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Capitol siege presents new challenges for psychiatry to help prevent domestic terrorism
On Jan. 6, 2021, Americans and the world witnessed a violent insurrection at the U.S. Capitol inspired by a president and other elected leaders and driven by lies, conspiracy theories, militias, and white supremacy. The violent insurrection was carried out by thousands of citizens, including many with weapons.
Psychiatric organizations condemned the attack and warned about the potential traumatic impact of these events on those directly involved as well as for others in the United States already living under anxiety and fear tied to the surging COVID pandemic.
A major challenge for U.S. society is to prevent other potential future violent attacks. For those who didn’t already know, the Capitol attack made it apparent that the United States faces major problems with white supremacists and domestic terrorism. FBI Director Christopher Wray stipulated that those involved in the Jan. 6 events were violent agitators and extremists.
Addressing the causes and preventing domestic terrorism is also a challenge and opportunity for psychiatry and other mental health professionals. I write as a psychiatrist in academic medicine who has spent more than 10 years advocating for public health approaches to the causes and consequences of violence, especially involving violent extremism. and that psychiatrists have a role to play as part of a whole-of-society coalition with other multidisciplinary practitioners and stakeholders.
Day by day, we learn more and more about those responsible for the insurrection and how to understand their motivations, intentions, and actions. Seditionists incite or commit acts of violence against a lawful authority with the goal of destroying or overthrowing it. Domestic terrorists commit violent, criminal acts to further ideological goals stemming from domestic influences, such as those of a political, religious, social, racial, or environmental nature. The mob that attacked the Capitol contained both. What’s more, the Capitol insurrection might inspire others to take similar actions. The risk for even broader and deeper radicalization to violence is a grave concern.
Aided by more than 100,000 tips, the FBI is conducting a massive nationwide manhunt and thus far, dozens of people have been charged with crimes. Given that the United States has no law that makes domestic terrorism a crime, they are being charged with other crimes. Upholding the rule of law is necessary, but it should not be regarded as sufficient to deal with the white supremacism and domestic terrorism threats.
In many countries all over the world, and to a much lesser extent in the United States, there are successful non–law enforcement programs helping people move away from domestic terrorism and other forms of violence. One example in the United States is Life After Hate, a nongovernmental organization that uses former white supremacist extremists to counsel people to leave the movement. Another example is the Colorado Resilience Collaborative, which takes a socioecological approach to prevent terrorism and targeted violence. At Boston Children’s Hospital, a regional prevention initiative is focused on reducing youth risk for targeted violence and terrorism by reducing mental health problems and increasing social belonging among adolescents. These are but three of several initiatives currently being conducted throughout the United States.
Over the past decade, I have had the opportunity to become familiar with several of these programs domestically and internationally. These include programs aimed at rehabilitating and reintegrating repatriated foreign fighters and their children and other family members all over the world, including in Kazakhstan. I would like to share some of the lessons learned from these programs to aid in preventing domestic terrorism in the United States.
One lesson learned from combating international terrorism is that intelligence and law enforcement strategies (hard counterterrorism) need to be balanced with civil society–led prevention strategies. Overreliance on hard strategies can harm individuals and communities through oversecuritization. Alternatively, we need to build civil society–led initiatives that focus on other levers, such as addressing the underlying conditions, including individual psychosocial and mental health dimensions, or social dimensions (for example, lack of opportunity), that mitigate a person’s involvement in violent extremism.
A second lesson is not to focus exclusively on ideology and deradicalization. Yes, we need to challenge extremist ideology and disinformation, but a wide range of different factors explains involvement in violent extremism and the many pathways into it. Using a socioecological model, we can identify modifiable risk and protective factors that mitigate for or against extremist violence (for example, family support, job prospects, untreated mental health problems). In addition, it is well-established that prevention programs should seek to disengage, not deradicalize, potential violent extremists.
Third, we should leverage existing evidence-based interventions and best practices in mental health and public health, but we should also invest in building and evaluating new models through research approaches, especially for secondary and tertiary prevention. As much as possible, these should be integrated into broader programs to improve individual and community mental health and health.
A fourth lesson is we must vigorously protect the human rights and civil liberties of individuals and communities involved in these programs, and uphold racial equity. We can learn from public health experts about how to engage vulnerable individuals and communities without adding to their stigmatization. One way is to not focus on single communities, and not just on ideologically motivated violence, but to build violence prevention programs that are broad enough to address multiple forms of violence.
