Psychiatric Bulletin (2000) 24: 152. doi: 10.1192/pb.24.4.152-b
© 2000 The Royal College of Psychiatrists
Psychiatric Bulletin (2000) 24: 152
© 2000 The Royal College of Psychiatrists
Homicide is impossible to predict
J. R. King, Consultant Psychiatrist
Mental Health Directorate, Hill Crest, Quinneys Lane, Redditch B98
7WG
Sir: George Szmukler makes some excellent points in his article
(Psychiatric Bulletin, January 2000, 24, 6-10). It is indeed
impossible to predict rare events like homicide, for the sound mathematical
reasons he quotes. The phenomenon of retrospective distortion should be
understood by everyone who is tempted to be wise with hindsight. Inquiries are
very probably, as he says, a waste of time and money, repeated time and again
and no more useful than an obsessional symptom to a patient with a
neurosis.
In one sense, however, it is our own fault. It is easy for psychiatrists to
fall into the trap, to collude with the illusion that we are effective in
preventing individual tragic outcomes. The threat of such events is, after
all, about the only shroud-waving potential that the subject possesses, in the
battle for funds. The unit where I work is one of the most modern and
attractive buildings in the country, yet its closure as part of the
rationalisation of services, has produced scarcely a murmur of protest. I
suspect it might be different, if the public believed it was full of dangerous
people, who were only prevented from committing crimes by the skills of those
looking after them.