‘Gradual decline’: Killer Joel Cauchi’s email to clinic as mum pleaded for help over his mental health decline years before fatal Bondi attack

Concerns over notes suggesting Bondi killer Joel Cauchi believed he was under “satanic control” were raised to a mental health clinic by his mother shortly after he went off medication.

Bondi killer Joel Cauchi had asked for a “porn free phone” and had left notes suggesting he believed he was under “satanic control” months after he stopped taking all medication, with his mum raising concerns he might have been hearing voices.

Cauchi, 40, killed six people and stabbed another 10 during a stabbing rampage at Westfield Bondi Junction on April 13, 2024.

Dawn Singleton, Yixuan Cheng, Faraz Ahmed Tahir, Ashlee Good, Jade Young and Pikria Darchia died in the incident.

Cauchi was diagnosed with schizophrenia when he was 17 and was medicated for more than a decade to treat the condition until he stopped taking all psychotropic medication in 2019.

Counsel assisting the coroner Peggy Dwyer SC earlier noted that most people with schizophrenia “will never commit an act of violence”.

His mental health treatment is being probed over the five-week coronial inquest.

Joel Cauchi was diagnosed with schizophrenia when he was 17. Picture: Supplied

Cauchi was taken off medication under supervision

Cauchi was treated in the public system in Toowoomba from 2001-2012 until he was transferred to the care of a private psychiatrist, known as Dr A.

Cauchi saw the psychiatrist about once a month, and his dose of clozapine was gradually reduced while under his care until he stopped taking it in June 2018.

The court was earlier told Cauchi was concerned about over-sedation, and the decision to stop taking clozapine was supported by a second opinion from a psychiatrist in 2015 who had treated Cauchi in the public sector.

Cauchi then stopped taking abilify in 2019, meaning by June of that year he was not taking any psychotropic medications.

“In Mr Cauchi’s case, his cessation of treatment unfortunately coincided thereafter with him exiting the mental health system altogether. He was effectively lost to follow-up from early 2020,” Ms Dwyer earlier told the court.

She said evidence suggested Cauchi’s mother Michele had raised concerns several times with a Toowoomba clinic about her son hearing voices and writing notes he was “under satanic control”.

Dr A gave him scripts for abilify and rexulti in November and December 2019.

However, Cauchi didn’t take it due to side effects, and Dr A left it up to Cauchi to decide whether to take the prescribed medications.

Cauchi moved to Brisbane in 2020 and unsuccessfully tried to join a Skype session with Dr A.

When the clinic discovered he’d moved to Brisbane, they believed he wasn’t eligible for Medicare Skype appointments or nursing support.

Cauchi didn’t want to attend appointments in person due to difficulties travelling, so the clinic cancelled the appointment.

The court was told staff contacted him over a referral to a Brisbane GP, but he told them he didn’t have one yet and would keep them posted.

Dr A then discharged Cauchi into the care of his Toowoomba-based GP, which “signified a rather sudden end to Cauchi’s treatment by Dr A after what had been consistent treatment and attendance over eight years”.

Bondi stabbing victims (top l-r) Dawn Singleton, Ashlee Good, Cheng Yixuan, (bottom l-r) Faraz Tahir, Jade Young and Pikria Darchia.

Bondi killer’s email as mum asked for help

Cauchi had emailed the private Toowoomba clinic himself to ask for ideas for a “porn free phone and other devices” on November 12, 2019.

This was about five months after he’d stopped taking Abilify to treat OCD.

“If seeing a specialist is what you recommend I will consider that the same … I want a totally porn free internet on my devices if possible on all browsers and potential browsers, Xbox … and for it to include images too,” Cauchi wrote in the email, which was shown in court.

His sessions with a mental health nurse were moved from monthly to weekly about on November 14 upon direction from his psychiatrist, which RN3 agreed suggested there was a need for closer monitoring around that time.

His mother wrote an email to the clinic on November 20 where she wrote he hadn’t been doing very well since going off the Abilify.

“I know you thought that it wasn’t having any effect, but I have noticed a gradual decline in his condition,” she wrote in the email.

She said Cauchi had left notes around the place and she suspected he was hearing voices, describing him as distracted, forgetful, and his OCD was “getting out of hand”, going through half a cake of soap in one shower.

“I would hate to see him go back into hospital after 20 years of being stable on medication, but of course, being off it has made him realise how sedating it was. Although, I think it was the clozapine that did that, not the abilify,” his mum wrote.

“He is quite possibly won’t let on what is going on in his head, but I think you need to know how he is.

