A mental health system faces renewed calls for a shake-up five years after a major inquiry following a series of high-profile knife attacks.
City of Melbourne Lord Mayor Nick Reece has called for "hard questions" to be asked of Victoria's mental health system following the alleged murder of a delivery rider in a city alleyway.
Feng Jianming, 47, was allegedly stabbed to death on Friday night after he and another rider confronted a man tampering with their bikes in front of a restaurant near the Queen Victoria Market.
Roberto Urbano, 51, appeared agitated and exposed himself while appearing via video link in Melbourne Magistrates Court on Monday after being charged with murder and intentionally causing serious injury.
His lawyer said his client experienced schizophrenia and asked for the custody nurse to assess him.
"Something is not working in our mental health system at the moment, and it's a risk to these people, and it's a risk to the rest of society," Mr Reece said on Monday.
A 10-year overhaul of Victoria's mental health system was mapped out in 2021 following a royal commission that exposed overrun and under-resourced services operating in crisis mode.
Yet a decade on, increased mental health support was still desperately needed in Victoria, Salvation Army Major Brendan Nottle said.
"We're barely scratching the sides of the need and the reality is that we actually need to take that support to the people, rather than sitting back and waiting for them to come to us," he said.
In October, a 51-year-old woman was allegedly stabbed in the neck in a random attack on a Melbourne tram.
A year earlier, a sushi chef was allegedly stabbed in the chest in an unprovoked attack while walking to work on Little Bourke Street.
Both alleged perpetrators were experiencing declining mental health at the time of the incidents, according to court documents.
While the vast majority of people with psychosis are never violent, data compiled by consultant forensic psychiatrist Rajan Darjee highlights a significant increase in the number of psychosis-related homicides in Victoria.
About one in three homicides in 2024 and 2025 were committed by people with psychosis, compared with one in 10 a decade ago.
"It’s not about a return to institutional care or locking people up, it’s about making sure people with schizophrenia and other psychotic illnesses receive the treatment they need and deserve," Dr Darjee told AAP.
Recent SANE research with the National Mental Health Commission and the University of Melbourne found people living with conditions like long-term schizophrenia were more likely to be perceived as dangerous, less reliable and less able to be loved.
"Psychosis is not an explanation for violence," chief executive Rachel Green said.
"We can condemn violence, demand answers and examine failures in our mental health system without stigmatising an entire community in the process."
Urbano will return to court on April 26.
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