From act of terrorism to mental health symptom: we're shifting blame but at what cost?

Germany has been rattled by a series of violent attacks carried out by men with a Muslim background. Some of these were reportedly connected to Islamic terrorism, others were not.

As details of the incidents unfolded, the nation’s officials and media were understandably measured; hesitant to prematurely label them as terror acts. After the explosion in Ansbach, for example, most German reporters did not disclose ethnicity or religion of the perpetrator early on.

One motivation of this caution was to avoid panic. Another was to prevent potentially premature public speculations on the attackers' possible motivation as a consequence of disclosing the attacker’s (or attackers') Muslim background. Fear that Muslims and refugees in Germany could be stigmatised was an openly expressed and probably justified concern, especially given the rise of right-wing extremists in reaction to growing numbers of Muslim refugees coming to the country.

Attempting to avoid stigmatisation of people from Muslim backgrounds is laudable. But, in this instance, it seems to be coming at an unexpected cost. Media and officials have been quick to speculate on “mental health problems” as the probable cause of an attack when information was scarce.

Munich attack reporting

The attack in Munich in which nine people were killed is now considered less of a terrorist attack and more of a killing spree perpetrated by someone suffering from mental health issues. German police quickly made the perpetrator’s history of psychiatric illness the focus of their press release. They did so before it was clear how much of a contributing factor this was in the killing.

German news agencies quickly picked up the focus on mental illness in a sensationalist manner. One article screamed the killer was “Amok in the head”.

International newspapers weren’t innocent of sensationalist reporting either. The Daily Mail referred to the killer as the “Munich maniac”, for instance.

A journalist for Spiegel Online, a widely read German news website, was one of the few who realised the issue with how the killer’s mental health was being portrayed. He posted a video message warning of mental health stigma and explaining that depression was not commonly characterised by elevated aggressiveness.

Individual groups and newspapers have also caught on to the fact initial reporting of the incident was somewhat stigmatising. German newspaper Stern, for instance, published an article noting that it wasn’t clear whether the perpetrator’s depression was the main factor for the attack.

Mental health stigma

Mental health stigma is still an issue in our society and can have a range of serious consequences for people with mental health problems.

Research shows people tend to overestimate the capacity for aggression and violence in those with mental health problems. Other studies show people with mental health problems are actually more likely to be the victims of violent crimes than the ones committing them.

One study showed an association between some mental health diagnoses and violent behaviour, but found gender and ethnicity to be stronger predictors. Further, terror tendencies and mental health problems must not be mutually exclusive. Indeed many experts have noted terror group ISIS has a strategy of targeting those with mental health problems.

Most violent attacks in Germany are carried out by people without a migrant background. Research has also found most of those who commit a crime do not have a documented mental health issue.

While aggressive and violent behaviour can of course occur in people with depression (like in all other people), it is not a symptom. It is important for officials and the media to use the right wording so it does not feed into the misconception that violent behaviour is typical of those with mental health problems; it is especially not typical of people with depression.

There is a notable difference in sensitivity and awareness of mental health reporting in different countries. Some have nationally funded mental health campaigns, such as Australia (Beyond Blue), New Zealand (Like Minds Like Mine), England (Time to Change) and Denmark (One of Us).

In Australia, the organisation Mindframe Media trains journalists to be mindful when writing about mental health issues. Reporters are instructed, for example, not to portray mental health issues in a way that automatically associates them with aggressive behaviour.

It is likely that the lack of a “media watch” unit in Germany would play a role in regard to the nature of the initial reporting of last week’s incident.

However, Australian journalists sometimes republish stories from other countries and, while doing so, might ignore protocols they would otherwise use when writing their own. So stigmatising reporting can have an international impact.

While media should continue paying attention to avoiding fear-mongering and playing on ethnic or religious stereotypes, journalists should also be careful how they report on mental health. Stigmatising reporting of an incident with high public attention can increase stigma and quickly undo positive effects that years of educational campaigning around mental health might have achieved.

Terror attacks are meant to shake our way of living and beliefs. The best reaction for us is to stay truthful to our values, including not discriminating against minorities or vulnerable groups.

Bettina Friedrich is involved with the "Global Anti Stigma Alliance" (GASA) as an unpaid volunteer. GASA is an international network of mental health researchers and mental health campaigners. Some of the mental health campaigners mentioned in the article are involved with the network.