Characteristics of perpetrators in homicide-followed-by-suicide incidents: National Violent Death Reporting System—17 U.S. States, 2003-2005

Homicide-followed-by-suicide (homicide-suicide) incidents rarely occur but can lead to mass casualties. A better understanding of the perpetrators may provide insight into the nature of these violent acts as well as identify potential opportunities for prevention. Using 2003-2005 data from the National Violent Death Reporting System (NVDRS), this study characterizes perpetrators of different types of homicide-suicides (typology based on the perpetrator-victim relationship) and compares perpetrators to suicide victims using multiple data sources (e.g., coroner/medical examiner and police reports) to contextualize their unique qualities. Most incidents were intimate-partner-related (n=304); filicide (killing of children)-suicides (n=33) and extra-familial homicide-suicides (n=42) were less common. Homicide-suicides were mostly committed with firearms (88.2%) and by males (91.4%), those ≥19 years of age (97.6%), and those of White race (77.0%); however, a high proportion of filicide-suicides (51.5%) were perpetrated by females. Compared to male suicide victims, male homicide-suicide perpetrators were less likely to have mental health problems (odds ratio adjusted for age and race/ethnicity [AOR]: 0.3; 95%CI: 0.2-0.4) but more likely to have intimate-partner problems (AOR: 3.6; 95%CI: 2.9-4.5). Of the 191 male perpetrators who had intimate-partner problems and committed the act via firearm (46.8% of total), 75 (39.3%) committed the act in retaliation to a divorce or breakup. The results suggest the potential importance of prevention strategies that focus on defusing intimate-partner separations (e.g. counseling, access to family shelters). Also, during domestic legal proceedings, court/legal officials may be able to play a role in prevention by evaluating access to firearms, assessing domestic violence, and mandating psychiatric counseling.