Updated 6.34pm with pathologists' evidence below

A man who stands accused of having strangled his partner suffered acute psychosis and was therefore insane in terms of the Criminal Code, psychiatrist Joseph Cassar told a jury on Tuesday.

The accused, Michael Emmanuel is pleading to have been legally insane when he strangled Maria Lourdes Agius. The Attorney General is contesting his claim. 

The trial, which will determine whether that claim holds water, started on Monday when the victim's mother described how the relationship between her daughter and the accused had deteriorated, and how she found her daughter dead in bed. 

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Dr Cassar had been appointed by the Magistrates’ Court to examine Mr Emmanuel following his first admission to Mount Carmel Hospital in September 2018, less than a fortnight after the murder in Paola.

Dr Cassar had reported to the court that during an interview with the patient, on October 23, 2018, Mr Emmanuel was cognizant and cooperative, if anxious. Speech had been coherent and organized “in the sense that he could continue a conversation.”  

However, on the basis of what the patient told him and after consulting the patient’s psychiatric file, Dr Cassar said he had concluded that Mr Emmanuel had “acute psychosis and was therefore insane according to the Criminal Code.”

Dr Cassar stood by his conclusion when he was questioned by the prosecution on Tuesday.

“So you did not speak to the colleagues of the accused, his friends or Maltese family? Nor did you consult with other psychiatric professionals?” prosecuting lawyer Charles Mercieca asked.

“No,” Dr Cassar replied.

“Acute psychosis, contrary to non-acute, is not chronic but happens at a time, although it can last for up to a month. Mr Emmanuel was already being treated when I saw him.”

Dr Cassar explained how the accused, son of an Ivorian Christian pastor, had said that there was no past psychiatric history in the family.

“This is what he told me. Obviously, I had no records from the Ivory Coast or any other country to verify. I relied on what he told me.”

'Delusions of grandeur'

Dr Cassar said that on the basis of what the patient had recounted during that interview, coupled with his psychiatric file, including a note by another psychiatrist who had commented earlier that Mr Emmanuel had “some delusions of grandeur” and was “paranoidal towards his partner,” he had concluded that the man was acutely psychotic.

A delusion was a “fixed, false belief,” Dr Cassar explained. In this case, Mr Emmanuel, who also claimed that God had spoken to him at a younger age when he still lived in his African village, believed that his partner Maria Lourdes had a bad omen which she asked him to remove.

What he told me convinced me that he was delusional- Psychiatrist after examining the accused

After “removing” the omen, the man had told the psychiatrist how he had placed a crucifix upon her as though to bless her.

“I put the cross on her neck at 4.00am and I felt shock and again the cross shook,” the man had told Dr Cassar.

“What he told me convinced me that he was delusional. What he said, I felt was enough,” Dr Cassar said, also making reference, under questioning, to another earlier instance when Mr Emmanuel had allegedly been drilling and the cement “came out in the form of a star.”

Asked whether marijuana could induce such delusions, given that Mr Emmanuel appeared to have made regular use of the drug, Dr Cassar said that daily doses of marijuana “could lead to paranoidal delusions.”

This point was later seized upon by a juror seemed concerned with the fact that the jury was to assess the accused’s mental state at the time of the crime, when Dr Cassar had examined him over a month later.

Marijuana effects could be picked up through a urine test up to four weeks after consumption, Dr Cassar explained. “That is the only way to determine that fact.”

“Are you trained for people who lie?” Madam Justice Consuelo Scerri Herrera asked the doctor.

“There is no training for that. We pick it from experience. Usually it takes experience and time. The context also makes a major difference,” Dr Cassar replied. “The way he was speaking impressed me. It was very emotional. He made me feel that he was doing something that he was called to do.”

The accused had been discharged from Mount Carmel Hospital on medication on October 17, 2018 and was re-admitted in April this year, while still on anti-psychotics.

“After an hour’s meeting with the accused, based on the notes in his medical file, how sure can you be that he was telling the truth?” asked another juror.

“With experience you feel a patient. I was seeing someone on a very high dose of psychotic drugs. Any other person, like you or me would probably have been asleep under such medication,” Dr Cassar replied. 

Victim was strangled, no sign of struggle

Pathologists Marie Therese Camilleri Podesta’ and Ali Salfraz said the victim, a mother-of-seven,  had died of asphyxia caused by pressure on the neck that was compatible with fresh bruising on her face, neck and scalp. 

The victim had a lot of fresh bruising on the face, neck and even the scalp, with haemorrage in the underlying muscles of the neck, bruising on the pharynx and haemorrages even in the conjunctivi (white part) of the eyes.

“These are not days. These are hours, few hours, minutes,” said Dr Salfraz when asked by defence lawyer Marc Sant about the dating of the bruises.

There were no struggle marks.

A psychology graduate working at the Valletta YMCA shelter, Sarah Sciberras, recalled how on the evening of August 27, 2018, they had received a call from 179 about a man at the Birkirkara police station who needed shelter for the night.

Two policemen had accompanied that man to the shelter. It was Michael Emmanuel, looking very exhausted and somewhat disoriented.

He was about to trip on the spiral staircase while being taken to his room, but denied having drunk when asked, exhaling to prove to Ms Sciberras that there was no trace of alcohol on his breath.

Later, while chatting to the woman in understandable English, he mentioned his two children, shutting his eyes and crying each time he referred to them. He was ‘very, very hurt’ because his partner had kicked him out.

He had only slept at the shelter for one night, waking up early the next morning and mingling with other residents in the yard.

The witness said that upon admission, the man had presented “no drug, no alcohol, no health issues.

The trial continues on Wednesday.

Lawyers Charles Mercieca and Matthew Xuereb are prosecuting.

Lawyers Marc Sant and Dustin Camilleri are defence counsel.