Two psychiatrists have told a trial that a doctor accused of murdering her three-year-old autistic son fulfils the criteria for a special verdict of not guilty by reason of insanity.
Both witnesses were in agreement that Maha Al Adheem was suffering from paranoid schizophrenia in July 2017. The Kuwaiti woman was unable to appreciate that what she did at the time was morally wrong and would have been unable to refrain from her actions, the Central Criminal Court has heard.
Dr Paul O’Connell from the Central Mental Hospital was giving evidence on Wednesday in the trial of Maha Al Adheem, charged with murdering her only child over a year ago.
Ms Al Adheem (43) has admitted stabbing her son and told gardai that “a power” had made her go to a drawer and remove a knife. The boy was stabbed 20 times and four stab wounds had penetrated his lungs and heart, severing a vital artery. His cause of death was multiple stab wounds to his chest, abdomen and trunk as well as to his right thigh.
Ms Al Adheem, with an address at Riverside, Poddle Park, Kimmage, Dublin 12 has pleaded not guilty to murdering Omar Omran on July 10th, 2017 at the same address.
Dr O’Connell told defence counsel Patrick Gageby SC he was not treating the accused in the Central Mental Hospital so was independent for the purpose of preparing a report for the court.
The witness said he interviewed Ms Al Adheem on three occasions this year and she told him she had experienced hearing voices in the past and sometimes could hear a door open by itself.
Schizophrenia
Dr O’Connell said the accused qualified as doctor in Iraq in 2003 but it took her nine years to complete a six year medical degree as she was diagnosed with depression and schizophrenia while she was a medical student in 1996. Her mental illness at the time included her becoming reclusive and hearing critical voices which prevented her concentrating on her own thoughts.
Ms Al Adheem told the psychiatrist that she had seen an “out of this world” black cat with no tail from her apartment balcony in Kimmage and as a result prayed on the Quran day and night over three days to “ward off” its spirit.
Dr O’Connell said the accused seemed to be deluded that her life was being “laid bare” on Facebook by a previous suitor who was keeping her under surveillance and had hacked her account.
Ms Al Adheem told Dr O’Connell that her ex-husband had a limited ability to learn English and he had sensitivities which meant he could not tolerate loud noises including the sound of their baby crying. Her son Omar was born on January 9th, 2014 through assisted conception treatment. Their marriage ended when Omar was four months old and Ms Al Adheem applied for a legal separation that year which came into effect in 2016.
Developmental problems
The accused told Dr O’Connell that developmental problems became apparent in Omar when he was two and a half years old and there were issues finding a creche for him as he was non-verbal, needed one to one attention and his special needs were evident.
Ms Al Adheem felt very depressed in the months prior to the event because of her child’s autism and the fact schools were refusing to take her son. On March 14th, 2017 she felt suicidal and attended her GP with suicidal thoughts and was admitted to the psychiatry department in St James’s Hospital for five days, said the witness.
A safety plan was put in place for the accused and she told doctors she would seek support from her mother or brother. According to notes generated from St James’s Hospital, Ms Al Adheem was not presenting with any psychotic phenomena or psychotic ideation when she was discharged from St James’s Hospital.
The court heard the accused had put a knife to her throat at the beginning of 2017 but had not carried out her intent as the baby had cried.
Ms Al Adheem said a power took over her on the day of the killing which made her stab her son and she felt her wrists being twisted, said Dr O’Connell, adding that this was evidence of the accused’s prevailing delusions where she no longer believed she was in control of her own body.
The fact she thought gardai and Dublin Fire Brigade who arrived at the scene were “fake people” was consistent with someone experiencing paranoid psychosis, he indicated.
Dr O’Connell said the accused told her she had purchased the silver knife in Lidl and it was like a sword.
In conclusion, Dr O’Connell said Ms Al Adheem was suffering from a mental disorder, paranoid schizophrenia at the material time which impaired her mental functioning. This was evident from her abnormal behaviour leading up to the event and her preoccupation with delusional themes, he said.
The doctor said her behaviour suggested that she knew the nature and quality of her acts. However, Dr O’Connell stated Ms Al Adheem was unable to appreciate that what she did at the material time was morally wrong and such a state of psychosis was consistent with her being unable to refrain from committing the act.
The court heard Ms Al Adheem met two of the limbs required for the special verdict of not guilty by reason of insanity.
A second forensic psychiatrist, Dr Lisa McLoughlin of the Central Mental Hospital also gave evidence that the accused was suffering from paranoid schizophrenia at the time which seriously impaired her mental functioning.
Psychosocial stresses
Dr McLoughlin told prosecution counsel Michael Delaney SC that it would appear Ms Al Adheem was suffering from significant “psychosocial stresses” when she was admitted to St James’s Hospital in March 2017 as a result of raising her son as a single parent. “I think there is a substantial amount of evidence that she was preoccupied with a black cat at that time,” she added.
Doctors in St James’s Hospital who examined Ms Al Adheem after the killing in July 2017 noted that she had psychosis and was a contradictory historian at times, said the witness.
Dr McLoughlin said the accused retains the delusional belief about the black cat, although she does not currently see it, and there has been a substantial deterioration in her level of functioning.
The witness said she agreed with Dr O’Connell that Ms Al Adheem knew the nature and quality of her act. However, she said the accused was unable to appreciate what she did was wrong and would have been unable to refrain from committing the act.
The trial resumes tomorrow before Ms Justice Eileen Creedon and a jury of nine men and three women.