Fifth, if we expect community-based organizations to do the work, then they need adequate resources, capacity building, training and supervision, and quality improvement activities to succeed. For example, psychiatrists and other mental health professionals will require additional training to learn how to work effectively and ethically in this space.
Psychiatrists can start by building their knowledge and skills in understanding violent extremism and how it can be assessed and addressed, which is not the same as for suicidality. Psychiatrists can also become involved in established or emerging violence prevention programs, such as threat assessment programs in schools, workplaces, and communities. Across the country, there is a need for building new secondary and tertiary violence prevention initiatives, and they will need psychiatrists to work with them. Academic psychiatrists can become involved in building the models, developing and delivering training, and designing and conducting the program evaluations.
Finally, I suggest that psychiatrists look at domestic terrorism prevention through the lens of public health and not overly “psychiatrize” the issue. A public health approach uses evidence-based programs and policies, addresses underlying causes, and focuses on prevention. Public health builds programs with teams of experts from across disciplines – educators, health care workers, mental health professionals, faith leaders, youth leaders, community advocates, peers, and law enforcement.
As part of a public health–oriented team, psychiatrists can contribute to addressing the grave challenges of domestic terrorism facing our nation today.
Dr. Weine is professor of psychiatry, director of global medicine, and director of the Center for Global Health at the University of Illinois at Chicago. He has no conflicts of interest.
On Jan. 6, 2021, Americans and the world witnessed a violent insurrection at the U.S. Capitol inspired by a president and other elected leaders and driven by lies, conspiracy theories, militias, and white supremacy. The violent insurrection was carried out by thousands of citizens, including many with weapons.
Psychiatric organizations condemned the attack and warned about the potential traumatic impact of these events on those directly involved as well as for others in the United States already living under anxiety and fear tied to the surging COVID pandemic.
A major challenge for U.S. society is to prevent other potential future violent attacks. For those who didn’t already know, the Capitol attack made it apparent that the United States faces major problems with white supremacists and domestic terrorism. FBI Director Christopher Wray stipulated that those involved in the Jan. 6 events were violent agitators and extremists.
Addressing the causes and preventing domestic terrorism is also a challenge and opportunity for psychiatry and other mental health professionals. I write as a psychiatrist in academic medicine who has spent more than 10 years advocating for public health approaches to the causes and consequences of violence, especially involving violent extremism. and that psychiatrists have a role to play as part of a whole-of-society coalition with other multidisciplinary practitioners and stakeholders.
Day by day, we learn more and more about those responsible for the insurrection and how to understand their motivations, intentions, and actions. Seditionists incite or commit acts of violence against a lawful authority with the goal of destroying or overthrowing it. Domestic terrorists commit violent, criminal acts to further ideological goals stemming from domestic influences, such as those of a political, religious, social, racial, or environmental nature. The mob that attacked the Capitol contained both. What’s more, the Capitol insurrection might inspire others to take similar actions. The risk for even broader and deeper radicalization to violence is a grave concern.
Aided by more than 100,000 tips, the FBI is conducting a massive nationwide manhunt and thus far, dozens of people have been charged with crimes. Given that the United States has no law that makes domestic terrorism a crime, they are being charged with other crimes. Upholding the rule of law is necessary, but it should not be regarded as sufficient to deal with the white supremacism and domestic terrorism threats.
In many countries all over the world, and to a much lesser extent in the United States, there are successful non–law enforcement programs helping people move away from domestic terrorism and other forms of violence. One example in the United States is Life After Hate, a nongovernmental organization that uses former white supremacist extremists to counsel people to leave the movement. Another example is the Colorado Resilience Collaborative, which takes a socioecological approach to prevent terrorism and targeted violence. At Boston Children’s Hospital, a regional prevention initiative is focused on reducing youth risk for targeted violence and terrorism by reducing mental health problems and increasing social belonging among adolescents. These are but three of several initiatives currently being conducted throughout the United States.
Over the past decade, I have had the opportunity to become familiar with several of these programs domestically and internationally. These include programs aimed at rehabilitating and reintegrating repatriated foreign fighters and their children and other family members all over the world, including in Kazakhstan. I would like to share some of the lessons learned from these programs to aid in preventing domestic terrorism in the United States.
