11 Risk Factors for Intimate Partner Homicide-Suicide—and 5 Ways to Prevent It

Individual-level risk factors for IPHS can include:

• Physical abuse during childhood,
• Emotional neglect, 
• Witnessing intimate partner violence (IPV) of a parent, and/or
• A history of suicidal behavior.

In our focus groups, 24 percent of the survivors and families of victims of IPHS said that substance misuse or alcohol dependence was a circumstance prior to the incident. 

Research studies have examined the prior mental health and substance misuse histories of people who died by IPHS. However, little is known about their previous suicidal behaviors. These behaviors were present in our study for nearly 25 percent of perpetrators of IPHS. Prior suicidal behaviors included suicidal ideation, attempted suicide, and threats of suicide.

Relationship-level risk factors include:

• Unhealthy or harmful family relationships,
• Jealousy and/or possessiveness, and
• Divorce or separation. 

In the focus group, separation or divorce was a circumstance leading up to the IPHS incident for nearly 50 percent of survivors. Prior abuse by the perpetrator served as another risk factor for homicide-suicides.¹Bernie Auchter, “Men Who Murder Their Families: What the Research Tells Us,” NIJ Journal 266 (2010). Fifty-nine percent of victims or survivors in the focus groups endured short- or long-term abuse before the incident.

Risk factors for IPHS at the community level are:

• High rates of violence and crime,
• Limited support services,
• Social isolation from community residents, and
• Weak community sanction against intimate partner violence. Examples include unwillingness of neighbors and/or law enforcement to intervene in violent situations.

Rural residents have less access to support services such as local domestic violence shelters or community-based organizations. Focus group participants from rural areas indicated that even when support services were accessible, the options were limited. Research has shown that rural women are nearly twice as likely to be turned away from services because of inadequate staffing and a limited number of programs for survivors.¹Radha Iyengar and Lindsay Sabik, “The Dangerous Shortage Of Domestic Violence Services,” Health Affairs 28, no. Supplement 1 (January 2009): w1052–65, https://doi.org/10.1377/hlthaff.28.6.w1052.

Additionally, rural survivors in the focus groups experienced less effective responses from law enforcement than those in urban communities. For rural focus group participants, social isolation within their communities became a barrier to help-seeking. Research has shown that people who reported limited social connections in a community experienced higher rates of IPV.²Schreiber, Elizabeth, and Emily Georgia Salivar. “Using a vulnerability-stress-adaptation framework to model intimate partner violence risk factors in late life: A systematic review.” Aggression and Violent Behavior 57 (2021): 101493. Survivors in the focus group stated that this influenced the lack of intervention from community members.

Intimate partner violence should be a community-level concern. Education on neighborhood bystander intervention and local community-based resources can interrupt harmful situations. Such interventions also help those at risk access services, heal, and connect with a supportive community—leading to safety.

Societal factors contribute to incidents of IPHS or inhibit survivors from seeking intervention, mental health support services, or reporting their abuse. These factors include:

• Stigma of intimate partner violence and suicide, 
• Traditional gender norms on masculinity and femininity,
• Racial discrimination, and
• Sexism.

How society views intimate partner violence can encourage a culture of silence. Survivors may be told that they somehow “provoked” their abuse, or that they “could have left” the abusive situation. These messages promote self-blame and shame, which may lead to deadly consequences. Survivors anticipate the stigma they would receive from responders such as law enforcement, healthcare providers, and others.¹Nicole M. Overstreet and Diane M. Quinn, “The Intimate Partner Violence Stigmatization Model and Barriers to Help-Seeking,” Basic and Applied Social Psychology 35, no. 1 (January 1, 2013): 109–22, https://doi.org/10.1080/01973533.2012.746599. As a result, survivors can be hesitant or afraid to report their abuse or to seek interventions and protections.

Shame, stigma, and fear can limit women’s engagement with health services and the judicial system. Importantly, focus group participants also discussed the stigma that men experienced when seeking mental healthcare services. 

Research has shown that norms around what it means to be masculine, such as being “strong,” self-reliant, or avoiding emotions, can keep men from seeking mental health support when they are experiencing depression.²Silvia Krumm et al., “Men’s Views on Depression: A Systematic Review and Metasynthesis of Qualitative Research,” Psychopathology 50, no. 2 (March 11, 2017): 107–24, https://doi.org/10.1159/000455256. And even when they do seek help, providers may underestimate men’s needs and miss or misdiagnose their psychological needs because of their own gender biases.³Paul Sharp et al., “‘People Say Men Don’t Talk, Well That’s Bullshit’: A Focus Group Study Exploring Challenges and Opportunities for Men’s Mental Health Promotion,” PLoS One 17, no. 1 (January 21, 2022), https://doi.org/10.1371/journal.pone.0261997. 

Throughout the focus groups, there were 11 common risk factors for IPHS. Survivors and perpetrators of IPHS both navigate complex systems for intervention and support. These systems include:

• Victim services, 
• Substance misuse services, 
• Law enforcement, and 
• The court systems. 

Professionals in those systems, and any other systems encountering survivors, must understand the elevated risk of homicide-suicide. One way to further educate professionals on the realities of IPHS is through developing, survivor advisory councils at the local, state, and federal levels to offer opportunities for people most impacted to educate diverse stakeholders.

Policies that create time and space between a person experiencing a crisis and their firearm are crucial. These policies can prevent a moment of crisis from becoming an irreversible tragedy.

Policies and practices that can help mitigate the risks of firearm suicide or tragic actions include:

• Secure firearm storage in the home,
• Giving the keys or combination to the firearm storage device to a trusted friend or family member, or
• Storing guns outside of the home during a period of crisis. 

Domestic Violence Restraining Orders (DVROs) and Extreme Risk Protection Orders (ERPOs) are two tools to protect individuals from the risk of IPHS. Warning signs and risk factors from the focus groups indicate that these can be effective intervention methods.

DVROs include many vital protections for a survivor. These include, but are not limited to, housing protections and child custody provisions. ERPOs are solely focused on a person’s access to a firearm when they are a threat to themselves or others. These are both critical tools to keep individuals safe.

There is a high-risk link between intimate partner violence, suicidal threats, and access to a gun. Jurisdictions should consider including questions of suicide-related behaviors of the respondent on a DVRO petition. Suicide prevention and intervention resources should be shared with any respondent who demonstrates suicide-related behaviors.

For many survivors, it takes enormous courage to seek help and interventions. Systems responsible for the safety of the victim must quickly and safely disarm the abuser once they are prohibited from having firearms.

The Supreme Court recently upheld the constitutionality of the federal law prohibiting abusers subject to DVROs from possessing guns. The Court’s ruling in United States v. Rahimi provides a renewed call to action to states and local jurisdictions. Laws prohibiting domestic abusers from having guns and requiring prohibited abusers to turn in their guns must be well implemented to have their intended life-saving impacts.