Characterization of mentally ill maternal perpetrators of filicide assigned to a single psychiatric-forensic facility, including previous access to mental health services. A cross-sectional, retrospective analysis of medical records and legal documentation of maternal filicide patients at a single psychiatric-forensic facility (1990–2021) was performed. Socio-demographic, relationship, psychopathological, and criminological characteristics were collected. Data were compared according to previous perpetrators’ access to mental health services or not and access within 1 year prior to filicide or not. All 55 detainees (mean age 34.8 ± 6.2 years) were included. There were 64 victims; 15 (23%) were ≤ 1 year old and most (77%) were single victims. Some mothers had history of violence/abuse (29%), an aggressive parent (45%), and violent relationships with their intimate partner (46%) and were socially isolated (49%). Most crimes were motivated by altruism (53%). Women had attempted suicide in 39% of filicide cases. Previous psychiatric diagnoses were available for 56%; 71% had accessed services for ≤ 1 year. Patients unknown to mental health services were less likely Italian, with children below preschool age and with no history of physical abuse/violence, aggressive parent, or suicide attempts. Patients lost to mental health services (> 1 year) were less likely Italian or assuming psychopharmacological therapy, were in shorter relationships, and were mostly diagnosed with personality disorders. Female perpetrators of filicide are often unknown/lost to mental health services prior to the crime. Multifactorial historical and current characteristics aid in identifying mothers at risk. Communication of the availability of mental health services must be multi-lingual.
