Attacks on the British Royal Family: The Role of Psychotic Illness

Dr. James and Dr. Farnham are Consultant Forensic Psychiatrists, Dr. Preston is Clinical Psychologist, and Dr. Darnley is Research Registrar, North London Forensic Service, London, UK. Dr. Mullen is Professor of Forensic Psychiatry, Monash University, and Clinical Director, Victorian Institute of Forensic Mental Health, Fairfield, Victoria, Australia. Dr. Pathé is Consultant Forensic Psychiatrist, Threat Management Centre, Fitzroy, Victoria, Australia. Dr. Meloy is President, Forensis Inc., San Diego, CA. Address correspondence to: Paul E. Mullen, DSc, FRCPsych, Thomas Embling Hospital, Locked Bag 10, Fairfield, Victoria 3078, Australia. E-mail: paul.mullen{at}forensicare.vic.gov.au The role of psychotic disorders in attacks on British Royalty is examined. In the 23 attacks, there was evidence of psychotic illness at the time in 11 (48%) cases, with evidence of mental disorder in 4 additional ones. These data almost certainly underestimate the contribution of major mental disorder, as psychiatric evaluations were not available on several attackers. Psychotic states do not, however, preclude a rational element to the attackers' grievances. The objective of most attackers was to commit an outrageous act to bring attention to grievances. Nine attackers had stalked their victims. Greater attention to psychiatric disorder among those who harass royalty or other public figures would allow early intervention. Ensuring that the obviously mentally ill stalkers of prominent persons are referred to psychiatric services would meet the needs of most of them for treatment and care, while reducing the chances that a tiny minority will progress to attack.