THE UNIVERSITY OF
SYDNEY
Susan Hayes AO PhD FIASSID
Professor of Behavioural Sciences in Medicine
CLINICAL PSYCHOLOGICAL ASSESSMENT
OF
ALEXANDER BAILIFF
DOB m 25 AUGUST 1970
DATE 0F ASSESSMENT - 11 JUNE 2013
PREPARED BY SUSAN HAYES, AO, PHD
PROFESSOR OF BEHAVIOURAL SCIENCES IN MEDICINE
DEPARTMENT OF MEDICINE
UNIVERSITY 0F SYDNEY NSW 2006
Behavioural Sciences in Medicine T +61 2 9551 2776 Aam15211515 454
Sydney Medical School F +61 2 9551 5519 CRICOS GOOQSA
Blackburn Building U06 E Susan.hayes@sydneyßduau
The University of Sydney sydney.edu.au
CLINICAL PSYCHOLOGICAL ASSESSMENT
0F
ALEXANDER BAILIFF
DOB - 25 AUGUST 197()
DATE 0F ASSESSMENT - 11 JUNE 2013
Background
On 11 June 2013, Mr Alexander Bailiff attended my rooms at the University of Sydney for
the purposes of undertaking a clinical psychological assessment in relation to criminal
proceedings in the New South Wales Local Court. I am aware that Mr Bailiff is charged With
breaking and entering a dweliing house to commit a serious indictabie offence (property
damage). Additionally, in early October 2012 Mr Bailiff sent a series of text messages to a
former partner, some of which contained possible suicidal ideation. He was charged in the
ACT with contraveníng a Protection Order and the charges are listed before the ACT
Magistrates Court for determination in August 2013.
In preparing this report 1 had available to me a bundle of documents including the Court
Attendance Notice and Police Facts Sheet regarding events on ll March 2013; a copy of the
Criminal History of Mr Bailiff; Charges and Statements of Facts in relation to events in
October 2012, when the former partner received sorne text messages; clinical notes from the
Prince of Wales Hospital Kiloh Centre; and historical reports dating from 2003 to 2012.
I have been asked to Write a forensic report for use in court addressing the foìlowíng issues:
l Diagnosis of any mental illness, condition or developmental disability that Mr Bailiff
suffers from currently and at the time of the alleged offence on l 1 March 2013;
2 In respect of any diagnosis made, details of Mr Bailiffs current treatment regime (if
alfly);
3 Recommendations 0n any future treatment regime or support plan, including an
opinion on Whether the proposed treatment is available in mental health facilities or
through mental health services in NSW or the ACT, and
4 Recommendation on the degree of supervision or monitoring required under any
proposed treatment regime or support plan and the availability of such supervision
within NSW or the ACT.
In addition, I have been asked to express an Opinion as to whether the client is to plead
under the Presser Criteria.
To the extent that it was possible, I did not canvass 'the circumstances of the offences with Mr
Baiìiff, as requested.
Expert Witness Statement
I acknowledge that I have received and read a Copy of the Uniform Civil Procedure Rules
2005, Schedule 7, Expert Witness Code of Conduct, and I agree to be bound by it. I have the
degrees of BA (Hons I) and PhD from the School of Psychology at the University of New
South Wales. I am a registered psychologist in Australia and a member of the Australian
Psychological Society and its College of Forensic Psychologists` I am a Fellow of the
International Association for the Scientific Study of Intellectual Disability and member ofthe
Australasian Society for the Study of Intellectual Disability. I have undertaken clinical and
research Work in forensic psychology for more than two decades; I have published more than
2() books or book chapters, and more than 64 papers in professional journals in my ñelds of
expertise in psychology` In the matter of this client ï was asked to report on mentaì state, a
in which I am expert. I prepared the report in conformity with the Expert Witness Code
of Conduct.
Family and Social History
At the time of the assessment, Mr Baiìiff was aged 42 years, an overweight man Who was
inappropriately dressed for the weather (he was in shorts and a tee shirt on a cold winter day);
he Wore spectacles and had several days’ growth of stubble, and a strong body odour. He
wore a basebalì cap throughout the assessment.
Mr Bailifŕs conduct and demeanour was inappropriate. He was over-familiar with people
who passed by in the corridor, and entered an ofñce of a colleague on the same floor for a
chat. It was extremely difficult to conduct the interview because he was tangential in his
responses and over-ìncìusìve.
