Among physicians, psychiatrists are the most likely to be killed by their patients or a family member. The most common victims of homicide among mental health workers are young, female case workers, a systematic review of US murders among healthcare workers reveals. Michael Knable, MD, executive director of the Sylvan C. Herman Foundation, Washington, DC, reviewed all homicides of mental health workers or physicians since the early 1980s and found that overall, it was an uncommon event. Nevertheless, he identified a profile of perpetrators, which most often consisted of young men with a diagnosis of schizophrenia and/or a history of involuntary hospitalization. The most common method of homicide was by gunshot. Knable writes that "homicides of mental health workers, and of physicians generally, are rare events that emerge from a background of common aggression and violence in healthcare settings." He adds that "many of these homicides may have been preventable." The findings were presented here at the Schizophrenia International Research Society (SIRS) 2018 Biennial Meeting. Personal Experience Knable explained that he started the research because two of his friends, Wayne Fenton, MD, and Mark Lawrence, MD, were killed by their patients. "I asked myself the question: Is it common or is it rare, and is there anything we can do to know when it's going to happen?" He conducted systematic searches of news outlets, Internet sources, and the medical literature for accounts of homicides of US mental health workers between 1981 and 2014 and among US physicians between 1981 and 2017. He included homicides committed by patients, the family members of patients, and coworkers, and excluded homicides that occurred in correctional settings or in agencies not focused on healthcare, as well as those unrelated to the physician's professional role. Knable identified 33 homicides among mental health workers. He found that 39.8% of the victims were case workers, 30.3% were psychiatrists, 15.1% were social workers, 6.1% were psychologists, 6.1% were nurses, and 3.0% were physicians. Of the victims, 54.6% were women. The average age of female victims was 35.4 years, compared with 49.1 years among men. Gunshot was the most common method, occurring in 42.4% of cases, followed by stabbing (30.3%) and beating (12.1%). The homicides were carried out in residential facilities in 36.3% of cases; in public clinics and private hospitals in 18.2% of cases each; in private offices in 15.2%; and in public hospitals in 12.1%. The perpetrators were mostly male (81.8% of cases); the average age was 33.0 years, vs 44.3 years among women. The most common diagnosis among perpetrators was schizophrenia, in 54.5%. Source
