Consequences for Clinicians and Mental Health Services of a Homicide by a Current or Recent Patient: A European Union (EU) Wide Survey

Abstract

Contributors

Hans Schanda (Austria), Kris Goethals (Belgium), Peter Marinov (Bulgaria), Neophytos Papaneophytou (Cyprus), Jan Vevera (Czech Republic), Tina Gram Larsen (Denmark), Andres Lehtmets (Estonia), Hanna Putkonen (Finland), Florence Thibaut (France), Norbert Nedopil (Germany), Giogos Alevizopoulos (Greece), Peter Silfin (Hungary), Enda Dooley (Ireland), Francesca Villanti (Italy), Ingrida Cera (Latvia), Hans-Gerd Gumprecht (Luxembourg), Anton Grech (Malta), Ellen van Lier (Netherlands), Knut Rypdal (Norway), Małgorzata Opio (Poland), Máximo Fernández Colón (Portugal), Nicoleta Tataru (Romania), Lubomira Izakova (Slovakia), Peter Pregelj (Slovenia), Esperanza Gomez (Spain), Per Lindqvist (Sweden), Marc Graf (Switzerland), Jenny Shaw, Christine Kennedy, John Crighton (England & Wales, Northern Ireland and Scotland respectively, United Kingdom [UK]).

When a mental health service user kills, concerns arise about that service. Our aim was to examine consequent reviews of services across the European Union (EU), Norway, and Switzerland. A systematic review of published literature and a questionnaire survey with a psychiatrist with forensic expertise from each EU country, Switzerland, and Norway were completed. Collated findings were circulated to respondents for correction and/or further observations. There were no relevant journal publications from the EU outside the UK. Survey responses came from 28 of 30 countries surveyed. An inquiry almost always occurred in four countries and at least sometimes in all but five others. Where an inquiry occurred, it was generally internal rather than by an independent body. The UK has a national inquiry database; Norway, the Netherlands, and Finland collect similar data nationally, but most EU countries do not. Legal (civil or criminal) or disciplinary proceedings were uncommon anywhere, but in France and in Italy a treating psychiatrist has been convicted of manslaughter; service authorities appear more-or-less immune everywhere. Except where inquiry is invariable, victims' relatives generally drive actions. The concept of individual inquiry after homicide is widely recognised and often occurs, but practice varies. The impact of such process still requires evaluation.

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