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Rates of mental disorder in people convicted of homicide: National clinical survey

  • Jenny Shaw (a1), Isabelle M. Hunt (a1), Sandra Flynn (a1), Janet Meehan (a1), Jo Robinson (a1), Harriet Bickley (a1), Rebecca Parsons (a1), Kerry McCann (a1), James Burns (a1), Tim Amos (a1), Navneet Kapur (a1) and Louis Appleby (a1)...
Abstract
Background

Previous studies of people convicted of homicide have used different definitions of mental disorder.

Aims

To estimate the rate of mental disorder in people convicted of homicide; to examine the relationship between definitions, verdict and outcome in court.

Method

A national clinical survey of people convicted of homicide (n=1594) in England and Wales (1996–1999). Rates of mental disorder were estimated based on: lifetime diagnosis, mental illness at the time of the offence, contact with psychiatric services, diminished responsibility verdict and hospital disposal.

Results

Of the 1594, 545 (34%) had a mental disorder: most had not attended psychiatric services; 85 (5%) had schizophrenia (lifetime); 164 (10%) had symptoms of mental illness at the time of the offence; 149 (9%) received a diminished responsibility verdict and 111 (7%) a hospital disposal – both were associated with severe mental illness and symptoms of psychosis.

Conclusions

The findings suggest an association between schizophrenia and conviction for homicide. Most perpetrators with a history of mental disorder were not acutely ill or under mental healthcare at the time of the offence. Some perpetrators receive prison sentences despite having severe mental illness.

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Copyright
Corresponding author
Professor Louis Appleby, Centre for Suicide Prevention, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK. E-mail: Louis.appleby@manchester.ac.uk
Footnotes
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See pp. 129–134 and 135–142, this issue.

Declaration of Interest

L.A. is the National Director of Mental Health for England. Funding detailed in Acknowledgements.

Footnotes
References
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Rates of mental disorder in people convicted of homicide: National clinical survey

  • Jenny Shaw (a1), Isabelle M. Hunt (a1), Sandra Flynn (a1), Janet Meehan (a1), Jo Robinson (a1), Harriet Bickley (a1), Rebecca Parsons (a1), Kerry McCann (a1), James Burns (a1), Tim Amos (a1), Navneet Kapur (a1) and Louis Appleby (a1)...
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eLetters

Easy to catch? Over representation of schizophrenia in people convicted of homicide

Mohammad S Rahman, Senior House Officer in Psychiatry
01 March 2006

Shaw el al (2006) found that 5% of people who were convicted of homicide had a life time diagnosis of schizophrenia. This is about 10 times more than the population prevalence of this illness (Golder et al, 2002). The authors conclude that there is an association between schizophrenia and homicide convictions.

In 1999 the conviction rate of homicide in the UK was around 65% (US Department of Justice, 2004). That means some 35% of people escape conviction. Given the extensive cognitive impairment associated with long and enduring mental illness, we wonder if people with schizophrenia had been easy to catch and convict. In our experience, they give little afore thought to their acts and rarely attempt extensive cover up. In other words, their offences are easy to detect while the more cognitively able perpetrators might have been able to evade detection and hence conviction.This may have introduced a bias into Shaw et al’s study. We therefore suggest exercising caution in interpreting these results as evidence for increased rates of serious violence in schizophrenic patients.

References:

Goldner E M el al (2002) Prevalence and Incidence Studies of Schizophrenic Disorders: A Systematic Review of the Literature Canadian Journal of Psychiatry; 47:833-843

Shaw J el al (2006) Rates of mental disorder in people convicted of homicide: National clinical survey British Journal of Psychiatry 188: 143-147. doi: 10.1192/bjp.188.2.143

U.S. Department of Justice (2004) Cross-National Studies in Crime andJustice. http://www.ojp.usdoj.gov/bjs/pub/pdf/cnscj.pdf (accessed 8th February, 2006)
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Conflict of interest: None Declared

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