Serious Incident Inquiries: a survival kit for psychiatrists

Abstract

Since 1999, a formal external inquiry into every homicide committed by a person with a mental disorder has been mandatory in the UK (Department of Health, 1994). Common opinion among psychiatrists is that Serious Incident Inquiries are unhelpful as they all reach similar conclusions, add nothing to our current knowledge and do more harm than good in terms of adverse publicity for mental health services (Buchanan, 1999). Despite this, there is presently little sign of a change in public policy. Psychiatrists continue to face the fact that the next incident could be ‘the one that's coming here’. Although the many flaws of the inquiry process have been well described (Szmukler, 2000), few have interpreted this knowledge in a way that is of practical help to a psychiatrist facing an inquiry.