The man who stabbed a child with a knife in a Wangen supermarket at the beginning of April must be permanently hospitalized. This is the verdict recently passed in the security trial for attempted murder. How should one imagine the accommodation and everyday life of such a patient in the penal system? And what does “permanent” mean in purely legal terms?
Since 1871, criminal law has made a difference
The basic rule in Germany is: mentally ill lawbreakers who are unable to see the injustice of their crime or act accordingly at the time of the crime are considered to be incapable of guilt. This is what the German criminal law provides. For the first time in 1871, this distinguished between culpable perpetrators and those who were mentally ill. People who are incapable of committing guilt cannot be punished in the classic sense, for example with a prison sentence. In these cases, a different way of dealing with the perpetrators is planned.
The punishment is replaced by a so-called custodial measure, i.e. placement in a psychiatric hospital. The legal mandate for placement in the penal system is correction and security. It is therefore both about treating the sick person and protecting society from the perpetrator.
Psychiatrist diagnoses serious mental illness
In the case of the knife attack in Wangen, the court also found it proven that the man committed the crime because of his illness and ordered him to be placed in a psychiatric hospital. An expert had diagnosed a serious mental illness and was unable to give a good prognosis. The public prosecutor’s office argued accordingly and emphasized that there was a risk that the man would commit serious crimes again if left untreated.
In Baden-Württemberg there are eight correctional facilities in which mentally ill or drug addicts are treated. One of these is the Clinic for Forensic Psychiatry and Psychotherapy in Ravensburg-Weissenau with nine wards and 170 budgeted beds. She is responsible for mentally ill perpetrators in the Stuttgart and Ravensburg regional court districts. The forensic wards in the area of acute treatment are structurally and technically more secure than general psychiatric wards. “We are not a prison, we are a psychiatric hospital in which the regulations for the penal system apply,” says the medical director of the forensic clinic, Roswita Hietel-Weniger. “Our mission is to secure the detainees in an untreated condition and begin treatment.”
This is part of the therapeutic concept in the penal system
The 59-year-old does not want to and is not allowed to comment on the specific case. However, it can provide a general insight into the work and accommodation situation. The people in prison would initially be treated in the closed reception ward. There they can only move freely in clearly defined areas, but cannot leave the station. In addition to medication and psychiatric care, the therapeutic concept also includes psychoeducation, psychotherapy, work, movement and occupational therapy as well as social training.
According to Hietel-Weniger, the aim is for those accommodated to cope with their everyday lives on their own and take their medication reliably. “Many of our patients are unable to follow a fixed daily structure due to their illness,” she says. The detainees may learn things that are self-evident for healthy people: standing up, personal hygiene, eating regularly, or even basic rules of social behavior and building trusting relationships.
Relaxation is only possible under certain conditions
In the further course of the accommodation, restrictions are relaxed – adapted to the progress in therapy – which, for tried and tested patients, can also include a transfer to an open ward in the clinic. Exits will initially only be permitted to the secured garden if accompanied by staff, and later also within the hospital premises. “Only when this is successful and the patients are in stable remission (the disease has stabilized, note. d. Red.), only then are individual outputs possible. Outside the clinic premises, the consent of the public prosecutor is required. As a rule, the testing phase lasts several years,” explains Hietel-Weniger.
The court decides whether a mentally ill offender can be released on probation. “Dismissal is only possible if there is no risk of further crimes,” explains Hietel-Weniger. There are mandatory requirements, compliance with which is checked by the forensic outpatient clinic and which ensure the success of the treatment. “The illness must be treated to such an extent that it no longer has any relevance to action,” explains Hietel-Weniger.
Depending on the clinical picture, patients may no longer act driven by delusion or prompted by voices. “If it has been treated safely – which usually takes years -, they are on medication, there is acceptance of the treatment and a reasonable understanding of the illness, the precipitating offense has been dealt with and they have been tried and tested in everyday life for a sufficient period of time, then it’s fine They no longer pose any danger because their actions are no longer determined by the illness,” says Hietel-Weniger. The treatment is only completed once the patient is stable and integrated into society.
Far from successful integration
It is difficult to predict whether and when the man who caused life-threatening injuries to a four-year-old girl in Wangen due to his illness will be released. “We were only able to go through the four days of trial in a calm and compact manner because the accused is under sedating medication,” said presiding judge Veiko Böhm when announcing the verdict about the accused. This is only at the beginning of the treatment and we are a long way from successful integration.
The man’s criminal defense lawyer, Uwe Rung, spoke in court about being housed in a group with other mentally ill people in shared rooms: “Such accommodation is not a blessing.” There is no time limit here, compared to a prison sentence.
The placement is then reviewed by the court
In fact, placement in a psychiatric hospital is an initially indefinite deprivation of liberty measure. Once a year, the court must check whether the conditions for deprivation of liberty are still met. The treating clinic must provide an expert opinion on this. An external expert must also be called in after three, six and then every two years.
Accommodation initially means indefinite deprivation of liberty
Presiding Judge Böhm also pointed out that placement is never temporary, and in the present case a very, very long placement is to be expected. In contrast to a life sentence, which is usually limited in time, it can definitely be for life.
Regardless of the Wangen case, Hietel-Weniger knows the average length of stay for patients. She speaks of an average of four years that patients in Baden-Württemberg stay in facilities such as the Forensic Clinic in Weissenau. Depending on the severity of the illness, treatment could take a significantly longer time and ultimately be necessary on a permanent basis.
