Substance Abuse, Not Mental Illness, Often Drives Homicides of Strangers

Article excerpt

It is widely thought in Great Britain that the halving of the number of mental health beds between 1967 and 1997 increased the risk for random violence by mentally ill people now living in the community.

But substance abuse rather than mental illness was the driving force behind many of the murders committed in England and Wales between 1967 and 1997 by people who did not know their victims, according to a report by Jenny Shaw, M.D., and her associates at the University of Manchester (England).

Dr. Shaw and her colleagues compared stranger homicides with those in which perpetrators were known to victims. They then compared criminological, personal, and clinical variables.

Psychiatric reports were prepared on 65% (234) of the 358 people convicted of murdering a stranger. Perpetrators were more likely to have a history of drug misuse, and alcohol and drugs were more likely to have contributed to the offense, Dr. Shaw found.

Compared with people who killed acquaintances, those who murdered a stranger were less likely to have had a lifetime history of mental illness, symptoms of mental illness at the time of the crime, or previous contact with mental health services (BMJ 2004;328:734-7, 2004).

Among those convicted of murdering a stranger, 37 had contact with mental health services. Of these, 10 had received a diagnosis of schizophrenia. Eight of the 10 were in contact with mental health services in the year before the murder and two in the previous week.

The total number of convicted murderers placed under a hospital order--used by the investigators as a proxy for mental illness--did not increase between 1967 and 1997. …