27 January 2020

Violent extremism is a mental health issue

By

I’m presenting a half-hour documentary on Radio 4 tomorrow morning on what more we can do to reduce the dangerousness and challenge the mindset of violent extremists in prison and after release. The quality and diversity of the people I spoke with about the problems and solutions makes it impossible to do full justice to this sensitive topic in just 30 scant minutes.

The programme uses the journey of Usman Khan through custody and into the community, where he made a date with infamy in Fishmongers Hall late last November, to frame some of these awkward challenges.

Can we ever be safe from people who believe they have divine permission to kill? Do secular psycho-social interventions make any difference or are they merely a means whereby sophisticated and determined terrorists can ‘play the game’ and feign rehabilitation? How do we reintegrate terrorist offenders after custody, ensuring that public protection and intense scepticism is our default approach?

This is meat enough to chew on, but a packed programme did not allow space for another intensely important and equally sensitive topic – the relationship between violent extremism and mental health.

Two recent incidents illustrate the problem. Earlier this month, French Police in Metz in the east of the country shot and wounded a knifeman who attempted to attack them. The man was said by prosecutors to be known for ‘his radicalisation and personality disorder.’ This was hours after a similar knife attack by a Muslim convert in Paris where a man, said to be suffering a ‘psychiatric illness’ murdered a man and injured two women before being shot dead.

These examples join a growing list of ‘lone actor’ attacks where the perpetrator has had contact with mental health services earlier in his life and has ongoing problems. When this is disclosed by authorities in the aftermath of an outrage the labelling often provokes a furious reaction in the media, most typically when the perpetrator is ascribed an Islamist ideology.

The reaction takes two forms – suspicion that the state is using mental illness to conceal and obscure religious motives that don’t sit well with a narrative of multiculturalism and/or outrage that something apparently outside the control of the perpetrator – his mental disorder  – seems to absolve him of responsibility for his actions and therefore criminal sanction.

This is illustrated by outcry over the trial of Malian immigrant Kobili Traore in 2017 for the grotesque antisemitic murder of a Jewish Kindergarten teacher, Sarah Halimi, in Paris. In December last year the appeal court finally ordered that he had suffered a psychotic episode through cannabis consumption and could not stand trial. Police waited for an hour outside Ms Halimi’s apartment as he battered her to death, ‘shouting about Allah’ and then threw her from the third storey window of her apartment.

In one important sense it doesn’t matter whether these attackers were mentally ill or not – their victims are just as dead as if they were fully competent. But for relatives of victims who feel cheated from justice and for the rest of society, we need to start talking about this link and crucially what we can do to halt the slide from disordered thought to murderous action.

Here of course, the usual caveats apply. Most mentally ill people are harmless and if they are a danger, it is overwhelmingly only to themselves. But we mustn’t allow this important qualification to deter us from looking at the small minority of people whose mental impairment puts them at risk of being drawn into radicalised behaviour.

Until the last few years, the prevailing view of academics interested in this murky subject held that violent extremists, religiously or politically motivated did not recruit mentally ill people to terrorist gangs. The reason for this was simple – organised, often highly complex terror plots could not sustain people who were unstable, as they would pose a clear risk to the security and success of an operation. This seems to fit the notion of centrally directed and large scale Al Qaeda generation ‘spectaculars’.

But the rise of ISIS and the rise and fall of the caliphate in Syria and Iraq has stimulated a different threat. Lone actor terrorism with individuals radicalised online, inspired, encouraged or claimed by Daesh actively requires people who are vulnerable and suggestible to hateful ideologies. Some of these people are mentally ill and their irrationality becomes a blade to be sharpened by groomers and the proliferation of easy to access hardcore hate material on Big Tech platforms.

Of course, this relatively new threat is not the sole province of Islamism. Indeed, lone actor terrorism by far right violent extremists like Anders Brevik in Norway and Brenton Tarrant in New Zealand has accounted for devastating death tolls that dwarf all other lone actors casualties combined. In both cases psychiatrists argue over whether they are insane or not – scant comfort to the hundreds of bereaved relatives left behind.

A recent survey published in the British Journal of Psychiatry looking at the relationship between mental illness and extremism in a group of white and Pakistani English men concluded that “depression…and symptoms of anxiety and post-traumatic stress are associated with extremist sympathies”. It’s important to emphasise that having extremist sympathies is a necessary but insufficient ingredient in the radicalisation of a person towards an act of violent extremism. But it is there. And the dead are still dead.

We also know that migration, particularly from war-torn countries in crisis and an often fraught illegal journey to a place of safety, like the UK, is often a stimulant for PTSD and other psychiatric disorders. Moreover, migrants who experience disappointment and dislocation at the reality of life in Britain as opposed to the image people traffickers have sold them don’t always choose reconciliation over revenge.

So while we must not generalise neither must we shy away from the prospect of damaged lone individuals out there who are more susceptible to ideological indoctrination, manipulation and coercion as a consequence of mental illness or even as a consequence of developmental disorders.

They are obviously by definition hard to find, but one gateway many will pass through is the NHS, including its child and adolescent mental health service. A proper strategy to screen vulnerable populations for PTSD – migrants, veterans, prisoners – and linking this to interventions to deradicalise those deemed at risk would be a decent start.  Ultimately, violent extremism is a mental health issue.

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Ian Acheson is Senior Advisor to the Counter Extremism Project. ‘The crisis within’ is broadcast on Tuesday on BBC Radio 4 at 11am.