Victim relations and factors triggering homicides committed by offenders with schizophrenia

Auteur(s) / Author(s)

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

Résumé / Abstract

In this study, all 48 homicides from 1992-2000 committed by offenders in Sweden diagnosed with schizophrenia
were studied in order to identify possibly triggering factors related to victim relations.
Nine of the 52 victims were strangers to the offender.
In 54% of cases, the homicides were associated with obvious delusions and/or hallucinations.
Among offenders with family victims 72% suffered from obvious delusions and/or hallucinations,
as compared to 43% of offenders with non-family victims.
Of the offenders, 79% were known to psychiatric services,
but at the time of the crime only 33% had any ongoing contact.
Despite 48% having been prescribed antipsychotic drugs,
no more than two individuals were actually taking their medication. The offenders who had killed members of their biological families were seldom intoxicated
and few had earlier convictions for violent crime.

The mental health care services have a major responsibility to prevent homicides and violent crimes being committed by those with schizophrenia.

Revue / Journal Title

Source / Source

E-mail reaction is welcome ,,, click on mica2@tiscali.co.uk

The basic change to be confirmed by Managers - to find out for themselves - is that the senior clinical lead decision maker is always there at the regular Team Meetings.
Any member of the team who has uncertainty, or has fresh information, knows that issues arising from that will be aired, for further action. Two things stand out

1.

There is usually important information in the community network, particulartly family members and friends, and family doctors
around the patient perpetrator, that was not made known to the decision makers; which was not sought by them

The professional decision makers had not made their system able to r to go out, seek, and obtain that information,
nor had they set up and left with the significant community observer, a certain and easy receiving point of contact
for getting information into the team, particularly for family carers,
which worked to allow that information to be obtained.

The team individuals believed that what they were told in a professional interview was the whole truth,
because they felt their interview manner, had built such trust that the patient could always know
what the professional should be told, and would be able to do that.
To obtain that trust confidentiality was assured, and it led to a perceived difficulty in approaching others for thier observation.

The natural point of access to accessory input, was the social worker through the office in the hospital,
but the social worker is now embedded ( and lost ) within the team,
and the old function of the social worker keeping in touch with carer who mattered, has lapsed.
It should be restored.

2.

Very rarely does an Inquiry Panel go into the actual details of how the mental health team involved
worked as a team: their working practice.

Does the top clinical lead - the consultant - especially any locum consultant
- always attend the reception team meeting where new cases
ar presented, reviewed, assigned, and feed back arranged.
Is there a weekly meeting where continuing cases can be aired and repriesed.

Managers should be expected, in their practice, to look for this information.

(a) a record of who attends , who is there throughout, and how often are all the members there at the meetings.
Where is the record kept of who has attended and some record of what, and which, patient concerns was addressed.

(b) how often do the managers seek to talk separately each of the line managers of the team members,
so that there is a natural occasion when anythings at an issue within the team, can be expected to be brought up.

The mental health team system must be prepared to accept information in confidence for use within the team only.
There needs to be a point of contact
which the community can use when it is anxious,
where the informant can be protected fom recrimination.

These questions about actual practices - what is actually going on - are never sought.
They are the responsibility of managers to do somethimg [ take an action ] about them
and manage the changes required, by ongoing supervison which will involve meeting the people concerned

One solution was to have an Outpatient for carers.

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