Preventing homicide in the context of psychosis

Megan J Kalucy and Ross S Kalucy
Med J Aust 2007; 186 (6): . || doi: 10.5694/j.1326-5377.2007.tb00899.x
Published online: 19 March 2007

Careful attention to persecutory delusions of patients and to concerns of family members may help

Any homicide is a tragedy, with devastating consequences for all involved, including perpetrators, their families and the community. People with a psychotic illness make a small, steady contribution to homicide figures. Strangers are rarely victims of such events, with family members and others known to the individual at much higher risk.1,2 Other than the impact of psychotic symptoms themselves, the risk factors for violence by people with psychotic illness are similar to those for the rest of the population, and include being young and male, having a background of crime and/or violence, substance misuse, personality disorder, brain injury, and socioeconomic deprivation.3

  • 1 School of Population Health, University of Western Australia, Perth, WA.
  • 2 Department of Psychiatry, Flinders Medical Centre, Adelaide, SA.


  • 1. Simpson AIF, McKenna B, Moskowitz A, et al. Homicide and mental illness in New Zealand. Br J Psychiatry 2004; 185: 394-398.
  • 2. Shaw J, Hunt IM, Flynn S, et al. Rates of mental disorder in people convicted of homicide. National clinical survey. Br J Psychiatry 2006; 188: 143-147.
  • 3. Wallace C, Mullen PE, Burgess P. Criminal offending in schizophrenia over a 25-year period marked by deinstitutionalisation and increasing prevalence of comorbid substance use disorders. Am J Psychiatry 2004; 161: 716-727.
  • 4. Nielssen OB, Westmore BD, Large MMB, Hayes RA. Homicide during psychotic illness in New South Wales between 1993 and 2002. Med J Aust 2007; 186: 301-304. <MJA full text>
  • 5. Taylor PJ. When symptoms of psychosis drive serious violence. Soc Psychiatry Psychiatr Epidemiol 1998; 33 Suppl 1: S47-S54.
  • 6. Swanson JW, Borum R, Swartz MS, et al. Psychotic symptoms and disorders and the risk of violent behaviour in the community. Crim Behav Ment Health 1996; 6: 309-329.
  • 7. Appelbaum PS, Robbins PC, Monahan J. Violence and delusions: data from the MacArthur violence risk assessment study. Am J Psychiatry 2000; 157: 566-572.
  • 8. Jablensky A, McGrath J, Herrman H, et al. People living with psychotic illness: an Australian study 1997–98. Canberra: Department of Health and Aged Care, 1999. (accessed Mar 2007).
  • 9. Mouzos J. Homicide in Australia: 2003–2004 National Homicide Monitoring Program (NHMP) annual report. Research and public policy series No. 66. Canberra: Australian Institute of Criminology, 2005.
  • 10. Szmukler G. Homicide inquiries: what sense do they make? Psychiatr Bull 2000; 24: 6-10.
  • 11. Appleby L. Safer services: conclusions from the report of the National Confidential Inquiry. Advan Psychiatr Treat 2000; 6: 5-15.
  • 12. Mullen PE. Schizophrenia and violence: from correlations to preventive strategies. Advan Psychiatr Treat 2006; 12: 239-248.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.