Four-point system

“The targeting of the Jewish mentally-ill was comprised of four processes including public assistance withdrawal, hospital treatment limitations, sterilization and murder. Jewish “patients” became indiscriminate victims not only on the basis of psychiatric diagnosis, but also on the basis of race. The killing was efficiently coordinated with assembly in collection centers prior to being transferred to their deaths. The process included deceiving Jewish patients’ family members and caregivers in order to extract financial support long after patients had been killed. Jewish patients were targeted since they were helpless and considered the embodiment of evil. Since nobody stood up for the Jews, the Nazis could treat the Jewish patients as they saw fit. (Strous, 2008)”

During the Holocaust, the Nazi’s staged a vicious attack on the Jewish mentally ill. However, Nazi officers were able to keep such an attack under wraps by implementing new laws discreetly leading up to the extermination of the mentally ill. They started by removing any public assistance from those in need, leaving their families to struggle over how to handle the mentally ill and disabled. The Nazi’s were aware of the burden that this would place on Jewish communities. It gave them an anchor for slowly gaining control over the mentally ill and disabled population. After patients were left to fend for themselves, Hitler ordered that Jewish patients be refused any care (from both public hospitals and private psychiatrists). In the midst of Hitler’s regime, many families were unable to care for their ailing relatives and fled, leaving them to perish under Nazi control. This rapidly lead to sterilization and murder of the Jewish mentally ill. Below is an outline of the four-point system put into place to help the Nazi’s gain control of the mentally ill members of Jewish society. (Strous, 2008)

In the mid 1930’s to 1940’s, a four-point system was put into place to exterminate the Jewish mentally-ill, handicapped, and generally “unfit” (Mueller & Beddies, 2006).

1. Withdraw of public assistance

  • Amidst the chaos that was Nazi Germany, many families left their disabled counterparts behind as the fled their home country. They were left to care for themselves, which unfortunately did not work to their benefit.
  • In 1938, a law issued by Hitler stated that the Jewish were no longer allowed to receive welfare or government assistance. The responsibility to care for these mentally ill citizens fell on their fellow neighbors in Jewish communities. This was a stepping stone to Nazi’s gaining full control over Jewish citizens.

2.  Exclusion from treatment

  • With Nazi’s effort to obtain control over Jewish people came the exclusion of the mentally ill from seeking treatment in mental institutions, from private psychiatrists, etc. German state hospitals were no longer allowed to accept Jewish patients. As the exclusion and removal of Jewish patients from state hospitals continued, Jewish hospitals were also being taken over.

3. Sterilization

  • I will not mention too much about sterilization as it is covered in other sections of this website, but it was the third step in promoting “racial hygiene” in Germany in the late 1930’s. Jewish patients of hospitals and mental institutions were coerced into undergoing sterilization in an attempt to prevent the spread of mental illness.

4. Murder

  • The decision to distinctly kill the Jewish mentally ill came to be in 1940. There were several euthanasia programs put into place that lead to their extermination.
  • In 1940, the Reich Interior Ministry insisted that all Jewish patients in hospitals be transferred to a common place. This common area assisted in the “quick and easy” removal of the Jewish people. Upon their arrival, they would be sorted into several groups. These groups were then put to death.



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