Number of mentally ill Victorians killing their parents doubles as health reforms stall

The number of parents killed by their mentally ill children has more than doubled in the four years since Victoria’s mental health royal commission, as key recommendations intended to prevent such tragedies remain stalled.

Frustrated experts say the deaths are the extreme symptom of a far larger and growing mental health crisis and that state government promises to fix the broken system are failing to match reality.

State Coroner John Cain has also called on the Allan government to protect the “hidden mental health carers and families” at risk due to the lack of support for them and the loved ones they care for.

Twenty-one parents or step-parents were killed by their children (including adult children) in Victoria between January 2021 and December 2024, according to data released to The Age by Victoria’s Crime Statistics Agency.

In the previous four years, from January 2017 to December 2020, there were 10 or fewer.

Those working in or relying on Victoria’s mental health system say there are not enough acute psychiatric beds or services to treat those who need them when they need them.

Families are forced to manage acutely unwell loved ones in their own homes because they cannot get a bed until there is a crisis, said a worker from a regional service supporting mental health carers, who is not authorised to speak to the media.

“It can take a long time for someone to actually get support, and it often hits that crisis point when there’s family violence involved, or there’s harm to themselves and others,” the worker said. “It gets to that point where you have to call the police before you can get support … or the ambulance can come and help get them into hospital because they’re so acutely unwell.

“Families and carers don’t have formal training. They’re going in, they’re blindly trying to find a way, and they get exhausted and burnt just trying to support someone who’s acutely unwell.

“There’s a missing middle of support in the community, and so we have a large number of homeless people, people sleeping rough, and people who have unmanaged mental health challenges because they can’t afford to get treated privately.”

Overall, family violence claims between 11 and 23 Victorian lives a year. A Victoria Police spokesperson said mental health was identified as a contributing factor in 57 per cent of family violence incidents attended by officers.

“Mental health is a known risk factor for family violence and Victoria Police will identify if a perpetrator or victim has any mental health issues as part of their risk assessment at every incident,” the spokesperson said.

Consultant forensic psychiatrist Dr Rajan Darjee has consulted on many of the recent homicides. He said the most extreme consequences of failures in the state’s mental health system were becoming much more common.

“It’s disproportionately family members who bear the brunt – and quite often, family members who have been desperate to try and get people help,” Darjee said.

“We’re seeing all these cases where people are being violent towards their parents or other people, where you think there should be more being done to provide people treatment to either prevent that or, when they’ve already started to be violent, to at least address it afterwards so you don’t get further violence.

“Working in forensic, you only see the people after it’s gone wrong. But there’s a wider issue that mental health services are just not able to provide what people with severe mental illness need.

“I think there’s probably more violence now, and I remember when the royal commission and the new Mental Health Act were suggested that I and other people were saying, ‘We’re going to have more people being killed’, and that might be what’s been happening.”

The final report from the Royal Commission into Victoria’s Mental Health System, released in March 2021, made 65 recommendations, which the state government promised to implement in full. The government has since imposed a $1 billion annual levy to support improving the mental health system.

Former Australian of the year Patrick McGorry, who chaired the royal commission’s expert advisory committee, said delays in tackling the issues the commission raised were damaging the lives of unwell Victorians and potentially endangering those of their carers.

Instances of violence perpetrated by people with acute mental illness remain rare, and McGorry said a rise in homicides was an indicator of an increase in unmet mental health needs, particularly in young people and those with severe mental illness such as psychosis.

“The system is way underdone to meet the needs for even people with severe mental illness, and that is what the royal commission provided a blueprint to fix,” McGorry said.

“However, despite a 50 per cent surge in mental illness in young people, youth mental health reform has been deferred, and it is now much harder to get into the youth mental health system than it was before. That means there will be longer periods of untreated illness that there was before.

“Community safety is only one component of it, but better outcomes for young people is the main one.

‘The system is way underdone to meet the needs for even people with severe mental illness, and that is what the royal commission provided a blueprint to fix.’

Professor Patrick McGorry

“The implementation of the royal commission needs a major rethink with a focus on young people and older adults with severe mental illness, especially psychosis.”

McGorry said funding raised by the mental health levy must be quarantined and released to expand mental health care, while clinical and reform expertise was needed to help the Department of Health reorient system reform agenda.

A spokesperson for Mental Health Minister Ingrid Stitt said the government considers and acts on any findings or reviews regarding homicides when linked to mental ill-health, though it was vital such incidents were not used to stigmatise people living with illness.

Cain last month flagged that he was dealing with several cases of parents being killed by their mentally ill children, and urged the Allan government to introduce several safeguards to better protect and identify carers and families not currently receiving help from police or services.

