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Court hears murder accused's judgment was "grossly impaired" by his mental illness

Court hears murder accused's judgment was "grossly impaired" by his mental illness

A nurse at a psychiatric hospital feared for his life when one of the residents attacked him during a psychotic episode, a Central Criminal Court murder trial has heard.

Paul Cuddihy (38), a former resident of St Otteran's psychiatric unit in Waterford City, has pleaded not guilty by reason of insanity to the murder of Maria O'Brien (55) at St Otteran's on September 5, 2014.

Mr Cuddihy is also charged with assault causing harm to nurses Breda Fennelly, Mary Grant and Terry Hayes and fellow hospital resident Mary Nugent. He pleaded not guilty by reason of insanity to all charges.

Prosecuting counsel Mr John O'Kelly SC yesterday told the jury that they will hear from two psychiatrists, one for the State and another for the defence, who agree that Mr Cuddihy was suffering from a mental disorder when he killed Maria O'Brien and attacked other residents and hospital staff.

Mr Terry Hayes, nursing director at St Otteran's, told Mr O'Kelly that he came to the residential unit, known as Glendarragh, when the alarm was raised that Mr Cuddihy had attacked residents.

When he went inside he found Mr Cuddihy and when he called out to him, Mr Cuddihy stared at him, repeated "Terry fucking Hayes" twice and then lunged at him.

He defended himself and got out of the house but he said the attack continued outside with Mr Cuddihy trying to punch, kick and headbutt him. "I feared for my life," he said.

Having known Mr Cuddihy for about 20 years, he said he had never seen him act in this way before

Forensic Psychiatrist at the Central Mental Hospital in Dundrum, Dr Paul O'Connell, carried out a report on Mr Cuddihy following the September episode.

He told Mr O'Kelly that Mr Cuddihy had a history of mental illness dating back about 20 years.

In that time he had accused his father of killing his mother, although she died of cancer, and had on occasion become violent and delusional.

He talked of being "led by the Holy Ghost" and seeing furniture moving by itself. In March 2012 he attacked his father, telling him "I want to send you to an early grave."

He had, over the years, heard voices in his head and on the evening of the attack he believed that if he did not kill Maria O'Brien something terrible would happen - that he would go to hell or that his family would suffer or that the world would suffer.

He said that he concluded that years of evidence and previous diagnoses showed that Mr Cuddihy suffers from paranoid schizophrenia.

He said that although Mr Cuddihy was on medication to treat his illness the levels of medication in his system varied greatly.

This, he said, could be due to many factors as the medication he takes can be inhibited by diet, by smoking or other factors.

On the evening of the attack, according to Dr O'Connell, Mr Cuddihy was unable to regulate his emotions or consider his actions.

His judgment was "grossly impaired" by his mental illness and although he understood he was attacking Ms O'Brien, he did not understand the moral consequences of his actions.

"He may have known what he was doing," he said, "but he could not know that it was wrong."

He also, he concluded, could not stop himself attacking his carers and fellow residents.

Under the Criminal Law, Insanity Act, a verdict of not guilty by reason of insanity should be brought when a person is unable to refrain from their actions or unable to understand what they are doing due to a mental illness.

The trial continues tomorrow in front of a jury of seven women and five men and Justice Patrick McCarthy.

Mr Justice George Birmingham, Mr Justice Garrett Sheehan and Mr Justice John Edwards, reserved judgment.