Transcript England Homicide (2003

National Confidential Inquiry into Suicide
and Homicide by People with Mental Illness
Homicide data for England (2003-2013)
© 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
Female
17%
1000
9%
500
32%
28%
3%
24%
11%
4%
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.
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1%
1%
65-74
1% 1%
75+
General population homicides: relationship to
perpetrator by gender of perpetrator
2000
43%
1800
1600
Number of homicides
1400
28%
1200
1000
Male
18%
800
600
Female
11%
400
200
26%
34%
32%
8%
0
Family
Spouse
Acquaintance
Relationship
ENGLAND_HOMICIDE (2002-2012)
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Stranger
General population homicides: age of victims
by gender of perpetrator
1400
23%
23%
1200
22%
Number of homicides
1000
800
13%
Male
600
Female
8%
400
4%
3%
4%
200
17%
12%
17%
21%
14%
7%
4%
8%
0
0-14
15-24
25-34
35-44
45-54
Age-groups
55-64
ENGLAND_HOMICIDE (2002-2012)
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65-74
75+
General population homicides: method of homicide
by gender of perpetrator
2,500
40%
Number of homicides
2,000
1,500
Male
20%
1,000
Female
15%
12%
500
8%
5%
49%
26%
9%
11%
3%
3%
0
Sharp
instrument
Blunt
instrument
Hitting and Strangulation
kicking
Method
Firearms
ENGLAND_HOMICIDE (2002-2012)
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Other
methods
Number of homicide convictions in
England & Wales (1973-2012/13)
Convictions
Murder
Manslaughter section 2
Other manslaughter
Infanticide
700
Number of homicides
600
500
400
300
200
100
1967
1968
1969
1970
1971
1972
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
2005/06
2006/07
2007/08
2008/09
2009/10
2010/11
2011/12
2012/13
2013/14
0
Year offence recorded
Source: ONS (2015). Crime Statistic. Focus on Violent Crime and Sexual Offence, 2013/14
ENGLAND_HOMICIDE (2002-2012)
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Number of perpetrators convicted of manslaughter
section 2 (diminished responsibility) by gender
40
37
35
Number of homicides
30
26
24
25
24
21
20
19
18
18
20
19
18
Male
Female
15
10
5
5
1
2
1
1
2005
2006
2
4
3
5
4
2
0
2003
2004
2007
2008
2009
Year of conviction
2010
ENGLAND_HOMICIDE (2002-2012)
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2011
2012
2013
Primary diagnoses of perpetrators committed to
hospital
(Numbers based on Inquiry questionnaire data)
14
Schizophrenia and other
delusional disorders
6
5
Affective disorder
6
3
Anxiety/phobia/panic
disorder/OCD
Alcohol dependence/misuse
21
Drug dependence/misuse
113
Personality disorder
Other
ENGLAND_HOMICIDE (2002-2012)
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Primary diagnoses of perpetrators committed to
hospital
(Numbers based on psychiatric court report data)
Schizophrenia and other
delusional disorders
19
8
13
2
Affective disorder
Anxiety/phobia/panic
disorder/ocd
33
Alcohol dependence
Substance dependence
Personality disorder
198
Other
ENGLAND_HOMICIDE (2002-2012)
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Number of perpetrators receiving a hospital
disposal by gender
40
37
37
35
31
30
29
30
26
Number of homicides
28
27
25
20
17
17
Male
17
Female
15
10
7
5
6
3
6
5
6
5
5
3
2
1
0
2003
2004
2005
2006
2007
2008
2009
Year of conviction
2010
ENGLAND_HOMICIDE (2002-2012)
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2011
2012
2013
Number of homicide perpetrators with a lifetime
history of schizophrenia by gender
45
41
40
Number of homicides
35
38
34
33
30
28
28
28
24
25
21
20
Male
18
17
Female
15
10
5
4
5
5
3
3
4
3
2
4
3
0
0
2003
2004
2005
2006
2007
2008
2009
Year of conviction
2010
ENGLAND_HOMICIDE (2002-2012)
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2011
2012
2013
Number of patient homicides by gender
70
65
64
60
58
58
52
50
45
Number of patients
44
42
40
40
35
33
Male
30
Female
20
12
12
8
10
9
11
10
8
7
6
8
3
0
2003
2004
2005
2006
2007 2008 2009
Year of conviction
2010
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.
2011
2012
2013
Primary diagnosis of patient homicides
(based on Inquiry questionnaire data)
Schizophrenia and other delusional disorders
29%
Affective disorder
13%
Alcohol dependence/misuse
13%
Drug dependence/misuse
19%
Personality disorder
15%
Other
7%
0
20
40
60
80
100 120 140 160 180
Number of patients
ENGLAND_HOMICIDE (2002-2012)
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Secondary diagnosis of patient homicides
(based on Inquiry questionnaire data)
Affective disorder
14%
Alcohol dependence/misuse
25%
Drug dependence/misuse
29%
Personality disorder
18%
Adjustment disorder/reaction
3%
Organic disorder
1%
Learning disability
1%
Pervasive development disorder/autistic
1%
ADHD/conduct disorder
1%
Anxiety/phobia/panic disorder/OCD
6%
Dementia
<1%
Other
1%
0
20
40
60
80
Number of patients
ENGLAND_HOMICIDE (2002-2012)
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100
120
Timing of last contact with mental health services
200
31%
180
160
26%
23%
Number of patients
140
20%
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)
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More than 13 wks
Mental health teams’ estimation of risk of violence at
last contact: patient homicides
250
47%
44%
200
Number of patients
39%
150
33%
Long-term risk
22%
100
50
Immediate risk
8%
6%
1%
0
No risk
Low
Moderate
Risk of violence
ENGLAND_HOMICIDE (2002-2012)
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High
Risk assessment in patient homicides with severe
mental illness and a history of violence
Risk moderate/high
7 cases (9%)
Yes
102 cases (39%)
Risk low/none
73 cases (91%)
Previous violence
Risk moderate/high
8 cases (6%)
No
158 cases (61%)
Risk low/none
117 cases (94%)
Note: Valid percentages used, numbers may not tally due to missing data
ENGLAND_HOMICIDE (2002-2012)
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved.
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Factors which could have made homicide less likely:
patient homicides
Patient taking medication in line with treatment plan
28%
Greater availability of psychiatric beds
4%
Better staff training in risk assessment
16%
Better communication between teams
16%
Use of MHA
4%
Closer supervision of patient
22%
Access to psychological treatment
9%
Access to drug services
8%
Access to alcohol services
9%
Availability of dual diagnosis services
13%
Closer contact with patient's family
20%
Other factors
21%
0
20
40
60
80
100 120
Number of patients
ENGLAND_HOMICIDE (2002-2012)
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140
160