Patient breached leave twice before murder of Laisa Waka Tunidau, inquest hears

A mental health patient twice breached the conditions of his unescorted leave in the weeks before he murdered a woman in 2022, an inquest has heard.

Laisa Waka Tunidau was stabbed to death by Zakariye Mohamed Hussein outside her Sockburn home on 25 June 2022, while Hussein was on unescorted leave from Hillmorton Hospital. Hussein was jailed for life, with a 13-year non-parole period, in November that year, and had previously been jailed for more than six years for kidnapping, stabbing and intimidating people across Christchurch in March 2012.

The second phase of an inquest into Waka Tunidau's death resumed in Christchurch on Wednesday before coroner Alexandra Cunninghame. A psychiatrist who treated Hussein between 2015 and 2022 continued giving evidence on Wednesday. The clinician's identity is suppressed.

Counsel assisting the coroner Stephanie Grieve KC questioned the clinician about how decisions were made to allow Hussein unescorted leave. The court heard Hussein went to locations without permission while on unescorted community leave on 6 June and 10 June 2022.

"[After] the second incident on the 10th of June there wasn't any consequence of that, was there, imposed in terms of a step back of his leave?" Grieve asked.

"No there wasn't," the clinician said.

"There was a discussion with the team in consideration of what it meant and where the risks were at, but there wasn't a consequence."

The clinician said mental health services did not operate on the basis that a patient should be punished for doing something wrong.

"If you're saying to me should a mental health patient who breaches leave two times in four days should there always be a consequence, my answer is no. There should be a considered assessment."

The court heard clinicians were also considering increasing Hussein's leave.

"At that time that was the decision we'd come to that these weren't indicators of increased risk and that things were going generally well for him," the clinician said.

"If you asked me with hindsight then it would've been great to have stopped all his leave and changed everything radically. We weren't to know what was going to happen."

The court heard Hussein had also been involved in several incidents in the month before the killing in which he became angry, including throwing water at another patient and swearing at staff. The clinician accepted the incidents were relevant to assessing risk, but said they needed to be considered alongside Hussein's overall progress.

"The key thing is you're looking at the wider picture and the knowledge that you've built of someone over seven years," they said.

The clinician said there had been "a lot of really positive things" about how Hussein was doing from late April through May and June, including his ability to talk to staff and work through difficult situations.

"In of itself incidents of irritation or those things that are documented, that's the thoroughness of the staff doing a great job of documenting things, but many of those were small things."

The clinician said the team's view at the time was that Hussein was making good progress.

"Right now we sit here with this tragic event having happened, so of course we want to go back and do things differently, but the team sitting in that moment, with all the structures that we had, our weekly MDT [multidisciplinary team meetings], our case conference in February, our risk management care plan that considered his risks, that's where we were at that time."

More than 20 doctors, psychologists, psychiatrists and nurses involved in Hussein's care were due to give evidence during the inquest.