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Remembering a Quarter of a Million "Mental Patients" Murdered in the 1930s and 1940s

We can draw parallels to today’s genetic theories and compulsory treatment.

Key points

  • Many people diagnosed "schizophrenic" in Germany and surrounding countries were killed, by psychiatrists, during World War II.
  • The same unproven genetic theories still underpin mental health services today, which in some countries include "genetic counseling."
  • In the 1990s, psychiatrists discovered that most elderly "schizophrenic" patients in Israeli psychiatric hospitals were Holocaust survivors.

In 1941, the staff of the Hadamar Psychiatric Institution—psychiatrists, nurses and secretaries—attended a ceremony and were each given a bottle of beer. The occasion was the murder of the ten-thousandth mental patient.

These are the opening words of a paper by Jeffrey Masson and myself, just published in the scientific journal Ethical Human Psychology and Psychiatry, entitled "Biological psychiatry and the mass murder of ‘schizophrenics’: from denial to inspirational alternative."1

This month has already seen the publication of a historic literature review by an international team of psychiatrists concluding that the "chemical imbalance" explanation of depression is an unsubstantiated myth. The other central pillar of biological psychiatry’s "medical model" of human distress is the notion that depression, schizophrenia, and other "mental illnesses" have a strong genetic component. This, too, is controversial.

Our paper documenting psychiatry’s role, all those years ago, in the killing of patients is intended not only to remind people, including today’s psychiatrists, of the rarely discussed facts but also to learn from them by drawing parallels to today’s genetic theories and compulsory treatments.

About a quarter of a million "mental patients," mostly diagnosed with "schizophrenia," were deemed, by a programme run by the professors of psychiatry at the leading German universities, to be leading a "life devoid of value." They were sent to six specially adapted psychiatric hospitals, at Bernberg, Brandenberg, Grafeneck, Hartheim, Sonnenstein, and Hadamar, to be killed. The rationale was that these people were suffering from genetically caused conditions that could be eliminated by preventing reproduction. which was international. Tens of thousands of sterilizations of the "mentally ill" had taken place in the United States and Scandinavia before the killings in Nazi-controlled Europe began. Leading psychologists, such as Burt, Cattell, and Spearman, subscribed to this eugenics movement.

In 1941, the gas chambers at psychiatric institutions were moved east to Belzec, Majdanek, Auschwitz, Treblinka, and Sobidor. The doctors and nurses often accompanied the equipment. Dr Irmfried Eberl, a psychiatrist who had run two hospitals where tens of thousands of patients had been murdered, became Commandant of Treblinka.

Thus, the mass murders by psychiatrists provided the "scientific" rationale, the staff, and the equipment, for the Holocaust. One of the shamefully tiny number of papers on the killings published by psychiatrists over the next 80 years states: "These programmes formed the template for the extension into concentration camps and the 'Final Solution' which killed six million Jews."

Our paper documents how psychiatry textbooks and history books have either ignored the events completely or referred to the work of some of the leading architects of the "euthanasia programme," such as Ernst Rüdin and Franz Kallman (who are often described, accurately, as the grandfathers of psychiatric genetics) with no mention of their role in the murders.

Many of the psychiatrists who had been directly involved returned, unsanctioned, to their work. Three became presidents of the Association of German Neurologists and Psychiatrists. Kallman, who advocated the sterilization of "schizophrenics" (and all their relatives) and homosexuals, moved to the United States where he wrote annual updates for the American Journal of Psychiatry on "psychiatric progress" on the issue of "heredity and eugenics."

An "Inspirational Alternative"

Meanwhile, hundreds of Holocaust survivors had made it to Israel, only to be locked up and sedated with "antipsychotic" drugs for decades, diagnosed as "schizophrenics." In 1996, one of them, Yochevet Mark, was visited by her son in Geha Hospital. She was terrified because she believed he was an SS officer. He was actually Dr Moti Mark, Israel’s chief psychiatrist. Dr Mark went on to discover that most elderly patients in Israel’s psychiatric hospitals were Holocaust survivors. Alongside other psychiatrists, he campaigned to offer them treatment for Holocaust trauma. Several hundred Holocaust survivors were eventually moved into special facilities where efforts were made to address their trauma.

Some of the survivors had not spoken for years. Efforts to reach them included giving them the same kind of animals they had loved as pets when they were young. It also involved making video recordings of their testimony of what had happened to them in the camps and ghettoes. When some of them later watched their own video they did not, at first, recognise themselves.


This extreme example of the increasingly popular "trauma-informed" approach to mental health services stands in beautiful contrast to the extreme example of the bio-genetic approach. Obviously, today’s psychiatrists and mental health service managers are in no way responsible for the events of the 1930s and 1940s. But our response to difference, extreme emotional distress, or "madness" has always, for centuries, included streaks of dangerous, sometimes violent, treatments and force. Today, psychiatry remains the only medical discipline to which we grant the power to forcibly treat us against our will, including with injections of "antipsychotic" drugs that can, along with any benefits, reduce brain volume and shorten life span, and electroshock therapy, which can cause significant memory loss. Another continuity is the genetic counseling that still goes on, particularly in the United States, whereby potential parents with a diagnosis of "schizophrenia" are warned of the supposed probability of any offspring inheriting the same "illness."

In one country at least, all this was eventually acknowledged. On November 26, 2010, 65 years after the killings ended, Professor Frank Schneider, president of the German Association for Psychiatry and Psychotherapy, addressed a commemorative event in Berlin. Following a detailed documentation of the facts summarised in our paper, Professor Schneider said:

Under National Socialism, psychiatrists showed contempt towards the patients in their care; they lied to them, and deceived them and their families. They forced them to be sterilised, arranged their deaths and even performed killings themselves....For too long now we have been hiding, denying a crucial part of our past. For that, we are truly ashamed.

One final lesson to be learned is that these grotesque events unintentionally provided an enormous natural test of the genetic theory that had justified the killings back then, and which underpins our overly biological approach to treatment today. If "schizophrenia" is a genetically based illness, killing almost everyone with that diagnosis would have dramatically reduced the disorder in the next generation. This did not occur.


1. Read, J., Masson, J. (2022). Biological psychiatry and the mass murder of 'schizophrenics': From denial to inpirational alternative. Ethical Human Psychology and Psychiatry 24, (2).

This article is an amended, updated version of: Read, J., & Masson, J. (2013). Genetics, eugenics and the mass murder of ‘schizophrenics’. In Read J & Dillon J (eds.) Models of Madness: Psychological, Social and Biological Approaches to Psychosis. London: Routledge, 34-46.

We thank Yoram Barak and Rael Straus (Tel Aviv University) and Dori Laub (Yale University) for their helpful comments on the original 2013 chapter, and Professor Frank Schneider for his positive response to a draft thereof.

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