It’s important to learn from the rare cases of children who murder

Psychiatrist Professor Dame Sue Bailey, argues such cases show the need to give equal priority to children’s mental health

Will Cornick, identified by the court after being found guilty of the murder of his spanish teacher Ann Maguire.

When any ‘child’ carries out in public a very violent, totally unprovoked act that results in the death of a highly respected and caring person the reaction is one of shock, horror and mystification.

The question asked is: what drives a young person to behave in this way? And were there any signs that could have been picked up by professionals to predict this behaviour?

Most professionals working in child mental health, social care, justice, and education are used to dealing with young people with a conduct disorder on a day-to-day basis. However, both practitioners and researchers are beginning to realise there is a small subgroup who are of higher intelligence, who do not have a very notable history of criminal behaviour, but who present with cold, callous, unemotional traits.

Personality disorders, including psychopathic personality disorders, have been seen as conditions that emerge in adolescence, but diagnosis is not made before the age of 18.

In addition, more recent work on understanding the nature of personality disorder has shifted from the concept of it being a fixed condition to one of it being dynamic and changing over both time and circumstances.

In the past, personality disorder has been measured by what is observable ‘bad’ behaviour. But what often seems to happen in some cases is an event, or series of events in an already possibly biologically vulnerable brain that leads to the young person experiencing intense anxiety.  Anxiety that must be controlled at all costs.

Coping mechanisms come into play that deliver immediate relief, but are in the medium to long-term, maladaptive – storing up trouble for the future.

In turn, some children as they enter adolescence discover that there is an increasing sense of pleasure to be gained from the domination and control of others in both fantasy and fact. This is the path to ongoing and escalating sadistic thoughts and subsequently behaviours.

What started them onto the pathway to murder may appear to us to be a trivial event in their lives. But for them that event was critical. This could be anything from being ‘put down’ by a significant person in their life, facing the onset of a chronic illness or believing the only way they can have any sense of self is through destroying another person.

Not uncommonly, the young person does not hide their intentions from others.  But what triggers the final act – the final place, time, and victim choice – often does not emerge in therapy for months or indeed years after the offence.

The majority of young people who have murdered – even the group with cold, callous and unemotional traits – are able to make some tacit acknowledgment of what this might mean for the victim’s family.

It is important for these young people to move on from needing a sense of domination and power and wanting to denigrate others, towards pro-social thinking where they can cope with whatever has set them on a path to murder.

Over many years, working with other professionals, I have seen, assessed, and been part of a team intervening with young people who have killed. Many serve what, compared to other countries, are long sentences in detention. But carefully risk managed, these young people do eventually gain parole (often when they are adults) and go on to lead pro-social lives under conditions of license. Like the victim’s family, and their own family, their lives are changed forever.

A very small number remain ‘untouchable’ and spend their lives in prison where the staff have the task of delivering humane care.

In society the debate on what should happen to such young people continues as does discussion about whose fault it is –parents, the impact of social media and whether some  people are just ‘born bad ‘.

But what’s really important is to learn from these ‘rare cases’ and feed that knowledge back into the system so that together we can better prevent any child setting off on the path to murder.

To do that we need society as a whole to realise that a child’s mental health matters as much as their physical health.

Professor Dame Sue Bailey is the chair of children and young people’s mental health coalition, and past president of the Royal College of Psychiatrists

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One Response to It’s important to learn from the rare cases of children who murder

  1. June Jellies November 10, 2014 at 12:11 pm #

    Many adoptive parents of teenagers that come from a background of maltreatment in their birth families have followed this case with unease. There but for the grace of [your] god go we.

    ‘However, both practitioners and researchers are beginning to realise there is a small subgroup who are of higher intelligence, who do not have a very notable history of criminal behaviour, but who present with cold, callous, unemotional traits’ Sadly this paragraph could be about our children and young people.

    We struggle daily with professionals who cannot agree on why our young people are so anxious/depressed/verbally & physically aggressive/ not progressing at school/ antisocial / abuse substances/ are sexually active at a young age and are involved in criminal activity.

    Our young people return to an `uncaring` care system/ YOI /theraputic communities or mental health units – still without a diagnosis that Psychiatrists/ Psychologists/ Social Workers or Support Agencies can agree on.

    The following excerpt from Professor Bailey says it all;

    `In the past, personality disorder has been measured by what is observable ‘bad’ behaviour. But what often seems to happen in some cases is an event, or series of events in AN ALREADY POSSIBLY BIOLOGICALLY VULNERABLE BRAIN that leads to the young person experiencing intense anxiety. Anxiety that must be controlled at all costs.

    As parents actively, tirelessly, advocating for care, understanding and theraputic help to stop our young people becoming the next Will Cormack, we need professionals to stop talking about `an already possibly biological vulnerable brain’ with such wishy washy disreguard.

    Society needs to decide whether they want to really change the future for these vulnerable young people so that they can lead pro social lives. I would argue that the professionals that Professor Bailey used to lead and those in the C&YP MH Coalition could make a start by encouraging services and therapies that overwhelmingly help adopters to re parent their young people, even where those therapies may be unevidenced.

    Parents are doing their best – Professionals need to stop arguing over the why’s and wherefore’s , stop the blame game and , yes please, learn from the rare cases but also learn from those that are but one step away.