In Scotland, as in England, Wales and elsewhere, the report found that homicide is a crime committed primarily by young men against young men. The team found that, in the cases they studied, alcohol and drugs had often been taken and the weapon was usually a knife or other sharp object.
"Drugs and knives are a dangerous mix, so policy response to these deaths should focus on alcohol and drug abuse in young people and on the carrying of knives by young men," said Professor Appleby.
"The rise in homicide rates in recent years is the result of an increase in killings by young people, mainly men under 25 years, but most are not mentally ill. Therefore, a public health approach to homicide would target alcohol and drug use before mental health illness.
"Alcohol and drug misuse runs through these findings and it appears to be a major contributor to risk in mental health care and broader society. The findings suggest that alcohol and drugs lie behind Scotland's high rates of suicide and homicide and the frequency with which they occur as antecedents in our report are striking."
Of the 1,373 patient suicides in the report, there was a history of alcohol misuse in 785 cases, an average of 131 deaths per year; a history of drug misuse was witnessed in 522 cases, or 87 deaths per year.
Of the 58 patient homicides observed, 41 had a history of alcohol abuse and 45 had drug misuse. Among all perpetrators, whether patients or not, drug and alcohol dependence were the most common diagnoses. In both suicide and homicide, most were not under the care of addiction services.
"Our findings support the view that alcohol and drugs are the most pressing mental health problems in Scotland and mental health services can play their part," said Professor Appleby, who
|Contact: Aeron Haworth|
University of Manchester