People with mental illness at highly increased risk of being murder victims

The perpetration of homicide by people with mental disorders has received much attention, but their risk of being victims of homicide has rarely been examined. Yet such information may help develop more effective strategies for improving the safety and health of people with mental illness.

So a team of researchers from Sweden and the USA assessed and homicides across the entire population of Swedish adults between 2001 and 2008.

Mental disorders were grouped into the following categories: substance use disorder; schizophrenia; including bipolar disorder and depression; anxiety disorders and . Results were adjusted for several factors such as sex, age, marital status, , employment status and income.

Of 7,253,516 adults in the study, 141 (22%) out of 615 homicidal deaths were among people with mental disorders.

After adjusting for several factors, the results show that people with any mental disorder were at a five-fold increased risk of homicidal death, relative to people without mental disorders.

The risk was highest among those with substance use disorders (approximately nine-fold), but was also increased among those with personality disorders ((3.2-fold), depression (2.6-fold), (2.2-fold), or schizophrenia (1.8-fold) and did not seem to be explained by .

One explanation for the findings may be that those with mental disorders are more likely to live in high deprivation neighbourhoods, which have higher , say the authors. They may also be in closer contact with other mentally ill people and be less aware of their safety risks owing to symptoms of the underlying illness.

They suggest that interventions to reduce these risks "should include collaborations between mental health clinics and the to develop personal safety and conflict management skills among people with mental illness."

Improved housing, financial stability, and substance abuse treatment may also reduce vulnerability to violent crime, they add.

A key implication of these new findings is that clinicians should assess risk for the full array of adverse outcomes that may befall people with mental health problems, say Roger Webb and colleagues at the University of Manchester, in an accompanying editorial. This would include being a victim of violence as well as committing it, abuse and bullying, suicidal behaviour, accidental drug overdoses, and other major adverse events linked with intoxication or impulsivity.

These risks go together, and people with mental illness, as well as their families, should receive advice on avoiding various types of harm, they suggest.

They acknowledge that some important questions remain unanswered, but suggest that national mental health strategies "should reflect the broad nature of safety concerns in mental healthcare, while anti-stigma campaigns among the public should aim to counter fear of mentally ill people with sympathy for the risks they face."

More information: www.bmj.com/cgi/doi/10.1136/bmj.f557
www.bmj.com/cgi/doi/10.1136/bmj.f1336

add to favorites email to friend print save as pdf

Related Stories

Mental disorders and exposure to war in Lebanon

Apr 01, 2008

In the first study in the Arab world to document mental illness and treatment on a national level, researchers from Lebanon have described the prevalence of mental disorders and their relation to exposure to war.

The crime of mental illness

May 31, 2010

Canada needs to change its approach to mentally ill prisoners as correctional facilities worldwide contain a higher percentage of people with mental illness than the general population, states an editorial in CMAJ (Canadian Me ...

Recommended for you

Intervention program helps prevent high-school dropouts

1 hour ago

New research findings from a team of prevention scientists at Arizona State University demonstrates that a family-focused intervention program for middle-school Mexican American children leads to fewer drop-out rates and ...

Bilingualism over the lifespan

2 hours ago

It's a scene that plays out every day in Montreal. On the bus, in schools, in the office and at home, conversations weave seamlessly back and forth between French and English, or one of the many other languages represented ...

User comments