One lesson learned from combating international terrorism is that intelligence and law enforcement strategies (hard counterterrorism) need to be balanced with civil society–led prevention strategies. Overreliance on hard strategies can harm individuals and communities through oversecuritization. Alternatively, we need to build civil society–led initiatives that focus on other levers, such as addressing the underlying conditions, including individual psychosocial and mental health dimensions, or social dimensions (for example, lack of opportunity), that mitigate a person’s involvement in violent extremism.
A second lesson is not to focus exclusively on ideology and deradicalization. Yes, we need to challenge extremist ideology and disinformation, but a wide range of different factors explains involvement in violent extremism and the many pathways into it. Using a socioecological model, we can identify modifiable risk and protective factors that mitigate for or against extremist violence (for example, family support, job prospects, untreated mental health problems). In addition, it is well-established that prevention programs should seek to disengage, not deradicalize, potential violent extremists.
Third, we should leverage existing evidence-based interventions and best practices in mental health and public health, but we should also invest in building and evaluating new models through research approaches, especially for secondary and tertiary prevention. As much as possible, these should be integrated into broader programs to improve individual and community mental health and health.
A fourth lesson is we must vigorously protect the human rights and civil liberties of individuals and communities involved in these programs, and uphold racial equity. We can learn from public health experts about how to engage vulnerable individuals and communities without adding to their stigmatization. One way is to not focus on single communities, and not just on ideologically motivated violence, but to build violence prevention programs that are broad enough to address multiple forms of violence.
Fifth, if we expect community-based organizations to do the work, then they need adequate resources, capacity building, training and supervision, and quality improvement activities to succeed. For example, psychiatrists and other mental health professionals will require additional training to learn how to work effectively and ethically in this space.
Psychiatrists can start by building their knowledge and skills in understanding violent extremism and how it can be assessed and addressed, which is not the same as for suicidality. Psychiatrists can also become involved in established or emerging violence prevention programs, such as threat assessment programs in schools, workplaces, and communities. Across the country, there is a need for building new secondary and tertiary violence prevention initiatives, and they will need psychiatrists to work with them. Academic psychiatrists can become involved in building the models, developing and delivering training, and designing and conducting the program evaluations.
Finally, I suggest that psychiatrists look at domestic terrorism prevention through the lens of public health and not overly “psychiatrize” the issue. A public health approach uses evidence-based programs and policies, addresses underlying causes, and focuses on prevention. Public health builds programs with teams of experts from across disciplines – educators, health care workers, mental health professionals, faith leaders, youth leaders, community advocates, peers, and law enforcement.
As part of a public health–oriented team, psychiatrists can contribute to addressing the grave challenges of domestic terrorism facing our nation today.
Dr. Weine is professor of psychiatry, director of global medicine, and director of the Center for Global Health at the University of Illinois at Chicago. He has no conflicts of interest.
On Jan. 6, 2021, Americans and the world witnessed a violent insurrection at the U.S. Capitol inspired by a president and other elected leaders and driven by lies, conspiracy theories, militias, and white supremacy. The violent insurrection was carried out by thousands of citizens, including many with weapons.
Psychiatric organizations condemned the attack and warned about the potential traumatic impact of these events on those directly involved as well as for others in the United States already living under anxiety and fear tied to the surging COVID pandemic.
A major challenge for U.S. society is to prevent other potential future violent attacks. For those who didn’t already know, the Capitol attack made it apparent that the United States faces major problems with white supremacists and domestic terrorism. FBI Director Christopher Wray stipulated that those involved in the Jan. 6 events were violent agitators and extremists.
Addressing the causes and preventing domestic terrorism is also a challenge and opportunity for psychiatry and other mental health professionals. I write as a psychiatrist in academic medicine who has spent more than 10 years advocating for public health approaches to the causes and consequences of violence, especially involving violent extremism. and that psychiatrists have a role to play as part of a whole-of-society coalition with other multidisciplinary practitioners and stakeholders.
Day by day, we learn more and more about those responsible for the insurrection and how to understand their motivations, intentions, and actions. Seditionists incite or commit acts of violence against a lawful authority with the goal of destroying or overthrowing it. Domestic terrorists commit violent, criminal acts to further ideological goals stemming from domestic influences, such as those of a political, religious, social, racial, or environmental nature. The mob that attacked the Capitol contained both. What’s more, the Capitol insurrection might inspire others to take similar actions. The risk for even broader and deeper radicalization to violence is a grave concern.
