Psychiatrist: Dewani not mentally ill

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IOL pic jun20 shrien dewani leaves court file Independent Newspapers Honeymoon murder accused Shrien Dewani pleaded not guilty to killing his wife Anni in Cape Town in 2010, and other related charges. File picture: Brenton Geach

 

Cape Town - Honeymoon murder accused Shrien Dewani is not suffering from a mental illness and should be discharged from Valkenberg Psychiatric Hospital, the senior specialist psychiatrist treating him has reported.

The first insight into the opinions of the specialists treating Dewani, and helping decide whether he is fit to stand trial for the murder of his wife Anni, emerged on Friday when a report compiled by Dr Sean Exner Baumann was handed to the Western Cape High Court.

In it, Baumann said a diagnosis of post-traumatic stress disorder (PTSD) was “deferred” because, while Dewani appeared to meet the criteria for such a diagnosis, “it was considered that the context should be taken into account, in that symptoms of anxiety could be accounted for by his current predicament”.

“The avoidance displayed could be less an inability to recall past traumatic events than an understandable anxiety with regard to needing to appear in court to account for circumstances leading to him being charged with the murder of his wife,” he said.

In a separate report, also handed to the court on Friday, private psychiatrist Professor Tuviah Zabow said Dewani was “not mentally ill to such a degree that involuntary admission should be instituted”. His view was, however, that Dewani remained mentally ill in terms of the Mental Health Care Act definitions.

His opinion was Dewani needed continued appropriate management, care and supervision. The contrasting opinions in the two reports, both dated June 3, led the State to formally apply to the High Court on Friday to have Dewani referred for psychiatric observation.

In Baumann’s report, it emerged that Dewani presented as calm, alert and co-operative, with a confident and self-assured manner when he was first admitted to Valkenberg in April.

“He showed no features of anxiety or depression. He denied suicidal thoughts. There were no psychotic symptoms nor any evidence of cognitive impairment. He declared that his intention was to appear in court to face the charges against him, and that he wanted no further delay in the proceedings,” Baumann said, adding that the finding appeared inconsistent with the discharge report from the UK.

He said it was possible Dewani’s symptoms were maintained by the repeated delays in extradition and anxiety relating to the charges against him, which changed when it became clear he would return to South Africa. Due to the low risk he presented, he was transferred to a medium secure unit.

 

“During the following weeks, his confident demeanour diminished. He appeared more anxious, particularly during more formal interviews, and at these times showed hypervigilant behaviour… He was distracted by these external stimuli but was able to rapidly regain the focus of his attention. The occasional symptoms of anxiety, tearfulness and depression were considered understandable in the context of his failed extradition and pending court appearance,” Baumann added.

In hospital, his medication was gradually withdrawn due to the side effects. Dewani was also not willing to engage in the recommended treatment programme, the report stated.

Baumann said members of the multi-disciplinary team treating Dewani agreed he was not depressed.

He recommended that Dewani be discharged, saying further time in hospital would probably not benefit him. In fact, it might “have the adverse effect of reinforcing the avoidant behaviour…”

Baumann recommended further counselling, aimed at helping Dewani move “beyond what appears to be his possible entrapment in the traumatic events of the past”. A secondary aim would be to prepare Dewani for court.

Zabow’s report, however, indicated Dewani was “mentally ill with the persistence of features of the psychiatric disorder which were the focus of attention while in the UK”. It said he was clinically ill with PTSD, Panic Disorder and Dysthymic Mood Disorder.

His condition had, however, improved since his admission to the hospital and “there is no lack of appreciation of the seriousness of the situation”. Dewani was “motivated to progress”.

Zabow added Dewani’s capacity for participation in a fair trial could reasonably be expected “with minimal disruptions if improvement is maintained”.

He recommended management, care and supervision.

In court on Friday, Western Cape Director of Public Prosecutions Rodney de Kock told Judge President John Hlophe that Dewani should be referred so that the matter could be “resolved definitively”.

Defence advocate Francois van Zyl SC did not oppose the application, saying the defence wanted the issue of Dewani’s mental state resolved properly.

The court granted the request, which means Dewani will now be evaluated by a panel of three psychiatrists, including Zabow, senior forensic psychiatrist Sean Kaliski, and a clinical psychologist, before his next appearance on August 15.

A provisional trial date of October 6 was set.

Van Zyl, however, placed on record that “we are of the view that the accused will be ready and fit to plead on the 6 October 2014”.

Meanwhile, the man Dewani allegedly paid to kill his bride was discharged from Groote Schuur Hospital this week.

Earlier this month it was reported Xolile Mngeni, who was diagnosed with brain cancer in 2011, was in a critical condition.

Mngeni is serving life imprisonment after he was convicted of killing Anni during a staged hijacking on November 13, 2010.

Weekend Argus



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