Coroner's Court of Western Australia

Inquest into the Death of Samuel Mark WALSH

Inquest into the Death of Samuel Mark WALSH

Delivered on :  29 June 2021

Delivered at : Perth

Finding of : Coroner Urquhart

Recommendations : N/A

Orders/Rules : N/A

Suppression Order : N/A

Summary : Immediately before death Mr Walsh was a “person held in care” under the Coroners Act 1996 because he was subject to a custody order made under section 21(a) of the Criminal Law (Mentally Impaired Accused) Act 1996.  He was 38 years old.

Mr Samuel Mark Walsh (Mr Walsh) died between 5 October 2014 and 12 October 2014 near Karalee Rocks Pumping Station, Yellowdine Nature Reserve.  The cause of death was carbon monoxide toxicity.  The Coroner found the manner of death was suicide. 

Mr Walsh was charged with the wilful murder of his mother and was remanded in custody at Eastern Goldfields Regional Prison.  On 18 October 2005, he was refused bail and transferred on a hospital order to the Frankland Centre at Graylands Hospital.  Mr Walsh had no previous psychiatric history prior to his admission to the Frankland Centre.  He was assessed as floridly psychotic.  He expressed bizarre, grandiose and religious delusions; describing a multi-national conspiracy directed against him which involved the police.  His thought form was rambling and over-inclusive with looseness of association.  Mr Walsh had no insight into his legal situation and his judgement was assessed as impaired.

Mr Walsh showed signs of improvement when he was commenced on the anti-psychotic medication, clozapine.  Later he was also prescribed the anti-depressant, mirtazapine.

On 26 March 2007, Mr Walsh pleaded not guilty in the Supreme Court on account of unsoundness of mind at the time of doing the act that killed his mother.  On 30 March 2007, Mr Walsh was found not guilty on account of unsoundness of mind and placed on a custody order.

On 5 April 2007, Mr Walsh was transferred from Hakea Prison to the Frankland Centre at Graylands Hospital.  Records indicate that Mr Walsh continued to make a very good recovery.  By 2010, his paranoid schizophrenia was considered to have been in remission with the treatment he had received for many years.  As his progress was so significant, Mr Walsh was granted a leave of absence from the Frankland Centre.  He gradually increased his Leave of Absence periods from the Frankland Centre from one night per week to three nights per week in February 2011 to six nights per week in August 2011, and eventually for 13 days per fortnight following a Leave of Absence Order dated 1 May 2012.

At about 8.30 am on 5 October 2014, Mr Walsh was spoken to by the Duty Supervisor at Romily House who described him as being happy that morning.  Mr Walsh then left for the day in his car which was his normal practice on a Sunday.  Mr Walsh’s car was recorded as driving on Great Eastern Highway in Hines Hill and at 12.09 pm Mr Walsh and his car were observed on CCTV camera footage at the BP service station on Great Eastern Highway in Merredin.  Mr Walsh refuelled his car, went to the toilet and purchased a chocolate bar with cash.  He then drove away in an easterly direction on Great Eastern Highway towards Southern Cross.  This is the last confirmed sighting of Mr Walsh.

On 11 January 2017, his body was found in his car in remote bushland 400 km east of Perth.

The Coroner was satisfied that the supervision, treatment and care of Mr Walsh by police, prison staff and mental health clinicians from the time of his arrest on 17 October 2005 was appropriate.

Catch Words : Person Held in Care : Criminal Law (Mentally Impaired Accused) :  Supervision, Treatment and Care : Suicide

Last updated: 29-Sep-2021

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