“I would like to see him being able to successfully live independently and be doing as well as he was a year ago when he first moved out of home.”

Cauchi was reported as having “changes in behaviour” and extreme OCD by those known to him in clinical notes made on November 20.

“Mother read some notes with some content of under satanic control of religious beings, desires for porn in conflict of his religious beliefs, and wanting no access to porn sites,” the clinical notes read.

He’d even left his phone with his mother at her home overnight so he wouldn’t use his phone for porn sites, the notes read, with his mother also reporting “he is walking funny, changes in his gait”.

He was also afraid of getting sick and was wearing layers of clothes to prevent himself from getting sick.

However RN3 spoke with Cauchi’s father on November 21 (who also appeared to suffer from a mental health condition) and had indicated he didn’t want his son to take medication, despite Mrs Cauchi’s concerns.

On November 28 Cauchi had a consult with his psychiatrist, and while Cauchi wasn’t keen on starting Abilify due side effects, he was happy to go on another antipsychotic medication called rexulti.

One of his treating nurses, who can only be known as RN3, encouraged him to start medication, however he didn’t take any.

Cauchi’s mother Michele had expressed concern in early 2020. Picture: NewsWire/Tertius Pickard

Cauchi went to the Sunshine Coast for a holiday in early December with his cousin and agreed to a face-to-face appointment on December 19 at the clinic.

He also agreed to take medication if he noticed changes in his behaviour.

The court was told Cauchi left his family in the Sunshine Coast to go to Brisbane, with his mother receiving a call from his aunt that he was on medication for HIV, which Cauchi later told the clinic was a precaution following a dangerous sexual encounter at a licensed brothel.

He was worried he may contract an STD despite the sex worker telling him they had been tested, and was put on preventive HIV medication for a month “just in case”.

Despite having an appointment booked on December 19, Cauchi said he wouldn’t return to Toowoomba until the 22nd, and told the clinic he wanted to discuss advice to restart medication as he felt mentally well.

Cauchi denied symptoms of psychosis over the phone to the clinic on December 19, and was booked in to attend the clinic on January 8.

Clinical notes made on January 8, 2020, stated Cauchi was “totally well and going well” and that he would continue with no medication.

RN3 made notes on January 30 that she’d called Cauchi, who was trying to get information on whether clozapine had “damaged his body’s temperature system” and questioned if there was damage to the “temperature centre in his brain” as a result of the medication, which he was not taking at the time.

When questioned on whether this might be concerning given he wasn’t on clozapine, RN3 told the court she “still thought it was a valid question”.

Cauchi’s mother again raised concerns over her son’s health on February 14, though RN3 was on leave at the time, leaving RN2 to speak with Mrs Cauchi over the phone.

When she returned from leave, RN3 said she was “surprised” to find Cauchi had been discharged, but didn’t recall raising this.

Joel Cauchi was shot dead by Inspector Amy Scott. Picture: Supplied.

She agreed Cauchi was a patient who would require follow-up, but agreed by the time he had moved to Brisbane he was “effectively lost to mental health follow-up”.

Important Cauchi have follow-up after concerns

RN3 said she had “no recollection” if the psychiatrist was concerned Cauchi hadn’t started the Rixulti, given his mother’s worries about a possible relapse from October 2019.

However, she agreed it was important he have a follow-up given what his mother had flagged.

She said things “could’ve been different” when asked whether more should have been done to ensure Cauchi received psychiatric follow up when he moved to Brisbane.

“It’s very, very hard … people do get lost to follow up from time to time. With hindsight things could’ve been done differently,” she said.

“Joel was wanting to get on with his life that had been in a hiatus for some time, he was looking to use his qualifications, this is a man who’d come off medications (and) still managed to get high distinctions in his studies.”

She said he was able to learn and speak about six languages, but he still didn’t have the ability to manage his daily activities, speak to women, and socially speak to most people.

“I can see that he wanted that autonomy to have that freedom to live his life, but the illness was always going to be there that would have an impact on him,” she said.

“I don’t know how you can make somebody who continually presents well and was seen by other doctors after he was discharged from … the centre.”

Nurse breaks down over ‘Joel we knew’

RN2 had called RN3 after discovering Cauchi was behind the fatal attack.

In tears, RN3 said her thoughts had gone out to all those who knew Cauchi.

“The Joel we knew was not the person who did what happened on the 13th of April, and so we were all very shocked that that happened, and that we had spent time with (someone who) could do that,” she told the court.

She agreed she believed if Cauchi had remained medicated and mentally well he “would not have been capable of committing this travesty”.

