Characteristics of perpetrators of homicide in independent inquiries.

An independent inquiry has been mandatory for all homicides committed by persons in contact with mental health services in England and Wales since 1994. The aim of this study is to provide a detailed description of the characteristics of the perpetrators of homicides covered by the independent inquiries between 1994 and 2002. Ninety-seven published inquiry reports were collected for analysis. Descriptive case data regarding the perpetrator was manually abstracted from each report using a structured questionnaire. Ninety-nine individuals committed 109 homicides. Most perpetrators of homicide were male, with a diagnosis of schizophrenia or other psychotic illness. Victims are most likely to be a family member or an acquaintance. Psychotic symptoms as well as alcohol or substance misuse were found to be present at the time of homicide. Comparisons with the National Confidential Inquiry into Suicides and Homicide by People with a Mental Illness suggest that independent inquiries appear to focus on high profile cases. Patient characteristics can be used to inform risk assessments that may improve current prediction of violence in mentally ill persons.