The British Journal of Psychiatry (2008) 193: 130-133. doi: 10.1192/bjp.bp.107.046581
© 2008 The Royal College of Psychiatrists
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Homicide due to mental disorder in England and Wales over 50 years

Matthew Large, FRANZCP

private practice, Sydney, Australia

Glen Smith, MB BS

Northern Sydney Central Coast Area Health Service, Macquarie Hospital, North Ryde, Australia

Nicola Swinson, MB ChB, BSc, MRCPsych and Jenny Shaw, MRCPsych, PhD

National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, University of Manchester, Manchester, UK

Olav Nielssen, FRANZCP

private practice, and Clinical Research Unit for Anxiety Disorders, School of Psychiatry, University of New South Wales at St Vincent’s Hospital, Sydney, Australia

Correspondence: Dr Large, PO Box 110, Double Bay, 1360 NSW Australia. Email: mmbl{at}bigpond.com

Declaration of interest

None.

Background

It has been stated that rates of homicide due to mental disorder are constant over time.

Aims

To examine whether there were changes in the rates of homicide due to mental disorder over time, and whether changes in these rates were associated with changes in the rates of other homicides in England and Wales.

Method

Examination of four sets of official homicide statistics from England and Wales from 1946 to 2004.

Results

The rate of total homicide and the rate of homicide due to mental disorder rose steadily until the mid-1970s. From then there was a reversal in the rate of homicides attributed to mental disorder, which declined to historically low levels, while other homicides continued to rise.

Conclusions

The reasons for the rise and fall in homicides attributed to mental disorder are not clear. The earlier increase in such homicides may have been due to the same sociological factors that caused the increase in other homicides over that time. The subsequent decline may have been due to improvements in psychiatric treatments and service organisation. Another possibility is that there has been an informal change to the legal tests for the finding of homicide due to mental disorder.


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