Half of all stranger homicides in Victoria in the same period were committed by people with psychosis, Dr Darjee’s research shows, as were two in three intimate partner and family homicides, raising questions about the adequacy of domestic violence prevention policies which emphasise addressing gender inequality and “disrespectful” attitudes.<\/p>\n
“I remember looking at the raw number” \u2014 43 homicides in two years, with 45 victims \u2014 “going, this is astounding,” said Dr Darjee, clinical director of psychiatry at Forensic Behavioural Assessment and Consultation Services and adjunct professor at Swinburne University’s Centre for Behavioural Science.<\/p>\n
But perhaps the most important finding, he said, is that almost 84 per cent of homicide offenders in the sample had previously received treatment by mental health services, while half were connected with a service at the time of the incident.<\/p>\n
‘The public should not feel safe’<\/p>\n
Psychosis is a set of psychological symptoms that impair a person’s sense of reality. A central feature of schizophrenia spectrum disorders, it usually occurs in episodes that last days, months or even years and can include hallucinations, delusions, disordered thinking and disordered behaviour.<\/p>\n
Though most people with psychotic disorders are never violent, there is a clear association<\/a> between psychosis and violence. Australian<\/a> and international studies<\/a> also show people with psychotic illness<\/a> are more likely to perpetrate homicide than people in the general population \u2014 a major reason why experts have long stressed<\/a> the importance of effectively treating psychosis to reduce and prevent violence<\/a>.<\/p>\n Aussie mothers with postpartum psychosis ‘falling through cracks’<\/a><\/p>\n Many Australian women with postpartum psychosis actively seek help despite not understanding what is wrong with them, research finds.<\/p>\n “If you treat people with psychosis early and effectively, you prevent poor outcomes later, including chronic mental ill-health, disengagement from family, not being able to work, homelessness \u2026 but also violence and aggression,” Dr Darjee said.<\/p>\n Dr Darjee and his colleagues designed the study \u2014 which is yet to be published in a peer-reviewed journal \u2014 to understand whether their anecdotal observations were reflected in formal data.<\/p>\n He surveyed nine forensic psychiatrists who write defence reports for courts in Victoria about how many people they assessed in 2024 or 2025 who were charged with murder or manslaughter and diagnosed with psychosis, and whether they were connected with mental health services, among other details.<\/p>\n “It’s terrible that 45 people have died, especially when you think the majority of those were probably preventable deaths,” Dr Darjee said. “But the homicides are the tip of the iceberg. The bigger [part of the] iceberg underneath means that people with mental illness and their families are living lives that are much worse than they need to be.”<\/p>\n Professor Patrick McGorry chaired the expert advisory committee for the Royal Commission into Victoria’s Mental Health System. (Supplied: Orygen)<\/p>\n Professor Patrick McGorry, a psychiatrist who chaired the expert advisory committee for the Royal Commission into Victoria’s Mental Health System, said the homicide data was the result of a “public policy failure” to build a modern system of care to replace the state’s old psychiatric hospitals, which were decommissioned in the 1990s.<\/p>\n “What it shows is that people have had ineffective contact with mental health services,” Professor McGorry said. “They’ve either tried to get access but have failed, or they’ve gained access but haven’t been able to get effective treatment, which is what people with serious mental illness need. They get episodes of care rather than sustained, safety net-type treatment.”<\/p>\n The royal commission, which ran from 2018 to 2021, was “largely a successful blueprint” to fix the system, he said, but the government “has not really invested properly in implementing its recommendations \u2014 every single one has been delayed or poorly implemented”.<\/p>\n “I thought for sure the royal commission \u2026 would have led to a once-in-a-generation transformational reform \u2014 I was wrong,” Professor McGorry said. “So I think the only thing \u2026 that will actually galvanise the public into demanding something is done is if they themselves don’t feel safe. And the public should not feel safe in the context of the current mental health system.”<\/p>\n Crucially, he added, most people with psychosis pose no harm when they are well. “It’s the acute illness that has made them dangerous and so that’s a tragedy \u2014 not just for their victims but for them personally \u2014 that they’ve been allowed to harm other people. And it’s not a character problem, it’s a health problem.”<\/p>\n Compulsory treatment can be ‘life-saving’<\/p>\n Several experts told ABC News they were particularly concerned about an anecdotal increase in the number of short-term admissions to mental health units when longer stays are generally required to stabilise patients with psychosis.<\/p>\n Many are also worried a royal commission recommendation<\/a> to reduce the use and duration of compulsory treatment orders has contributed to a system-wide reluctance to use them, including in cases where they ought to be.<\/p>\n “With the best of intentions we’ve instigated these least restrictive care policies but they’ve become negligent,” Dr Darjee said. “I don’t like compelling people [into treatment], I always do it reluctantly, but sometimes it’s life saving.”<\/p>\n Brendan Nugent’s mental health <\/a><\/p>\n Once known as a passionate environmentalist, neighbours and family say Brendan Nugent became increasingly isolated in the years before Monday’s alleged attack.<\/p>\n Forensicare chief executive and Swinburne University Adjunct Professor Colm\u00e1n O’Driscoll agreed people should ideally be compelled to take psychiatric treatment only as a last resort. But he said the mental health system was at risk of “swinging the pendulum too far the other way” if people with psychosis aren’t being put on compulsory treatment orders when they need to be.<\/p>\n “We always think about these orders as a compulsion on the individual to receive care. In my view, a significant part of their benefit is that they compel the system to provide the care you deserve as a member of our community,” Professor O’Driscoll said.<\/p>\n And given psychosis can affect people’s ability to make “good decisions”, he said, maintaining their engagement with treatment is crucial, and leads to better outcomes.\u00a0<\/p>\n Australian studies have found people with psychosis are much more likely to be convicted<\/a> of a violent criminal offence than the general population, but that early and frequent contact with mental health services reduces their risk of reoffending<\/a> \u2014 and those on community treatment orders are less likely to reoffend<\/a> than those who receive punitive sanctions.<\/p>\n “The starting point is finding a way to conceptualise violence among people with psychosis as a complication of their illness and therefore we should have a health system that sees the prevention of it as core to its work, not separate from it,” Professor O’Driscoll said.<\/p>\n He said Victoria should be invest more in programs that divert people with psychosis away from the criminal justice system into treatment programs, focus on improving patient engagement with such programs, and upskill the mental health workforce in violence risk assessment and management.<\/p>\n Dr Darjee believes there should be a “wholesale review” of the royal commission’s recommendations. (ABC News: Danielle Bonica)<\/p>\n![\"A](\"https:\/\/www.newsbeep.com\/uk\/wp-content\/uploads\/2026\/10\/e1ec2e20fce269ee251f7598cd6cddbf.jpeg\")
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