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Articles   |    
Mental Illness and Domestic Homicide: A Population-Based Descriptive Study
Siân Oram, M.Sc., Ph.D.; Sandra Marie Flynn, M.A., Ph.D.; Jenny Shaw, Ph.D., M.B.Ch.B.; Louis Appleby, M.D., F.R.C.Psych.; Louise Michele Howard, Ph.D., M.R.C.Psych.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201200484
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Dr. Oram and Prof. Howard are affiliated with the Department of Health Service and Population Research at the Institute of Psychiatry, King’s College London, PO31 David Goldberg Centre, De Crespigny Park, London SE5 8AF, United Kingdom (e-mail: sian.oram@kcl.ac.uk). Dr. Flynn, Prof. Shaw, and Prof. Appleby are with the Centre for Mental Health and Risk, University of Manchester, Manchester, United Kingdom.

Copyright © 2013 by the American Psychiatric Association

Abstract

Objective  Approximately 10% of convicted homicide perpetrators in England and Wales have symptoms of mental illness at the time of homicide. The prevalence among perpetrators of adult domestic homicide is unclear.

Methods  The study was a consecutive case series of all convicted adult domestic homicide perpetrators in England and Wales between 1997 and 2008. Sociodemographic, clinical, and offense characteristics were gathered from the United Kingdom Home Office, the Police National Computer, psychiatric court reports, and, for psychiatric patients, questionnaires completed by supervising clinicians.

Results  A total of 1,180 perpetrators were convicted of intimate partner homicide, and 251 were convicted of homicide of an adult family member. Fourteen percent of perpetrators of intimate partner homicide and 23% of perpetrators of adult family homicide had been in contact with mental health services in the year before the offense; 20% of intimate partner homicide perpetrators and 34% of adult family homicide perpetrators had symptoms of mental illness at the time of offense. Perpetrators with symptoms of mental illness at the time of offense were less likely than perpetrators without symptoms to have previous violence convictions or history of alcohol abuse.

Conclusions  A significant minority of adult domestic homicide perpetrators had symptoms of mental illness at the time of the homicide. Most perpetrators, including those with mental illnesses, were not in contact with mental health services in the year before the offense. Risk reduction could be achieved through initiatives that encourage individuals with mental health problems to access mental health services and that develop closer interagency working, including between mental health services, police, social services, and domestic violence services.

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Table 1Sociodemographic and offense characteristics of 1,431 perpetrators convicted of adult family or intimate partner homicide, 1997–2008
Table Footer Note

a Denominator varies because of missing data; table presents valid percentages.

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Table 2Clinical and service use characteristics of 1,431 perpetrators of domestic homicide, 1997–2008
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