Psychiatrists wanted to understand homicide patterns. They found a deadly warning

Homicides committed by people experiencing psychosis in Victoria have quintupled, jumping from just over four per year a decade ago to more than 20, in what researchers say is a “dangerous sign” that gaps in the state’s mental health system are allowing preventable tragedies.

New research reveals that 12 of the cases in the past two years involved someone accused of killing a stranger while in the grip of psychosis, when statistics indicate there would usually be only one or two such cases in that time.

Experts warn that recent high-profile incidents, including last week’s attack on MP Helen Haines in Wangaratta and the Dezi Freeman police killings in nearby Porepunkah, are in part a consequence of a chronically under-resourced and poorly organised system stretched to breaking point.

Last year, nine forensic psychiatrists across Victoria became concerned by the mounting number of very unwell people they were being asked to assess for court and undertook research to see if this was the extreme result of a wider crisis in the mental health system.

Their findings, to be presented at a gathering of the Australian and New Zealand Association of Psychiatry, Psychology and Law on Wednesday, are alarming.

Forty-five people diagnosed with psychotic disorders were charged with homicides in the two years between January 2024 and December 2025. By comparison, in the 18 years between 1997 and 2015, there were 77 homicides committed by someone experiencing psychosis.

The rate of psychotic homicides in 2024-25 has risen to 3.1 per million people a year – almost four times the rate of 0.79 per million in the earlier decade. The analysis, led by practising forensic psychiatrist Rajan Darjee of Swinburne University, found four out of five of the unwell people charged with murder or manslaughter had received treatment from mental health services in the past, though about half were not under active treatment at the time of the homicide.

Based on the previous levels of illness and violence here and in similar jurisdictions, Darjee found that Victoria could have expected 10 homicides related to psychosis over those two years – meaning the 33 additional deaths could have been prevented by the availability of better mental health care across the state.

In Victoria’s north-east regions, those healthcare supports Haines’ alleged attacker Brendan Nugent had sought out are in short supply, this masthead has revealed, while dangerous conspiracies and anti-government ideologies have taken root locally.

It’s just one part of a statewide mental healthcare crisis, extensively reported on by this masthead, which experts say has failed to attract sufficient government action even after the Freeman case, the pandemic and a royal commission calling for major investment in the regions five years ago.

Dr Pramudie Gunaratne, who heads the Australian Society of Psychiatrists and was not involved in the homicide analysis, said it was too early to say how big a factor mental health played in the Haines incident. But the case and others “shows what happens when we’re flying blind”, she said.

Darjee and Gunaratne stress that violence committed by people with mental illness is still extremely rare, and that mental health does not explain extremism. Freeman, for example, was not believed to be in the grip of psychosis when he murdered two police officers and injured a third.

Violence by people who are mentally unwell is just the tip of the iceberg when it comes to problems with mental healthcare, says Darjee, and “homicide is the very tip of that tip”. When the number of homicides grows, it means the iceberg of mental healthcare problems is getting bigger, he says. It’s a warning.

“There are so many stories of people hurting, even killing, their families, that never reach the media” and they never would have happened if the person had been well, Gunaratne said. “We have effective treatments, but it’s still so hard to get someone into care.”

She pointed to the Westfield Bondi Junction attacks of 2024, which revealed major failings in psychiatric care when Joel Cauchi, a man living with schizophrenia who had fallen into homelessness, went on a fatal stabbing spree.

“We have these tragedies, but nothing ever changes,” Gunaratne said. “We don’t even keep waiting lists like we do for knee surgeries and things so we don’t know who we’re turning away.”

The psychiatrists’ society will write to federal Health Minister Mark Butler on Monday with an urgent proposal to fund a national “observatory” project, tracking mental health service demand to help fix the “fragmented, siloed” system.

“It’s a postcode lottery right now,” Gunaratne said. “Treatment depends on what’s available where you are, not what you need. The equivalent in cancer care would be telling a patient that the best treatment for their condition is surgery and chemotherapy, but sorry, we don’t have surgery as an option here so we’ll just do chemo…”

Police are investigating connections between Haines and her accused attacker Nugent, as well as any potential connection between Nugent and the local sovereign citizen movement to which Freeman belonged.

A 2016 study led by the Queensland Fixated Threat Assessment Centre found that “fixated loners” who target public officials frequently suffer from serious mental illnesses, including psychiatric disorders.

In 93 per cent of the moderate and high-risk cases examined, the offender was known to police or health professionals, but their risk was not properly identified. Nearly half suffered from severe mental illness, with delusional disorders frequently missed or neglected by clinicians.

Victoria Police’s counter-terrorism command strategy noted back in 2022 that “there has been an increase in the presence of mental disorders” among terrorists, especially lone actors.

Earlier this year, ASIO said it was observing a rise in domestic actors who are driven by both personal grievance and ideology, including conspiracy theories and anti-government views.

Ahead of presenting the latest findings on Victorian psychotic homicides on Wednesday, Darjee stressed that the attention should be on failures in the healthcare system, rather than on the vulnerable people who rely on it.

“We found that in over 80 per cent of cases, the psychosis played a direct role in the homicide,” Darjee said. “By that, I mean that the person maybe had paranoid delusions or hallucinations that actually directly drove them to the behaviour that led to the victim dying.”

Even in less clear-cut cases, illness played a significant role, he said. “For example, where people are very, very unwell, and that leads them to being disorganised, disinhibited, and scared and, in that context, a homicide occurs.”

That meant with better access to treatment, including earlier support before conditions spiral or compulsory admissions when needed, Darjee said tragedies like this could be avoided.

”When these people are well, they’re not people who usually have a propensity towards violence,” Darjee said. Many he had met “after they’ve gotten better” weren’t aggressive or violent, and were usually left “absolutely distraught” that they had hurt someone while unwell. Often that victim was someone close to them, he added.

The president of the Victorian branch of the Australian Medical Association Dr Simon Judkins said there was a desperate shortage of mental health beds and facilities, including for drug and alcohol issues, outside the cities. There had been little improvement since the royal commission into mental health of 2021, he said, noting that the Carroll government had paused its plan to establish regional mental health and wellbeing boards.

Haines, a former nurse, had long been calling herself for an urgent injection of healthcare resources in Victoria’s north-east. Just days before she was attacked, Haines had been lobbying Prime Minister Anthony Albanese to address an estimated $9 billion spending gap between the regions and the cities. “I regularly hear from people who can’t find a GP [or] must travel long distances for mental health appointments,” she said.

With Cameron Houston