Mental Health of the Abuser
Perhaps the most important way to reduce domestic violence-related murder-suicides in our state is to address the needs of domestic violence perpetrators who have a co-occurring mental health issue.
Despite clear connections between suicidal threats or attempts among domestic violence perpetrators and increased risk of murder-suicide, depression and suicidal ideation in domestic violence perpetrators are often overlooked by helping professionals as a serious indicator of danger. It also appears screening for depression and suicidal ideation in abusers is not routine.
Moreover, our reviews of murder-suicide cases have revealed those helping professionals working with suicidal and depressed individuals are not screening for domestic violence indicators. Increasing screening and supportive services for suicidal domestic violence perpetrators could prevent suicides, murder-suicides and domestic violence-related homicides.
CHART: OVERLAPPING INDICATORS OF INCREASED RISK OF SUICIDE AND DOMESTIC VIOLENCE HOMICIDE
A review of indicators of increased risk of suicide and increased risk of domestic violence homicide reveal overlapping factors. All bolded indicators outlined in the chart below appeared in murder-suicide cases reviewed by the Project. Given the duplicative nature of these indicators, it is clear more can be done to integrate suicide prevention work into domestic violence work and vice versa.
CHART: PERPETRATOR’S KNOWN SUICIDE AND DEPRESSION HISTORY
Cases in which prior known suicide threats or attempts existed before the perpetrator went on to attempt to kill another person represent missed opportunities to intervene before escalation to murder-suicide. In the Project’s reviewed murder-suicide cases, 55% of perpetrators threatened or attempted suicide prior to the murder-suicide as compared to 26% of perpetrators in other
In essence, these individuals made clear their intentions to injure themselves and later followed through with these threats, which in turn put their partners at an increased risk. While threats of suicide are a tactic used by abusers to manipulate victims, all threats of suicide should be taken seriously.
Depression is another risk factor for suicide and domestic violence homicide: 48% of murder-suicide perpetrators in reviewed cases showed signs of depression prior to committing murder-suicide, as compared to 28% of cases where there was no suicide following the homicide.
CHART: PERPETRATOR’S MENTAL HEALTH AND MEDICAL CONTACT
In several reviewed murder-suicide cases, perpetrators who were depressed and suicidal were in contact with the medical and mental health community — sometimes just days before the fatal incident. Specifically, 33% of murder-suicide perpetrators were in contact with a mental health provider within five years of the fatal incident, as compared to 18% who made contact in homicide cases. Similarly, 33% of murder-suicide perpetrators were in contact with a private physician, as compared to 11% of perpetrators in reviewed cases where suicide was not a factor.
Further analysis of the Project’s murder-suicide cases reflects that only 15% of those perpetrators were in contact with both a private physician and mental health provider. Over half of murder-suicide perpetrators (68%) were only in contact with either a private physician or a mental health provider, revealing a need to ensure suicidal perpetrators are receiving the correct referrals for additional services.
Mental Health Providers, Medical Providers, Substance Abuse Providers, Family Violence Intervention Programs, Child Support Services, Domestic Violence Programs
- Develop partnerships to link victims and abusers with assistance
they need. In communities where substance abuse and mental health services do not exist or are inaccessible, increase advocacy for more funding to expand services.
- Collaborate to develop screening tools to routinely assess depressed and suicidal men for abusive and dangerous behaviors.
- Work together to develop agency protocols for referrals, treatment and disclosure to family members. Know the resources in your community and be prepared to provide mental health and Family Violence Intervention Program referrals.
- Ensure employees are aware of services afforded to them through Employee Assistance Programs (EAPs).
- Ensure employee health insurance plans include adequate coverage for mental health and substance abuse treatment.
- Reduce the stigma of both domestic violence and mental health issues by posting information about resources, publishing information in employee newsletters or inviting guest speakers for “lunch and learn” sessions.
- Implement personnel policies and leave benefits which show a commitment to employees’ well-being and health, such as flexible schedules and time off that allows employees to address mental health and personal needs.
- Routinely ask callers about abusers’ history of depression or suicidal ideation. Relay noted concerns to responding officers.
- Take additional precautions when responding to domestic violence incidents where either depression or suicidal ideation is known to be present.
- Routinely ask all parties and witnesses about depression and suicidal ideation of abusers to increase officer and victim safety.
- Relay concerns about a suicidal and depressed perpetrator to the victim, along with a referral to a domestic violence program, to improve her safety.
- Provide information on the intersection of suicide and domestic violence to people requesting involuntary commitments.
- When working with victims and their support systems, actively screen for indicators of depression and suicide in abusers. Talk with them about how these factors may affect their safety and conduct safety planning accordingly. Refer to “Intervention Strategies When Working with Victims” on page 61 of the 2014 Annual Report.
- Review and follow the FVIP Suicide Protocol available from the Georgia Commission on Family Violence for instructions on notifying victim liaisons when safety concerns arise. Refer to “Intervention Strategies When Working with Abusers” on page 60 of the 2014 Annual Report.