An Illawarra man accused of using a guitar to kill another man in Shellharbour Hospital's mental health unit had been a patient at the unit for some time, a court has heard.
Paul Hindmarsh appeared briefly in Port Kembla Local Court on Friday charged with one count of murder following the death of a 47-year-old man at the facility in the early hours of Thursday morning.
His lawyer, Angela Melouney, told the court Hindmarsh had been at the facility as an involuntary patient for some period of time.
She said it was likely that Hindmarsh's mental health issues would play a large role in determining how the court matter proceeded in the future, flagging the possibility that he could be declared mentally unfit to enter a formal plea.
Hindmarsh did not apply for bail and it was formally refused.
Magistrate Michael Stoddart made a recommendation that Hindmarsh be referred to Justice Health while on remand.
The case will return to court on October 1.