Homicides by people with mental illness: myth and reality

BACKGROUND: Tragic and high profile killings by people with mental illness have been used to suggest that the community care model for mental health services has failed. AIMS: To consider whether such homicides have become more frequent as psychiatric services have changed. METHOD: Data were extracted from Home Office-generated criminal statistics for England and Wales between 1957 and 1995 and subjected to trends analysis. RESULTS: There was little fluctuation in numbers of people with a mental illness committing criminal homicide over the 38 years studied, and a 3% annual decline in their contribution to the official statistics. CONCLUSIONS: There are many reasons for improving the resources and quality of care for people with a mental disorder, but there is no evidence that it is anything but stigmatising to claim that their living in the community is a dangerous experiment that should be reversed. There appears to be some case for specially focused improvement of services for people with a personality disorder and/or substance misuse.