On March 24 the Germanwings flight 9525 crashed into the Alps, causing 150 deaths. Rigorous investigation indicates that the co-pilot, Andreas Lubitz, was responsible. Less rigorous investigation suggests that his actions were somehow linked to his diagnosis of clinical depression.
Once details of his mental health emerged, it was hard to escape the coverage of it. In the Daily Mail, Piers Morgan said: ‘Depressed pilots on medication for mental illness should not be flying passenger planes’. The Express described Lubitz as ‘the depressed killer co-pilot’, and in the days following we were given every detail about his medical history, from the doctors he visited to the chemist he picked medication up from.
But is it really possible to say that his depression was a key factor behind the Germanwings tragedy?
There isn’t a great deal of research into depression and violence. Professor Seena Fazel and colleagues at the University of Oxford published an impressive study this year looking at the potential link in Sweden. It found that those with depression were twice as likely to commit a violent crime. (The absolute percentage of depressed people who committed a crime was 3.7 per cent for men and 0.5 per cent for women.)
When Fazel’s team analysed the odds ratio (ie how likely one population is to do something compared with another), they found that depressed men were three times as likely to commit homicide or attempted homicide. But this actually equated to five depressed men out of 17,249 committing such acts during the period of the study — that is, only 0.03 per cent of homicides were committed by someone with depression. With so few cases, statistically, the odds ratio calculated could be down to chance alone. (There were no cases of homicide/attempted homicide among the 29,909 depressed women studied.)
Further, we know no detail of these five cases, either about the motivation or the context. Therefore, there is no evidence that a diagnosis of depression makes it more likely that someone will commit mass murder. Nor is the absolute figure high enough to justify any regulation.
There are other situations where we put our lives in the hands of others. Several studies indicate that depression and thoughts of suicide are more common among doctors than the general public. Should doctors undergo stricter regulation? At the moment there is simply not the evidence to support such an aggressive stance.
The media coverage of the Germanwings tragedy had other consequences. A paper due to be published in November in the Journal of Affective Disorders suggests it increased stigma towards mental health in Munich.
The authors used a telephone questionnaire to assess the emotional responses and attributes ascribed to people with depression by the general public, as well as a ‘desire for social distance’ from depressed people in specific contexts.
They found that, compared to an identically designed study performed in 2014, several beliefs about depression differed: fewer believed those with depression were in need of help and that depression was an illness on a continuum, while more felt people with depression were unpredictable and dangerous; fewer felt the need to help, and were more likely to react with anger and fear; and fewer were likely to accept someone with depression as a tenant or as a child carer.
The changes were not dramatic. For example, participants were asked if they agreed with the statement ‘I feel the need to help’ and their responses rated from four (completely agree) down to one (completely disagree). The average response was 3.23 in 2014 and 3.16 this year. Therefore, the majority of people still agreed with the statement.
There were limitations of this study, too: most notably, that a change in stigma from one year to the next may not be caused by the Germanwings coverage.
As the authors of the study conclude, focusing on stricter regulations for employed people with mental health problems will only increase stigma in the long run.
But it is important that more work is done looking into how media coverage can affect stigma before demanding that either news outlets or professional bodies should undergo hefty shifts in regulation.
Meanwhile, let’s stop using sensationalist headlines when it comes to mental health and violence, and be careful about our assumptions. What is one life worth? More than the number of clicks on your article, that’s for sure.