In the ICE from Passau to Hamburg, a 27-year-old attacked fellow travelers with a knife on Saturday morning, seriously injuring three men. What prompted the man to act was still unclear on Sunday. According to the police, initial assessments indicate psychological problems. Can such incidents be prevented? A conversation with Falk Schnabel, 52, the police chief of Münster, where a mentally ill driver killed four people in 2018. Since then, the city and the state of North Rhine-Westphalia have been striving for stronger prevention.
SZ: Mr. Schnabel, in the case of spectacular acts of violence, the explanation has been heard more often lately that this is psychological. So now in the case of the ICE knife attack. How often do you experience mental health problems that pose a risk to other people?
Falk Schnabel: In day-to-day police operations, we are repeatedly called to work because obviously confused people riot, threaten, insult or even get violent on others. Sometimes they also stand out due to confused submissions to the authorities. The dimensions of these cases should not be underestimated: In North Rhine-Westphalia, for example, around 18,000 people are placed in a clinic every year because they pose a danger to themselves or others. About 40 percent of them are released after 48 hours.
Because they turn out to be harmless?
I can not judge over this. I remember a case, probably 15 years ago, in which a man hit an employee at the – I mean – social welfare office because – as he later said – he had ordered monkeys to do so. The proceedings were discontinued because of insignificance, and the man moved to live with his mother in another state. Some time later, monkeys apparently ordered him to attack his mother’s neighbors, which he then did – with an ax. An exchange of information would have been essential here.
Falk Schnabel, 52, police chief of Münster.
(Photo: private / private)
There are often confused letters, confused talk. Should the police intervene in each of these cases in the future?
When it comes to certain delusions, I find that we need to pay attention. Without stigmatizing the people who urgently need help. But we have to take care. Here at the police station we get letters from people who write that their neighbors terrorize them at night with harmful rays and possibly try to kill them. If this is not stopped soon by the authorities, one has to fight back. These are situations in which an imagined danger can easily become a real one.
What can you do as the police?
All of these people I have described suffered from a mental disorder. Often with voices in their heads that are perceived as real, ordering them to do things or telling them that others wanted them bad. Nowadays this can be managed well with neuroleptics, but the medication must be taken permanently. The problem is, so the therapists say: In the absence of insight into the disease – the voices are real to them – it is often difficult to get the sick to take it.
If it succeeds, the voices will soon be gone.
That’s how I had it described to me. But then the patients, who are usually not hospitalized, sometimes stop taking the medication on their own. The voices are gone, you feel normal again. Some of the drugs also have side effects such as tiredness and weight gain, which is uncomfortable. And then it can happen that the voices come back.
Isn’t that something that doctors can best judge? Don’t you, the police?
Of course, the police cannot and must not be a substitute for medical care. That is not our claim either. Cooperation is important. However, this presupposes that we receive information about a disease from the health sector. Too often we only become aware of an illness through an acute hazard or even a physical attack. Our rule of law then reacts very strongly: Serious crimes can lead to detention in the penal system. This takes an average of five to eight years.
But then it’s already too late.
Yes, we want to prevent that. My conclusion is: between a very short time in psychiatry and five to eight years in forensics, we have to have a well-functioning outpatient support structure. With the “Periscope” model project, we are working in North Rhine-Westphalia on exchanging data between the medical side and the police side, within the framework of what is legally permissible. We are committed to finding new ways to prevent an escalation. Not least for the benefit of the patient.
What do you need from your point of view?
From the police point of view, it is necessary to know about such cases as early as possible. When sick people trigger an operation, the police are often only left with immediate coercion. Nobody can want that. We neither! That is why it is important for us to know how we can approach these people without it escalating. To do this, however, we need to know what the person concerned has and how we can deal with him properly.
Many doctors fear that if the police are informed, it will destroy the patient’s trust.
I can understand this objection. This information in particular would also be in the interests of good treatment. As a rule, nobody checks whether the patient continues to take his neuroleptics after being discharged from the psychiatric clinic. The police officers are most likely to notice this when the neighbor calls again because the sick person is rioting again.
Doesn’t that mean: more repression against the sick?
I don’t think so. First and foremost, it is about help and about preventing worse things from happening. From one district I remember another case, also many years ago, in which a man – mostly men – patrolled his house with a crossbow, but was otherwise accessible. When a uniformed policeman with a service dog approached him on such a patrol, the man suddenly shot the officer, luckily missing him, but the man was seriously injured by the intervening service dog. All that might have been saved if it had been known that the man believed the police wanted to kill him. Such findings help us to assess the situation and enable a professional approach. In such a case, for example, in civilian clothes.