A mentally ill man races into groups of people on Berlin’s Ku’damm, a woman dies. Now the focus is on his illness. Are mentally ill people more violent? And do people who commit such acts generally have psychological problems? That’s what experts say.

With crimes like the death drive in Berlin, the assumption can be made that they are committed by mentally ill perpetrators – but according to experts, very few are really. “The mentally ill are no more violent than the general public, but when such spectacular cases occur, then of course it causes a stir in the media,” said the director of the clinic and university outpatient clinic for psychiatry and psychotherapy at the Charité Berlin, Isabella Heuser, the German press agency. This creates the impression that only the mentally ill are capable of such acts.

According to the criminal psychologist Karoline Roshdi, who advises, among other things, on dealing with threatening behavior and the prevention of serious violence and amok, only around a third of such acts are committed by people with mental disorders.

Mental illnesses – from anxiety disorders and depression to disorders caused by alcohol consumption, for example – are quite common in the population: According to the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology, almost 28 percent of the adult population are affected by a mental illness every year. That corresponds to around 17.8 million people.

According to the public prosecutor’s office, the death driver from Berlin should come to a psychiatric ward. There is evidence that the 29-year-old suffers from paranoid schizophrenia, it said. Drugs were found during a search of his home. Berlin’s interior senator Iris Spranger (SPD) reported that the man had often been noticed by the police in the past, that there had been investigations into bodily harm, trespassing and insults.

On Wednesday morning, the man raced near the Memorial Church on the sidewalks of Ku’damm and Tauentzienstrasse. According to the latest information, a teacher was killed and 32 people injured, including many 10th grade students from Hesse.

Another case in which a mentally ill man went on a rampage occurred in Heidelberg in February 2017: a 35-year-old crashed into a group of people. A 73-year-old man died. The perpetrator was committed to a psychiatric hospital.

A year later, in April 2018, a similar case happened in Münster. Another man crashed into a group of people. Five people died and more than 20 were injured. The man then shot himself. The investigators assume that the perpetrator was mentally ill.

There was also a rampage in Bottrop and Essen. In January 2019, a mentally ill right-wing extremist steered his car into revelers in both places, whom he believed to be foreigners. 14 people were injured. The man was taken to the closed psychiatric ward.

Despite this list, the clinic director Heuser emphasizes that these are isolated cases. She cannot conclusively answer the question of what moves such perpetrators. “If the perpetrator actually has a mental disorder, then the causes are very different.” They ranged from depression to paranoid psychoses.

Roshdi is a little more specific: In the current case, a lot is still unclear, so an accurate assessment is difficult. In such cases, however, schizophrenia with paranoia is often present. In the current case, in view of the special crime scene – the Islamist attack was nearby in 2016 – an “imitation dynamic” can also be considered.

Schizophrenia is a serious mental illness. According to the classification in the ICD-10, the thinking, the language and the self-perception of those affected are disturbed. Schizophrenia is often accompanied by psychopathological phenomena such as hearing voices, delusions, delusions of control or thought disorders.

Typically, the disease begins during adolescence or early adulthood.

WHO says people diagnosed with schizophrenia can lead normal lives if treated properly.

Regarding the question of how predictable such acts are, the criminal psychologist says that one can make risk assessments, for which there are also solid instruments – “but this is a snapshot for the here and now”. Violent fantasies and the experience of crises could contribute to people getting into such exceptional states. “What we have relatively often is that shortly before such an act is committed, something happens that morally shakes the perpetrators very badly,” said Roshdi.

The problem with prevention is that perpetrators often do not disclose their violent fantasies, says Heuser. Some of them made aggressive or gloomy comments on social media, for example. “But the sad truth is that you only find out about all this after the fact.”

In general, experts warn against stigmatizing the mentally ill – which could prevent those affected from seeking help in good time. “People with mental illness still experience societal stigma. Above all, severely mentally ill people are confronted with the fact that others distance themselves from them,” writes the German Society for Psychiatry and Psychotherapy, Psychosomatic Medicine and Neurology. “Prejudices about mental illnesses are transferred to those affected, who consequently find it all the more difficult to deal openly with their illness and seek help in good time.”

If the people around a possible perpetrator overhear such aggressive statements, they should communicate with him in the first place. In addition, there are, for example, violence prevention centers that you can call, says Heuser.

If you notice in yourself or in your environment that someone could be suffering from depression or another psychological emergency, you can contact various counseling centers:

But such an act is particularly shocking for the victims and their families. They often need psychological support after such an experience. According to Heuser, you have to provide them with an emergency chaplain immediately. That probably worked out well after learning the lessons from the terrorist attack on Breitscheidplatz in 2016. Emergency chaplains were on site immediately.