Suicide and murder in child murderers and child sexual abusers

A better understanding of the child protection-forensic psychiatric interface could contribute to prevention of child homicide and suicide. Assailant rates in potential 'risk' groups (1986-95) and the suicide of assailants and male sex abusers (1995-6) were calculated, based upon an epidemiological analysis of police and official records, from within a population of 2.4 million people. There were 27 murderers. Of the murders, 81% were intra-familial. In the group of murderers 55% were 'mentally ill', 27% were 'child neglecters' and 18% were 'violent offenders'. All extra-familial assailants were child sex abusers (CSA). The homicide rate of 'mentally ill mothers' (MIM) was 10 per 100,000 (pht) p.a. of those estimated to be at risk. The 'violent offenders' rate was 44 pht p.a.; 'neglecting' mothers rate, 83 pht p.a.; and violent 'multi-criminal child sex abusers' (MCCSA) rate, 870 pht p.a. Half the 'mentally ill' murderers committed suicide, but none of the violent 'MCCSA' assailants. In the CSA cohort of 374, 3.2% of 'sex offences only'(SOO) abusers killed themselves. The violent MCCSA killed at more than 80+ times the rate of MIM; while the suicide rate of SOO abusers was 200 times the general population rate, highlighting the possibilities for the forensic psychiatric-child protection interface in prevention strategies.