Taking advantage of opportunities for early intervention in families that come into contact with health workers, welfare agencies and the police may help reduce the rate of child homicide in Australia, according to a study in the latest edition of the Medical Journal of Australia.
During the study, Dr Olav Nielssen, a psychiatrist from St Vincent's Hospital in Sydney, and his colleagues, examined the cases of 165 child homicides by 157 offenders in the years between 1991 and 2005 and found that most child homicides were the result of the physical abuse of children, while others were associated with severe mental illness, anger arising from the breakdown of relationships, and a range of less common reasons.
"The findings of the study show that fatal child abuse is the most common reason for child homicide in NSW, accounting for 36 per cent of the deaths. The offenders are usually young fathers or stepfathers," Dr Nielssen said.
"Another large group of offenders were affected by severe mental illness at the time of the homicide. Many of those had been in contact with mental health and welfare services before the child's death."
Dr Nielssen said some lives could be saved by measures that reduce the incidence of child abuse, including the prohibition of corporal punishment of children.
"Child Welfare agencies and the police should be notified of domestic violence and of any specific threats to a child's mother."
Dr Nielssen also recommended earlier recognition and treatment of psychosis to reduce the number of child homicides committed by people during psychotic illness, particularly the first episode of psychosis.
"Health workers should always consider the safety of children under the care of acutely mentally ill patients."
The authors also identified five deaths that occurred as a result of children being given methadone.
"Changes to the supervision of methadone supply to addicts with children under their care might reduce this form of homicide."
The Medical Journal of Australia
is a publication of the Australian Medical Association.