See related article by Laursen et al
Child Murder and Mental Illness in Parents: Implications for Psychiatrists
Susan Hatters Friedman, MD, and Phillip J. Resnick, MD
Filicide is the killing of a child by the parent. Studies have used different sample types and definitions of filicide, and many past studies have been fraught with methodological problems. National registries are exceptionally rich sources of data for studies of such rare phenomena due to a large sample size and potentially comprehensive information. However, national databases often provide limited data about the perpetrator. Rich psychiatric data are seldom included.
Laursen and colleagues1 compared homicide victimization rates of children whose parents were previously psychiatrically hospitalized with rates in the general population. They also compared risk across psychiatric diagnoses. To do this, they used 34 years of national registry data from Denmark. They were able to access police records for 6 years in order to quantify how frequently the perpetrator was a parent.
Of all 187 child homicide victims (not necessarily killed by their parent), 60 had a parent with a prior psychiatric admission. During the 6 years in which the authors could identify the perpetrator, 29 of 33 children (88%) were killed by a parent, 7 of whom had prior psychiatric hospitalizations. They found that in Denmark a child’s risk of becoming a homicide victim was significantly higher if the parent had been previously admitted to a psychiatric hospital. However, the absolute risk of homicide victimization only went from 0.009% to 0.051%.
Both the child’s age and parental mental health history were related to filicide risk. The relative risk was higher when the mother had previously been hospitalized rather than the father. Children whose mothers were diagnosed with schizophrenic or mood disorders were at higher risk than those whose mothers had other psychiatric diagnoses. Children under age 5 had the highest relative risk associated with maternal mental disorders. Younger children may be more likely to be at home during the day with the mentally ill mother, rather than at school as older children would be.
Caution must be used in making cross-national comparisons. Rates across nations differ substantially, possibly due to cultural and societal differences. The national registry data in this study were limited to severe mental disorders involving psychiatric hospitalization. Many parents with mental illness are managed on an outpatient basis. Also, psychiatric admission criteria vary across nations. The psychiatric admission diagnoses in the current study1 included drug abuse, which may be a less common reason for psychiatric hospitalization elsewhere.
Parents kill their children for 5 major reasons: fatal maltreatment, altruistic, acutely psychotic, unwanted child, and spouse revenge.2 Fatal maltreatment deaths occur as the end result of child abuse, neglect, or factitious disorder by proxy. This is the most common type of filicide. In altruistic cases, parents kill out of love, believing that death is in their child’s best interest (which can occur in psychosis or depression or terminal child illness). Parents who are acutely psychotic kill their child for no rational reason, such as in response to command hallucinations. Unwanted children may be killed because they are seen as a hindrance to the parent’s own goals. In spouse revenge filicide, one parent kills the child in order to severely emotionally wound the other parent.
The United States has the distinction of leading the world in infant homicide rates. In the few years since our analysis of maternal filicide studies,3 several investigators have utilized national-level data to examine a variety of dimensions of filicide. A recent study4 in England and Wales (N = 112) described a case series of persons convicted of infant homicide from 1996 to 2001. Data were collected from psychiatric court reports and mental health treatment teams. Over four-fifths (81%) of the infants were killed by their parents (fathers killed 50% and mothers 31%). One-quarter of the perpetrators evidenced symptoms of mental illness at the time, and one-third had a lifetime history of mental illness. Of the women who killed, 29% had a mood disorder, while more than half of the men had an alcohol or substance use disorder. The need for increased parenting support and perinatal psychiatric assessments was suggested.
Recently, parents who killed in Finland over a 25-year period (N = 200) were compared by reviewing medical, psychiatric, legal, and autopsy records from Statistics Finland.5 Finland’s rate of filicide was approximately 5 times higher than that of their Swedish neighbors. The mean age of victims killed by their mother was younger than that of those killed by their father. Fathers committed the act of filicide-suicide more frequently than mothers; this gender disparity was reversed for filicide alone. In forensic interviews, mothers reported high levels of stress and low levels of support.
