Schizophrenia, homicide and long-term follow-up

The increase in the number of homicides committed by people with schizophrenia, revealed in the 2009 Annual Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, is a cause for concern. 1 The report suggests that the increase is accounted for by individuals not classified as ‘patients’, i.e. those who have not been in contact with services in the past 12 months. Assessing patients for mental health review tribunals, I have noted that many teams often simply discharge patients when they do not cooperate with follow-up. There may be a lesson that long-term follow-up of patients with schizophrenia is justified, even if the patient appears well. 1 National Confidential Inquiry into Suicide and Homicide by People with Mental Illness.