Photo/Illutration People line up for a chance to win a seat at the Yokohama District Court, where the trial of a man accused of killing or injuring 45 people opened on Jan. 8. (Reina Kitamura)

YOKOHAMA--A man admitted to murdering 19 people at a facility for disabled people in Kanagawa Prefecture, offered “deep apologies” and then disrupted the first hearing of his trial with erratic behavior.

The main issue in the trial of Satoshi Uematsu, 29, which opened at the Yokohama District Court on Jan. 8, is whether he can be held responsible for his crimes, given his mental state.

Uematsu also admitted to injuring 26 others in his stabbing rampage at Tsukui Yamayurien, a care home for people with disabilities, in Sagamihara, Kanagawa Prefecture, on July 26, 2016.

But the court was thrown into turmoil when the defendant, wearing a black suit with a navy tie, hunched over and appeared to press his neck with both hands.

Four court officers immediately dashed toward Uematsu, shouting, “Stop.”

Presiding Judge Kiyoshi Aonuma adjourned the court proceedings. The hearing resumed at 1:20 p.m. without the defendant.

The defendant, a former worker at Tsukui Yamayurien, sneaked into the building early in the morning, prosecutors said. Using knives that he brought with him, Uematsu tried to kill many residents who could not communicate because of their severe disabilities, the indictment said.

Two staff members were wounded in the stabbing spree.

Uematsu’s defense team has entered a plea of not guilty, saying their client was not mentally fit to take responsibility for his actions.

“At the time of the attack, his responsibility capacity was either lost or extremely weakened because of the psychiatric disorders he had suffered from,” one of the lawyers told the court.

Five months before the attack, Uematsu was hospitalized on the order of Sagamihara authorities. Medical experts said Uematsu had developed “psychiatric and behavioral disorders due to his use of cannabis.”

Right before he was hospitalized, Uematsu wrote a letter in February 2016 that said he is “ready to wipe out a total of 470 people with disabilities.”

He handed the letter to a guard at the official residence of the Lower House speaker in Tokyo. He quit his job at Tsukui Yamayurien the same month.

A psychiatric test commissioned by the Yokohama District Public Prosecutors Office showed that Uematsu suffered from multiple personality disorders, including narcissistic personality disorder.

However, prosecutors concluded that they could still indict him on charges of murder and attempted murder because they believed his disorders did not affect his ability to tell right from wrong.

A court-ordered psychiatric evaluation taken after Uematsu was prosecuted backed the arguments of the prosecutors.

The case is being tried under the lay judge system. A ruling is scheduled for March 16 after 26 hearings.

The trial opened at 11:25 a.m., 25 minutes behind the schedule, after 1,944 people lined up for a lottery for 26 seats in the court gallery.

(This article was written by Mirei Jinguji and Hirohisa Yamashita.)