Transcript Document

National Confidential Inquiry into Suicide
and Homicide by People with Mental Illness
Homicide data for England (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
General population homicides: age and
gender of perpetrators
2500
42%
Number of homicides
2000
28%
1500
Male
17%
1000
Female
9%
500
32%
26%
25%
3%
12%
3%
1%
1%
0%
0%
0
<25
25-34
35-44
45-54
Age-groups
55-64
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
65-74
75+
General population homicides: relationship to
perpetrator by gender of perpetrator
2500
Number of homicides
2000
43%
1500
28%
Male
Female
1000
18%
500
11%
27%
35%
30%
7%
0
Family
Spouse
Acquaintance
Relationship
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
Stranger
General population homicides: age of victims
by gender of perpetrator
1400
23%
23%
22%
1200
Number of homicides
1000
800
13%
Male
600
Female
8%
400
4%
4%
200
17%
12%
17%
21%
14%
7%
3%
4%
8%
0
0-14
15-24
25-34
35-44
45-54
Age-groups
55-64
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
65-74
75+
General population homicides: method of homicide
by gender of perpetrator
2,500
39%
Number of homicides
2,000
1,500
20%
Male
1,000
Female
15%
12%
8%
500
6%
50%
26%
8%
10%
2%
3%
0
Sharp instrument Blunt instrument
Hitting and
Strangulation
kicking
Method
ENGLAND_HOMICIDE (2002-2012)
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Not to be reproduced in whole or part without the permission of the copyright holder.
Firearms
Other methods
Number of homicide convictions in
England & Wales (1973-2012/13)
Convictions
Murder
Manslaughter section 2
Other manslaughter
Infanticide
800
Number of homicides
700
600
500
400
300
200
100
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1997/98
1998/99
1999/00
2000/01
2001/02
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
2008/09
2009/10
2010/11
2011/12
2012/13
0
Year offence recorded
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
Number of perpetrators convicted of manslaughter
section 2 (diminished responsibility) by gender
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
Primary diagnoses of perpetrators committed to
hospital
(based on Inquiry questionnaire data)
14
Schizophrenia and other delusional
disorders
5
4
5
Affective disorder
2
Anxiety/phobia/panic disorder/OCD
Alcohol dependence/misuse
24
Drug dependence/misuse
106
Personality disorder
Other
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
Primary diagnoses of perpetrators committed to
hospital
(based on psychiatric court report data)
20
Schizophrenia and other delusional
disorders
9
3
1
2
Affective disorder
Anxiety/phobia/panic disorder/ocd
35
Alcohol dependence
Substance dependence
Personality disorder
189
Other
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
Number of perpetrators receiving a hospital
disposal by gender
40
37
37
35
31
30
29
30
Number of homicides
27
28
26
25
20
17
Male
17
Female
15
15
10
7
5
3
6
3
5
5
2006
2007
2008
Year of conviction
2009
6
5
5
2011
2012
3
1
0
2002
2003
2004
2005
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
2010
Number of homicide perpetrators with a lifetime
history of schizophrenia by gender
45
40
40
38
Number of homicidess
35
34
33
29
30
29
29
26
25
22
Male
20
Female
17
15
13
10
5
4
4
5
5
3
3
5
3
2
3
0
0
2002
2003
2004
2005
2006
2007
2008
Year of conviction
2009
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
2010
2011
2012
Number of patient homicides by gender
70
65
64
60
58
60
52
Number of patients
50
40
47
42
41
39
36
36
Male
30
Female
20
12
12
12
8
10
9
11
8
5
7
7
2
0
2002
2003
2004
2005
2006 2007 2008
Year of conviction
2009
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
2010
2011
2012
Primary diagnosis of patient homicides
(based on Inquiry questionnaire data)
Schizophrenia and other delusional disorders
30%
Affective disorder
13%
Alcohol dependence/misuse
13%
Drug dependence/misuse
16%
Personality disorder
16%
Other
11%
0
20
40
60
80
100
120
Number of patients
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
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140
160
180
Secondary diagnosis of patient homicides
(based on Inquiry questionnaire data)
Affective disorder
17%
Alcohol dependence/misuse
25%
Drug dependence/misuse
30%
Personality disorder
17%
Adjustment disorder/reaction
4%
Organic disorder
1%
Learning disability
1%
Pervasive development disorder/autistic
1%
ADHD/conduct disorder
1%
Anxiety/phobia/panic disorder/OCD
5%
Dementia
1%
Other
1%
0
20
40
60
80
Number of patients
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
100
120
Timing of last contact with mental health services
200
32%
180
160
25%
Number of patients
140
22%
21%
120
100
80
60
40
20
0
<7 days
1-4 wks
5-13 wks
Time between last contact and homicide
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
More than 13 wks
Mental health teams’ estimation of risk of violence at
last contact: patient homicides
250
48%
200
42%
Number of patients
38%
150
33%
Long-term risk
Immediate risk
22%
100
50
8%
7%
1%
0
No risk
Low
Moderate
Risk of violence
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
High
Risk assessment in patient homicides with severe
mental illness and a history of violence
Risk moderate/high
8 cases (9%)
Yes
102 cases (41%)
Risk low/none
79 cases (91%)
Previous violence
Risk moderate/high
8 cases (7%)
No
149 cases (59%)
Risk low/none
109 cases (93%)
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
Factors which could have made homicide less likely:
patient homicides
Patient taking medication in line with treatment plan
29%
Greater availability of psychiatric beds
4%
Better staff training in risk assessment
17%
Better communication between teams
16%
Use of MHA
5%
Closer supervision of patient
23%
Access to psychological treatment
8%
Access to drug services
9%
Access to alcohol services
9%
Availability of dual diagnosis services
14%
Closer contact with patient's family
21%
Other factors
69%
0
20
40
60
80
100 120
Number of patients
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
Not to be reproduced in whole or part without the permission of the copyright holder.
140
160