Queensland Inquest Examines Failures Before Elizabeth Struhs Death

Queensland authorities are facing scrutiny over missed opportunities to protect Elizabeth Struhs, an eight-year-old girl who died at her family's home near Toowoomba on January 7, 2022, after her father stopped administering insulin for her type 1 diabetes. A coronial inquest is examining how child safety, health and police agencies responded to warnings about her family's religious beliefs and refusal of medical treatment.

Coroner Ainslie Kirkegaard is also considering whether recommendations from Victoria's inquiry into cults and organized fringe groups could help prevent similar cases. Evidence presented during the hearings has highlighted gaps in interagency communication, staff training and the assessment of risks associated with extreme religious beliefs.

Elizabeth developed diabetic ketoacidosis after her insulin was withheld, a condition that can cause severe complications and death. Her parents, Jason Struhs and Kerrie Struhs, and 12 other adult members of the Saints were convicted of manslaughter in 2025, according to the reports. Elizabeth's parents received 14-year prison terms.

During the inquest, Kirkegaard questioned why officials had accepted Kerrie's religious convictions without examining their origins or influence on the children. The coroner said the evidence pointed to a missed opportunity to understand the broader circumstances affecting the family.

One child safety officer acknowledged shortcomings in their understanding of the church's influence. The officer told the inquest, "At that time, I was not understanding well the influence of the church and that's something I've thought about a lot since then."

The officer had approved Elizabeth's return home after her hospitalization in 2019, when she was six, believing Jason would continue managing her diabetes. At that time, Jason had not adopted his wife's religious beliefs. He later joined the Saints and agreed to stop administering insulin before Elizabeth's death.

Earlier medical evidence had raised serious concerns about Elizabeth's safety. A pediatrician testified that the girl was comatose and close to death when she was taken to Brisbane Children's Hospital in July 2019. The doctor said child protection officials had been aware of concerns that returning Elizabeth to her mother's care could expose her to an extreme risk of harm.

The endocrinologist treating Elizabeth had also warned that the condition was life-threatening if Kerrie continued refusing treatment. The inquest heard that the safety plan relied partly on Elizabeth recognizing and reporting when she was unwell, an approach the pediatrician considered unsuitable for a child of her age.

Elizabeth's older sister, Jayde Struhs, had raised concerns about the family's religious environment before the fatal incident. Evidence presented at the inquest indicated that she contacted a school nurse in 2013, expressing concern about the religion's controlling nature and the beliefs expected of family members. Jayde left the family home the following year but remained in contact with Elizabeth.

Witnesses have also described weaknesses in communication between Queensland Police Service and the Department of Child Safety. A senior police officer told the inquest that, in 2019, there was no established protocol requiring the two agencies to share information about criminal charges. An intervention involving parental agreement ended in December 2019.

A memorandum of understanding between police and the department was established that month to facilitate the exchange of documents, including criminal histories and domestic violence summaries. The officer said police had no reason to believe in March 2020 that child safety services were no longer involved with the family.

Another child safety witness described the difficulty of assessing the family's circumstances, while education department evidence highlighted heavy workloads and a lack of formal training for incoming specialist staff. The inquest has examined whether these limitations contributed to decisions that failed to account adequately for the influence of the Saints.

Queensland Police introduced an additional reporting flag in June 2026 to identify people displaying what the service calls an "ideology of concern." The category includes religious, racist and anti-government ideologies and expanded on an existing system used to flag sovereign citizen beliefs.

A senior police officer told Kirkegaard that Victoria's inquiry could provide relevant lessons but cautioned that its recommendations would require assessment under Queensland law. The officer also emphasized the need to distinguish between religious beliefs and conduct that creates a risk to children.

Victoria's inquiry recommended considering a new offense similar to coercive control provisions in domestic violence law, applied to organized groups such as cults. The Queensland inquest is scheduled to continue through October 23, with further examination of how government agencies identified and responded to risks before Elizabeth's death.