Insane killer deceived his doctors

By ELEANOR BLACK and NAOMI LARKIN

The murder of a Rotorua woman by her mentally ill tenant has brought an admission of professional errors and more calls to tighten the Mental Health Act.

Grant Milliken, aged 31, was found not guilty by reason of insanity in the High Court at Rotorua yesterday of murdering his landlady, Joanna Monk, and attempting to murder her husband, Philip Monk.

Mental health specialists had assessed Milliken on four occasions, but while he was diagnosed with various disorders and prescribed medication, he did not follow through with treatment.

The country's most senior mental health officer, Dr David Chaplow, who gave evidence at the trial, said Milliken tried to hide his illness but it should have been obvious to doctors that he desperately needed help.

In four years he was seen by doctors in Rotorua, Invercargill and Christchurch.

Dr Chaplow, the Director of Mental Health, said: "I have been sitting here with embarrassment thinking: how could so many services miss his mental illness?"

Mr Monk, who was seriously injured in the attack which killed his wife almost instantly, told the Weekend Herald that too many people were falling through holes in the mental health system and hurting themselves and others.

He wants the law reviewed and services for the mentally ill and their families made more accessible.

Milliken, a paranoid schizophrenic who had refused treatment for his delusions, rented a unit on the Monk property and lived there for 14 months without incident.

They had no reason to suspect anything unusual about the sickness beneficiary who kept to himself but came outside each morning to sweep the drive and clean his guttering.

But last autumn Milliken became enraged when the Monks' son, Andrew, parked a car in the tenant's piece of drive and refused to move it.

Milliken wrote a letter of apology for losing his temper, but when he went to deliver it on April 11 he attacked the Monks with a knife.

Psychiatrist David Simpson, who treated Milliken at Hamilton's Henry Bennett Centre after his arrest, said he was clearly disturbed, but without his cooperation little could be done.

But Dr Chaplow told the Weekend Herald that doctors concerned about mentally ill patients refusing treatment should discuss the case with a colleague and, if still worried, see if the patient could be committed.

"You cannot always blame the system, but having said that, this case does raise the issue of were the assessments adequate?"

Dr Chaplow said the Ministry of Health was working with the services which assessed Milliken to see if they should have acted differently.

Brian Pickering, director of area mental health services for the Rotorua region, said Milliken did not fit the criteria for committal set out in the Mental Health Act when he was seen by doctors.

Southland Hospital in Invercargill would not comment, and the director of Christchurch's Hillmorton Hospital (formerly Sunnyside) could not be contacted.

A spokesman for Annette King said the Health Minister could not comment on clinical diagnosis or why people had missed the diagnosis.

More money had been put into mental health but the services were rundown and skilled staff were short.

Kathleen Rushworth, chairwoman of Schizophrenia Fellowship Auckland, said families desperate for a family member to be taken in and treated found themselves frustrated "far too often."

Margaret Honeyman, chairwoman of the New Zealand national committee of the Royal Australian and New Zealand College of Psychiatrists, said that when someone refused treatment and moved from one service to another it was difficult for information to be passed on.

Patricia Perkins, secretary of Caring Communities, a group which keeps records of psychiatric-related homicides, said this was just one of a growing list of tragedies where people with a history of mental disorder had been allowed to remain in the community.

Incidents in which the mentally ill turned away by health services went on to kill had happened "with monotonous regularity."