homicide

To Wong Foo, Thanks For Everything, Julie Newmar

/ Siobhan O'Dwyer

I woke up at 4am this morning full of dread. My colleagues and I had recently conducted a study of homicidal ideation in family carers and it was about to hit the press. I was terrified that dodgy journalists and click-hungry editors would twist the story, shaming carers and making it even harder for them to ask for or receive the support they need. I was worried that the carers who trusted me with their stories would think I’d sold them out and that the advocacy organisations I work with would regret ever having supported the research.

It’s now almost 8pm and I’ve barely been off the phone. I’m exhausted, I’m hungry, I’m pretty sure I smell, and I am completely overwhelmed by the positive response. From the first story in the Sydney Morning Herald, to an interview with The World Today that I did in my dressing gown, every journalist I’ve spoken to has been respectful, cautious, and genuinely concerned about the wellbeing of carers. Even the outlets that are not normally known for their tact have been incredibly compassionate. 2GB’s Chris Smith, for example, sent a fruit basket to one carer who called in, because he felt so helpless in the face of her despair. And the fact that this was the Most Read story on The Age website today is testament to just how important these issues are!

It’s been a privilege to spend my day talking about carers and the amazing work that they do, raising awareness of the dark times, and encouraging a public discussion about how our society thinks about care. I’ve spoken to journalists from Tamworth to Toorak and I want to send a heartfelt thanks to every one of them for helping us raise the profile of carers and being brave enough to have these difficult conversations without resorting to nasty headlines and cheap clickbait. I especially want to thank those who gave carers the opportunity to call in and share their stories on air – it was compelling, heartbreaking, and a thousand times more powerful than anything I said.

But now my mascara is sliding down my face, my throat is sore, and it’s time for bed. Tomorrow I will get up and keep fighting the good fight. Because carers are worth it!

It’s Complicated

/ Siobhan O'Dwyer / 3 Comments

While conducting research on suicide risk in family carers of people with dementia, my colleagues and I received a note from a participant that said You asked if I wanted to kill myself, but you didn’t ask if I wanted to kill the person I’m caring for. Naturally this raised a lot of questions and concerns and we decided to embark on a study of homicidal ideation in family carers. The findings from that study were published this week and I thought I’d take the opportunity to share them here and discuss the implications.

Here’s a brief summary:

  • We interviewed 21 Australians providing care for a family member with dementia.
  • Two reported actively contemplating homicide while caring and four expressed a passive desire for the care recipient’s death.
  • When asked about homicide, four carers talked about euthanasia.
  • Thought of homicide and passive death wishes were the result of physical and psychological fatigue, an unwillingness to place the person with dementia into residential care, self-defence, isolation, and a sense of being trapped in the caring role.
  • Thoughts of euthanasia were framed in terms of compassion, quality of life, dignity and respect for the person with dementia.
  • None of the carers who had contemplated homicide or had passive death wishes had ever acted on their thoughts.
  • Those who spoke of euthanasia were frustrated at the lack of legal options, but adamant that they wouldn’t take matters into their own hands.
  • All the carers who reported homicidal thoughts or passive death wishes were women.
  • None of the carers who had contemplated homicide or had passive death wishes had ever shared their thoughts with anyone.

To our knowledge there has been no previous research on homicidal ideation in family carers. What previous research has shown, however, is that up to 40% of completed spousal homicide-suicides among older adults are perpetrated by someone caring for a partner with a long-term illness or disability. By asking carers about homicidal thoughts while they are caring, the current research allows us to better understand the factors that place people at risk and identify ways to prevent these sort of deaths in the future.

Although thoughts of homicide do not necessarily lead to homicidal behaviour, the fact that some carers are contemplating homicide is a cause for concern and reflects the high level of distress that many carers experience on a daily basis. Unfortunately, some people will be quick to use this work to shame carers who contemplate homicide. Although I don’t condone violence or abuse, I also don’t want to see carers vilified. The vast majority of carers are amazing people, doing an incredibly difficult job, with very little support. So let’s use this research to help them see that they’re not alone and help them find the support they need. Those on the frontline – GPs, social workers, nurses, pharmacists, aged care providers, and advocacy organisations – all have a part to play in identifying and supporting carers who are struggling. These are not easy conversations, but they are important ones.

I think it’s also important to recognise that these findings are indicative of a bigger social problem. It’s easy to think of dementia and caring as personal issues, but they are social, political, and economic issues. In Australia alone there are more than 300,000 people caring for family members with dementia and if they all stopped tomorrow, it would cost the government more than $30 billion a year to replace the care they provide. Carers make a significant social contribution, but much of the stress they experience stems directly from a lack of social, political, and economic support — delays in the dementia diagnosis, a lack of access to quality respite care, a lack of understanding from employers, and the challenges of navigating the aged care system, just to name a few. So while we must work to identify and support individual carers who are contemplating homicide, we must also take action at a higher level, advocating and agitating for a social, political, and economic framework that makes caring a less stressful and more sustainable experience.

