On Friday, a psychiatrist further testified to the mental state of former UBC student Thamer Almestadi, 19, who is on trial for attacking a fellow UBC student Mary Hare in Totem Park residence last year. Almestadi has been charged with attempted murder, aggravated assault and assault with a weapon.
Dr. Jeannette Smith, a psychiatrist with a focus in forensic psychiatry and criminal responsibility, spoke to the demeanor and mental state of Almestadi garnered from the four times she assessed him. She expressed her professional opinion that Almestadi had been suffering from a brief psychotic episode (BPE) in the days before, during and after the attack.
Smith explained that the delusions and “clear disturbance in function” Almestadi experienced in that timeframe as part of his BPE were most likely triggered by stress.
According to Smith, who first met with Almestadi on October 10, 2016 — six days after the attack on October 4 — Almestadi “wasn’t agitated, bizarre or angry in his behaviour, [but] it was quite clear he did not want to pursue the assessment.” After he made it clear that he felt his religion prohibited him from being alone with a woman, Smith left.
In their second meeting on October 17, Almestadi apologized for his previous behaviour and was “pleasant and polite,” but he seemed “wary of speaking openly and guarded.” Smith further testified that he seemed “appropriately concerned with his predicament and not abnormally preoccupied [with it],” in contrast to their first meeting when he seemed disengaged.
After meeting with Almestadi’s parents and one of his sisters in late October, she learned that they had noticed a change in his demeanor about one week before the attack took place, and that there was no family history of mental illness. His mother had also noted that “he sounded sad and alone” in the week prior.
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In their third meeting, Almestadi “appeared quite emotional trying to explain what happened.”
“My understanding was that his purpose was to kill [Hare],” said Smith, who noted that his post-attack concern for Hare’s well-being was consistent with his explanation. “But there was no malice — he didn’t want her to suffer.”
At this time, Smith testified that she supported the conclusion that Almestadi was not criminally responsible (NCR) for his actions.
In their fourth meeting on July 4, 2017, Smith recalled Almestadi seemed vaguely paranoid, and despite being polite, likened the assessment to a test from God. According to her, this paranoia is linked to the concept of ideas of reference, where an individual takes an insignificant, neutral stimulus and interprets it as personally significant.
Smith further elaborated that psychotic episodes, psychosis and schizophrenia exist on a spectrum, and that she had ruled out anything more serious than a psychotic episode because of the limited timeframe during which his symptoms presented.
“I’m confident that he was mentally-ill at the time,” said Smith, who also ruled out intoxication as an explanation of his behaviour because no evidence of substances were found at the time of the attack.
After being asked by the defense whether she thought now that Almedstadi was criminally responsible, Smith reiterated that that was a decision to be made by the court.
“He understood at the time that he was attacking Mary, that he was trying to kill her,” she testified when asked as to his awareness of his own actions and their morality. “At the time, he believed he was doing God’s will.
“I don’t think he stopped to consider whether it was right or wrong … he would have believed at the time his acts were morally right [but] his mental illness rendered him unable to appreciate that what he was doing was wrong.”
When questioned about the professional opinion of a colleague, Dr. Robertson, who performed Almestadi’s initial fitness assessment, Smith noted that while he considered more options, they both came to the same conclusion that he had suffered a BPE.
“This was an unusual case because the psychosis resolved itself without any psychiatric treatment,” said Smith.
Next, the prosecution began cross-examining Smith by questioning why she had ruled out another diagnosis, such as a psychotic disorder or schizophrenia, to which Smith responded that there was “no evidence to support that conclusion,” as Almestadi had had no symptoms before 2016, and disorders tend to come on more gradually.
Smith then testified that while research is conflicting over the correlation of BPE with psychological disorders, the depressive symptoms Almestadi exhibited most likely did not trigger the episode. According to her, he should continue to be monitored in order to see if symptoms recur. She noted that his demeanor had changed quite a lot from the pleasant person she had assessed to his “stiff” testimony at trial, but that she “assumed he was very anxious.”
After finishing the cross-examination, the Crown stated that it feels “there is evidence to find that Mr. Almestadi is not criminally responsible, [and it] would not dispute but support that finding.”
On Monday, the court will be presented with written submissions from both the prosecution and the defense, who at this time have both expressed interest in finding Almestadi not criminally responsible for his alleged actions.