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 Studies have suggested the prevalence of mental health issues among
militants working together on major strikes is very low but a string
of killings by so-called lone wolves has fueled concerns mental
illness could be a factor behind some attacks.
Authorities say some of those involved in four attacks in Britain
this year blamed on Islamist militants appeared to people who had
self-radicalized via the internet and whose mental state had been
questioned.
To look more closely at the issue, British police launched pilot
programs in April last year in England's three biggest urban areas -
London, Birmingham and Manchester - to embed mental health experts
with counter-terrorism officers.
The aim was to give psychiatrists the chance to identify people
referred to Britain's counter-radicalization program Prevent who had
mental health issues, and treat them.
"Anecdotally, I am surprised that there appears to be a much higher
prevalence of people with mental health problems than you would
expect," said Professor Jennifer Shaw, the mental health lead for
Greater Manchester Police, referring to the people her team had
dealt with since the pilot was launched.
The hubs are considered so successful by the government they have
been expanded nationwide, Shaw, professor of forensic psychiatry at
the University of Manchester, told Reuters.
But such is the secrecy around the work of Prevent and Channel - a
de-radicalization program within the overall project - there are few
details about its successes or failings and Shaw's work has not
previously been discussed in the media.
Some psychiatrists argue that no scientific link between mental
health issues and terrorist attacks has yet been established and
they worry the programs risk stigmatizing people suffering from
mental illnesses.
Another psychiatrist gathering data under the pilot programs told
Reuters that Britain's Office for Security and Counter-Terrorism had
told them not to disclose any details of their findings ahead of a
final report.
Those findings are expected to be among a raft of data about people
referred to Prevent due to be released this week.
Britain's interior ministry did not respond to requests for comment.
'WE WANT THE FACTS'
Dr Adrian James, registrar at Britain's Royal College of
Psychiatrists (RCP), said the link between mental health problems
and terrorist acts had not been established.
He said a lack of evidence, partly because militant attacks were so
rare, was at the heart of the problem, adding that an unnecessary
level of secrecy about Prevent also meant many psychiatrists viewed
the program with suspicion.
"If it is true that there is a link, we need to know and then need
to look at the causes of that and what we can do about them," James
told Reuters. "We just want the facts."
Past studies have disagreed about the significance of mental health
issues among lone wolf attackers, with some academics concluding
that such illnesses are blamed to try to explain often complex
reasons for attacks.
British police decided to launch the pilot programs because they
believed that roughly half the 7,500 people referred to Prevent each
year had a broad range of mental health and psychological
difficulties.
Those working on the pilot projects hope the information being
gathered will now help experts assess any possible links between
mental health issues and attacks.
Shaw said determining who might be a potential attacker from mental
health problems alone was not really feasible and fraught with
problems, but she said it might be possible to ascertain the
characteristics of people most likely to be at risk and ensure they
got appropriate help.
"That doesn't mean you can't manage the risks. Trying to nip it in
the bud, that's all you can do. But that's good if you can achieve
that, it's going a long way," said Shaw.
Police officers say they have struggled in the past to reach medical
practitioners when they had concerns about some people and Shaw said
the pilot was designed to address those worries.
According to one of Shaw's case studies, a man went to a hospital
saying he monitored Islamic State websites, had been walking around
the city center working out how many people he could kill in a gun
attack, and wanted to behead his mother.
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Shaw's team discovered the man had no contact with mental health
services and no diagnosis of any illness. An urgent assessment
concluded his anger stemmed from experiences in his childhood and
safeguarding measures were put in place.
'TERRORIST METHODOLOGY'
British police have no doubts about the importance of the work,
especially given the global shift from carefully planned spectacular
attacks by militant networks to unsophisticated, strikes by
individuals using cars and knives as weapons.
Mark Rowley, Britain's most senior counter-terrorism officer, told
the British Medical Journal in April that a disproportionate number
of suspects in 13 attacks foiled by British police since 2013 had
mental health issues.
"If part of the terrorist methodology is to prey on the vulnerable
... then it stands to reason that there will be people with certain
mental health conditions who will be ... susceptible to that," he
said.
"Radicalizing and inciting someone who is vulnerable to go and carry
out some ghastly attack seems to be part of their tactics, and that
has brought in a whole load of vulnerability issues, including
mental health, that we now have to wrestle with," said Rowley.
A study by University College London's (UCL) Department of Security
and Crime Science looked at 55 attacks involving 76 individuals
between May 2014 and September 2016 where reports had shown the
perpetrators may have been influenced by IS.
The study found 34 percent of those involved in attacks inspired by
Islamic State - rather than actually directed by the militant group
- had mental health issues.
Health experts estimate about one in four people will suffer some
form of mental health issue and those with mental illnesses are
generally less likely to commit violent crimes than the overall
population.
STIGMATIZATION CONCERNS
Shaw said those with mental health issues and developmental
disorders referred to her team at Prevent were more likely to be
suffering from psychosis and autism, adding that people with serious
mental illnesses often had tiny social networks.
"They can therefore, when unwell, be influenced by messages that go
out that say come and belong to our group. It can be quite
compelling. The same for people with autism. The internet kind of
way of getting the message out makes those people, particularly
vulnerable. So I think that's a big issue."
Psychiatrists worry that all people with mental health issues could
be stigmatized and considered potential militants, possibly
deterring them from seeking help.
Prevent, one of the four strands of Britain's counter-terrorism
strategy known as Contest launched in 2003, has also been dogged by
claims it is used to spy on Muslim communities.
A government edict in 2015 instructing public bodies such as
schools, health workers and universities to raise any concerns they
have about individuals with the authorities has exacerbated those
concerns.
Shaw acknowledged more work was needed on the outcomes of their
mental health interventions under the Prevent pilot programs to
determine what made a difference.
Asked if people her team had treated might have committed violent
acts if their conditions had not been addressed, she said: "That is
the obvious question. You can't say that in any kind of scientific
way.
"We're attempting to try and get at that. Is it completely to do
with their mental illness, half to do with it, or not at all?" said
Shaw.
"We have had cases where people have had ideologies, they have also
had a mental health problem, and they are not linked at all. The
last thing we need is 'all these bombers are nutters'. We don't want
that going on."
(Editing by David Clarke)
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