Holocaust Memorial Day: remembering the psychiatric patients who were victims of Nazi persecution

27th Jan 2017
Challenging mental health inequalities
David Crepaz-Keay

Dr David Crepaz-Keay

Head of Research and Applied Learning

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This content mentions death or bereavement and discusses discrimination or discriminatory violence (such as antisemitism, homophobia, racism, sexism and ableism), which some people may find triggering.

We’re all familiar with the horror of the Nazi attempts to annihilate the Jewish population in the 1940s – the Holocaust.

One of the less well-known aspects of Nazi policy was the genocide that included the slaughter of up to 275,0001 psychiatric patients. The majority of them, like me, had a diagnosis of schizophrenia. A further 400,000 people were sterilised on medical grounds.

Nazi persecution

Between 1941 and 1945, the Nazis attempted to kill all Jewish people in Europe. This is known as the Holocaust (The Shoah in Hebrew). In addition, the Nazis targeted Gypsies, Black people, Slavic people, LGBTQIA+ people, people with disabilities, political opponents and those whose religious beliefs conflicted with Nazi ideology. (Information taken from the Holocaust Memorial Day Trust website)

Holocaust Memorial Day

This year’s theme for Holocaust Memorial Day is “how can life go on?” It includes remembering past events, encouraging us to consider how we are facing hate today and how we can help people from persecuted groups to ensure that life goes on in the face of hate and persecution.

With these themes in mind, consider some of the arguments used to promote the murderous policy adopted toward psychiatric patients and why we must be aware of the impact this thinking could have now and in the future.

In the 1930s, the eugenics movement was well established in the US and UK. The work of Ernst Rüdin and Franz Kallmann reinforced this - they believed that schizophrenia was simply an inherited disease. It became part of the quest for rassenhygiene (racial hygiene), which drove the Holocaust with mass murder at its core.

But this interpretation of the science was by no means the only driver. One early motivation was cutting the cost of care for psychiatric patients. Funding for care decreased as demand increased.2

In 1920, Karl Binding and Alfred Hoche published Permission for the Destruction of Life Unworthy of Life. In it, they asked the question “Is there human life [whose] prolongation represents a perpetual loss of value, both for its bearer and for society as a whole?” They answered this by describing patients as “mentally dead”. This argument was repeated in, among others, The Eradication of the Less Valuable from Society.2

Hitler adopted these arguments. The result was a memorandum on "the destruction of life unworthy of life" and a draft law that included the following provision:

"The life of a person who, because of incurable mental illness, requires permanent institutionalisation and is not able to sustain an independent existence, may be prematurely terminated by medical measures in a painless and covert manner. Selected professors of psychiatry and asylum directors, known to be sympathetic to the plan, were asked to comment on the draft. All agreed that such a programme was necessary." 1,2,3

On 1 September 1939, Hitler wrote a letter authorising the programme to kill psychiatric patients and, from October that year, a committee of psychiatrists assessed all patients. The committee identified the first 70,000 patients who were to die as part of the policy. By August 1941, records showed that 70,273 patients had been killed.

The killing continued throughout the war. The exact figures are unknown but the best estimates give us 200,000 to 275,000, with a further 400,000 subjected to forced sterilisation.

In short, the murder of about a quarter of a million, just like many of our fellow citizens who today thrive in their families and workplaces, was based on poor science, cost-cutting, economic prejudice, propaganda and media portrayals which presented us as worthless substandard human beings.

What implications does this have for the present day?

In Nazi Germany, a diagnosis of schizophrenia was a death sentence. Today it merely reduces life expectancy by 10-25 years (Laursen, Munk-Olsen, & Vestergaard, 2012). Thankfully, in large part attitudes towards people living with mental health problems have improved dramatically. However, this isn’t to say that discrimination doesn’t exist. We must remain ever vigilant.

There is no better time to remember the importance of behaving as a whole community. We must never forget what happens when hatred, discrimination, poor science and blaming community problems on the most disadvantaged in communities goes unchallenged.

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