The elephant in the room.
This campaign would be worth nothing if it flinched from the hardest fact of all. Very rarely — a few dozen times in a year of hundreds of homicides — a person in the depths of untreated psychosis, off their medication, takes a life. Pretending it never happens would be a lie, and lies are exactly what stigma feeds on.
So we will not look away. We will look at it soberly, honour the people who died, and ask the question that actually matters: why does it keep happening?
Two tragedies, thirty years apart
Behind every one of these rare events are people whose lives mattered, and families whose grief is real and permanent. They deserve the truth far more than they deserve a headline. Two cases, three decades apart, tell the same story — and point to the same answer.
Jonathan Zito
1992Jonathan Zito, a 27-year-old musician, was killed at Finsbury Park Underground station by Christopher Clunis, a man with paranoid schizophrenia who had fallen repeatedly through the gaps in his care. The independent Ritchie inquiry that followed described not a monster but a “catalogue of failure” — missed appointments, poor communication, and chances to step in that were let slip again and again.
His widow, Jayne Zito, did not answer with vengeance. In 1994 she co-founded the Zito Trust with Michael Howlett — not to blame people who are ill, but to fight for the care that would stop this happening to anyone else. The Trust helped shape the Mental Health Act 2007 and ran for fifteen years before closing in 2009, its core aims met.
Barnaby Webber, Grace O’Malley-Kumar and Ian Coates
2023In Nottingham, two 19-year-old students and a 65-year-old school caretaker were killed by Valdo Calocane during a psychotic episode. He had paranoid schizophrenia, had been sectioned four times between 2020 and 2022, and was then discharged because services “could not find him”. For around nine months before the attacks he had no contact with mental health services, was not taking his medication, and an outstanding warrant for his arrest was left unactioned.
The independent investigation and public inquiry that followed found, three decades after the Ritchie report, almost exactly the same failures: a system reacting to crises instead of preventing them, a risk never properly understood or recorded, and a family whose alarm went unheard. The names change. The pattern does not.
The Zito Trust began the way the best responses do — not as a blame economy against people who are ill, but as a refusal to let a system’s failures pass quietly. That is the spirit this page is written in.
How rare — and how it is not the whole story
Honesty cuts both ways. These events are real, and they are also extraordinarily rare against the hundreds of thousands of people in the UK who live with schizophrenia and will never harm anyone. Both things are true at once.
homicides in a typical year across the UK — from every cause combined.
of those are estimated to involve a person diagnosed with schizophrenia — roughly 5–10%.
of mental-health homicide inquiry cases (England, 2010–2023) involved someone who had stopped treatment or disengaged from follow-up care.
The thread that runs through every case
Read the inquiries and the same factors appear again and again. These are not the hallmarks of an inherently dangerous group of people. They are the hallmarks of care that arrived too late, or never arrived at all.
Untreated, not “untreatable”
In case after case the person was in the depths of acute psychosis and not in any meaningful contact with care. These are not stories of evil; they are stories of illness left to run unchecked.
Off medication, disengaged from services
Stopping treatment and dropping out of follow-up is the single most consistent thread running through these tragedies — and it is precisely what a functioning system is supposed to catch.
Warning signs that were missed
Prior violence, visible deterioration, families ringing the alarm — the signals were usually there. What failed was the response to them, not the prediction of them.
A system without capacity
Too few beds, assertive outreach cut back, people discharged to a “GP follow-up” that never happens. Tragedy tends to grow in the gaps that underfunding leaves behind.
Fear is not a safety policy
It is tempting to think that fearing people with schizophrenia keeps us safe. It does the opposite. The fear-soaked headline drives the underfunding, the closed beds and the shame that stops people seeking help — the very conditions in which these rare tragedies grow. Stigma is not the price we pay for safety. It is one of the things making us less safe.
What actually prevents these deaths is unglamorous and well understood: fast, assertive, properly resourced care that does not lose people; treatment people are supported to stay on; and families who are listened to the first time they raise the alarm. The same care that protects the public protects the person who is ill — and the hundreds of thousands who will never hurt anyone but are tarred by association.
The victims deserve the truth and real change. The hundreds of thousands who will never harm a soul deserve not to be branded by the rarest of tragedies. Holding both at once is not a contradiction — it is the only honest place to stand.
If you are worried about someone, or struggling yourself, you are not alone. In the UK you can call Samaritans on 116 123 free, any time, or NHS 111 for urgent mental-health help. If someone is in immediate danger, call 999. Outside the UK, find a helpline at findahelpline.com.
Sources and caveats. Around 570–600 homicides are recorded in the UK in a typical year, from all causes (Office for National Statistics: 570 in England & Wales in the year to March 2024). The National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) estimates that roughly 57 a year are committed by people who had been in contact with mental health services in the previous 12 months — about 11% of all homicides. The schizophrenia-specific figure of approximately 35 a year (about 5–10% of homicides) is an estimate that varies with how a “mental-health homicide” is defined; the charity Hundred Families argues official counts understate the true number because they exclude cases without a conviction or where the person was never under specialist care. A review of mental-health homicide inquiries in England (2010–2023) found 52% of those involved had a diagnosis of schizophrenia and 52% had a documented history of stopping medication or disengaging from follow-up. A national case-control study of homicide by men diagnosed with schizophrenia found that 94% of those homicides were committed by people who either misused drugs or alcohol or were not receiving their planned treatment — in other words, the danger concentrates almost entirely where care has broken down. Substance misuse is a major aggravating factor, present in a large share of cases. Crucially, for people with schizophrenia who are engaged in planned care and not misusing drugs or alcohol, homicide is exceptionally rare — and people with schizophrenia remain far more likely to be victims of violence than perpetrators (by one robust estimate around 14 times more likely), with suicide a far more common cause of premature death than homicide. Case details are drawn from the 1994 Ritchie inquiry into the care of Christopher Clunis, and from the independent review and public inquiry into the care of Valdo Calocane, who was sentenced in January 2024 to an indefinite hospital order. This page honours the victims named here; it is not medical or legal advice.