Researchers identified people convicted of homicide in England and Wales between 1996 and 1999 and recorded whether the victim was known to the perpetrator.
Stranger homicides increased substantially since 1967. However, contrary to popular fears, perpetrators of stranger homicides were less likely to have a mental illness or to have been under mental health care than perpetrators of homicides in general. Instead, stranger homicides were most likely to be committed by young men with a history of alcohol or drug misuse.
These findings suggest that stranger homicide is more often associated with alcohol and drug misuse than with severe mental illness, say the authors. This is also true of non-stranger homicides.
Failings in mental health care have contributed to individual cases, and steps should be taken to prevent this. However, stranger homicides are more often committed by young men under the influence of alcohol and drugs, and a public health approach to homicide prevention should place greater emphasis on reducing alcohol and drug misuse in this group, they conclude.