Murder-Suicide: When Killing Yourself Isn’t Enough

Murder-suicide, homicide-suicide, and dyadic death all refer to an incident where a homicide is committed followed by the perpetrator's suicide almost immediately or within 24 hours after the homicide. Although murder-suicides are relatively uncommon, they account for 5% of all homicidal deaths in this country, and murder-suicides appear to be occurring with increasing frequency in the USA. Medical studies estimate that between 1,000 and 1,500 deaths per year. Nearly all the victims were unaware of the perpetrator’s plan.

The Facts

90% of the perpetrators are men.
80-90% of their victims are spouses or intimate partners.
Adults aged 55+ have homicide-suicide rates that are twice as high as younger adults.
Homicide is the only crime that regularly results in offenders taking their own lives following a criminal act.
25% of the cases involve more than one victim
Men tend to kill their children and their intimate partners prior to suicide.
Women tend to kill their children but spare their partners.
Over 75% of murder-suicides occur in the home.
Within the home, more murder-suicides are committed in the bedroom than any other room.

Increased Risks

Killing an ex-spouse/lover increased the risk of suicide the most (13X)
Killing a child (10X)
Killing spouse (8X)
Boyfriend or girlfriend (6X)
Friend (2x)

Reasons behind Murder-Suicide

Murder-suicide cases make pretty sensational headlines. Here are some recent examples: “Grandkids Find Bodies in Possible Murder-Suicide” (July 2012); “Arizona Murder-Suicide Dad Had a Brain Tumor” (June 2012); “Breakup Led Buffalo Doctor to Kill Lover, Self” (June, 2012); “Florida Mom Kills Kids — Shoots 4 Children, Turns Gun on Herself” (May, 2012). Everyone wants to know “why”? The following offers the most frequent reasons why an individual chooses to end the life of another and then take their own.

Dominant Themes: Ages 18-55

At the core of a murder-suicide lies a frustrated, turbulent, intimate, long-term personal relationship. The perpetrator has had a strong ambivalence about the relationship, vacillating between anger and love. Perpetrators suffer from jealousy and/or morbid jealousy (a delusion that one’s sexual partner has been sexually unfaithful). "Amorous jealousy", involves one half to three quarters of all murder-suicides in the U.S. The triggering event is most often a separation or threatened separation from the loved one. The perpetrator feels helpless and powerless in the relationship; the homicidal act is the culmination of this sense of intolerable powerlessness. When the perpetrator realizes his guilt after the crime, he proceeds with a suicidal impulse. In this age group, suppressed rage is the most common reason for homicide followed by suicide scenarios.

Over-controlled men with dependent personality types are the most likely to commit abandonment/ estrangement murders, to attempt suicide after the murder, and to kill "reactively". Most murders followed by suicides occurred during a failed reconciliation, or when a partner first announces her plan to leave the perpetrator. These types of homicides are more impulsive in nature and frequently involved “overkill” (5-25 lethal actions towards victim).

Risk Assessment: Younger Adults

The greatest risk factor for murder-suicide is when one partner feels anxious and unsafe without the compliant presence of the other. In another, more extreme and dangerous form, one partner feels or believes they are "incomplete" without the other.

To appropriately assess the risk, officers need to evaluate both the material and the emotional "overlaps" between people's lives. How much does the abuser's sense of self depend on the relationship? Has the abuser ever said, "I'd be lost without you" or (being ordered into counseling or drug/alcohol treatment,) "I can't do this without you" or "If you leave me, I have nothing to live for"?

Obviously in a heightened risk potential, the law enforcement officer will evaluate for current homicidal and/or suicidal ideation. There are additional red flags to consider including: a history of suicidal and homicidal threats, history of violence with increasing violence towards partner (especially choking or strangulation), increased violence towards the children, comorbid major stressors in social relationships (work, personal, and financial hardships.) Law enforcement personnel are also key in evaluating the plan and feasibility of homicide and/or suicide risks: does the suspect have possession/access to lethal weapons, are there multiple weapons, where are the weapons kept, is having and being willing to use weapons part of their self-image? (This is particularly crucial in relationships that involve people in law enforcement, corrections, the military, and the criminal justice system.)

Additional risk factors include "anniversary date" of a traumatic incident from the perpetrator’s past, history of or current stalking behavior, alcohol or drug abuse as well as a childhood history of abuse.

Dominant Themes: Age 55+

Older adults have homicide-suicide rates that are twice as high as younger adults. Each year more than 500 homicide-suicides or 1,000 deaths occur in persons 55 years and older. 20 older Americans die each week in a homicide-suicide. Murder-suicides in older people were previously considered to be suicide pacts, mercy killings or altruistic homicide- suicides where both partners were old and sick. This has been proven to be untrue. Murder-suicide acts are a result of desperation and depression. Almost all homicide-suicides in older persons involve a husband who kills his wife before killing himself.