Putkonen and colleagues6 also recently completed a register-based study of filicides (N = 124) in Austria and Finland from 1995 to 2005. They found that the bulk of the perpetrators were mothers. In 32% to 54% of cases, a suicide attempt or suicide occurred in conjunction with the filicide. Mood disorders (both psychotic and nonpsychotic) were frequently diagnosed, as were personality disorders and substance use disorders.
While many parents experience thoughts of child harm, filicide itself remains a rare occurrence. A prospective Indian study7 (N = 50) found that among severely mentally ill women admitted to a psychiatric hospital, 43% had infanticidal thoughts, 36% reported infanticidal behavior, and 34% reported both. Infanticidal behavior was associated with psychotic ideas about the infant, adverse maternal reaction to separating from the infant, and female infant sex (possibly for sociocultural reasons). Mothers with postpartum depression also commonly experience thoughts of harming their children. One study8 (N = 100) indicated that 41% of depressed mothers admitted to having such thoughts. Obsessive-compulsive distressing thoughts may occur comorbidly in mothers with postpartum depression and are ego-dystonic.9 This does not necessarily imply elevated risk. (This must be differentiated from a mother with ego-syntonic psychotic thoughts.) Again, while many mothers may have these thoughts, most do not act on them. Clinicians should be aware of such thoughts and not be afraid to inquire specifically.10
Although more research has been completed regarding mothers compared to fathers who kill their children, they have similar rates of filicide perpetration. A recent literature review11 found that fathers more often attempt or complete suicide after filicide. They often have multiple victims and may kill their spouse as well. Fathers, like mothers, may kill as part of chronic abuse or neglect, related to mental illness such as psychosis or depression, or as revenge against a former partner.
Further studies are needed in order to develop effective prevention strategies and programs. For example, while it may be shown that children are at greater risk of victimization when their parents have been psychiatrically hospitalized, the vast majority of parents who are mentally ill do not kill their children. What is it about certain parents and their interactions with their children that elevate the risk? The age of the child and the coping strategies and services engaged by the mother are important. Similar concerns are raised in the child welfare arena; of mothers and fathers who are reported for abuse, many "work their case plans" and are reunited without further harm. However, a subpopulation, with very similar risk factors, are reunited and go on to perpetrate serious violence or murder. There appears to be no "magic" factor in need of discovery. However, more research to further delineate which parents should cause psychiatrists and child protection the greatest concern would be valuable.
The current study by Laursen and colleagues, using national data, did not identify putative motives. Effective prevention strategies will differ according to motive. Although some parents kill in the throes of acute psychosis, many more kill due to chronic abuse and neglect. Research on parenting capacity is needed, along with systems research on how to make effective partnerships between mental health and child protective services.
When parents kill, a combination of risk factors appears to be more critical than any single factor. In addition to psychiatric history, risk factors may include violence history, victim characteristics, situational factors, social milieu, and demographics.3 Furthermore, there are many risk factors for violence and homicide other than mental illness. For example, in the United States, infants at elevated risk for homicide have young, poor mothers who sought prenatal care late.3
Laursen and colleagues found that those at highest risk of homicide victimization in Denmark were young children whose mothers were hospitalized because of schizophrenia or mood disorders. A parent’s history of prior psychiatric admission is a long-term static risk factor—one that cannot be altered. Dynamic risk factors, which can be modified to decrease risk, may include acute symptoms of mental illness, poor coping skills, the feeling of being overwhelmed, and poor parenting skills. In conclusion, we wish to emphasize that the vast majority of parents with mental illness do not kill their children.
Author affiliations: Department of Pediatrics (Dr Hatters Friedman) and Department of Psychiatry (both authors), Case Western Reserve University School of Medicine, Cleveland, Ohio.
Potential conflicts of interest: None reported.
Funding/support: None reported.
1. Laursen TM, Munk-Olsen T, Mortensen PB, et al. Filicide in offspring of parents with severe psychiatric disorders: a population-based cohort study of child homicide. J Clin Psychiatry. 2011;72(5):698-703.
