Homicide followed by suicide: A cross-sectional study

Background: Approximately 30 incidents of homicide followed by suicide occur in England and Wales each year. Previous studies have not examined mental health characteristics in any detail. Aims: This study aims to identify the social, clinical, and criminological characteristics of a national sample of perpetrators, to identify any previous contact with mental health services and to establish risk of suicide after homicide. Method: A national cross-sectional study of perpetrators in England and Wales 1996-2005. Results: 203 incidents were recorded over 9 years. The median age of perpetrators was 41 years (range 18-88 years); most were male. Men more often killed a spouse/partner, whilst women more commonly killed their children. Eighty-four (42%) perpetrators died by suicide on the day of the homicide. The most common method of homicide was sharp instrument (44, 23%). Fifty-nine (29%) used hanging as a method of suicide. Twenty (10%) had previous contact with mental health services, 14 were seen within a year of the offence. The most common diagnoses were personality disorder and affective disorder. The risk of suicide increased the closer the relationship between the perpetrator and the victim. Conclusions: Significantly fewer perpetrators of homicide-suicide compared with homicide or suicide only were in contact with mental health services. Prevention is discussed and suggestions made for the use of psychological autopsy methodology to study rates of mental disorder. © 2009 Taylor & Francis.