There are at least three types of murder-suicide in older couples. The common feature in all three is a perception by the husband of an unacceptable threat to the relationship. This threat could be a pending move to a nursing home or assisted living facility, a real or perceived change in health, or marital conflict and domestic abuse.

Most commonly the male had made a unilateral decision to commit the act. The perpetrator had thought about a homicide-suicide for months if not years. His wife or lover is not a knowing or willing participant. Most victims are shot and killed in their sleep, and then perpetrator then turns the weapon on himself.

Elderly men who commit murder/suicide generally have significant health problems and have had a recent significant decline in health prior to the act. They sense an unacceptable threat related to the integrity of their relationship, most frequently impending institutionalization of themselves or their partners. Statistically, about 50% of spousal homicide-suicides in the elderly are dependent and protective in nature. The man, who has been dominant in the relationship, fears losing his control and ability to care for or protect his wife. Even if his spouse is not sick, a real or perceived change in his health can precipitate the process. At least half of the perpetrators of this subtype are depressed or have other psychiatric problems that have been undetected or untreated.

About 30% of elder murder-suicides are aggressive in nature, with a positive history of domestic violence. This is more common in couples in their 60's, but it does occur in older couples. A pending or real separation, restraining orders against the husband, and familial involvement are the most common features.

A third type is a symbiotic homicide-suicide, occurring in 20% of couples. This is characterized by extreme interdependency in an older couple. One or (usually) both parties are very ill, leading the husband to a mercy killing and suicide. The husband and wife are so enmeshed in each other that their individual characteristics are frequently blurred.

Risk Assessment: Older Adults

The greatest at risk is the older couple (ages 75+) who have been married a long time and the husband has a dominant personality. Most frequently the husband is a caregiver and the wife has Alzheimer's disease or a related disorder. One or both have multiple medical problems, and the health status of one or both is changing. A move to a nursing home or assisted living facility is pending or under discussion. The older couple is becoming more socially isolated, withdrawing from family, friends and social activities. The couple has been arguing or there is talk of divorce or a history of estrangement. The male suffers from undiagnosed mental illness, most often depression. Alcohol or prescription abuse may be present. Since the husband is usually the perpetrator, look for the following additional signs: changes in his eating or sleeping patterns, crying for no apparent reason, an inability to feel good about the future, talk of feeling helpless or hopeless, talk that the future is bleak, threats to harm the wife, loss of interest in activities that used to give him pleasure, anxiety and agitation, giving things away that are important to the couple, and making plans to give someone a key to the home.

Additional Considerations for Law Enforcement Officers

Do not be afraid to ask if a person has had thoughts about homicide, suicide, or both. You will not be giving them any new ideas. Here are specific questions that will assist in your risk/lethality assessment. All suicidal subjects should be evaluated for homicidal ideation, and all homicidal subjects should be evaluated for suicidal ideation. Suicide is an act of aggression; in essence suicide is homicide turned inwards—murder in the 180^th degree.

Spousal Conflict:

Have you ever thought that if you killed both of you all of your problems would be over?
Have you ever wondered if it would be better for both of you just to get life over with?
I know you love your husband (wife), does that love include helping him/her avoid a painful death?
Have you ever discussed ending your lives together?

Families

Now that I know you are thinking of suicide, I’m wonder what will become of your children if you die?
Have you ever felt it was your duty to take care of your family no matter what happens?
How will you care for your family if you are dead?

Employees/Students

Who seems to be pushing you towards suicide?
Who do you see as being the root of your problems?

When you think about the problems suicide would solve, do any of these problems occur at work/school?

Finally, ask the person what plans they have related to death and their funerals. The more detailed the plan, the higher the risk. Ascertain whether there are guns in the house or not. Remove guns and other methods to kill. Remember that separating the perpetrator and victim may appear to be appropriate in order to diffuse the tension and protect the victim; however, separation is often the trigger for violence in murder-suicide cases (especially the elderly).

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About The Author:

Pamela Kulbarsh, RN, BSW has been a psychiatric nurse for over 25 years. She has worked with law enforcement in crisis intervention for the past ten years. She has worked in patrol with officers and deputies as a member of San Diego's Psychiatric Emergency Response Team (PERT) and at the Pima County Detention Center in Tucson. Pam has been a frequent guest speaker related to psychiatric emergencies and has published articles in both law enforcement and nursing magazines.