The history that was obtained was extremely fragmented. Mr Bailiff immediately informed
me that his behaviour was disinhibited owing to the fact that he suffered from brain damage
incurred in a motor vehicle accident when he was about 15. He attempted (in my opinion
deliberately) to exhibit the behaviours which were described on one of the documents
available to me, apparently written by Mr Roger Parker QC, entitled Adducing Evidence to
Prove or Dfsprove Brain Damage (Brain Damage Medico-Legal Aspects, Blackwell Press,
Sydney (1994)). This refers to Work by Dr William Lishman. To quote briefly from this
page:
“Most characteristic (of focal cerebral disorder) is o disinhibition with expansive over
familiarity, tactlessness, over tolkativeness, childish excitement or pronkish and panning
social and ethical control may be diminished with lack of concern for the future and for the
consequences of actions (sic) . . . elevation of mood is often seen, namely an empty and
famous euphoria rather than a trae elation which communicates to the observer . . .
concentration, attention and ability to carry out a planned activity are impaired by these
changes but performance on tests of formal intelligence is often surprisingly well preserved
once the parienf’s cooperation has been secured.
As indicated, it seemed that Mr Bailiff was trying to emphasise aspects of this description.
Mr Baiiiff informed me that he had heen bom at the Royal Hospital for Women and was eight
weeks premature because his mother was under stress at the time. He had a Sister, Vanessa,
who was older than he was and she was killed during the car accident in Which Mr Bailiff was
involved when he was aged i5. He has a brother who is 11 years younger than he is. He said
that his natural parents separated by the time that he was 10, prior to the brother being born.
He maintained that his mother was on a range of prescribed medication when he was young
and that she bashed both himsehC and his older sister. He claimed that the mother was driving
the oar which caused the death ofthe sister and his brain injury. He Said that at the age of 15
after the accident he was sent to a number of refuges by his mother.
Mr attended a number of schools in Victoria up until the time that his sister was killed
and he was injured. The family initially lived in Glen Iris until he was about three years of
age and then in Healesville. He describes his life as being traumatic because of the car
accident. At one stage he was in Prince Henry Hospital for rehabilitation. He went t0
Canberra and lived with his natural father. He lived in Melbourne with a girlfriend. For
about the last years he has lived atan address in Narrabundah by himself.
He spent a great deal of time trying to talk about the Car accident and also the relationship
with his former girlfriend who is involved in the Apprehended Violence Order that he
breached by sending her text messages. Mr was repeatedly asked to return to the
question which was asked and as this process continued it appeared that he became irritated
by the fact that he was not sanctioned to speak at length about the issues about which he
wanted to talk about. Despite repeatedly telling Mr Bailiff that I had been asked not to
canvass the circumstances of the offences with him, he responded that I had not asked him
about the offences, but be was telling me. it was Very difficult to stop the torrent of
infomation which he gave.
Amongst the various pieces of infomation that Mr Bailiff produced was that he once Spent
four months in gaol in the ACT and he was found “not guilty by reason of impaiïment”.
He said that at the time of the offences in New South Wales he was in Sydney for six months
living at the residence of his mother and her current partner.
Mr Baíhff informed me that he currently resided at the Matthew Talbot Hostel and had been
there since in 2013.
When asked if he had ever held paid employment he replied, “Why would I have paid
employment when I am a genius, a savant?" He claimed that he Was able to establish a WHO
Precedent; he also gave a lengthy and garbled account of a story concerning the Pope. He
spoke at length about his previous legal matters and the supposed defences which he had
successfully used.
Health
When asked about his health, Mr Bailift` replied that his health is ñne. He denied using
alcohol or taking any medication and said that he was impaired as a result ofthe car accident.
Mental Health
According to the Discharge Summary from the Prince of Wales Hospital Mental Health
Program, dated 15 October 2012, in relation to an admission from 4-9 October 2012, the
client was diagnosed with situational crísis and acquired brain injury. 0n discharge he was
medicated on one milligram of Risperidone. He was described as having acquired brain
injury and a resultant hypo manic state and he presented to hospital with police after
contemplating suicide by jumping off the Gap. He called police himself and requested
psychiatric help. Suicidal ideation was secondary to multiple psychosocial stressors. He
denied any suicidal idcation at the time of the discharge and there was no evidence of acute
major mood disorder or psychotic illness at discharge. He was transferred back home and
travelled by train to Canberra. It was recommended that he be followed up with the
Community Mental Health Service in Canberra.
