Killer's doctor 'can't be blamed' for fatal mall attack

Joel Cauchi, 40, was experiencing psychotic symptoms and armed with a knife on April 13, 2024, when he killed six people and injured 10 others, including a nine-month-old baby.

Dawn Singleton, 25, Ashlee Good, 38, Jade Young, 47, Pikria Darchia, 55, Yixuan Cheng, 27, and security guard Faraz Tahir, 30, died before Cauchi was fatally shot by Inspector Amy Scott. 

Contrary to expert evidence Cauchi was "floridly psychotic" at the time of the attack, his long-time psychiatrist Andrea Boros-Lavack initially suggested he was motivated by frustration and hatred of women.

"That was nothing to do with psychosis," she told an inquest. 

She later withdrew the speculation but it was deemed "shocking, genuinely shocking" by counsel assisting Peggy Dwyer SC in her closing address. 

Dr Dwyer noted the psychiatrist had shown an "exceptional ... level of belligerence and confrontation" in the witness box, but Dr Boros-Lavack's lawyer took issue with the criticism. 

His client had been in pain, on medication and "clearly felt she was under attack" during the questioning, Mark Lynch said on Friday. 

Dr Boros-Lavack was unqualified to answer the question because she had been called as a treating psychiatrist instead of an expert and hadn't read the expert reports, Mr Lynch said. 

"It was grossly unfair to be forced to give an answer to that question," he said. 

Suggestions she had been attempting to justify her decision to wean Cauchi off antipsychotic medication or her statement that he didn't have chronic schizophrenia were "perverse", he argued.

"It's deeply regrettable that the families felt further traumatised by those remarks, but in one sense they never should have been asked," Mr Lynch told the inquest. 

An audible scoff was heard in the courtroom and Dr Dwyer was seen shaking her head. 

Cauchi had been successfully treated for schizophrenia since he was a teenager before he decided with Dr Boros-Lavack to wean off antipsychotic medication.

"He decided for himself 'I'm not going to take those anymore'. Dr Boros-Lavack cannot be blamed for that," Mr Lynch told the inquest. 

The psychiatrist's "largely exemplary care" for eight years could not be said to be a material cause for his rampage on the Bondi Junction Westfield centre four years later, he said. 

Although she had admitted there were deficiencies in her discharge of Cauchi into the care of his general practitioner, Mr Lynch said there was no warrant to refer Dr Boros-Lavack for referral to a regulatory body as suggested by the victims' families. 

Cauchi fell through the cracks of mental health care after moving from Queensland to NSW and becoming homeless, the inquest has been told. 

Dr Dwyer suggested the coroner recommend psychiatry regulatory bodies develop guidelines for the management of patients with chronic schizophrenia. 

She proposed a focus on professional guidelines for de-prescribing antipsychotic medication when patients decline to continue.

They should include strict requirements for a discharge letter for a patient with treatment-resistent schizophrenia, such as the probability of relapse and early warning signs.

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Australian Associated Press