Dr Ciara Staunton: We need to talk about homicidal ideation

By having the difficult conversations about murderous thoughts, we can encourage people to seek help, before they act on them

Andrew, Conor, Carla, Darragh McGinley and Deirdre Morley. Pictures: Andrew McGinley/Conor's Clips

Have you ever thought about killing a loved one? No, thankfully, is the answer for the vast majority of us. 

But what if you did have such thoughts? Like a shooting star, was it a fleeting thought that suddenly appeared in your consciousness, but just as quickly disappeared? 

Or are the thoughts recurring? Have they become intrusive? If the answer is yes to either of these questions, you need to seek help.

Homicidal ideation is the term used for thoughts of harm or murder. 

Suicidal ideation is a strong predictor of death by suicide. 

Knowing this has allowed professionals to intervene appropriately. Practitioners all over the country support people who have suicidal thoughts to deal with and manage those thoughts before they become actions. 

Because thinking about something and carrying it out are two very separate things. 

Training is provided in many organisations, institutions, and services empowering people to ask the question: Are you thinking of suicide?

We have learned that we need to ask that hard question. We can’t afford to let people suffer in quiet desperation and so we have learned that by asking the question, we are reaching out and recognising the pain that the person may be in. 

Role of CBT

Cognitive behavioural therapy does wonders in helping people to disentangle the complex relationship between their thoughts, emotions, and behaviours.

They learn that having the thought in the first place, if left unchallenged, can fester and seep into consciousness until those thoughts start to trick the brain into hatching a plan. 

And that may deepen the feelings of isolation and despair that the person is experiencing, because surely no one else thinks such thoughts, I must be mad!

But they are not mad. Other people do have those thoughts. And the great news is that people can help. The first step is to admit to having those thoughts and then to seek help to challenge them.

So we need to talk about homicidal ideation in the same way. 

We need to not use the rhetoric that mental ill health is the cause of murderous acts. 

People who suffer from mental ill health or distress are far more likely to have thoughts of critical self-loathing, not of murderous intent. But if those kinds of thoughts are present in the first place, and become pervasive, logic sadly dictates that a plan will follow.

Homicidal thoughts span from vague ideas to detailed and fully formed plans about the act itself. 

Many people who have homicidal thoughts do not commit murder, however, it is a real risk factor and so cannot be ignored. They can also be present in certain psychiatric illnesses that have psychotic symptoms. 

Psychotic moral justification

What this means is that in some instances, both homicidal thoughts and mental illness are present within the same person. But in many other cases, the thoughts are present in the absence of any form of mental distress.

The underlying mental processes that can shape a person’s thoughts and logic, the hidden intensity of emotions experienced, and the heightened level of impulsiveness and maladaptive logic can wreak havoc with one’s internal mindset — this can lead to a psychotic moral justification of the murderous acts that unfold.

Clarissa McCarthy was killed by her father Martin. 

Martin McCarthy thought about killing his beautiful daughter, Clarissa. He thought about it, wrote about it in a letter and then he did it. 

Tadhg O’Sullivan and his son Diarmuid thought about killing their son and brother, Mark. They thought about it for a long time, they hatched a plan, wrote about it and then they did it. 

Deirdre Morley thought about killing her children. But they didn't eat the cereal that she had given them that morning. Their instincts kicked in. So Deirdre thought about it some more, the plan changed and the next day she carried it through. For God’s sake, let’s talk about that!

Implying that an everyday squabble over screentime is sufficient to push a mother over the edge to murdering her three children is a step too far.

The woman was clearly in deep psychological pain. She thought about and then planned the killings. The squabble with her son only provided a catalyst.

We need to start having the difficult conversations about murderous thoughts. Like suicidal ideation, once we talk about homicidal ideation openly then we can encourage people to seek help, before they act on their thoughts.

Thinking about something, even something as terrible as murdering your own children, is not a crime. This is the critical point for intervention.

If you are experiencing a mental health crisis please contact your GP, phone Pieta House on 1800 247 247 or Samaritans on 116 123. 

Alternatively, phone the HSE's Mental Health Service line on 1800 111 888 to find out about supports available. 

*This article was amended on 31 May 2021 to reflect concerns raised by the mental health media monitoring body Headline and to include helpline details.