Insanity caused Melb neurosurgeon attack

An Iranian refugee who cried "bastard I kill you" during a frenzied stabbing attack on his neurosurgeon has been found not guilty because of his mental impairment.

Michael Wong was stabbed and slashed in the face, neck, chest, hands, arms, torso, stomach and legs as he arrived for work at Melbourne's Western General Hospital in February last year.

Kareem Al-Salami, 49, appeared in the Supreme Court of Victoria on Monday where he pleaded not guilty to five charges, including the attempted murder of Dr Wong in the hospital foyer.

Hospital staff and patients tried to stop his attack, but were also assaulted and threatened with the 19 centimetre knife.

Crown Prosecutor Richard Pirrie said Dr Wong had successfully operated on Al-Salami's spine in 2012.

But Al-Salami "gradually developed delusional beliefs his operation had gone wrong".

He also believed Dr Wong was in a conspiracy against him.

Dr Wong received life-threatening injuries in the stabbing, and only survived because he was treated quickly, Mr Pirrie said.

Numerous psychiatric reports found Al-Salami was, and still is, experiencing mental illness in the form of late onset paranoid schizophrenia.

They also found he was unable to reason, with sense, that his actions were wrong at the time.

Defence barrister Simon Moglia said his client was sorry for the incident and accepted he would receive a custodial sentence and be supervised indefinitely.

"He is sorry," Mr Moglia told the court.

Justice Elizabeth Hollingworth found Al-Salami not guilty on all charges on grounds of mental impairment and remanded him in custody until sentencing on March 17.

She said despite his mental illness he would remain in the Melbourne Assessment Prison because of a lack of available beds at Thomas Embling Hospital.

"It's scandalous that the government is not doing more," she told the court of the shortage of available beds for mentally-ill inmates.

Al-Salami, dressed in grey, showed no emotion during the hearing.