Mental Health

19.03.18

Four MH trusts screen all patients for radicalisation, report finds

Applying radicalisation screening to all mental health service users risks “inappropriately stigmatising the mentally ill”, a report has warned.

Research carried out by Warwick University found that four mental health trusts currently include radicalisation criteria in their comprehensive risk assessments for all service users.

The university’s pilot study, ‘Counterterrorism in the NHS: Evaluating Prevent Duty safeguarding by Midlands healthcare providers,’ aimed to explore the methods and outcomes of embedding counterterrorism safeguarding within the broader safeguarding mechanisms.

A Freedom of Information request revealed that of the 49 mental health trusts that responded (out of a total of 54), four routinely screen all service users for signs of radicalisation.

Previous research has argued that up to 40% of lone terrorists have some form of mental illness, but the authors of the report have said that this correlation should be “taken with a pinch of salt.”

One trust screened every service user as part of an independent risk assessment, not falling within the safeguarding assessment, and encouraged a referral to be made if just half of the criteria were met.

The authors of the report warned that this “inappropriately positions” those with mental illnesses as a community from which terrorism originates.

The Prevent Duty, which is a component of the Counter-Terrorism and Security Act 2015, requires healthcare providers to train their staff about the signs of radicalisation, and how to report patients and staff to safeguarding teams.

As well as conducting interviews of 17 experts within the NHS and police, the researchers distributed questionnaires to NHS staff about the Prevent training received by them, and their understanding of the signs of radicalisation.

Although staff reported feeling comfortable with the Prevent training that they had received and felt confident to detect radicalisation, they also strongly identified hate speech, possession of radical Islamic or anarchist philosophy, and anger at foreign policy as indicators of radicalisation, even though Prevent training modules do not identify these factors.

One trust’s safeguarding team received a Prevent referral when a healthcare professional performing a home visit noticed a child watching an Arabic news channel on television and Arabic reading materials around the home.

Another received a referral where “an Asian man” had been discussing his future Hajj pilgrimage to Saudi Arabia.

Staff raise concerns for place of screening in healthcare

Less than half of staff who responded to the survey agreed that Prevent is a genuine safeguarding procedure, and less than half agreed that it belonged in healthcare.

In an interview, a consultant psychiatrist said: “Anyone who knows anything about safeguarding can clearly see [Prevent} is not safeguarding, really. There’s no audit, there’s no clinical governance.”

Two thirds of respondents were also ‘not confident’ that Prevent was not a form of surveillance, but there was still a high level of confidence in individual trusts and CCGs to make sensible and appropriate decisions about Prevent referrals.

The researchers have said that they intend to contact the health select committee to “advise them of the gap separating the Care Act 2014 and Prevent Duty safeguarding,” and to raise the concerns that safeguarding experts are expected to work in “a legal grey area between the provisions of the Care Act and the Counterterrorism And Security Act.”

They concluded that Mental Health Trusts should not integrate radicalisation into Comprehensive Risk Assessments performed on all service users, which “inappropriately stigmatises the mentally ill,” and that staff should be made aware of their unconscious bias when making referrals.

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