The coroner’s plea was made in the finding into the tragic death of Stephen Peter O’Brien, who was killed by his son Scott, then 43, in 2023. Scott O’Brien had never moved out of home and lived with schizophrenia, but was not receiving any treatment when he bludgeoned his father to death while under the belief he was a federal police officer spying on him. Scott was charged over his father’s death but was found not guilty by way of mental impairment.

“Stephen’s case, sadly, is one of several cases being investigated by the court in which an adult child with undiagnosed or untreated mental health issues has assaulted and killed an older or elderly parent,” Cain found.

“My recommendations are therefore aimed at improving awareness for elderly Victorians who have contact with or care for adult children with mental illness.”

The coroner’s request reiterated a plea to the royal commission more than five years earlier by Mind Australia. In a July 2019 submission, the support agency warned that mental health carers and families were unsafe.

Cain also cited delays in the rollout of royal commission recommendations in his December 2022 findings into the death of Gabriel Messo, who was fatally shot by police in 2020 while repeatedly stabbing his mother, Lilla, in the face with a stick days after the family’s repeated pleas for inpatient mental health care were rejected.

“There is clearly significant room for improvement in the mental health system,” Cain found. “Within this finding I have avoided duplicating the royal commission’s inquiries and investigations, but acknowledge that implementation of the recommendations remains ongoing, and is intended to address the identical issues experienced by Gabriel and his family.”

Despite initially promising to implement all the royal commission’s reforms in full, including timelines spelt out in the commission’s report, the Allan government in December released a “Phase 2 Reform Plan” which altered recommendations and spelt out new schedules.

Some policies were two years behind schedule, and delays have been tracked by several advocacy groups, including in the annual report tabled by the Mental Health and Wellbeing Commission.

Although the state government initially announced that paramedics would take over mental health callouts from police from September 2023, the government recently conceded the key royal commission recommendation would be delayed to 2027.

Gabriel Messo is one of three Victorians shot by police while attacking their parents or step-parents since 2020, and Victoria Police Association secretary Wayne Gatt said delays in rolling out the royal commission recommendation were endangering officers and families.

“The Police Association has long said that its members are not the most appropriate or qualified to act as the first response to incidences of mental health crises,” Gatt said.

“The longer the delay in implementing this reform, the more chance there is of adverse outcomes for people suffering mental health crises in Victoria.”

Darjee said the average admission to a Victorian mental health unit for patients suffering acute episodes of psychosis is now two weeks or less, despite it taking at least four to six weeks to begin addressing the underlying cause of their illness.

He said a reluctance to order unwell people into involuntary care following the royal commission now made it even harder to get people help before they deteriorated, which compounded a severe lack of acute beds and reluctance of families to place loved ones in “awful psychiatric units”.

Department of Health mental health performance indicator data shows that while one-third of patients in community care units in 2021 were on community treatment orders, this had now dropped to a quarter.

Rather than trying an impossible guess to provide treatment for the extremely rare cases that may turn violent, Darjee said the state had a duty to treat all people in need, for as long as it took.

“I see people after they’ve really been violent, and then I’m asked to do risk assessments and try to identify the people to worry about. Now that’s a whole different issue, because I’ve seen people when they’ve already committed assault, murder, rape or whatever,” he said.

“Rather than thinking about individuals and trying to specifically target this person, you’ve got to go for a population-level approach.

“It’s good for people to have good treatment for mental illness, and that involves compulsion in some cases. That’s going to improve the lives of a lot of people with mental illness and their families, and the knock-on effect to that is you get fewer murders.

“If that was the approach that’s taken to people with mental illness, you could prevent probably over half of the homicides that are committed by people with mental illness.”

McGorry agrees that too many people are being discharged into the care of their families and the community before their needs are met, increasing the likelihood of a relapse and a revolving door that places everyone’s health in danger.

“Obviously, no one wants to treat people involuntarily if you don’t have to. If you find people at an earlier stage of the illness, whether it’s the first episode or a relapse, they’re much more likely to accept voluntary treatment in the community and not require admission,” McGorry said.

“But even since the royal commission, the system has withdrawn from doing that. It’s discharged all the voluntary patients from community mental health care in many networks, and they’re only treating people on orders.

“So it’s harder to get early treatment than it was even before the royal commission in many places.”

If you or anyone you know needs support, you can contact the National Sexual Assault, Domestic and Family Violence Counselling Service on 1800RESPECT (1800 737 732), Lifeline 131 114, or Beyond Blue 1300 224 636.

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