Robertson, Elsie May

Contributing factors

• Domestic violence inflicted by partner
• Alcohol intoxication
• Cannabis intoxication
• Unreasonable delay in police response (80 minutes)
• Failure to call emergency services earlier despite clear signs of serious harm
• Ineffective domestic violence protection orders
• History of intimate partner violence normalised in community context

Coroner's recommendations

1. QPS implement Recommendation 3 of Not Now Not Ever Report - establishing an advocacy and audit oversight body with ATSI representation
2. QPS implement Recommendation 9 - developing place-based, culturally appropriate integrated responses to domestic violence in discrete Indigenous communities including shelters, wraparound services, and expanded Community Justice Groups
3. QPS implement Recommendation 15 - recognising importance of prevention programs and providing committed funding for both prevention and response
4. QPS implement Recommendation 16 - promoting sustained intergenerational community communication about seriousness of domestic violence and available services
5. QPS implement Recommendation 74 - establishing pilots for integrated response models in urban, regional, and discrete Indigenous community settings
6. QPS implement Recommendation 80 - increasing access to domestic violence perpetrator intervention initiatives statewide
7. QPS implement Recommendation 81 - changing eligibility for therapeutic intervention programs for offenders in custody less than 12 months for DFV offences
8. QPS implement Recommendations 96-97-100 - establishing specialist domestic violence courts with appropriately trained magistrates in rural and remote areas
9. QPS implement Recommendation 117 - amend Domestic and Family Violence Protection Act 2012 to require courts to consider excluding perpetrators from home
10. QPS implement Recommendations 118-121 - review sufficiency of penalties for repeat DVO contraventions and creation of further criminal offences with circumstances of aggravation
11. QPS implement Recommendation 123 - trial use of GPS monitoring for high-risk perpetrators
12. QPS implement Recommendations 124-125 - employ court support workers at all Magistrates Courts for DFV matters
13. QPS implement Recommendations 126-128 - implement State-wide duty lawyer service for DFV matters
14. QPS implement Recommendations 131-133 - consider alternative investigation strategies and evidence gathering for DFV matters
15. QPS implement Recommendation 134 - adopt pro-active investigation and protection policy with victim safety as paramount consideration
16. Extend implementation of Recommendation 138 (training on domestic violence) to all QPS officers likely to contact DFV situations, not only sworn officers but also administrative staff
17. QPS implement Recommendation 140 - review Domestic and Family Violence Protection Act 2012 to ensure cohesive legislative framework incorporating all Report recommendations