The majority of people with psychosis who commit violent offences are known to mental health services which struggle to meet the needs of this group.
Three out of four people who committed serious violent offences in NSW and were found not guilty due to mental illness had visited at least one mental health service prior to the attack, a study led by UNSW Sydney has found.
The study, which was reported today in the Australian and New Zealand Journal of Psychiatry, examined 477 cases of violent offences committed by people with a mental illness that were recorded by the NSW Mental Health Review Tribunal between 1990 and 2016. It found that while most of the offenders had contact with health services prior to the violent offence, many were not identified as having a psychotic illness.
UNSW School of Psychiatry's Professor Kimberlie Dean said that if services for those with severe and complex mental health problems were adequately resourced, there may be opportunities for health and legal authorities to intervene more effectively and minimise the chances of individuals harming themselves or others while in an untreated state of psychosis.
"This is not to say that the psychosis may have emerged or deteriorated in the period between contact with the health services and the time of the offence," she said.
"For those seen by mental health services prior to violence but not identified as having psychosis, there may have been emerging or underlying psychosis that was missed or attributed to other conditions or that the diagnosis was not yet clear."
Timely research
The research comes as the country reels from a recent horrific attack at Bondi Junction last month that left six people dead after a 40-year-old man stabbed people in a shopping centre in an apparent state of psychosis.
While declining to comment on the circumstances of this case, Prof. Dean told ABC radio in the aftermath of the event that it isn't always clear whether much could have been done in the present conditions of mental health support services to have prevented the violent act.
"I think this case does highlight that there is a group of people in our community…with severe and complex mental health problems … who I think most clinicians working in the area would say are not sufficiently well served by our current services in Australia. I think services, especially public mental health services, state based public mental health services, are really stretched," Prof. Dean said.
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