Psychiatric and Other Contributing Factors in Homicide-Suicide Cases, from Northern Gauteng, South Africa Over a Six-Year Period

Abstract

Homicide committed by a person who subsequently commits suicide within one week of the homicide, is a relatively rare event. The current study used an explanatory sequential design, including psychological autopsies, to identify psychiatric and other contributing factors in 35 homicide-suicide cases in northern Gauteng Province, South Africa. This research highlighted the complex multifactorial nature of these events. Identification of high-risk individuals and delineation of contributing factors is important. Early recognition and effective treatment of psychiatric illness, particularly depression and substance use problems, in people experiencing relationship issues (with pending/recent separations) and financial stressors, is an essential component in the prevention of homicide-suicide incidents. Evaluations should always include direct questioning about suicidal and homicidal ideations. Mental health practitioners have a definite role to play in offering comfort, support and treatment to all those who remain behind after these devastating events. Urgent attention needs to be given to the availability of support and treatment for investigating police officers and surviving family and friends.

Homicide–suicide: practical implications for risk reduction and support services at primary care level

“…Most victims were female and the perpetrator's younger intimate partner (mean age 26.0 years). 15 It has been reported before that full-time employment is not protective against HS. 5 The most frequent findings with regard to the employment status of the perpetrator in the recent study were unemployment and employment in the security sector that requires carrying of a firearm (e.g.…”

“…The HS classifications found in this study were 22 cases of intimate-possessive HS, 7 cases of filicidesuicide, 4 cases of familicide-suicide, 1 case of extrafamilial HS, and 1 case of familial-psychotic HS. 15 A review done in 2007 included 21 studies and 16 of these studies reported that more than 90% of perpetrators are male with a mean age of 40-50 years. In almost all HS between intimate partners the victims were female.…”

“…The overrepresentation of employment in the security sector was also found in both of the previously mentioned South African studies and all three of the local studies found that shooting was the most common method of committing homicide and suicide. 7,8,15 The recent study included three female perpetrators, and in all three cases they killed their children. The one extrafamilial case in this study, where the victim was not a partner or family member, followed the pattern that has been described as adversarial HS and involved a disgruntled individual.…”

“…The one extrafamilial case in this study, where the victim was not a partner or family member, followed the pattern that has been described as adversarial HS and involved a disgruntled individual. 15,18 These perpetrators or later victims may present at a primary care level prior to the event. Primary care physicians should be aware of these characteristics and keep this in mind when consulting with these patients, as it may change the approach to the consultation.…”

“…Another aspect of importance that will be addressed is the availability of support to people affected by HS events. 15…”