Christopher Raftopoulos, 31, is accused of carrying a bag of knives and going on an unprovoked stabbing spree over three hours in Melbourne's inner suburbs between Saturday and Sunday.
Police allege he may have used multiple different knives to stab five people in four separate attacks across the CBD and St Kilda.
Raftopoulos was due to face Melbourne Magistrates Court on Monday morning, but he did not appear in person or via video link after being charged with more than a dozen assault offences on Sunday.
His lawyer Michael Amad said he had been unable to take any instructions from Raftopoulos, as he was refusing to speak to him.
"Regrettably, Mr Raftopoulos is not prepared to speak to anyone," he told the court.
"I attempted to speak to him about an hour ago and his position is he does not wish to speak to anyone."
Mr Amad submitted a mental health report on Raftopoulos to the court.
He said his client was not currently engaged with any mental health services but had previously been ordered to undergo community treatment.
Raftopoulos has not been assessed by mental health professionals since his arrest, due to his refusal to speak, Mr Amad said.
"Perhaps if the matter could be adjourned for a few days, he may be in a better place in respect to giving instructions," he said.
Magistrate Rose Falla told Mr Amad to organise for mental health specialists to speak to Raftopoulos as he "may or may not be suffering from a psychiatric episode or be psychiatrically unwell", before she decides whether to adjourn the case.
"I want Forensicare to say they spoke to him today ... and what their observations are of him today," she said.
Police said none of the victims knew their alleged attacker.
Detectives are investigating whether the spree began with the stabbing of a 28-year-old Mount Waverley man on City Road in Southbank at 9.20pm on Saturday.
Forty minutes later, a 24-year-old man was stabbed outside a King Street burger store and taken to hospital with a leg injury, police said.
A couple, both aged 31, were stabbed about 11pm, while walking along Dandenong Road in St Kilda East.
The woman is in a serious but stable condition and her partner, a Glen Waverley man, had a serious laceration to his arm.
A 31-year-old English man was attacked on Acland Street in St Kilda at about 12.30am on Sunday, and taken to hospital with leg injuries.
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