2. Resnick PJ. Child murder by parents: a psychiatric review of filicide. Am J Psychiatry. 1969;126(3):325-334. PubMed
3. Friedman SH, Horwitz SM, Resnick PJ. Child murder by mothers: a critical analysis of the current state of knowledge and a research agenda. Am J Psychiatry. 2005;162(9):1578-1587. PubMed doi:10.1176/appi.ajp.162.9.1578
4. Flynn SM, Shaw JJ, Abel KM. Homicide of infants: a cross-sectional study. J Clin Psychiatry. 2007;68(10):1501-1509. PubMed doi:10.4088/JCP.v68n1005
5. Kauppi A, Kumpulainen K, Karkola K, et al. Maternal and paternal filicides: a retrospective review of filicides in Finland. J Am Acad Psychiatry Law. 2010;38(2):229-238. PubMed
6. Putkonen H, Amon S, Almiron MP, et al. Filicide in Austria and Finland—a register-based study on all filicide cases in Austria and Finland 1995-2005. BMC Psychiatry. 2009;9(1):74. PubMed doi:10.1186/1471-244X-9-74
7. Chandra PS, Venkatasubramanian G, Thomas T. Infanticidal ideas and infanticidal behavior in Indian women with severe postpartum psychiatric disorders. J Nerv Ment Dis. 2002;190(7):457-461. PubMed doi:10.1097/00005053-200207000-00006
8. Jennings KD, Ross S, Popper S, et al. Thoughts of harming infants in depressed and nondepressed mothers. J Affect Disord. 1999;54(1-2):21-28. PubMed doi:10.1016/S0165-0327(98)00185-2
9. Spinelli MG. Postpartum psychosis: detection of risk and management. Am J Psychiatry. 2009;166(4):405-408. PubMed doi:10.1176/appi.ajp.2008.08121899
10. Friedman SH, Sorrentino RM, Stankowski JE, et al. Psychiatrists’ knowledge about maternal filicidal thoughts. Compr Psychiatry. 2008;49(1):106-110. PubMed doi:10.1016/j.comppsych.2007.07.001
11. West SG, Friedman SH, Resnick PJ. Fathers who kill their children: an analysis of the literature. J Forensic Sci. 2009;54(2):463-468. PubMed doi:10.1111/j.1556-4029.2008.00964.x
Submitted: September 7, 2010; accepted September 7, 2010
J Clin Psychiatry 2011;72(5):587-588 (doi:10.4088/JCP.10com06563).
Corresponding author: Susan Hatters Friedman, MD, Case Western Reserve University School of Medicine, Departments of Psychiatry and Pediatrics, Cleveland, OH 44106 (firstname.lastname@example.org).
© Copyright 2011 Physicians Postgraduate Press, Inc.
What impact does a parent's mental illness have on children? ›
If parents experience mental health problems in pregnancy or the first year of a baby's life, this can affect the way they are able to bond with and care for their child. This can have an impact on the child's intellectual, emotional, social and psychological development (Gajos and Beaver, 2017; Hogg, 2013).What strategies have helped people cope with mental illness? ›
- Radical Acceptance. ...
- Deep Breathing. ...
- Opposite-to-Emotion Thinking. ...
- The 5 Senses. ...
- Mental Reframing. ...
- Emotion Awareness.
Looking after a family member with a mental illness can be an extremely stressful time and coping with stress may rouse various reactions such as somatic problems (migraines, loss of appetite, fatigue, and insomnia), cognitive and emotional problems (anxiety, depression, guilt, fear, anger, confusion) and behavioural ...Can you get mental illness from parents? ›
Mental Illness in Families. Mental illnesses in parents represent a risk for children in the family. These children have a higher risk for developing mental illnesses than other children. When both parents are mentally ill, the chance is even greater that the child might become mentally ill.Are parents responsible for their children's mental health? ›
A child's mental health is supported by their parents
A child's healthy development depends on their parents—and other caregivers who act in the role of parents—who serve as their first sources of support in becoming independent and leading healthy and successful lives.
