A Nowra man has been found unfit to stand trial for the murder of Denise Brameld near Nowra in 2021, but could return to court if his condition improves.
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Louis Norman Woodham, 38, appeared in the Supreme Court via video link from Long Bay Hospital for a mental health fitness enquiry on Monday and Tuesday.
Woodham is charged with the murder of Ms Brameld at Numbaa, east of Nowra on June 10, 2021.
Woodham was released from custody only six weeks earlier, in what Justice Peter Hamill described as a "perplexing" series of events.
Woodham was charged in 2018 with a number of violent offences, these included allegedly stabbing a female police officer with a pen and assaulting two men on Australia Day.
During court proceedings following the charge forensic psychiatrists were involved to assess Woodham's mental fitness, this led to his condition being "fully explored", Justice Hamill said.
Woodham was found to have significant cognitive impairments and chronic schizophrenia. Woodham's symptoms include hallucinations, bizarre delusions, mood disturbances and manic episodes. Woodham cannot read or write.
Woodham's existing mental illness was exacerbated by many years of substance abuse.
While in custody, following the 2019 incidents, Woodham was given some treatment, however it appeared to have stopped and had been halted for some time at the time of his release in 2021.
Upon his release, "Woodham was not subject to any treatment plan for psychiatric or cognitive impairment," Justice Hamill said.
The lack of treatment when the justice system was well aware of Woodham's condition also perplexed Crown Prosecutor Nerissa Keay.
"It is difficult to understand why treatment ceased while in custody," she said. "When released into community on no medication, six weeks later [Woodham is] arrested for this serious offence."
Defence Barrister Philip Young agreed.
"It is staggering what happened to him on his release."
On June 11, Ms Brameld's son went to her Comerong Island Road home after being unable to contact her.
There he found his 51-year-old mother's body in what police at the time described as a "very confronting" scene.
Woodham was arrested soon afterwards at an adjacent property and taken to Nowra police station.
Once again in custody, Woodham's condition deteriorated as he refused medication. In September he was transferred from Lithgow Correctional Centre to Long Bay.
At Long Bay, Woodham's medication was changed and forensic psychiatrist Dr Kerri Eagle said he exhibited some improvement after the anti-psychotic medication clozapine was administered, a medication Dr Eagle described as the "gold standard" for people with treatment-resistant schizophrenia.
During an hour-long hearing on Monday afternoon Ms Keay and Mr Young questioned Dr Eagle and forensic psychiatrist Dr Adam Martin whether Woodham would be fit to stand trial for murder.
Dr Eagle said while clozapine treated Woodham's schizophrenia and associated symptoms, it would not address his fitness due to his cognitive impairments.
"I think it's unlikely that Woodham would significantly improve in terms of his functional capacity, his ability to understand the court process, his ability to understand the relevance of certain aspects of evidence and understand how that evidence applies to him and alleged offending."
Evidence of this included Woodham telling Dr Eagle that he intended to plead guilty to murder, rather than manslaughter, but in almost the same breath said he did not mean to kill Ms Brameld, making it almost impossible for him to enter a plea to the charges.
Dr Martin agreed with Dr Eagle's assessment, highlighting the cognitive impairment was the least likely to change.
"The paranoia, the hearing voices, can be treated but cognitive impairments are more persistent."
The court was also required to assess whether there was a likelihood that Woodham's condition would improve in the next 12 months enough that he could stand trial.
In questioning, neither psychiatrist could commit to certainty when it came to predicting Woodham's condition.
"I would find that it is highly unlikely [that Woodham] would become fit in the next 12 months," Dr Eagle said.
Dr Martin agreed, noting the lack of a definitive answer.
"Very few things in psychiatry are certain."
In coming to a decision on Tuesday, Justice Hamill said despite the difference in certainty between the law and psychiatry, the standard legislation had required a high bar of certainty.
"There remains a possibility that Woodham will improve with treatment and may be fit to be trialled in next 12 months."
Woodham remains in custody and will return to court at a later date, depending on his condition.
Joining the hearing online were two of Ms Brameld's children and Justice Hamill acknowledged their presence.
"I cannot imagine the shock and grief [Ms Brameld's] family is enduring. Two of her adult children have kept vigil over this inquiry. Ms Brameld's family has the deepest sympathies and condolences of the Court, nothing I can say would assuage their grief."
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