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Editorial Juvenile homicide

In the United Kingdom and most industrialized countries outside the USAjuvenile homicide is very rare (Justice, 1996). The low base rate inevitablymakes it difficult to establish whether juvenile killers constitute a distinctgroup. In the United States, the rate of homicides by young people is some 15times higher (Snyder et al., 1996), and such a huge national difference in rateraises questions on comparability. Killing by children in the United Statesmay occur more often in the course of acquisitive crime and probably reflects,in part, the much greater availability of guns. School-based killings by juve-niles have reopened the debate, a debate informed by a series of texts (Elliottet al., 1998; Kelleher, 1998; Heide, 1999).

In the USA the surge in violence during the late 1980s and early 1990sincluded more than homicides. Between 1988 and 1991 the rate of juvenilearrest for non-lethal violent crimes (assaults, robberies and rapes) increased by38% (Snyder and Sickmund, 1995). The ‘Monitoring the Future’ Study,involving a national sample of high school seniors, also found an 18%increase in the proportion of students reporting a serious assault on anotherperson between 1984 and 1994 (Maguire and Pastore, 1996). Although thisproved undramatic in terms of increased episodes (Elliott, 1994), fights that inearlier years resulted in black eyes and bloody noses now often involve deathor serious injury as the number of youths carrying guns and other weapons hasincreased substantially.

In the 1990s, homicide became the second leading cause of death amongadolescents in the USA, and the leading cause of death among African-American male adolescents (Snyder and Sickmund, 1995). In addition to theincreased use of firearms, there were more seemingly ‘random’ violent events,and assaults on strangers without provocations (Fox, 1996). Violence eruptedin places previously thought to be safe - trains, restaurants and schools. Theresult of this combination has been high levels of fear of violence experiencedby both children and adults alike (Elliott, 1994).

In her analysis of crime patterns in the United States over 13 years,Kathleen Heide revealed that homicides for juveniles rose every year from1984 through to 1993, when the number of juveniles arrested (under 18 years

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of age), 3284, was three times higher than the number arrested in 1984. Thisincrease, although felt in urban, suburban and rural areas across America, wasparticularly noticeable in US cities, 8.3% of all homicide arrests in 1984 risingto 18.1% in 1994. In 1996, one out of six homicide arrests in cities involvedjuveniles. From a public health perspective, the 50 000 deaths caused by vio-lence across all age groups is much greater than the number caused by AIDS(30 000 per year) and greater than the number of deaths caused by drunk dri-ving (18 000 per year).

Juvenile homicide offenders, like their adult counterparts, are far morelikely to kill one victim than several. When two or more juveniles kill, thevictim is more likely to be a stranger. During the last decade in the UnitedStates, gang membership has increased, and gangs have become increasinglyresponsible for a disproportionate amount of violence, related not only toavailability of firearms, but also perhaps to the effect and role of ‘crackcocaine’ wars.

Race and juvenile homicide remains a controversial issue. From 1985 to1994, homicide-offending rates of white youths aged 14 to 17 doubled from7.0 to 15.6 per hundred thousand, but the rates for black youths tripled from44.3 to 139.6 per hundred thousand. African-Americans comprised 55-61% ofjuveniles arrested for homicide during the period 1987-96. During this decadeAfrican-Americans made up approximately 14% of the juvenile population inthe United States.

Juvenile homicide remains an overwhelmingly male phenomenon. Whengirls kill, they are more likely than their male counterparts to kill people theyknow (Bailey, 2000).

