German MH Response After Tragedy Differs From Typical U.S. Approach

In Germany current trends from the United States include not only those things that are fashionable or faddish, such as online shopping, Starbucks coffee, and Converse All-Star sneakers, but also the tragic—a school shooting.

On April 26 Germany experienced its own version of the 1999 shooting at Columbine High School in Littleton, Colo., when Robert Steinhäuser, a student at the Gutenberg High School in Erfurt, Thuringia, Germany, killed 12 teachers, a secretary, two students, a police officer, and himself.

Not surprisingly, the German people were as shocked at, and dismayed over, the rampage as Americans had been by the shootings at Columbine and elsewhere. More than 100,000 people showed up for the official mourning ceremony for the victims of the shooting on May 3, and in the several days following the shooting, students hugged, shed tears, and tried to console each other. They also placed thousands of flowers and candles in front of the school’s entrance.

In investigating Germany’s response to the high school students and others traumatized by the shooting, Psychiatric News found differences in how such tragedies are handled within Germany and the United States.

First, the mental health of the students at Gutenberg High School was being looked after by the government—specifically by the Thuringia Ministry for Social, Family, and Health Affairs, according to Konrad Peter, M.D., a child psychiatrist in Erfurt; Michael Geyer, M.D., director of the clinic for psychotherapy and psychosomatic diseases at the University of Leipzig (which is near Erfut); and Sigrid Befer, Ph.D., who handles the psychological hotline at the Thuringia Ministry for Social, Family, and Health Affairs. In contrast, after the shootings at Columbine and other U.S. high schools, individual psychiatrists responded, many through their local APA district branches and other organizations.

Second, the ministry was deploying psychologists instead of psychiatrists as its first line of help in assisting the students, both Befer and Georg Pieper, Ph.D., a psychologist with the Thuringia Ministry for Social, Family, and Health Affairs, reported.

And the reason why psychologists were being deployed as the first line of help, Pieper explained, “is because we do not want to ‘psychiatrize’ the students. After all, the students are naturally shocked, and that is not a psychological illness.”

However, Pieper added, even though the psychologists were using psychological interventions to keep the students from developing posttraumatic stress disorder, it could well happen that some of the students will eventually develop the disorder. And in that case, he said, child and adolescent psychiatrists will be called in to care for them.

A German proverb observes: “Andere Länder, andere Sitten” (other countries have other customs). This proverb obviously applies to the way that Germany is dealing with the school shooting in Erfurt. The German government plays a major part in caring for the mental and physical health of its citizens, and that includes care in the context of a school shooting or other disasters. Also in Germany, people are keenly aware of the job they have to perform and where their job ends and somebody else’s begins, including psychologists and psychiatrists. ▪

Tamara Treichel is a graduate student at the University of Heidelberg.