Filicide, the killing of a child by a parent, is a devastating form of violence and an often-overlooked public health tragedy. This rare and shocking act reverberates across families, communities, and health systems.  

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For nurses, particularly in mental health and midwifery, understanding filicide risk is crucial as a first step in supporting appropriate intervention with compassionate, preventative care. Mental health nurses and midwives are often the first point of contact for parents struggling with mental health, trauma, or overwhelming social pressures.¹ Yet research shows that filicide remains under-recognised in education and practice,² leaving many clinicians without the tools to identify and respond to warning signs.

What the evidence tells us

A recent scoping review of international literature examined the circumstances and risk indicators linked to filicide. Although cases vary, clear themes emerge.

First, parental mental illness featured prominently.^3,4 Disorders such as psychosis, depression, and personality disturbance were often present in parents who killed their children. Importantly, not every parent with mental illness is at risk, but unrecognised or untreated mental health disorders can elevate vulnerability.

Second, gendered patterns are also evident. Mothers were more likely to commit filicide or experience filicidal thoughts during the perinatal period or when struggling with postnatal mental health issues.^5,6 Fathers acts of filicide were more frequently linked to revenge motives in the context of separation or custody disputes.⁷ This underscores the need for gender-sensitive approaches in both assessment and prevention.

Third, trauma and cumulative stressors consistently emerged.^3,4 Parents who themselves had histories of abuse, intimate partner violence, social isolation, or substance misuse were overrepresented in cases. The interplay of multiple adversities rather than a single trigger often set the scene for tragedy. Many parents experienced financial stress, unemployment, or unstable housing in addition to mental health challenges, leaving few protective factors.

Finally, the review highlighted that filicide is rarely “out of the blue.” Missed opportunities for intervention were common, including overlooked disclosures, fragmented care, or services that focused narrowly on either the parent or child but not both. These gaps reveal systemic weaknesses that health professionals, including mental health nurses and midwives, are well placed to help address.

Why this matters for nurses and midwives

Mental health nurses and midwives, working on the frontlines in settings where at-risk parents appear, have both a unique opportunity and responsibility to identify and support them.

For midwives, the antenatal and postnatal period is a unique window for prevention. Midwives often develop trusted, ongoing relationships with mothers, making them ideally placed to detect early warning signs such as worsening depression, thoughts of self-harm, or unsafe relationships. Sensitive questioning, coupled with appropriate referral pathways, can mean the difference between timely support and escalating risk.

Mental health nurses frequently work with adult clients, but practice that also considers dependent children can help identify potential risks. In acute, community, and forensic settings, nurses may be among the few professionals aware of a parent’s distress, substance misuse, or violent tendencies. Recognising the potential implications for children requires a holistic, family-focused approach.

However, nursing and midwifery education rarely addresses filicide explicitly.Without structured training, many clinicians may feel ill-equipped to ask difficult questions about parenting stress, domestic violence or filicidal thoughts. This silence can perpetuate stigma and prevent parents from seeking help.

Incorporating filicide awareness into trauma-informed care is essential. Rather than framing parents as potential perpetrators, nurses and midwives should approach assessment through the lens of compassion, safety, and prevention. For example, routinely asking about distress symptoms, substance use, support networks, and experiences of violence provides openings for early intervention without judgement.

A call to action

Filicide is complex, multifactorial, and confronting, yet in many cases, it can be preventable. For nursing and midwifery practice, three priorities stand out:

1. Education: Embed filicide prevention into undergraduate and postgraduate curricula so that nurses and midwives graduate with awareness of risk factors and confidence to respond.
2. Practice support: Develop clear guidelines and decision-making tools for frontline clinicians, particularly in mental health, perinatal, and emergency care. These should outline not only risk assessment but also safe referral and collaboration with child protection.
3. Compassionate engagement: Foster cultures where parents can disclose struggles without fear of judgement, ensuring early support rather than punitive responses. Reducing stigma encourages parents to seek help before reaching crisis point.

Australia’s healthcare landscape must confront the hidden tragedy of filicide. Integrating filicide prevention into everyday practice, nursing and midwifery can help shift the focus from reaction to prevention, protecting vulnerable children while supporting parents through crisis. With awareness and compassionate practice, the profession can play a pivotal role in filicide prevention and safeguarding families.

Declaration of interest: None

Financial Disclosure statement: None

References

1 Coates D, Foureur M. The role and competence of midwives in supporting women with mental health concerns during the perinatal period: A scoping review. Health Soc Care Community. 2019 Jul;27(4):e389-e405. doi: 10.1111/hsc.12740. Epub 2019 Mar 21. PMID: 30900371.

2 Brown, T. C., Tyson, D., & Fernandez Arias, P. (2025). Filicide: Implications of new research for practice. Children Australia,47(2), 3053. doi.org/10.61605/cha_3053

3 Giacco, S., Tarter, I., Lucchini, G., & Cicolini, A. (2023). Filicide by mentally ill maternal perpetrators: a longitudinal, retrospective study over 30 years in a single Northern Italy psychiatric-forensic facility. Archives of Women’s Mental Health, 26(2), 153-165. https://doi.org/10.1007/s00737-023-01303-6

4 Özcanlı, T., Aslıyüksek, H., Okur, İ., Aksoy Poyraz, C., & Kocabaşoğlu, N. (2024). Patterns in paternal and maternal filicide: A comparative analysis of filicide cases in Turkey. Journal of Forensic Sciences, 69(6), 2110-2119. https://doi.org/10.1111/1556-4029.15625

5 Barone, L., & Carone, N. (2021). Childhood abuse and neglect experiences, Hostile-Helpless attachment, and reflective functioning in mentally ill filicidal mothers. Attachment and Human Development, 23(6), 771-794. https://doi.org/10.1080/14616734.2020.1738510

6 Bramante, A., & Di Florio, A. (2023). A case–control study of filicide/infanticide in 90 mothers. Archives of Women’s Mental Health. https://doi.org/10.1007/s00737-023-01401-5

7 Myers, W. C., Lee, E., Montplaisir, R., Lazarou, E., Safarik, M., Chan, H. C. O., & Beauregard, E. (2021). Revenge filicide: An international perspective through 62 cases. Behavioral Sciences and the Law, 39(2), 205-215. https://doi.org/10.1002/bsl.2505

Authors:

Claire Hayes, School of Nursing and Midwifery, Centre for Quality & Patient Safety, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia. ORCIDiD: 0000-0003-2908-9304

Alison Hansen, School of Nursing and Midwifery, Monash University, Victoria, Australia

Louise Alexander, School of Nursing and Midwifery, Centre for Quality & Patient Safety, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia. Alfred Health. Mental & Addiction Health, Melbourne, Victoria, Australia. ORCiD: 0000-0002-1686-1476