Although there is a paucity of systematic comparative studies of juvenilehomicide, there are several reviews of what is known about the characteristicsof young people who kill (Wilson, 1973; Cornell et al., 1987; Goetting, 1995;Cavadino, 1996), a comparative study of adolescents convicted of homicideand those convicted of property offences (Toupin, 1997) and one follow-upstudy of nine delinquents who subsequently killed (Lewis et al., 1985). Inaddition, there are a number of detailed studies of small groups (Myers et al.,1995; Bailey 1996; Myers and Scott, 1998). Taking the evidence as a whole(Rutter et al., 1998), two conclusions seem reasonably well justified. First,both the nature of the homicidal acts and the characteristics of the youngpeople who commit the acts are heterogeneous and, second, the children whokill tend to have disturbed, often abusive family backgrounds, and also show arange of personal problems. Accordingly, in a great majority of cases it wouldseem appropriate to consider the homicides as a result of personal psy-chopathology and serious psychosocial adversities, rather than simple acts ofserious wrongdoing or the consequences of ‘innate evil’. At present these con-siderations are poorly represented in the ways in which child killers are dealtwith by the British judicial system. In a landmark judgment in December1999, ‘Children in criminal proceedings - the right to a fair trial - the cases of T

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and V’ (V v. the UK, application number 24888/94 and T v. the UK, applicationnumber 2472/94) the European Court of Human Rights stated that Article 6,read as a whole, guarantees the right of a fair trial. In practice the impact of thisjudgment means that in all cases of juveniles account will need to be taken ofhis or her age, level of maturity and intellectual and emotional capacities, andthat steps are taken to promote his or her ability to understand and participateeffectively in the proceedings. This has major implications for psychiatrists andpsychologists preparing pre-trial reports on all minors with regard to both train-ing and a standardized systematic assessment process. This aspect of medico-legal work is already being addressed in the USA (Grisso, 1999).

Following a spate of killings in schools in the USA, there has been discussionamong professionals on both sides of the Atlantic on the extent to which juve-nile homicide reflects the severe end of juvenile delinquent behaviour. It isapparent that there is much in common between juveniles who kill and otherdelinquents. However, there is one respect in which the two seem different, atleast in the UK. Over the last 50 years there has been a massive increase in juve-nile delinquency in most Westernized industrialized countries (Rutter and Smith,1995), accompanied by similar (although less marked) rises in other psychosocialdisorders in young people, such as drug and alcohol abuse, depression and suicide.The rate of juvenile homicide in the UK does not, though, appear to have risento any appreciable extent (McNally, 1995; Justice, 1996). A proportion of thesekillings involved sexual assaults and/or extreme repeated violence (Bailey, 1996).It may be inferred tentatively that in the UK killings by children or adolescentsmay be more likely to reflect serious personal psychopathology, although rarelyillnesses such as schizophrenia, than is the case with most other serious crimecommitted by young people. (Clare et al., in press).

In Lost Boys Garborino (1999) attempts to unravel the processes that leadto extreme aggression, citing genetic inheritance, parental upbringing and the‘increasing toxic nature of contemporary American society’ as contributory fac-tors. Adolescent males fall victim to an unfortunate synchronicity between ‘thedemons inhabiting their own internal world and the corrupting influences ofmodern American culture, vicarious violence, crude sexuality, shallow materi-alism, mean spirited competitiveness and spiritual emptiness’. For most, prob-lems begin in early childhood, with boys describing abuse and/or abandon-ment; they gradually lose the capacity to feel emotions and externalization ofthe pain. This is echoed in the paranoid attributions noted by Myers and Scott(1998), and described in the evolution of violent and sadistic fantasy by Bailey(1997) and in the failure of home, school and community to respond to theclues presented by young males in the six months prior to the final indecentact. There is a progression and combination in some young people from inse-cure attachment in infancy, early antisocial behaviour, adolescent rage andpost-traumatic stress disorder to past trauma and sense of abandonment.

Any discussion of juvenile homicide has to explore not only the impact ofgun availability in the United States, but also the influence of pervasive vio-

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lence as portrayed through the media. In film and television violence, violentacts committed by not only the villain but also the hero are often accompa-nied by no show of remorse and no criticism of their acts.

