Graham Dwyer Trial: Elaine O'Hara told doctors she was 'fighting a losing battle' in weeks before she disappeared, court hears
Psychiatrist who treated her described this as a 'dip' and felt condition improving overall
ELAINE O'Hara told doctors in the weeks before she disappeared that she felt like she was "about to burst" and that she was "fighting a losing battle."
However, her psychiatrist told the Central Criminal Court she had been in this frame of mind many times before and while this was a "dip", he felt her condition had been improving overall.
Dr Matt Murphy was being cross-examined by the defence in the trial of Graham Dwyer this afternoon.
Mr Dwyer (42), of Kerrymount Close, Foxrock, is pleading not guilty to the murder of Ms O’Hara (36) at Killakee, Rathfarnham on August 22, 2012.
Ms O’Hara, a childcare assistant from Killiney, was last seen alive near Shanganagh Cemetery in Shankill that day.
Her remains were found by a dog walker in undergrowth in the Dublin mountains on September 13, 2013.
The prosecution maintains Mr Dwyer killed her for his own sexual gratification.
Defence Barrister Ronan Kennedy continued to refer to notes from Ms O'Hara's records from St Edmundsbury Hospital.
The court heard on August 6, there was a note that she stated she had a good weekend but continued to seem angry in manner and slept poorly.
She had been working at the weekend but complained of feeling fleeting suicidal thoughts and said she felt safe in the ward.
The next day, August 7, 2012, it was noted that her mood “wasn’t great” and she said: “I didn’t have a good day.”
Later, she was restless and the note stated she: “wishes she would not wake up in the morning but denies any suicidal plans or intent at present.”
Dr Murphy told Mr Kennedy he believed this was less strong than suicidal ideation and described it as a “passive death wish.”
There were references to things that may have been on her mind such as her exams being deferred.
At this time, Dr Murphy said he was thinking about a lesser dose of medication, which might have suited her better in terms of “less variability in mood.”
This was against the background of her medication having been reduced over a number of years, Dr Murphy said.
Her mood swings were of ongoing concern and it was a case of “trial and error,” he said.
An entry in the notes referred to her taking a rope from her workplace but later discarding it.
Dr Murphy could not recall if this was the first time this was mentioned.
On August 8, 2012, her mood was described in the notes as “flat”. There was a care plan review and Ms O’Hara was asked for her views.
“Mood swings are bad and I feel I am about to burst,” she was noted as saying. “My chest is heavy and mixed up, as is my head. I am frustrated, I am so angry and fed up. I am fighting a losing battle.”
Dr Murphy agreed that this was following a weekend of leave. It was noted that she was “minimally improved.”
“From a long acquaintance with Elaine, the feeling was overall that she was improving,” Dr Murphy said. “Her behaviours were not as extreme as previously in the overall context of things. Even though this was a dip, the general feeling was that things were getting better.”
He added that Ms O’Hara would have been in “that place, in that frame of mind many times before.”
“We took it seriously but it wasn’t terribly new,” he said.
Her risk assessment was put at medium at that time - Dr Murphy explained that there were only three categories and “high” was for someone more immediately liable to harm themselves.
On August 8, she was again expressing suicidal thoughts but denied any intent or plan. She was feeling flat but going on a day’s leave to work.
The next day, August 9, it was noted that she was anxious and agitated and there was a “superficial laceration to her left forearm.”
Dr Murphy did not recall how this happened.
Asked if he considered this an escalation because she had not self harmed for two years, Dr Murphy said he would have had doubts that this was the case.
Another entry stated: “self-inflicted scratch after work to relieve tension.”
On August 13, it was noted she felt OK, her manner was pleasant and she felt safe and comfortable in the hospital.
On August 14, she was “much improved” and another notes said she appeared “irritable but lighter overall.”
In the next care review plan, on August 15, Ms O’Hara was noted as saying: “Things seem to be improving.” She said she was leaving the following week but was not sure she trusted herself. She was “kind of scared.”
She later described her mood as good but she continued to experience some anxiety.
Dr Murphy explained that showed Ms O’Hara “is worried about going home at the weekend but understands it is a step she needs to take.”
Asked if the hospital was “essentially a comfort blanket,” Dr Murphy said: “I suppose so” and explained that while she was getting extra support, the downside was that “she can’t live in the hospital forever.”
The trial continues before Mr Justice Tony Hunt and a jury of seven men and five women.