A long-time psychiatrist for a man who killed six people in a stabbing rampage was "likely deliberately disingenuous" as she played down his illness and should be investigated, a coroner has been asked to find.
Joel Cauchi, 40, was experiencing acute psychotic symptoms when he killed six people and injured 10 others, including a nine-month-old baby, inside Westfield Bondi Junction shopping centre.
Dawn Singleton, 25, Ashlee Good, 38, Jade Young, 47, Pikria Darchia, 55, Yixuan Cheng, 27 and security guard Faraz Tahir, 30, all died in the 13 April 2024 attack.
Cauchi had been successfully treated for schizophrenia since he was a teenager, but he was weaned off anti-psychotic medication and fell through the cracks before the incident.
Andrea Boros-Lavack, who treated Cauchi for eight years, initially gave evidence he did not have chronic schizophrenia and he was not unwell at the time of the attack.
Pikria Darchia was one of the six victims of the knife attack at Bondi Junction. Source: NSW Police, PA / Family handout
'Genuinely shocking'
That answer "was shocking, it was genuinely shocking," counsel assisting Peggy Dwyer said on Tuesday.
As she outlined findings and recommendations the coroner could make about events leading to the April 2024 attack, Dwyer said Boros-Lavack's answer — recanted the next day — had caused distress to the families of the victims.
Joel Cauchi was shot dead by police. Source: Facebook
But it was "more likely a deliberately disingenuous" attempt to justify her own decision to wean him off medication and her statement that he was not unwell at the time of the attack, the coroner was told.
Boros-Lavack, through her lawyer, disputes she suggested Cauchi was not unwell at the time.
The inquest is investigating issues, including whether Cauchi's mental health was appropriately managed and whether there were missed opportunities to detect his deterioration.
There were multiple red flags in the months after Cauchi was taken off his medication, Dwyer said.
But they were not noted by the treating psychiatrist when she discharged him into the care of his GP, she said.
Six people were killed and more seriously injured during the stabbing rampage at Westfield Bondi Junction in April 2024. Source: AAP / Steven Saphore
Dwyer said the concession was welcome but would not be accepted by the coroner as genuine because Boros-Lavack had been "lacking in insight" as a witness.
"It was exceptional the level of belligerence and confrontation Dr Boros-Lavack demonstrated in the witness box," the counsel assisting said.
"It's highly concerning that someone charged with the care of some of the most vulnerable in our society would be so unwilling to reflect and learn."
The families of Cauchi's victims have called for the psychiatrist to be referred to a regulatory body following her evidence, the inquest was told.
Dwyer said it was an option open to state coroner Teresa O'Sullivan, noting the inquest was not charged with reviewing the psychiatrist's treatment history.
Dwyer recommended implementing a preventive mental health care model rather than a crisis-driven approach.
"It's an opportunity to look at this tragedy and see whether there are broader reforms that could save lives," Dwyer said.
The inquest continues.
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