Increasing focus following a spate of teenage murderers in the USA has cen-tred on the impact of violent video-game play (Anderson and Dill, 2000).Violent video games provide a forum for learning and practising aggressive solu-tions to conflict situations. The effect appears to be cognitive in the short term,primary aggressive thoughts in the long term leading to changes in everydaysocial interactions. Given the trend towards (1) greater realism and more graph-ic violence in video games, (2) their increasing popularity, (3) the game playbecoming synonymous with the game character, (4) the active participationinvolved in video games and (5) their addictive nature, close monitoring andnew research are called for to clarify for society what risks are entailed - especial-ly for disaffected, isolated, alienated young people who have failed in school andin normal peer interactions and who have neuropsychotic vulnerabilities.

Both the Heide and Kelleher texts contrast the nature of public preconcep-tions about juvenile killers as a homogeneous group, characterized by threat,fear, loss of control, explosive rage, high levels of aggression, hostility, impul-sivity and unpredictability, with the reality of the importance of individualdifferences. Both authors emphasize the fact that most convicted killers areeventually released back into the community. Heide takes practitionersthrough the forensic examination of mental state and health in young killers,set within a complex legal framework. She emphasizes that with sensitiveinterviewing and behavioural observations, it is possible to elucidate whichand how many factors act in concert, and the child’s responses to each factorand the combination of factors. Of critical importance is the clinician’s abilityto unravel sequences of input and output, and parallel sequences in theprocesses of killing, and combination of the thoughts, emotions and expecta-tions, attitudes and other behaviours of the young person at the time. Heideconcludes that clinical assessment is to help understand, not to stereotype oroversimplify. Echoed in similar long-term work with young killers in the UK(Bailey and Aulich, 1997), she believes that these young people can changesubstantially, but need considerable assistance, direction and treatment whichcan only follow on from a detailed initial evaluation that is still not empow-ered by the courts. Often in England and Wales a tension remains betweenthe clinician’s wish to fully assess and treat and the lawyer’s imperative toensure that the rights of his/her client are maintained, rooted in the inherentadversarial nature of the English Legal System (Cavadino and Allen, 2000).

There are similar dilemmas facing clinicians in respect of the legal frame-work in both the UK and the USA, with one major exception. In some feder-al states of the USA, the death penalty still stands for 16-year-olds. Legal hur-dles to be traversed in the UK/USA include transfer to adult criminal court,mental state at the time of the offence in relation to defences of insanity,automatism, diminished capacity, self-defence, mitigating or aggravating fac-

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tors and in the USA distinctions between primary, secondary, first-degreemurder and manslaughter (Ashford and Chard, 2000).

In both the USA and UK, professionals practise in a climate of dual handi-cap: on the one hand, increasingly punitive responses towards young offendersand, on the other, a simultaneous expectation of a ‘quick fix’ solution for long-term reduction of violent crime committed by young people. This is epitomizedin England and Wales in the major reform of juvenile justice legislation: theCrime and Disorder Act 1998. Children aged 10 years in England and Walesand eight years in Scotland are now considered to be as criminally responsiblefor their acts as adults. To address this issue adequately there is a need to revisitthe process by which moral development progresses from childhood into adult-hood, and the impact of neuropsychological and psychosocial adversity on thisprocess, given the changing circumstances of many youngsters. As the childpasses from pre-trial to trial and what in the UK can be an indefinite sentenceof HMP (Her Majesty’s Pleasure), this will need repeated re-evaluation.

In a refreshing and scholarly paper, Rutter (1999) re-evaluates the psychoso-cial influences on child psychopathology. He argues that it is important to ‘putaside the absurd brain-mind dualisms of the past’. This message has been takenup in a positive and constructive review of how to reduce violence in the partic-ular social environment of American schools (Elliott et al., 1998). Only anapproach that brings together the multiple scientific fields described by theseauthors can help reduce the problem of violence within schools, the communityand the home. It could also help to counter the media rhetoric and public out-cry that accompanies the phenomenon of juvenile homicide. It should alsoallow mental health teams to work more effectively with other agencies to playtheir part in contributing to the common goal of creating a safer society but alsofulfilling the clinician’s role of working with the child to allow him/her toachieve safe autonomy in adolescence and on into adulthood (Bailey, 1999).

Susan Bailey Consultant Adolescent Forensic Psychiatrist

South London and Maudsley NHS Trust

References

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