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Setting fires is often ignored in forensic mental health, but it should not be. Many people who set fires intentionally have mental disorders, and the fires they set can have deadly results.
In their presentation for the International Forensic Psychiatry Lecture Series, Drs. Renée Sorrentino, Susan Hatters Friedman, and Lawrence Belcher said forensic psychiatry education and knowledge about firesetting behaviour are lacking, although that is changing. Forensic psychiatrists should be aware of the risk factors, assessment, and treatment for people who set fires, so they can plan appropriate treatment for this population.
Researchers have recently developed guidelines and specialized questionnaires to help psychiatrists assess individuals who set fires. Professionals can now benefit from an organization working in this area, the International Association for Firesetting Intervention, Research, and Education (IFIRE).
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Understanding Who Sets Fires and Why
Intentional firesetting is what forensic mental health professionals call the behaviour. If the person is charged with a crime, it is called arson. If a mental health professional diagnoses pyromania, it means the person’s firesetting behaviour meets specific characteristics listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition.
Research shows that many people charged with arson have a history of mental health issues and are more likely to have schizophrenia than the general public. Studies also show that people with mental disorders who set fires often lack dependable relationships, have a history of brain injury or abnormal results of tests for brain electrical activity, or have substance use disorder or antisocial personality disorder. They have higher rates of suicide, suicide attempts, and self-injury (including burns) than other people with mental disorders who offend.
Some research findings about people who commit arson show they are like other people who offend, except they are more likely to have a learning disability or autism spectrum disorder. But other studies find people who offend by setting fires are more likely to be single, lack education and stable employment, have lower self-esteem, have more behavioural problems as children, and be more hostile, passive aggressive, and irritable.
Most people with mental disorders who set fires do not have a diagnosis of pyromania, which is a rare disorder. The small proportion of people with pyromania often have other mental disorders as well.
People who set fires may have motives for their behaviour. One study showed that the motives for a group of people charged with arson were revenge, attention-getting, covering up other crimes, and suicide.
Studies of people with mental disorders who set fires show differences between men and women. Compared with men who set fires, women who set fires are more likely to have relationship difficulties and personality disorders. They are also more likely to set fires to attract attention or to harm themselves. Women are also more likely to have had emotional difficulty, impulsive behaviour, or a triggering event in the month before they set a fire. When women set fires, they are more likely to target someone and to plan the fire. But they are less likely to have a serious alcohol problem or to be intoxicated when they set fires.
Legal Outcomes in the U.S.
In many lawsuits in the United States, judges have ruled that mental health professionals and organizations have legal obligations when a patient has set fires in the past. Courts in several cases held organizations or professionals liable when a person with a history of setting fires set another fire that damaged property or endangered others. In one case, a court ruled that a mental health therapist had a duty to warn when a patient threatened to burn his parents’ property and later did so.
American courts are more likely to find people who committed arson not competent to stand trial or not guilty by reason of insanity than people who committed other crimes. But people who commit arson are usually found not guilty due to psychotic disorders or intellectual disabilities, rather than pyromania.
People who have committed arson also tend to break other laws and are often convicted of other crimes as well. Studies show that people charged with arson often continue to commit crimes. A study of more than 12,000 people who had committed arson in the United Kingdom showed that well more than half later committed other criminal acts, and up to 10 per cent committed arson again.
But Dr. Belcher described several people who had set fires and could later live in the community without setting more fires. In these cases, the individuals received treatment for several years in forensic or civil hospitals. They could return to the community after assessment showed a low risk that they would set fires again.
Assessing People Who Set Fires
Research in the past few years has shown how to assess a person’s risk of setting fires. Questionnaires for assessing people who set fires — such as the Four-Factor Fire Scales, the Fire-setting Assessment Schedule, and the Identification with Fire Questionnaire — use different questions and approaches than those used in violence risk assessment. In addition, IFIRE is developing best practices and guidelines for mental health professionals. Risk assessment for firesetting is relatively new, so its potential as a useful clinical tool for identifying fire-specific treatment needs remains unclear.
For more details, watch the recording of the November 13, 2025, lecture, “Fire Setting and Forensic Mental Health” on our website
Written by Carolyn Brown and approved by Drs. Renée Sorrentino, Susan Hatters Friedman, and Lawrence Belcher.