Boundaries are important, but setting them can be difficult when your parent/guardian is mentally ill. They might overshare or depend on you more than they should. Start small. If your parent is oversharing, then suggest they talk to someone else who could provide more help or information.What is the most serious mental illness? ›
By all accounts, serious mental illnesses include “schizophrenia-spectrum disorders,” “severe bipolar disorder,” and “severe major depression” as specifically and narrowly defined in DSM. People with those disorders comprise the bulk of those with serious mental illness.What is classed as a severe mental illness? ›
Purpose. The phrase severe mental illness ( SMI ) refers to people with psychological problems that are often so debilitating that their ability to engage in functional and occupational activities is severely impaired. Schizophrenia and bipolar disorder are often referred to as an SMI [footnote 1].How do you survive living with a mentally ill person? ›
Try to eat healthy meals, get some exercise, and get enough sleep. Making time to do things you enjoy will help you keep your stress levels in check. You'll be better able to support your loved one if you take steps to maintain your own physical and mental health.What are 3 effects that mental illness has on a person's life? ›
Significant tiredness, low energy or problems sleeping. Detachment from reality (delusions), paranoia or hallucinations. Inability to cope with daily problems or stress. Trouble understanding and relating to situations and to people.
How do you deal with a mentally unstable family member? ›
Get Help for Your Friend or Family Member
You can call a crisis line or the National Suicide Prevention Line at 1-800-273-TALK (8255). If you think your friend or family member is in need of community mental health services you can find help in your area.
Families are frequently excluded from treatment and care plans. Reasons for this include the belief that the individual has the right to a confidential relationship with his doctor. Mental health professionals are trained to maintain confidentiality.What it's like growing up with a mentally ill parent? ›
"Growing up with a parent who is mentally ill 'can lead to a child feeling uncertain, anxious, and neglected," says Talkspace therapist Kimberly Leitch, a licensed clinical social worker. "Life can be unstable and unpredictable, and children may not learn proper coping skills." I didn't. It is a challenge I still face.Is mental illness inherited or learned? ›
Certain mental disorders tend to run in families, and having a close relative with a mental disorder could mean you are at a higher risk. If a family member has a mental disorder, it does not necessarily mean you will develop one. Many other factors also play a role.Is schizophrenia inherited from mother or father? ›
Schizophrenia Is Tough to Nail Down Genetically
One of the hardest parts about determining whether schizophrenia is inherited from your mother or father is that scientists are having trouble distinguishing the genes where the disease originates.
Don't be afraid to seek professional help, whether that be going to a therapist in your area or using a service like BetterHelp. Please get the help you need and take care of yourself. People love you, care for you and want to see you making progress.Do single parent families affect children's mental and emotional health? ›
Potential Emotional and Behavioral Impact on Children
Kids from single-parent families are more likely to face emotional and behavioral health challenges — like aggression or engaging in high-risk behaviors — when compared to peers raised by married parents.
According to VOI, self-centered parents can create children who have low self-esteem, and no confidence in themselves. This can lead to mental health struggles, like anxiety, depression, and even runaway behavior. Basically, it changes how a child grows up.How do you prove a parent is mentally unstable? ›
- A history of child abuse. ...
- A history of substance abuse. ...
- A history of domestic violence. ...
- The parent's ability to make age-appropriate decisions for a child. ...
- The parent's ability to communicate with a child. ...
- Psychiatric concerns. ...
- The parent's living conditions.
People with toxic parents tend to have low self-esteem, trust issues, and other problems that affect their quality of life. Therapy can help you learn how to deal with toxic parents.
