violence against other people, which is “extremely rare” in such cases, Hickie said.

“Often these things are complicated by other factors: drug use, disconnection, social isolation, homelessness.”

No two psychotic people have the same thoughts, which are shaped by each person’s idiosyncratic, irrational perception of the world, Hickie said.

Cauchi may have attacked women simply because men could defend themselves better. Like Frenchman Damien Guerot, he was hailed as a hero for fending off the attacker with a metal pole, he said.

– ‘Acutely psychotic’ –

“The broader issue of domestic violence and the number of women in our country being harmed or killed by men who do not have a mental illness is a national problem. I don’t think this is a manifestation of that problem,” Hickie said. .

“The social factors of interest here are homelessness and isolation, and the stigmatization of treatments for mental illness.”

Cauchi’s parents say he gradually weaned himself off his medications over several years in consultation with a doctor because he felt he was doing well. He moved from the family home in the Queensland city of Toowoomba to the capital Brisbane and recently traveled to Sydney.

He had been living in a car and hostels since leaving home and had only sporadic contact with his family through text messages.

He didn’t seem to realize he was getting sick and “became homeless, completely disconnected from all sources of support, and ended up in this very acutely psychotic state,” says Patrick McGorry, professor of youth mental health at the University of Melbourne.

His behavior was “completely disorganized or based on delusions,” said McGorry, a former president of the Schizophrenia International Research Society.

Attempts to attribute Cauchi’s actions to misogyny were “completely misguided”.

“It’s purely a case of untreated or poorly treated mental illness,” he said.

It highlighted that Australia’s mental health system was “wholly inadequate” to ensure patients like Cauchi received ongoing care.

“It’s true that he wanted to move cities, but in that case health care at his destination should have been set up for him,” McGorry said.

If patients with schizophrenia stop taking the medication, there is a more than 80 percent chance that the disease will return, he told AFP.

“And if it comes back, it’s likely the person won’t recognize that it’s coming back and won’t seek help.”

– Going nowhere –

Carolyn Nikoloski, chief executive of Australia’s top group Mental Health Australia, said there is a gap in support for people with complex care needs.

People were often turned away from hospital emergency rooms because their illness was not considered serious enough at the time, she told AFP.

“That’s a common experience, and they have nowhere else to go,” Nikoloski said.

“We know that overall mental health spending does not cover the burden of disease, and that it has declined over time.”

The health care system was unable to catch people who fell through the cracks, says Professor Anthony Harris, head of psychiatry at Sydney Medical School with a special interest in psychosis.

“The real problem here is that this man has been diagnosed with schizophrenia – which is one of the most serious mental illnesses you can have – but he’s just leaving care and leaving the community,” he said.

“If you had cancer, if you had a serious physical illness, there is a whole system of aftercare,” Harris said. But with serious mental illness, “no one seems to blink.”

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