Abstract
General Overview: This article looks at femicide-suicide (the killing of women by men who then take their own lives) risk factors in an eleven-city case control study of femicide in the US.

Objectives: It aims to find out whether there are specific femicide-suicide risk factors that should be assessed at a point of contact with either partner violence victims or perpetrators for intervention and prevention.

Methods: Using logistic regression, victim, perpetrator, relationship and incident characteristics are analysed for 67 femicide-suicide cases and 356 controls of women in the community with non-fatal physical abuse across eleven US cities.

Discussion: The most identifiable risk factor in encounters prior to the event of femicide-suicide, was partner’s access to a gun, prior threats to kill her, prior threats with a weapon, a stepchild in the household, estrangement from the perpetrator and a marital relationship. In the final incident level regression analysis model, the use of a gun strongly predicted the femicide-suicide over the worst incident in an abusive relationship. Discussion also looks at the issue of availability, accessibility and effectiveness of mental health services for men to reduce the risk of femicide-suicide among abusive partners with depressive symptoms.

Results: The most important risk factor for intimate partner femicide-suicide is found to be prior domestic violence. The findings show a higher proportion (72%) of prior domestic violence among femicide-suicide cases than has been reported by others. The only difference in prior domestic violence among femicide-suicide cases is a smaller proportion of cases abused also during pregnancy. The risk factors in the regression analysis models that are specific to femicide-suicide cases compared to overall femicide risk analyses include prior perpetrator suicide threats and victims having ever been married to the perpetrator. The risk factor which did not become a significant independent predictor of femicide-suicide is perpetrator illicit drug use. However, 50% of femicide-suicide perpetrators are still reported to use illicit drugs.

Conclusions: Policy implications are raised with regard to access and use of guns as significantly increasing the risk of death for both victims and abusive partners. The femicide-suicide risk factors identified in this analysis are included in the revised Danger Assessment instrument. Health professionals, particularly in mental health and alcohol and drug treatment, should assess for dangerousness to assess men about past abusive behaviours, suicidal ideation and depression in the context of separating from their partner.