Christie Marceau inquest: killer's first psych assessment 'incomplete'

An inquest into Christie's death is under way at the Auckland District Court.

The forensic nurse who first assessed Akshay Anand Chand after he kidnapped and assaulted Christie Marceau has revealed what the disturbed teenager told her.

And she has conceded her assessment of Chand was "incomplete" and "rushed" and in hindsight she could have provided more information to the court about his mental condition.

An inquest into Christie's death is under way at the Auckland District Court.

Chand was denied bail three times before he was released to live at his mother's home on October 5, 2011.

He stabbed Christie to death in her home, less than a kilometre away, 33 days later.

Forensic court liaison nurse Ellen Wilson has given evidence about her first meeting with Chand after his initial arrest in September 2011.

She explained that she had been asked by police to assess Chand, following the offending and because he had tried to overdose on multivitamins.

Her role was to "look at safety issues and risk" and provide an assessment to police and the court.

Wilson told the inquest she started that assessment by explaining the process to Chand.

"I informed him that any information he provided would not remain confidential and would be made available to the court," she said.

Chand consented and agreed to participate.

Wilson said the assessment covered Chand's behaviour, affect, thought, orientation, memory and insight.

"I recall the interview quite well," she said.

"I saw Mr Chand in the holding cells wearing the police-issue suit for defendants who pose potential or ongoing risk.

"He was happy to speak of his problems and was only too willing to disclose his current unhappy state.

"He reported a lengthy period of depression and anxiety."

Chand told Wilson that his parents were divorced, he did not get on with his mother Suchita Chand and that his sister Shayal was "the only person who he considered to be family".

"He described a conflicted relationship with both parents and was unsure if his mother would be willing to have him home should he be bailed," Wilson recalled.

"Mr Chand was also able to give me a very brief account of his version of the events leading to his arrest, but was clearly unwilling to give me any detail regarding his rationale for the alleged charges.

"He became irritable with me when this issue of 'why' was again raised."

Chand then told the nurse that Christie was "his best friend but wasn't anymore".

He was able to give her a detailed list of the charges he was facing - kidnapping, threatening grievous bodily harm and assault with intent to rape.

Chand then revealed he had tried to take an overdose of Centrum vitamin tablets.

He said he'd taken 40 to 50 tablets as "a spur of the moment thing" because he was "concerned about what might happen to him once he appeared in court".

Chand had been seen by forensic mental health staff the night before Wilson saw him after he was taken to hospital for treatment for the overdose.

He said he'd been reluctant to speak to those people but "was glad that he had the opportunity to talk about himself" with Wilson.

"He was pleased that there were people in the world who 'don't judge you'," Wilson said.

Chand denied suicidal thoughts and "felt hopeful that his engaging with mental health services would be beneficial for him".

He said he wanted to apologise to his sister for the worry he had caused her.

Wilson said Chand was "considered, not scrambled, not speeding up or anxious, no worry in his voice".

"He was very logical and on track with the questions I put to him," she said.

"He was not disorganised in his speech, thought or behaviour."

After the assessment Wilson made recommendations to the court regarding Chand getting bail.

In a letter to the court she said "should he be further remanded back in custody" that she would contact the prison medical team with "an urgent referral regarding his potential risk to himself".

"Should the court choose to bail the defendant, I would also undertake to obtain an appointment with the North Shore Community Mental Health Team the next week with a request that the court make an attendance at this appointment a condition of his bail."

Wilson said if Chand was bailed she also would have contacted his mother and provided her with after hours crisis numbers.

She later provided another letter to the court "updating and further informing" the court about Chand's mental health, following additional assessments.

"Mr Chand had noticed an improvement in his mood since starting antidepressant medication," she said.

"He had denied suicidal and homicidal ideation and believed that a custodial sentence was likely once he had entered a plea.

"He appeared accepting of this anticipated outcome."

Report provided to court 'incomplete'

Under cross examination Wilson said she spent about 20 minutes with Chand and would have liked more time, given the severity of his charges.

"I did feel rushed," she said.

In hindsight, she wished she had asked the presiding judge for more time.

"I feel I could have done a relatively efficient screen within a 45-minute time frame," she said.

"But urgency required me to finish up - the urgency was he was going to be called [before the judge] immediately if not sooner, this was police outside the door waving to me to let me know this."

Marceau family lawyer Nikki Pender further questioned Wilson about the "rushed" assessment.

She challenged the nurse on whether she should have given more information in her letter to the court.

When asked, Wilson agreed that her assessment was "incomplete".

"I could have provided more," she said.

Pender also revealed that by the time Chand appeared in court Wilson had not written up her report and it was not put before the judge.

But an external review of the handling of the case by the Waitemata District Health Board found the assessment, given the urgency Wilson was under, was "appropriate".

There were "no criticisms that the report wasn't completed in time", Pender said.

Wilson said she was "reliant on Chand to self-report" and took the information "at face value".

"I wasn't comfortable with the assessment ... I had to do it so quickly.

"I would have liked to have explored more further with him."

She said in such a case she would hope the next person who assessed a defendant would have more time and information, including the police summary of facts, and be able to be more thorough.