Citation

Swinson N, Shaw J. Psychiatry 2007; 6(11): 452-454.

Copyright

(Copyright © 2007, Medicine Publishing Company Ltd.)

DOI

10.1016/j.mppsy.2007.09.001

PMID

unavailable

Abstract

The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness was established at the University of Manchester in 1996. The main aim is to collect detailed clinical data on all suicides and homicides by people in contact with mental health services. The Inquiry was notified of 2670 homicides in England and Wales from April 1999 to December 2003. Of those convicted of homicide during this period, 9% had been in contact with mental health services during the 12 months prior to the offence. The most common primary diagnosis was schizophrenia, followed by personality disorder. There were high rates of comorbid diagnoses and alcohol and drug misuse. Five percent of all perpetrators of homicide had a diagnosis of schizophrenia; just over half of these had been in contact with mental health services in the year preceding the homicide. Twenty-nine percent received a prison disposal. Of all those in recent contact with services, less than one-third were receiving care under the provisions of enhanced Care Programme Approach (CPA), and there were relatively high rates of non-adherence to medication and disengagement from services. Longitudinal trends show no increase in homicides by those with mental illness, either determined by lifetime diagnosis, contact with services or symptoms of mental illness at the time of the offence. There are, however, significant upward trends in drug and alcohol misuse and significant downward trends in those receiving a verdict of diminished responsibility, but not those receiving a hospital order. © 2007 Elsevier Ltd. All rights reserved.

Language: en

Keywords

human; homicide; suicide; alcoholism; prison; schizophrenia; hospitalization; mental illness; comorbidity; drug abuse; trends; mental health services; review; mental disease; personality disorder; responsibility; priority journal; mental health service; psychiatric diagnosis; confidentiality; patient compliance; risk management; National Confidential Inquiry