Wayne and Noah Smith: Lismore Inquest examines mental health care in suspected father, son murder-suicide at Yamba
An inquest into the suspected murder-suicide of Yamba dad Wayne Smith and his young boy heard the dad was “stable” but required ongoing monitoring, despite long-standing mental health problems and a “significant” episode in 2020.
NSW
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An inquest into the suspected murder-suicide of Yamba dad Wayne Smith and his young boy heard the dad was “stable” but required ongoing monitoring, despite long-standing mental health problems and a “significant” episode in 2020.
The inquest, now entering its third day, is examining the circumstances surrounding the deaths of Wayne, 56, and Noah Smith, 15, whose bodies were discovered in their Yamba home on June 1, 2023.
The pair were found dead from gunshot wounds in a bedroom, with Noah “likely asleep” before the “sudden” death, the inquest heard on Monday.
Dr Fiona Couper, a general practitioner at a Yamba clinic, testified about her consultations with Wayne and Noah Smith.
Her testimony was based on statements provided to police in 2023 and 2025.
Dr Couper took over Wayne and Noah’s care from Dr David Hope in January 2022, inheriting a large patient base of over 2400 individuals.
Dr Couper stated that her practice involved conducting in-person reviews before reissuing prescriptions, emphasising the importance of assessing clinical need, potential medication side effects, and patient progress.
She noted Wayne’s mood appeared “stable” but required ongoing monitoring.
The inquest heard Wayne was being reintroduced to lithium and other medications for depression and anxiety after ceasing them some months prior.
During a consultation on May 10, 2023, Wayne presented Dr Couper with all his medications, expressing confusion about their purpose. Dr Couper observed that he appeared to be in low spirits and sought her assistance, feeling “confused and overwhelmed” by his medication regime.
Counsel assisting the coroner, Ms Stevens, questioned Dr Couper about the potential impact of ceasing medication.
Dr Couper confirmed that stopping medication a week prior to the consultation could have had noticeable effects on Wayne’s mental health.
Wayne, who was the sole carer for his son Noah, reported feeling anxious and that his mood had deteriorated in recent months, although he denied suicidal ideation.
He described feeling overwhelmed by both home and work responsibilities, particularly the financial burden of repairing a boat following his son’s leg injury in a boating accident.
Dr Couper explained that she cautiously reintroduced Wayne’s medication due to the potential for increased anxiety when commencing such drugs. She initiated a low dose of mirtazapine to address his depression and sleep issues.
Blood tests were ordered to rule out any underlying physical causes, and a follow-up appointment was scheduled.
Despite Wayne’s history of mental health issues and antidepressant and lithium use, a specialist mental health referral was not made at the time, as his condition was not considered acute or urgent.
Dr Couper noted the lengthy waiting lists for private psychologists in the region.
At a subsequent consultation on May 24, 2023, roughly one week before the tragedy, Wayne reported engaging with an employee assistance program counsellor and denied any thoughts of self-harm.
Ms Stevens highlighted previous notes indicating past depression and suicidal thoughts.
Dr Couper said Wayne’s presentation did not warrant further investigation into those past ideations.
She also confirmed that she did not inquire about Wayne’s access to firearms.
The inquest further heard Wayne’s condition was not deemed severe enough for hospitalisation, and Dr Couper was gradually increasing his antidepressant and lithium dosages.
She provided him with a medical certificate for time off work to rest.
The potential for dangerous prescribing alerts within medical software systems was discussed in relation to the prescription of Temazepam.
The inquest also heard Wayne had contacted a Currumbin hospital as a potential admission option.
Dr Stewart Hase, a registered psychologist, provided statements detailing his treatment of Wayne in 2020 and 2021, following a referral from Dr Hope.
Dr Hase treated adults with various mental health conditions, including those at risk of suicide. He confirmed using standard suicide risk assessment questions.
A referral letter from Dr Hope to Dr Hase in 2020 noted Wayne’s longstanding depression.
Dr Hase stated that having a complete and up-to-date medical history would have been beneficial, particularly given changes to Wayne’s medication.
He also admitted to not recalling specific details about Wayne due to the high volume of patients he sees.
Another psychologist, Dr Alison O’Neil, criticised Dr Hase’s note-taking as insufficiently comprehensive.
Dr Hase countered that balancing note-taking with establishing rapport was crucial.
He stated that he did not perceive Wayne as an immediate suicide risk, although the topic was discussed.
The inquest revealed that Wayne had experienced a “significant” episode in May 2020, leading to a referral to the Grafton Mental Health Service.
Dr Hase was unaware of the referral, as well as a subsequent reply detailing Wayne’s condition, which he stated would have altered his treatment approach.
He also learned during the inquest of Wayne’s learning difficulties and his father’s cancer diagnosis.
The inquest continues.
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Originally published as Wayne and Noah Smith: Lismore Inquest examines mental health care in suspected father, son murder-suicide at Yamba
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