Homicide and mental disorder — structured clinical viva

Myth vs reality. High-profile killings drive community-care failure narratives; epidemiology shows low absolute risk and that most homicide is not by current patients. National survey order-of-magnitude: about one-third lifetime mental disorder among convicts; schizophrenia lifetime a small minority (~5% order).^[1][2]

FEP concentration. Among psychotic homicides, a large fraction occur before first treatment — prevention and early intervention are structural themes; family victims are common relative to strangers.^[3]

Pathways. Psychosis-driven; substance/dual diagnosis (major contributor in national homicide series); personality-antisocial instrumental; domestic; filicide (mental illness not universal; mothers more often ill than fathers); homicide-suicide (depression and relationship pathology high-yield).^[4][5][8]

Victimology. People with mental illness are also over-represented as homicide victims — bidirectional safety framing.^[6]

Responsibility opinion. Multi-source reconstruction at material time; nexus to local legal limbs; diagnosis ≠ defence; address substances and malingering; jurisdiction-specific labels without invented sections.^[7]

Temporal triad. Responsibility then; fitness now; risk future.^[7]