One in three Victorian homicides linked to psychosis, doctors warn

There is a set of data from Victoria that deserves attention, even though it is the kind of data most people would rather not look at directly.

ABC News published findings this weekend showing that approximately 43 of 126 homicides in Victoria in 2024 and 2025 involved a person experiencing psychosis — roughly one in three. A decade ago, about one in ten homicides per year were linked to psychotic disorders. This is not a statistical rounding error. It is a fourfold increase, and the people who died — 45 victims across those two years — had lives that could have been different.

The numbers come from consultant forensic psychiatrist Dr Rajan Darjee, who surveyed nine forensic psychiatrists writing defence reports for Victorian courts. The data have not yet been peer-reviewed, but the people generating them are the practitioners inside the system who see what the official statistics do not capture.

What the data actually show — and what they don’t

The first thing to say clearly: most people with psychotic illness are never violent. Psychosis is a feature of schizophrenia spectrum disorders, and it can cause hallucinations, delusions, and profound disorganisation of thinking and behaviour. It is also treatable. The research literature consistently shows that people with psychotic illness are more likely to be victims of violence than perpetrators.

The Victorian numbers are not an argument against people with mental illness. They are an argument about what happens to people with mental illness when they do not receive adequate, sustained care.

That distinction matters because of what else the data show: about 84% of those who committed homicide while experiencing psychosis had previously received mental health treatment, and half were connected with a service at the time. They were not strangers to the system. They were inside it — but the care they were receiving was not preventing the outcomes the system exists to prevent.

Dr Darjee described homicides as “the tip of the iceberg” of a much wider landscape of suffering among people with untreated or under-treated mental illness and their families. Stranger homicides, intimate partner homicides, family homicides — all showed psychosis involvement at rates that have risen sharply over the decade.

What went wrong in the system

Professor Patrick McGorry — who chaired the advisory committee for Victoria’s 2018-2021 mental health royal commission — was direct in his assessment. He said the homicide data reflect a “public policy failure” to build a modern care system after the state’s psychiatric hospitals were decommissioned in the 1990s.

The royal commission was, in his view, a largely successful blueprint. The problem is that implementation has been delayed or poorly executed. Many people with severe mental illness are receiving episodic care rather than the sustained, safety-net treatment their conditions require. Short-term admissions — sometimes described as “revolving door” care — may stabilise acute crises without addressing the underlying illness trajectory.

There is also a contested question about the use of compulsory treatment orders. Recommendation 55 of the royal commission aimed to reduce the use and duration of these orders. Dr Colmán O’Driscoll of Forensicare told the ABC that there may be a system-wide reluctance to use compulsory orders even when they would be clinically appropriate and potentially life-saving. He was careful to say compulsory orders should remain a last resort — but that the pendulum may have swung too far.

Both-and: what this is and isn’t

This is a genuinely difficult space, and it is worth naming where the contested lines are.

The case for prioritising severe mental illness in mental health system design is not an argument for reverting to institutional care, for over-medicalising distress, or for removing autonomy from people who are capable of making decisions about their own treatment. Those are real concerns and they are not resolved by simply noting that the homicide numbers have risen.

At the same time, the argument that compulsory orders should be a last resort does not mean they should rarely or never be used — particularly when a person’s capacity to consent to or refuse treatment is itself a feature of an acute psychotic episode. There is a difference between protective paternalism applied to people who do not need it and treatment intervention for someone whose illness prevents them from recognising that they need treatment.

What is not contested in this data: many of these deaths could have been prevented. The people who died were not killed by strangers who fell through the cracks of an otherwise functional system. They were killed in circumstances where 84% of those responsible had already been identified by the mental health system and assessed as needing care.

2 cents: what this means practically

If you have a family member or close friend with a psychotic illness, this data is not surprising. It will confirm what many families have experienced directly — the difficulty of getting sustained, adequate care for someone who may resist it, and the feeling that the system responds to crises rather than preventing them.

What can you do with that? A few practical observations:

Your GP is still the right starting point for navigating a referral to community mental health services. If you are concerned about someone whose engagement with services has lapsed, a GP can initiate a re-referral or a Mental Health Treatment Plan. If the situation is acute and you are worried about immediate safety, 000 is the number — not a helpline, not a waiting list.

SANE Australia (1800 18 7263) runs a helpline that provides specific support for families of people with complex mental health conditions. This is not a crisis line. It is a support and navigation service for the kind of sustained, non-acute concern that comes from supporting someone with an ongoing psychotic illness. It is one of the more useful things most families do not know about.

The broader question — whether the Victorian system will respond to this data with the kind of structural change the evidence is calling for — is a political and policy question. It is worth following.

Verdict: yes — worth knowing about.

If you or someone you know is in crisis: Lifeline 13 11 14. Beyond Blue 1300 22 46 36. 000 for immediate safety.

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Sources cited

1. One in three homicides fuelled by psychosis, as doctors fear growing crisis — ABC News, 26 October 2026
2. SANE Australia — psychosis information and helpline