What mental illness is hardest to treat? ›
But antisocial personality disorder is one of the most difficult types of personality disorders to treat. A person with antisocial personality disorder may also be reluctant to seek treatment and may only start therapy when ordered to do so by a court.What is the number 1 mental illness? ›
Depression. Impacting an estimated 300 million people, depression is the most-common mental disorder and generally affects women more often than men.What is the life expectancy of someone with mental illness? ›
According to the World Health Organization, people with severe mental health disorders have a 10–25-year reduction in life expectancy. Schizophrenia mortality rates are between 2 and 2.5 times those in the general population, while individuals with depression have a 1.8 times higher risk of premature mortality.What is classed as a severe mental illness UK? ›
It stipulated that “severe mental illness” is defined through diagnosis, disability, and duration, and includes disorders with psychotic symptoms such as schizophrenia, schizoaffective disorder, manic depressive disorder, autism, as well as severe forms of other disorders such as major depression, panic disorder, and ...What is classified as severe mental illness UK? ›
schizophrenic and delusional disorders mood (affective) disorders, including depressive, manic and bipolar forms neuroses, including phobic, panic and obsessive–compulsive disorders behavioural disorders, including eating, sleep and stress disorders personality disorders of eight different kinds.Does mental illness get worse with age? ›
Do mental health issues get worse with age? Mental illness isn't a natural part of aging. In fact, mental health disorders affect younger adults more often than the elderly, according to the National Institute of Mental Health. However, seniors are less likely to seek help.Can a mentally ill person be loved? ›
Mental illnesses are illnesses, and sometimes they can changes someone's circumstances…they can even change their personalities for a time, change their interests, their spirit. But they are the same person you have always loved, and they need you to see that person in them—even when they can't see themselves clearly.How do you deal with violent schizophrenia? ›
- Remember that you cannot reason with acute psychosis.
- The person may be terrified by their own feelings of loss of control.
- Don't express irritation or anger.
- Speak quietly and calmly, do not shout or threaten the person.
- Don't use sarcasm as a weapon.
Without treatment, the consequences of mental illness for the individual and society are staggering. Untreated mental health conditions can result in unnecessary disability, unemployment, substance abuse, homelessness, inappropriate incarceration, and suicide, and poor quality of life.What might worsen a person's mental health? ›
childhood abuse, trauma, or neglect. social isolation or loneliness. experiencing discrimination and stigma, including racism. social disadvantage, poverty or debt.
What are the 7 main mental disorders? ›
- Anxiety Disorders.
- Mood Disorders.
- Psychotic Disorders.
- Eating Disorders.
- Personality Disorders.
- Don't panic or overreact. ...
- Do listen non-judgmentally. ...
- Don't make medication, treatment, or diagnosis the focus. ...
- Do speak slowly and simply. ...
- Don't threaten. ...
- Do stay positive and encourage help. ...
- Don't hesitate to contact a mental health professional.
- Physical illness or injury. You may see or hear things if you have a high fever, head injury, or lead or mercury poisoning. ...
- Abuse or trauma. ...
- Recreational drugs. ...
- Alcohol and smoking. ...
- Prescribed medication.
For the majority of these untreated or under-treated individuals, the main barriers to mental health treatment and access are: Financial barriers to mental health treatment. Lack of mental health care professionals and services. Limited availability of mental health education and awareness.What are some of the challenges faced by families in need of mental health care today? ›
- Lack of transportation.
- Social stigma.
- Insufficient information.
- Inadequate bandwidth and internet.
An increasing body of research demonstrates that negative family relationships can cause stress, impact mental health and even cause physical symptoms. Research has demonstrated that non-supportive families can detract from someone's mental health and or cause a mental illness to worsen.How do you deal with a violent mentally ill person? ›
If a person living with a mental illness becomes aggressive or violent, some suggestions include: Try to remain calm, and speak in a calm, clear and slow voice. Give the person some physical space. Avoid a confrontation – sometimes leaving the house to wait for everyone to calm down is more productive.Can having a mentally ill parent cause trauma? ›
Most adults benefit greatly from having a trusted therapist who can help them process their childhood, and understand clearly how it has affected them. Since growing up with a mentally ill parent can be traumatic, it is often recommended that you find a therapist who specializes is overcoming trauma.What is an emotionally unstable parent? ›
They're dismissive or overwhelmed when the child has an emotional need. They're not interested in the child's life (interests, friend groups, school work). They have difficulty expressing their feelings, even with adults. They're unable or unwilling to provide comfort during emotional distress.Which mental illness is the most inherited? ›
One of the most highly genetically inherited psychiatric disorders is bipolar disorder which may affect as much as 1-4% of the population. Bipolar disorder is characterized by periods of depression followed by periods of abnormally elevated mood (mania/hypomania).