The overlap between homicide and euthanasia in this study also highlights the need for a serious public conversation about the right to die with dignity.

As this research gets disseminated – particularly via the media – the findings may be taken out of context, oversimplified, or hijacked. But homicidal ideation in family carers is a complex phenomenon – it cannot be reduced to soundbites, it must not be used for political gain, and there is so much about it we still don’t understand. Ultimately I hope that this research will start important conversations about caring and its role in our society. I also hope it will lead to further research on homicidal ideation in carers (including quantitative studies, comparisons across countries, and research on people caring for family members with other illnesses and disabilities) and help to facilitate the social, political, and economic changes that are needed to better support people with dementia and their families.

If you’d like to read the full paper and have institutional access, please go to the journal website. If you don’t have access, please contact me for a copy.

If you or someone you know is contemplating homicide or suicide, or needs urgent support, please contact Lifeline on 13 11 14, The Suicide Call Back Service on 1300 659 467, or the crisis line in your area.

On Voyeurism and Tragedy

/ Siobhan O'Dwyer / 2 Comments

On a cool Friday night in downtown Brisbane, people gathered to hear a famous author speak. Predominantly middle-aged and middle class, the stylishly attired crowd talked amongst themselves about their favourite books and rushed forward when the doors opened, eager to sit near the front. They listened closely as the author spoke – laughing, sighing, gasping in shock. And when she finished, they queued and asked her to sign the inside cover of her latest work.

This was my first time at a Writers Festival and the whole thing made me deeply uncomfortable. Why? Because the author was Helen Garner and the book was This House of Grief, the true story of a man convicted of killing his three children by driving his car into a dam.

To be clear, I admire Garner. As a writer she has an amazing ability to capture the complexities and discomfort of life’s darkest moments.  But there was something voyeuristic about the crowd that came to hear her speak. This was their Friday night entertainment. They had dinner reservations afterwards. They wanted an autographed copy of the book!

As I caught the train home, I wondered what it was about homicides, suicides, and other tragic events that brought out the voyeur in people. What makes people trawl newspapers and websites looking for the ‘exclusive interview’ with the grieving widow? What makes them watch the ‘dramatic reenactment’ on prime time television? How are they able to set aside the fact that these are real people and put a bookmark in when it’s time to pick the kids up?

But perhaps I judge too harshly. Perhaps it isn’t voyeurism, but simply a desire to understand the darker parts of human nature. Perhaps, because we are often shielded from the darkness, people struggle to know how to express their interest or concern appropriately. Perhaps a Writers Festival is a safe space to discuss the issues with like-minded people. And yet, the autographs…

For my part, I was interested in Garner’s experience as a researcher and writer, and was hoping to find a connection with someone who’d been where I was. I had recently finished analysing data for a study of homicidal ideation, a follow-up to earlier research on suicide risk in family carers. When I’d listened to the recordings of the research interviews, I’d had to wash dishes, knit, or draw. The repetitive, physical tasks kept my body occupied while my mind swam in the tragedy. Without them, the flight-or-fight response would have kicked in and I’d have turned off the tapes. Unlike the voyeurs at the Writers Festival, I would have given anything to look away from the car crash.

When I bought my copy of This House of Grief, the bookseller made a point of telling me how traumatising I would find it; as if being traumatised was a badge of honour. When I told her I did trauma for a living, she clicked her tongue and moved on to the next customer. It was as if she’d invited me to an S&M club and when I told her I was the warden of a detention centre, I was the one who’d crossed the line.  I wondered if what the voyeurs want is just enough tragedy to be titillated. Just enough to get a whiff of the humanity, but not so much that they have to get their hands dirty. They want grief and trauma, but only if it doesn’t pull them too far out of their comfort zone. And perhaps this is why Garner’s books sell – because she’s already done the hard work.

But here’s the thing – I didn’t find This House of Grief traumatic. I just found it depressingly familiar. For those of us who work in this space – researchers, doctors, lawyers, journalists, social workers – the darkest moments are all too common. We see them daily. They aren’t titillating anecdotes to tell at the next dinner party, they are big issues that we will spend our careers trying to address. And when the voyeurs have moved on to the next book, the next Writers Festival, the next ‘award-winning two part series’, we will still be here. Not watching from a safe distance, with cocktail in hand, or reading on the couch with a cup of tea and a Kit Kat, but working in the trenches to support people and shine a light on the darkness.