The claim
“A SUN investigation today reveals disturbing failings in Britain’s mental health system that have allowed high-risk patients to kill 1,200 people in a decade.”
Sun front page, 7 October 2013
The background
Today’s Sun splashed on an exclusive investigation into the number of murders carried out by people being treated for mental illness.
The newspaper was later accused of stigmatising mentally ill people and of inaccuracy in reporting the statistics used to back up the article.
The thrust of the piece is that the mental health system is failing to identify and supervise dangerous patients who go on to kill.
Mental health has proved to be something of a minefield for the tabloid over the years. Almost exactly ten years ago the Sun was heavily criticised by charities for calling the former boxer Frank Bruno “bonkers” and “a nut” after he was taken to a psychiatric hospital.
Is this another blunder, or does the story stand up?
The analysis
The headline reads: “1,200 killed by mental patients”, and the first paragraph of the story repeats the claim that “disturbing failings in Britain’s mental health system… have allowed high-risk patients to kill 1,200 people in a decade”.
The figures are all in here, the annual report into incidents of homicide and suicide by people with mental illness by experts at the University of Manchester.
It doesn’t take long to realise that a scare story on this subject appears ill-timed, if nothing else, because the latest statistics suggest things have been getting better not worse.
In fact the very first sentence of the opening Key Findings section of the report says: “Homicide by mental health patients has fallen substantially since a peak in 2006, and the figures for the most recent confirmed years, 2009-2010, are the lowest since we began data collection in 1997.”
The key table from the report is here, which says that there were 1,216 homicide victims of patients or people suffering from a mental illness at the time the crime was committed.
This is clearly the source of the Sun’s “1,200 victims in a decade” line. Note the oddly pessimistic take on the situation: there were 76 victims in 2010, down from a high of 163 in 2004.
[Update: thanks to reader Chris Squire for spotting that the numbers in the 2010 column don’t add up to 76. The University of Manchester have confirmed that this is a mistake. The total should be 86 victims in 2010 and 1226 over the whole decade. The 2010 figure is still the lowest total on record.]
More importantly, the newspaper is wrong to say that all these people were killed by “mental patients”. In fact, as is made clear in the heading above this table, the 1,216 total includes people who were being treated by mental health services at the time of the crime and those who were not.
The academics who prepared the report are clear on this. Prof Louis Appleby has tweeted that the Sun “misquoted” his work.
His colleague, co-author Dr Kirsten Windfuhr, gave us a statement saying: “What this table actually shows is the number of victims of perpetrators convicted of homicide who were in contact with mental health services (ie patients) OR individuals who were not in contact with mental health services, but were mentally ill at the time of the offence, as determined by a psychiatric assessment prepared for trial.
“It is therefore inaccurate to report that there were 1200 victims of patients with mental illness since these perpetrators were not all patients.”
“We look at two groups of perpetrators: 1) people who were mental health patients at the time of the offence and 2) people who were mentally ill at the time of offence, but were not in contact with mental health services.
“It is the former group that mental health services can focus on preventing – those in contact with their service. This is an important distinction, as to suggest that failings in Britain’s mental health system have allowed high risk patients to kill is inaccurate when not all individuals were in contact with mental health services prior to the homicide.”
In fact, if you look at genuine patients only – that’s people who were in contact with mental health services – the number of killings falls to 738 for the whole of the UK from 2001 to 2010.
That’s around 10 per cent of all UK homicides during that period. The number of perpetrators who had been in contact with mental health services in the 12 months prior to the killing was 615 over the decade.
Again, if you look at the year-on-year figures, things appear to be getting better. The number of homicides by mental patients was 40 in 2010, down from a high of 92 in 2005.
Not surprisingly, when the experts who compiled the research released their findings in July, they did not see it as evidence of widespread failings in the mental health system. It was quite the opposite: the evidence showed that we were making progress.
Prof Appleby said at the time: “It is welcome news that patient homicides are falling and reflects well on the safety measures taken by mental health staff.
“These are early trends and the precise causes are unknown but they may reflect better care for ‘dual diagnosis’ patients – those with both mental illness and alcohol or drug misuse. The introduction of new community treatment orders may also have played a part.”
Prof Appleby also pointed out today that homicides by patients with schizophrenia have now fallen to the lowest level on record.
What also comes across strongly in the report – though not in the Sun’s take on it – is that suicides among people with mental health problems have increased as homicides have fallen.
There were 1,333 suicides by mental health patients in England in 2011, the highest number on record.
The researchers say this could be partly down to a change in the way the causes of death are recorded, but most likely reflects a rise in suicide among the general population, which has been attributed to Britain’s economic problems.
Whatever the reason, it seems that people being treated for mental health problems are becoming less of a danger to others and more of a danger to themselves.
The verdict
As is arguably the case with the Daily Mail’s controversial attack on Ed Miliband’s father Ralph (“the man who hated Britain”), this could be chalked up as another case of newspaper sub-editors going for a high-impact headline that isn’t quite stood up by the article underneath it.
The story is more nuanced than the headline, but the error of attributing all the 1,216 deaths to “high-risk patients” is still repeated in the main body of the text.
The killers were not all patients and the statistics show that the problem is getting better, not worse.
Not that the Sun is relying completely on statistics here. The article also states: “Many believe the figures do not show the true extent of the problem because hundreds of murders linked to mental issues are not properly recorded.”
We’d be interested to see the evidence of that – and equally interested to know how often mental health issues are used as a legal defence by killers on the slenderest of evidence. But now we are leaving the world of checkable facts behind.
By Patrick Worrall
