Raising Cain: The Role of Serious Mental Illness in Family Homicides

Most individuals with serious mental illness are not dangerous. However, a small number may become dangerous to themselves or to others, particularly when untreated or abusing alcohol or other substances. Some of these individuals may assault or even kill family members. Raising Cain: The Role of Serious Mental Illness in Family Homicides was undertaken to analyze this rare but overlooked consequence of untreated serious mental illness. It is the first published study to examine the phenomenon and propose recommendations for reducing it.

Top Takeaway
An estimated 29% of family homicides and 7% of all homicides are associated with serious mental illness, typically untreated. In 2013, such fatalities outstripped the number of deaths attributed to meningitis, kidney infection or Hodgkin’s disease.

Fast Facts

• Serious mental illness is associated with an estimated 67% of homicides in which children kill parents and 50% of homicides in which parents kill children.
• While there has been a marked decrease in the overall homicide rate in the United States in recent years, there has been no decrease in these two categories of family homicide, which are the ones most strongly associated with serious mental illness.
• There are indications that elderly people, especially elderly women, are targeted disproportionately in family homicides. Elderly parents and grandparents living with children and grandchildren who have untreated serious mental illness are at increased risk.

Recommendations

• Provide adequate psychiatric treatment, especially for individuals who have risk factors making it more likely they will commit violent acts.
• Use assisted outpatient treatment to compel individuals with a history of violence and other qualifying risk factors to adhere to prescribed treatment plans as a condition for living in the community.
• Reform the Health Insurance Portability and Accountability Act (HIPAA) to assure that caregivers have access to basic medical information about family members with serious mental illness in their care.
• Improve data collection and research to develop the information necessary to understand the factors associated with family homicides and reduce them.