What are the 5 major psychiatric disorders? ›
Five major mental illnesses — autism, attention deficit-hyperactivity disorder, bipolar disorder, major depressive disorder and schizophrenia — appear to share some common genetic risk factors, according to an examination of genetic data from more than 60,000 people worldwide (The Lancet, online Feb. 28).Does psychosis run in families? ›
The majority of researchers now agree that most cases of psychosis, like many other common disorders, such as heart disease, diabetes and asthma, to name a few, are caused by a combination of inherited genetic factors and external environmental factors.Is schizophrenia caused by trauma? ›
Research suggests that schizophrenia occurs due to a combination of genetic and environmental factors, which can cause abnormal development in the brain. In people with these risk factors, severely stressful life events, trauma, abuse, or neglect may trigger the condition.What is a Schizophrenogenic mother? ›
The term “schizophrenogenic mother” is a negative stereotype found in the psychiatric literature of the 1950s through to the 1970s. It refers to mothers of individuals who develop schizophrenia, the implication being that the mother has induced the illness (Hartwell 1996).Is schizophrenia caused by the mother? ›
From the late 1940s to the early 1970s, the concept of the "schizophrenogenic mother" was popular in the psychiatric literature. Research later confirmed that the mother who could cause schizophrenia in her offspring did not exist.Can a mother's mental health impact a child's development? ›
A woman's mental health can have negative consequences on a child as early as pregnancy. Exposure to depression and anxiety during pregnancy may result in infants that are more irritable and less able to respond to stress. Science has shown that babies' brains form more than one million neural connections each secondi.How can mental illness in the mother affect the baby? ›
Untreated mental illness can cause a number of problems. For example, some research studies have found babies are more likely to have low birthweight if their mother has depression in pregnancy. Untreated mental illness can also affect a baby's development later on.How do you explain a parent's mental illness to a child? ›
- Keep Your Kids in the Loop. As soon as children are old enough to understand that mommy or daddy isn't “like the other mommies or daddies,” it's time to have a talk. ...
- Answer Their Questions. ...
- Be Honest About Medication. ...
- Keep the Conversation Going.
Scientific evidence indicates that bereaved parents are more likely to suffer more depressive symptoms, poorer well-being, less purpose in life, more health complications, marital disruption, psychiatric hospitalization, and even premature death for both mothers and fathers as early as age 40.What are the consequences of self centered mother on a child's mental wellbeing? ›
According to VOI, self-centered parents can create children who have low self-esteem, and no confidence in themselves. This can lead to mental health struggles, like anxiety, depression, and even runaway behavior. Basically, it changes how a child grows up.
How does parenting affect a child's brain? ›
Among a host of scientific studies on these issues, research from the Washington University School of Medicine shows that children of nurturing mothers have much larger, healthier brains. Furthermore, the hippocampi of neglected children were up to 10 percent smaller than those of children with caring, loving mothers.What are the factors that linked to maternal mental illness? ›
- Teen pregnancy.
- Food insecurity.
- HIV/ AIDS.
- Gender-based violence.
- Lack of social support.
- Substance misuse.
A traumatic childbirth could cause psychological distress, intense fear, or helplessness for the parturient and increases the risk of anxiety, depression and even post-traumatic stress disorder (PTSD) [1, 2].What is Cyclothymia in psychology? ›
Overview. Cyclothymia (sy-kloe-THIE-me-uh), also called cyclothymic disorder, is a rare mood disorder. Cyclothymia causes emotional ups and downs, but they're not as extreme as those in bipolar I or II disorder. With cyclothymia, you experience periods when your mood noticeably shifts up and down from your baseline.What is parental psychosis? ›
Being a parent with psychosis often involve challenges such as experiencing delusions, hallucinations, and negative symptoms while caring for a child. One study found that 50% of fathers and 36% of mothers were identified with severe impairments in parenting (Campbell et al., 2012).How do you deal with a mentally unstable parent? ›
- Go to Therapy.
- Seeking therapy with a caring and nonjudgmental therapist can help individuals understand and empathize with mentally ill parents. ...
- Practice Meditation and Mindfulness.
- A person's thoughts play a significant role in how they view their life.