Trauma of family's lifetime with mental health system brought home by Bondi killings (2024)

Claire Jones (not her real name) knows well the pain and trauma shared this week by the distraught parents of Bondi shopping centre killer Joel Cauchi.

Her journey with mental health has been ongoing for the past three decades.

Toowoomba couple Andrew and Michele Cauchi spoke openly of the battle of caring for their youngest child after saying he was diagnosed with schizophrenia when he was 17.

It is the same diagnosis Claire's brother received, and his illness is something her family has lived with for most of her life.

Claire's brother is not much older than Cauchi and, on Saturday night as she watched television coverage of the 40-year-old running through a Bondi shopping centre armed with a knife, she says she was "quietly distraught".

Claire does not want to be identified to avoid potentially upsetting her brother, but wants to advocate for those with schizophrenia and their families.

She has enormous empathy for the victims of Cauchi's attack and shares the heartache of the nation over the terrible events at Westfield Bondi Junction Shopping Centre last Saturday.

But she wants people to know the mental health system, as she has experienced it, is non-existent.

A spotlight on mental health

Cauchi fatally stabbed six people and seriously injured several others before he was shot dead in the Sydney shopping centre by a police inspector.

His distraught parents have said, as far as they understood it, he was no longer on mental health medication and would be devastated if he understood what he had done.

The couple, in their 70s, said their adult son made a decision, in consultation with his treating doctor, to come off his schizophrenia treatment about five years ago.

The dreadful circ*mstances of last Saturday afternoon are now the subject of a police and coronial investigation.

Part of the inquiry will focus on Cauchi's mental state at the time and in the months leading up to his move to Sydney from his family's home in Toowoomba, west of Brisbane.

The tragedy has shone a spotlight on the country's mental health system, sparking questions about whether enough is being done to help those with mental illness and their families.

Institutions shut down 30 years ago

National Association of Practising Psychiatrists president Philip Morris says problems with the system started 30 years ago when mental health institutions were closed down.

Suddenly, very unwell people were on the streets, families were expected to care for them, some ended up in homeless shelters or living rough, and many were picked up by police.

"Treatments were not followed up and they became a very disadvantaged group of people who should have been properly cared for," Dr Morris says.

"This group of patients are very marginalised."

Dr Morris says it is possible to reduce the risk of incidents such as the Bondi attack from happening.

"I would think one of the most important things to do is to start to improve the level of care for these groups of patients that have been disadvantaged over the last 30 to 40 years and provide them with the sort of care that they deserve and that they need to remain productive and safe members of the community," he says.

SANE is the national body representing Australians impacted by complex mental health, and says people with schizophrenia are the "most stigmatised" by media and more likely to be the victims of violent crime rather than its perpetrators.

SANE chief executive Rachel Green says there needs to be more funding and better coordination of mental health services at state and federal levels.

"Our current mental health system is filled with gaps and people have and continue to fall through and sometimes with devastating consequences," she says.

'It could have been us'

Claire Jones knows this all too well. Another brother is a frontline emergency worker and every time he attends a knife incident involving the mentally ill, he thinks, "But for the grace of God, this could be our family".

Her brother with schizophrenia last "spiralled out of control", as she calls it, two years ago.

"I spent two full days on the phone to every single mental health support agency from Brisbane to Sydney," Claire says.

"No one could provide any help.

"The main line kept me on hold for two full hours.

"When I finally got through, I was told to ring another program or support agency."

She rang her brother's doctor, who told her to go to the mental health clinic at the hospital.

The clinic had already told her to call the doctor.

Claire rang the local health authority crisis team.

They could not help because her brother was not deemed an immediate threat to anyone or to himself.

What is schizophrenia?

Dr Morris says schizophrenia is a chronic brain disorder that affects about 1 per cent of the population.

When schizophrenia is active, symptoms can include delusions, hallucinations, disorganised speech, trouble with thinking and a lack of motivation.

He says there are five types of schizophrenia – paranoid, catatonic, disorganised or hebephrenic, residual and undifferentiated.

Dr Morris says illicit drugs, such as cannabis, ice, speed and other stimulants, can aggravate schizophrenia.

Social engagement can be difficult for people with schizophrenia and Dr Morris says research indicates that, despite expressing interest in social interactions, people with schizophrenia report spending less time with others and feeling lonely.

Cauchi appears, from his use of dating and escort sites, and his social media calls for friends to go surfing and taking photographs, to have been searching for connection and friends.

Asked if schizophrenia patients can come off medication and live safely, Dr Morris says the majority of patients with psychosis should be monitored and many will need medication for a long period of time.

Rising contact numbers

Staff at a mental health service in Toowoomba have already seen a rise in the number of people with schizophrenia and other mental health issues who have contacted them for support since Saturday's incident.

Momentum Mental Health chief executive Shirley-Anne Gardiner said the Bondi incident "was a real tragedy" but it made people reflect.

"We've had people come forward, requesting more support … which is the best thing that could have happened out of this tragic event," she said.

"People have recognised that, 'I don't want to do something like that. Maybe I need a little bit more support'."

She says her team noticed that the incident resonated with people who have complex mental health conditions.

"So they are feeling like this is the opportunity to make sure they stay medicated, that they stay looked after and supported and find those connections," Ms Gardiner says.

Momentum offers group sessions and one-on-one coaching for people with mental health issues, and helps support people with more complex issues to feel connected, keep active and learn how to give back to the community.

"Joel [Cauchi] had schizophrenia but it wasn't controlled," Ms Gardiner says.

"There can be people that live fantastic lives and great wellbeing who have schizophrenia and are on medication.

"If you don't take your medication, you're not controlling your condition, just like any health condition.

"It's like diabetes, if you don't take your insulin. You need to.

"We can have people who live great lives, feeling supported, if they connect and follow instructions for their health."

'They are not monsters'

Queensland Mental Health Commissioner Ivan Frkovic says it is important to acknowledge the profound effect the Bondi attack may have had on those with lived experience of mental health challenges.

"We must be mindful that the terrible actions of one person do not cloud our perception of people living with mental illness, generally," he says.

"The evidence tells us that most people living with severe and persistent mental illness, like schizophrenia, are not violent, manage their symptoms effectively and access the treatment and support they may need."

Claire adds that they are "our loved ones".

"The community needs to understand that they are not monsters," she says.

"When they closed down all the mental health centres, they left it for the families to deal with and the families are exhausted."