PHOTO: DAVID GRAY / AFP
No one can know the mind of Sydney shopping mall killer Joel Cauchi, but psychiatrists say one underlying cause of his rampage is evident: he had schizophrenia, stopped his medication and fell out of treatment.
People have searched for a fathomable motive since the April 13 knife attack at Bondi Junction, in which five women and a male security guard were stabbed to death and another dozen wounded, including a nine-month-old girl.
Cauchi's parents have said their son was diagnosed with schizophrenia at the age of 17 and was successfully treated for about 18 years.
A serious mental disorder, schizophrenia can cause hallucinations, delusions and disordered behaviour. It requires lifelong treatment.
New South Wales police commissioner Karen Webb said it was "obvious" to her and detectives that the 40-year-old Cauchi had targeted women and avoided men, sparking a media debate about misogyny in Australia.
Prime Minister Anthony Albanese described the gender breakdown among the victims as "concerning" and vowed to do more to combat violence against women, citing a toll of one woman dying at the hands of a man they knew every week.
'NOWHERE TO GO'
Carolyn Nikoloski, chief executive of Australia's peak advocacy group Mental Health Australia, said there was a gap in support for people with complex care needs.
People were often turned away from hospital emergency departments because their illness was not judged to be serious enough at the time, she told AFP.
"That's a common experience, and there is nowhere else for them to go," Nikoloski said.
"We know that overall mental health expenditure does not meet the burden of disease, and it has declined over time."
The health system was unable to catch people who fell between the cracks, said professor Anthony Harris, head of psychiatry at the Sydney Medical School with a special interest in psychosis.
"The real issue here is that this man is diagnosed with schizophrenia -- that is one of the most severe mental illnesses you can have -- but he just drops out of care and drops out of community," he said.
"If you had cancer, if you had a severe physical illness, there's this whole system of follow-up care," Harris said. But with a severe mental illness, "nobody seems to blink an eye".