Nurse ‘vomited’ when she heard of Cauchi’s rampage

One of the nurses who treated Cauchi on and off in Toowoomba between 2011 and 2019 “vomited” when she first discovered he’d been behind the fatal attack.

The nurse, who can only be known as RN2, said she’d never thought Cauchi would have done something like that after finding out from a text message from someone in the Toowoomba area.

“I was incredibly shocked, I wouldn’t have ever thought that was something he would’ve ever done,” the nurse told the court.

“When they said it was Joel, I looked it up and then I vomited when I saw it was him.

“It still feels like … it’s odd because it’s incongruent with what I know of Joel. It really doesn’t make any sense.”

Cauchi ‘didn’t want to get unwell’

RN2 was Cauchi’s case manager from about 2015-2017.

She would monitor his mental and physical symptoms before he would then have appointments with the psychiatrist.

He was on a “moderate” level of clozapine (250mg), which was then lowered to 200mg in April 2016.

Cauchi was ultimately taken off the medication completely by June 2018.

RN2 said patients on clozapine were closely monitored due to potential life-threatening side-effects, and it was a general aim to keep dosage of the medication low.

The lowering of the dose was initially to manage Cauchi’s side effects rather than to end it completely, she told the court.

She also couldn’t recall having experience with any other patients where the dosage was stopped without then being prescribed a different antipsychotic medication.

The attack occurred at Westfield Bondi Junction. Picture: NewsWire / Jeremy Piper

She agreed that Cauchi appeared to have an understanding of the complexity of his condition during the first period of care from 2015 onwards.

“The fact that he was prescribed clopine … indicated that he had treatment-resistant schizophrenia, so that obviously meant that his condition was quite severe,” she said.

“However, because he was so compliant he wasn’t difficult to manage, and he was stable during that period as well in terms of mental state.”

She said Cauchi was “relatively insightful” and conscious of his illness and “had anxiety” about it.

“He was quite diligent in monitoring for signs of relapse, he didn’t want to get unwell, and he was very conscientious with regard to his mental health. I think that was evidenced by his punctuality and engagement with our service,” she said.

“He wanted to get the support and make sure that he did the right thing. I would’ve been very confident that if he had … symptoms (of a schizophrenia relapse), because he was concerned, that he would have been open about them.”

When monitoring for potential signs of a relapse, she said she’d monitor for pronounced changes in behaviour, declining functioning and self-care or cognitive decline.

Cauchi’s mum concerned over swearing, irritability

RN2 resigned in 2017 before returning to the clinic in 2019, but she did not care for Cauchi then.

The court was told Mrs Cauchi had raised concerns with the private clinic in February 2020 that her son’s unit was a mess and he appeared more isolated, irritable and was occasionally swearing.

The nurse was asked if she’d ever known Cauchi to swear, and she replied: “No.”

His mum had asked the nurse not to let Cauchi know she’d called, but she was worried if he moved to Brisbane that he may become homeless.

Cauchi was previously seeing a peer support worker but had decided to stop as he was planning to move to Brisbane.

RN2 offered Cauchi’s mum a referral to the support program or for the pair of them to come in for a session together; however, she declined the latter, the inquest was told.

RN2 ultimately made clinical notes about the phone call and then let either a doctor or administrator at the clinic know.

While she thought it was worth mentioning, she noted it wasn’t unusual for someone moving out of home for the first time – particularly with someone with Cauchi’s medication and condition – to have things like a messy unit.

Cauchi not eligible for appointments

RN2 was told Cauchi was discharged and referred to a GP when he moved to Brisbane in 2020, as he was no longer eligible for Skype appointments due to the nature of the funding system’s structure.

It meant he’d have to pay for appointments, which he didn’t want to go ahead with.

She said it “wasn’t an ideal system”.

“I think that given the barriers to accessing psychiatry in terms of cost and time frames and, also as you’re saying, someone’s quite disorganised, as a lot of people with various mental health (conditions) can be, then it puts a lot of barriers in place and it may ultimately result in not accessing services,” the nurse said.

First witness to offer condolences to Cauchi family

Another nurse who treated Cauchi has become the first witness to express her condolences to his family during the inquest.

“I wanted to say that this has been a profoundly tragic and sad event,” the nurse, who can only be known as RN3, told the court.

“(I) express condolences and sorry for all the families who lost a loved one … to those who have been injured physically and emotionally.

“I also wish to express my condolences to the Cauchi family.”

Originally published as ‘Gradual decline’: Killer Joel Cauchi’s email to clinic as mum pleaded for help over his mental health decline years before fatal Bondi attack