A report by Dr Stephen Allnutt, dated 10 April 2012, indicates that the client was assessed
Whilst incarcerated at the AMC (presumably the Alexander Maconoehie Centre, a correctional
centre in the ACT). Dr Allnutt describes the client as speaking rapidly with intensity,
manifesting suppressive speech, being overly talkative, over familiar, expansive in his affect
and manifesting a tendency towards perseveratien, and flight of ideas. He manifested
difficulty in inhibiting his underlying urgency and endorsed a number of symptoms that
seemed to be consistent with hypo mania. Dr Allnutt states that the client manifests a severe
cognitive impairment in his ability to conform his behaviour to social norms. Dr Allnutt
concludes that in relation to all of the offences which were the Subj ect of that report, the client
would have been suffering a mental impairment as a consequence of brain damage. Dr
Allnutt goes on to state that it is unlikely that his mental impairment seriously impaired his
capacity to know the nature and quality of his conduct or that he was compromised in his
capacity to know that his conduct was wrong; however, during the period of his offending his
mental impairment had the effect that his capacity to control his conduct Was seriousl)r
compromised and on balance he would have available to him a defence of mental impairment.
A series of reports by Dr G J George, consultant psychiatrist to Forensic Services in Mental
Health ACT, was available to me. The report dated 29 April 2011, states that Mr Bailiff is
unfît to plead and will remain unfit indeñnitely because he has a chronic mental impairment
through an acquired organic mental disorder related to a brain injury. He presents much of
the time in a chronic manic state and appears to suffer from signiñcant mood disorder. He is
highly distracted, somewhat fatuous in his mood and subject to impulsive and disinhìbìted
behaviour. His illness appears to be chronic.
A report by Dr Leonard Lambeth and Ms Natasha Shott from Forensic Services, Mental
Health ACT, dated 20 May 2009, indicates that the client presented as suffering an organic
mental disorder with predominantly frontal symptoms resulting in an organic personality
disorder. The report concluded that Mr Bailiff was unfit to plead because of impairment to
his mental processes. His behaviour was not considered to be modiñable by any form of
psychotherapy and the only way of would be medication, but he is rnost unlikely
to be compliant with medication. Therefore, a psychiatric treatment order Was recommended,
as Well as medication with a depot medication such as Rìsperdal Consta and prescription of
mood stabilìsìng medication (although this would probably not be beneñciaî due to his non-
compliance).
Other reports have stated similar conclusions.
In my opinion Mr Baiìiff can be diagnosed with 294.11 Major Nenrocognitive Disorder Due
to Traumatic Brain Injury (Diagnostic and Statistical Manual of Mental Dísorders-
Edition, American Psychiatric Association, 2013). He suffered a traumatic brain injury
which resulted in difficulties in the domains of Complex attention, executive ability, learning,
memory, speed of processing, and disturbances in social cognition. He exhibits disturbances
in emotional function (easy frustration, affective labílity), and personality changes
(dìsinhibition, suspiciousness).
Kaufman Briei` Intelligence Test Second Edition
The Kaufman Brief Intelligence Test Second Edition is a brief, individually administered
measure of verbal and non-verbal intelligence, and can be used for children, adolescents and
adults ranging from 4 to 90 years. The test yields three scores, Verbal, Nonverbal and IQ
Composite Score. The Verbal score includes results on two sub-tests, Verbal Knowledge and
Riddles, and assesses Verbal, school«reiated skills by assessing a person’s word knowledge,
range of general information, verbal concept formation and reasoning ability. The Nonverbal
score (the Matrices subtest) measures the ability to solve new problems by assessing an
individual’s ability to perceive relationships and complete visual analogies (A S Kaufman and
N L Kaufman, (1997) Kaufman Brief Intelligence Test Second Edition Manual, Pearson,
Minneapolis MN).
Mr Bailiff obtained the following results which are reported at the 90 per cent level of
confidence:
S Confidence Percentile
core Interval Rank
Verbal 80 74 88 9
Nonverbal 100 92 - 103 50
IQ Composite
Standard Score 89 84 i 95 23
These ïesults indicate that overall Mr Bailiff functions in the category of 10W average
intelligence. There is a significant difference between his verbal and non-»verbal standard
scores with his Verbal score being at the lower end of the range of low intelligence and his
non~verbai score being average. The KBIT~2 is an untimed test, and Mr Bailiff would have
received much lower results if a timed test of inteìiigence had been administered, because his
responses Were very Slow and iaboured.
