Prof Kamaldeep BhuiViolent radicalisation is a growing concern in the UK, but what drives people to do this and could a public health approach provide a way of preventing this happening? Sophie Goodchild reports:

Why are young people born in the UK attracted to supporting terrorism and violent radicalism? It is a question that community leaders and politicians have struggled to understand, along with the parents of those British teenagers who have abandoned western comforts, travelled to war zones and joined militant groups such as ISIS. The Government estimates about 500 British Muslims have gone to fight in Syria alone. Others dismiss this as ‘conservative’. Whatever the true figure, the trend poses real concerns, and raises the need for new approaches to prevent people adopting and acting out extremist behaviours.

A lot of resources are already spent on counterterrorism. However, little attention has been paid until now on ways of preventing radicalisation in the first place. One consultant psychiatrist who is attempting to find answers – and solutions – is Kamaldeep Bhui, professor of cultural psychiatry and epidemiology at Queen Mary University of London. Bhui has already published pioneering research (Bhui et al, 2014) that indicates that mental health issues and social isolation may play a part in making certain individuals more vulnerable to extremist propaganda. This is based on a qualitative survey involving more than 600 British Muslim men and women aged 18 to 45 living in London and Bradford who were asked about their sympathies to 16 terrorist actions including use of suicide bombs to fight injustice. What was reassuring was that very few of those surveyed did hold sympathies, and those who appeared at real risk of radicalisation were those born in the UK, isolated and from more affluent backgrounds.

“It wasn’t those who’d been discriminated against, or those who’d attended a mosque,” says Professor Bhui. “There were protective factors such as migrants not born in the UK were more likely to condemn terrorist behaviour along with those with larger social networks such as friends and family, and those with low social capital. Political ideas are more popular with those who can afford to do something about it.”

With the next phase of Professor Bhui’s research focusing on Pakistani and white British groups, the aim is “to follow people up and see who retains these [radical] ideas and loses them” and develop new approaches to dealing with those who have terrorist sympathies. Despite the apparent links with mental health, Professor Bhui is not advocating a response based on clinical intervention – although he does believe “positive” psychology could be useful.

Public health approach
Instead, he believes the best form of prevention could come from a public health approach similar to strategies used for preventing teenage pregnancy, drugs crime and suicide as well as conditions including heart disease.

“We’re not good at predicting [who terrorists will be] because it’s so rare but we can identify risk factors that make it more likely,” he explains. “The same approach has been applied to cardiovascular disease and alcohol abuse. We’re not trying to mitigate these offences but to prevent them, and it’s also about destigmatising the problem in the same way cancer and teen pregnancy has been. We’re dealing with a serious question of infectious ideas which divert budgets and we need to see what terrorism is trying to do, to identify and help people who are vulnerable.”

Although mosques and community leaders have been responsive to his research, Professor Bhui says it has been a challenge to carry out given the sensitive nature of the work. Participants, for example, had to be warned they could be in breach of the Terrorism Act if they expressed extremist views.

While acknowledging that governments must ‘beat the drum’ for punishing fighters returning from Syria, Professor Bhui is concerned that criminalising young people will be counter-productive. “Young people have a different way of seeing risk – they feel omnipotent. We’re talking about young people who haven’t seen a Sharia society and they’re too young to know what it means. We’ve got to own our young people – we can learn from them and criminalising doesn’t help.”

Identifying risk factors is all very well, but other experts argue these alone are not specific enough to pinpoint exactly what makes a minority act on radical views. The very term ‘radicalisation’ needs better definition before appropriate interventions can be developed, argues Neil Aggarwal from Columbia University’s Department of Psychiatry and assistant professor of clinical psychiatry at New York State Psychiatric Institute in the US. He also points out that people who subscribe to views that violence should be used for political change “may not actually commit violence themselves” and violent thoughts “may not lead to violent behaviours.”

Aggarwal adds: “The notion that social isolation, depression or any other risk factor would produce radicalisation rests upon the assumption that exposure to a risk factor causes the outcome of radicalisation. What we do not yet know is why people without social isolation or depression go on to radicalisation or why most people with social isolation or depression do not become radicalised.”

Radicals experience mental illness?
Psychiatric literature is divided as to whether radicals experience mental illness or not. Some studies among incarcerated Palestinian militants demonstrate higher rates of depressive and personality disorders, according to Aggarwal. Yet other studies with different groups demonstrate no mental illness. Aggarwal’s own work analysing Taliban and Al Qaeda primary source materials indicates that these militant groups appeal to religious sentiments such as the corruption of contemporary materialistic societies and the glory of an afterlife achieved by fighting on the path of God.

But psychiatry does have a role to play in understanding the psychology of violence and militancy, as Aggarwal’s book Mental Health in the War on Terror outlines. However, he cautions against pathologising beliefs with which we do not agree. “Teenagers who have gone to Syria to fight for ISIS and who have then returned should be treated as criminals if they have broken any laws,” says Aggarwal. “They can subsequently be screened for psychiatric disorders within the forensic mental health system. Any prevalent psychiatric disorders should be treated. Otherwise, extant law enforcement mechanisms exist to address any laws that may have been violated.”

Others believe, controversially, that the roots of radicalisation lie in mental and physical abuse. Just as the Catholic Church “took decades” to acknowledge that some priests were paedophiles, so the Muslim community too regards sexual abuse as taboo, according to clinical psychologist Elie Godsi.

“The elephant in the room is how does the Muslim community deal with sexual abuse?” says Godsi, author of Violence and Society: Making sense of madness and badness. “It’s taboo – they’re 40 years behind the Catholic Church. I agree there’s a public health issue in so much as it could be sexual abuse. A vulnerable child from an unbrutalised background would see an image like a beheading and go ‘Urgh! That’s disgusting.’ If they’ve been brutalised themselves or watched others around them then they’d just say ‘Oh.’”

Teenagers are particularly vulnerable to radicalisation because they are at the age when their sense of idealism dominates, according to psychologist Michael Reddy. “In a sense, I admire that form of idealism – the fact you might get killed means nothing at that age,” he says. “But what I don’t admire is them being radicalised by those who are vicious and barbaric.”

The factors which make seemingly ordinary people to commit atrocities against innocent people are complex and as yet not fully understood. In truth, only a tiny percentage of people translate thoughts of violent radicalism into behaviours. However, as Professor Bhui points out it only takes “one person” to commit an atrocity and “we need to stop waiting for terrorism to happen before acting.”

Aggarwal NK (2015) Mental Health in the War on Terror Culture, Science, And Statecraft. New York: Columbia University Press.
Bhui K, Everitt B & Jones E (2014) Might depression, psychosocial adversity, and limited social assets explain vulnerability to and resistance against violent radicalisation? PLOS ONE. DOI: 10.1371/journal.pone.0105918
Godsi E (2004) Violence and Society: Making sense of madness and badness. Monmouth: PCCS Books.