69 The document review was substantially the same as that recorded by Dr Neilssen in his 2017 report, although there are additional references to a reported bipolar disorder it seems in 2013,[1] and for presentations to doctors following the offender's release to parole. In that context Dr Neilssen recorded the offender's assertion that he had experienced "a schizophrenic episode" on the evening of 14 January 2022, with records confirming a brief presentation to Nepean Hospital from about 8pm on 14 January to about 1am on 15 January 2022, and the observations of ambulance officers that the offender had "been speaking to individuals who were obviously not present in his cell". Although Dr Nielssen does not refer to it, as the reference to a cell suggests, the evidence given at trial is that the offender was at Penrith Police Station prior to this supposed "schizophrenic episode", where he had been closely questioned by police about what had become of Charlise Mutten.
70 A Justice Health note referred to by Dr Nielssen recorded the offender as "normal" and "logical" and displaying no symptoms of psychosis on entry to custody. Despite the lack of observable symptoms, he was prescribed an antipsychotic on the basis of his self-report.
71 Dr Nielssen's own assessment was that the offender presented without any signs of neurological disorder, and with "no odd usages or beliefs suggesting the presence of an active psychotic illness, including any apparently delusional explanation for the presence of hallucinated voices".[2] His cognition and intelligence appeared normal. Despite the complete absence of any objective features of psychosis, Dr Neilssen diagnosed a "substance related psychotic illness" because of the offender's self-report. On the same basis, a substance use disorder was diagnosed.
72 Ex. S2 in the offender's case is a recording of a telephone call between the offender and his mother on 10 February 2022. An edited version was in evidence at trial as call 2 of Ex. X. The recording was tendered as evidence of the difficult custodial conditions it is submitted the offender faces and will face because of the nature of his crime. The recording opens with some discussion between the offender and his mother, with the sounds of another inmate
