A child safety staff member has told a coronial inquiry she never anticipated Elizabeth Struhs's father would convert to the religious sect and adopt its extreme views, which ultimately led to her death.
An inquest in the Brisbane Magistrates Court has heard from more than a dozen witnesses in its first week, as it probes whether the responses by various government departments on Elizabeth's case were appropriate.
The eight-year-old died in her Toowoomba home in January 2022 after her father, Jason Struhs, stopped providing her with insulin for her type 1 diabetes.
The Child Safety Department became involved in mid-2019 after Elizabeth was brought to hospital in a comatose state with late-stage diabetic ketoacidosis, before she was diagnosed with the disease.
Her mother had refused to get her medical help due to her extreme religious beliefs, but her father rushed Elizabeth to hospital against the mother's wishes when she became critically unwell.
She was returned into her father's care in their Toowoomba home in the August, with an intervention with parental agreement (IPA) put in place.
Both parents signed the agreement, which required Mr Struhs to continue providing Elizabeth with insulin, and stated that Ms Struhs would not prevent him from doing so.
Father's conversion was a shock
According to a child safety witness, "her mother did not believe in medical treatment and would not take part", while Mr Struhs appeared to be a "keen learner of Elizabeth's diabetes and how to treat it, and was in hospital majority of the time".
The inquest heard Mr Struhs had not initially held the same extreme Christian ideology and anti-medical intervention views as his wife and her church group.
According to the child safety witness, Mr Struhs had managed to treat Elizabeth's condition appropriately for more than two years prior to her death without child safety intervention, and had shown no indication of stopping, or changing his beliefs.
"I was really shocked … I never thought he was going to convert," she said.
"Mr Struhs was managing her diabetes really well, Elizabeth was going to school, going to the nurse's bay to inject insulin … it seemed it was being managed well at that particular time.
"I thought he would continue to care for Elizabeth and her diabetes."
In 2021, Kerrie Struhs was sent to prison for neglect over the 2019 incident that led Elizabeth to end up in a coma, and spent several months in custody.
While she was in jail, Mr Struhs converted to his wife's faith after pressure from his son and other church members.
In the weeks after Ms Struhs left prison, the church convinced him to withdraw giving Elizabeth her treatment.
When questioned whether the IPA should have been in place longer, the child safety worker agreed, but said she didn't feel it would have prevented Elizabeth's death.
She said having more information about the wider church group, and the way religion and culture could intersect with child safety cases more broadly, could have been beneficial.
"I didn't know much about the church group, I was not aware it was a small church group that held the same religious views as Mrs Struhs," she said.
Jason and Kerrie Struhs were found guilty of the manslaughter of their daughter Elizabeth last year. (ABC News: Sharon Gordon)
"I might have learned more about what was happening … I didn't realise what was going on behind the religious scene with that group."
When asked whether such information might have changed child safety's approach, she said "in hindsight, when I reflect on the information, that would have made a difference".
Witness shares condolences
Coroner Ainslie Kirkegaard questioned the witness over whether the department's current tools and decision-making frameworks to evaluate a family's risk had been appropriate in Elizabeth's case.
"It didn't fit because it came back low risk [for Jason Struhs] … even if we made Mrs Struhs the primary parent it would have come back low risk due to the fact we didn't have religious and cultural beliefs as a tick box," she said.
"It's mainly around domestic and family violence, is there drug use, have they been incarcerated, questions that didn't fit."
After giving evidence, the child safety witness shared a message with Elizabeth's loved ones.
Fourteen members of the religious group were found guilty of manslaughter last year. (ABC News: Sharon Gordon)
"I want to give my deepest condolences to Elizabeth's family, I know this must be a really challenging time," she said.
"In hindsight and reflection obviously this matter has taught me to move forward for my future practice.
"Especially when it comes to things I didn't fully understand around religious practices and cultural practices."