The Royal College of Psychiatrists has expressed its deepest
sympathy to the O’Neill and Gormley families following the
publication of the report of the Independent Inquiry Panel into the
deaths of Madeleine and Lauren O’Neill.
The tragedy of a mother taking the life of her child and then
her own, as in this homicide-suicide, is an extremely rare event;
in the report it is described as “at the less likely end of a rare
phenomenon”. While there are lessons to be learned, it is the case
that predicting such rare events is extremely difficult and, no
matter how effective any health system is, sad events sometimes do
occur.
The Royal College of Psychiatrists welcomes the comprehensive
report which has been produced by the Panel. We look forward to
working with a range of other agencies to implement the
recommendations, to continue trying to improve mental health
services, and to better communications with other agencies.
The College particularly welcomes:
- Recommendation 17, which asks the Trusts to put in place a
joint protocol to manage the interface between mental health and
child care services. The report recognises that the health system
is complex and that this can at times lead to communication
problems. The College is of the view that the reduction in the
number of Trusts last year from 19 to 5 will create the opportunity
for more integrated working across the different elements of the
system.
- Recommendation 24, with regard to discharge planning. Along
with other professional groups, users and carers, we have been
active in working with the Department of Health in drawing up
guidance on discharge planning and we look forward to implementing
the guidance, which is to be released in the near future.
- Recommendation 21, in regard to the development of guidance on
consolidated assessments, which we believe will enhance further the
capacity of staff to work across different programmes of care.
In this context, it is important to note the scale of the
pressures upon the mental health service in Northern Ireland. It is
acknowledged that Northern Ireland has 25% greater need than
England and Wales, but has 25% less resource. The report quotes
research showing that one third of individuals with mental illness
have dependent children. At least 5,000 people harm themselves each
year in Northern Ireland. The needs of those with psychiatric
illness are frequently complex and, despite treatment, the outcome
may not be predictable.
Psychiatrists, working along with other health and social care
professionals, users and carers, will study this report carefully
and work to try to develop the best quality service possible within
the available resources.
For further information please contact Liz Main, Public
Affairs and Communications Consultant on 07711 558 296;
lmain@nirelanddiv.rcpsych.ac.uk
Background Information on Filicide
Filicide is the term given to cases in which a parent kills one
or more of their children. Filicide-Suicide describes cases in
which a parent kills one or more of their children and then
themselves. Filicide is uncommon and Filicide-Suicide is a rare
phenomenon, which makes it extremely difficult to predict or
prevent. When a mother kills her child and then takes her own life,
this is termed Maternal Filicide. There is very little research on
filicide published because of the infrequency of these events.
The National Confidential Inquiry into Suicide and Homicide by
People with Mental Illness study into Avoidable Deaths does not
collect data on homicide-suicide cases for Northern Ireland.
However research in England and Wales identified 109 cases of
homicide-suicide between 2000-2004. Of these 7 women killed their
son, and three killed their daughter.
Research suggests that 41% of depressed mothers have thoughts of
harming their young child (Jennings 19991), although it is clear
that very few do so.
A 2002 study of 27 cases of maternal filicide over an 8-year
period found that the majority of the women had a history of
depression. Alcohol misuse was not a major factor in any of the
cases. In 15 of the 27 cases the mother died by suicide after
killing her child(ren). (Bourget and Gagné 2 )
A 2005 study of looked at 30 cases of Filicide-Suicide,
perpetrated by 20 men and 10 women, between 1958 and 2002 in a
county in Cleveland, U.S.A. Most of the mothers (70%) and 30% of
the fathers had previous contact with psychiatric services. Only
one of the 10 mothers had been psychotic. The study put forward the
idea that a large motivating factor on the part of the mother was
“altruism”, a belief that killing the child would in some way
relieve real or imagined suffering. However, this must be
interpreted with caution, as the findings are based on
retrospective assessment of records and interviews with family
members. The study concluded that the traditional risk factors for
violence are usually absent in these cases and that this makes
prediction of this rare event extremely difficult. (Friedman3 )
A 2006 study of 8 cases of Filicide-Suicide committed over a
10-year period in New Zealand found that, as in previous studies, a
past history of depression was common in the majority of the women
and a smaller percentage of the men. (Moskowitz 4)
The National Confidential Inquiry into Suicide and
Homicide by People with Mental Illness was published by the
University of Manchester in December 2006. The Avoidable Deaths
report can be downloaded at
http://www.medicine.manchester.ac.uk/suicideprevention/nci/Inquiry_publications/
For further information, please contact Liz Fox or Deborah
Hart in the Communications Department.
Telephone: 020 7235 2351 Extensions. 6298 or 6127
References:
1: Maternal Filicide in Quebec.
Dominque Bourget, M.D., and Pierre Gagné
Journal Am ACAD Psychiatry Law 30: 345 – 51, 2002.
2: Filicide-Suicide: Common Factors in parents who kill their children and themselves.
Susan Matters Friedman, M.D., et al.
Journal Am ACAD Psychiatry Law 33: 496 – 504, 2005.
3: The Role of Mental Illness in Homicide – Suicide in New Zealand,
1991 –2000. Andrew Moskovitz et al.
The Journal of Forensic Psychiatry and Psychology September, 2006; 17(3): 417 – 430
4: Thoughts of Harming Infants in Depressed and Non-depressed Mothers. Jennings, K.D., Ross, S. Popper, S.
Journal Affect Disorders 54: 21-8, 1999.