During the testing, when Mr Bailiff began to fail Some of the items, he Veered off onto
tangential topics such as his blog, and the legal precedent that he claimed to have been set in a
case in which he was involved in the ACT. He also reasoned out loud and engaged in fatuous
smiling which appeared to be unrelated to any stimulus in the test setting. This type of
distracted behaviour became more apparent as the questions became harder. He also
commented on his own presentation stating that he was going to take a “Wild guess” and that
he “ñippantly says things that he shouìdn’t say”. Therefore, it appears that to some degree Mr
Bailiff uses the distraction of tangential stories and comments to cover up and divert attention
from his limitations in reasoning.
An attempt was made to gain insight into Mr Baiiiff’ s difticulties with adaptive behaviour, but
he maintained that he had no such difticulties, and did not cooperate With answering
questions.
Fitness to be Tried
I attempted to canvass the Presser criteria with Mr Bailiff. He was able to tell me the charges
against hirn in the ACT and NSW. He stated that he would not be entering a plea because of
the “precedent” of not guilty by reason of impairment in the ACT. He did not respond to
questions about the jury or challenging the jury, and spoke at length about tangential topics
such as his blog. He stated in response to a question that his attention span was tine and he
had no problem following what happens in court. When asked about the issue of letting his
counsel know what his version ofthe facts is, he gave a garbled version of his defence being
that there is not an element of crime.
Mr Bailiff did not respond in any meaningful fashion to many questions about the Presser
criteria, and therefore I cannot make a determination as to whether in my opinion he is to
be tried. I note the previous reports by Dr George and others where the cìient has been
assessed as being unfit, although ï could not arrive at a clear conclusion on the basis of this
current assessment.
Summary and opinion
Diagnosis of any mental illness, condition or developmental disabili@ that Mr Bailiff
sujjfers from currently and at the time ofthe alleged oßence on 11 Marck 2013
Mr Bailiff suffers from the mental illness of 294.11 Major Neurocognitive Disorder Due to
Traumatic Brain injury which arose as a result of a car accident when he was aged 15.
Because the injury arose during ldie developmental period prior to the age of 18, this could be
regarded as a developmental disability. He has deficits and difficulties in the following
cognitive domains:
l Complex attention (eg. sustained attention, Selective attention, processing speed)
0 Executive function (eg. deficits in planning, decision making, ïesponding to
feedback, disinhibition, mental flexibility)
0 Learning and memory - his pre-morbid intelligence was probably higher than his
current low average level of functioning; he has difficulty with Word selection on
occasion and impairments in memory
n Social cognition (eg. behaviour clearly out of the acceptable social range,
insensitivity to social standards of personal presentation and conversation, excessive
focus on topics, poor decision making, little insight)
In respect 0f any diagnosis made, details of Mr BaiIWs current treatment regime
(ifmly)
Mr Bailiff appears t0 be receiving no treatment currently.
Recommendations on any future treatment regime or support plan, including an
opinion on whether the proposed treatment is available in mental health facilities or
through mental health services in NSW or the ACT
I recommend that Mr Bailifî` be assessed by a neurologist expert in the Íield of the long-term
effects of and possible rehabilitation for traumatic brain injury, including the possibility of
medication to assist in managing the client’s behaviour. There may be programs in the
domains of social and interpersonal skills which might assist him to better manage his
behavioural deficits and difficulties. It is doubtful whether treatment would be available in
mental health facilities in NSW or the ACT. The major issue in preventing further offending
behaviour is addressing Mr Bailiffs problematic challenging behaviour, and it seems that he
will not comply With any prescribed medication; therefore the only avaiiable courses of action
would be a treatment order for possible medication and/or participation in a behaviour
moditication rehabilitation program if there is an available program.
Recommendation on the degree of Supervision or monitoring required luider any
proposed treatment regime 0r support plan and the ofsuch supervision
within NSW or the ACT
Mr Bailiff would benefit from close supervision and Support, although it is unlikely that he
will cooperate with any treatment regime or support plan.
Fitness t0 be Tried 1m der the Presser criteria
I was unable to draw a conclusion about the c1ient’s capacity to comprehend the court process
as determined by the Presser criteria owing to his lack of responses to the questions asked.
Under the Kesavarajah criteria it is unlikely that he can sustain attention through the course of
the court proceedings and his disinhibited and intrusive social behaviour would be
problematic.
Thank you for asking me to assess this client.
Susan Hayes
14 June 2013
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