Vision needed to curb filicide

With great respect for Una Butler, I read the articles in the Irish Examiner (November 1) in which she revealed details of the heartbreaking experience of her husband who took the lives of her children and who subsequently ended his own life.

Sadly, this is not an isolated case.

Since 2000 in Ireland, there have been at least 23 cases in which parents took the lives of their child/children, involving in total 32 children. In 15 of the cases, the father or mother subsequently took his or her own life and in five cases the spouse or partner was also murdered.

Due to the relatively small numbers of these cases, also referred to as filicide, in any one country, systematic research in this area is limited.

However, the available international research shows consistency regarding a number of factors that may contribute to an increased risk of the occurrence of these tragic situations: 80% of the parents involved in filicide-suicide had a history of psychiatric disorders, in particular depression, 70% of mothers and 30% of fathers had previous contact with mental health services.

Parents involved in filicide-suicide showed higher rates of prior non-fatal suicidal acts compared to those who took their own lives but not the lives of others, and 30% of fathers had recently experienced a decrease in status of work or job loss. In 90% of filicide-suicide cases involving mothers and in 60% of cases involving fathers, a desire to alleviate real or imagined suffering in children was reported.

These findings clearly underline the need for greater involvement of family members and carers in the care planning of people using the mental health services.

In 2006, Vision for Change, a report of the Expert Group on Mental Health Policy, recommended greater involvement of family members and carers in the care planning of mental health service users. Vision for Change also recommended that the needs of children of people in the care of the mental health services should be addressed without breaching patient confidentiality.

These recommendations are in line with priorities of an action plan adopted by the WHO European Ministerial Conference in Helsinki in 2005. These recommendations should be best practice in the mental health services by now.

Considering that filicide is a relatively rare event, it would be important to conduct independent in-depth investigations of each case in order to improve our knowledge of risk factors and patterns, which will contribute to optimised risk assessment and prevention of similar cases in the future.

Professor Ella Arensman

Director of Research

National Suicide Research Foundation Adjunct Professor

Department of Epidemiology and Public Health

UCC