Aided by more than 100,000 tips, the FBI is conducting a massive nationwide manhunt and thus far, dozens of people have been charged with crimes. Given that the United States has no law that makes domestic terrorism a crime, they are being charged with other crimes. Upholding the rule of law is necessary, but it should not be regarded as sufficient to deal with the white supremacism and domestic terrorism threats.
In many countries all over the world, and to a much lesser extent in the United States, there are successful non–law enforcement programs helping people move away from domestic terrorism and other forms of violence. One example in the United States is Life After Hate, a nongovernmental organization that uses former white supremacist extremists to counsel people to leave the movement. Another example is the Colorado Resilience Collaborative, which takes a socioecological approach to prevent terrorism and targeted violence. At Boston Children’s Hospital, a regional prevention initiative is focused on reducing youth risk for targeted violence and terrorism by reducing mental health problems and increasing social belonging among adolescents. These are but three of several initiatives currently being conducted throughout the United States.
Over the past decade, I have had the opportunity to become familiar with several of these programs domestically and internationally. These include programs aimed at rehabilitating and reintegrating repatriated foreign fighters and their children and other family members all over the world, including in Kazakhstan. I would like to share some of the lessons learned from these programs to aid in preventing domestic terrorism in the United States.
One lesson learned from combating international terrorism is that intelligence and law enforcement strategies (hard counterterrorism) need to be balanced with civil society–led prevention strategies. Overreliance on hard strategies can harm individuals and communities through oversecuritization. Alternatively, we need to build civil society–led initiatives that focus on other levers, such as addressing the underlying conditions, including individual psychosocial and mental health dimensions, or social dimensions (for example, lack of opportunity), that mitigate a person’s involvement in violent extremism.
A second lesson is not to focus exclusively on ideology and deradicalization. Yes, we need to challenge extremist ideology and disinformation, but a wide range of different factors explains involvement in violent extremism and the many pathways into it. Using a socioecological model, we can identify modifiable risk and protective factors that mitigate for or against extremist violence (for example, family support, job prospects, untreated mental health problems). In addition, it is well-established that prevention programs should seek to disengage, not deradicalize, potential violent extremists.
Third, we should leverage existing evidence-based interventions and best practices in mental health and public health, but we should also invest in building and evaluating new models through research approaches, especially for secondary and tertiary prevention. As much as possible, these should be integrated into broader programs to improve individual and community mental health and health.
A fourth lesson is we must vigorously protect the human rights and civil liberties of individuals and communities involved in these programs, and uphold racial equity. We can learn from public health experts about how to engage vulnerable individuals and communities without adding to their stigmatization. One way is to not focus on single communities, and not just on ideologically motivated violence, but to build violence prevention programs that are broad enough to address multiple forms of violence.
Fifth, if we expect community-based organizations to do the work, then they need adequate resources, capacity building, training and supervision, and quality improvement activities to succeed. For example, psychiatrists and other mental health professionals will require additional training to learn how to work effectively and ethically in this space.
Psychiatrists can start by building their knowledge and skills in understanding violent extremism and how it can be assessed and addressed, which is not the same as for suicidality. Psychiatrists can also become involved in established or emerging violence prevention programs, such as threat assessment programs in schools, workplaces, and communities. Across the country, there is a need for building new secondary and tertiary violence prevention initiatives, and they will need psychiatrists to work with them. Academic psychiatrists can become involved in building the models, developing and delivering training, and designing and conducting the program evaluations.
Finally, I suggest that psychiatrists look at domestic terrorism prevention through the lens of public health and not overly “psychiatrize” the issue. A public health approach uses evidence-based programs and policies, addresses underlying causes, and focuses on prevention. Public health builds programs with teams of experts from across disciplines – educators, health care workers, mental health professionals, faith leaders, youth leaders, community advocates, peers, and law enforcement.
As part of a public health–oriented team, psychiatrists can contribute to addressing the grave challenges of domestic terrorism facing our nation today.
Dr. Weine is professor of psychiatry, director of global medicine, and director of the Center for Global Health at the University of Illinois at Chicago. He has no conflicts of interest.
Mobilizing mental health resources offers hope in countering violent extremism
At the recent White House Summit on Countering Violent Extremism, Vice President Joe Biden called for mobilizing “mental health resources” to stop people from becoming violent extremists. This followed President Obama’s call for solutions that lie in empowering communities. At the summit, I (SMW) heard many participants who are working with at-risk young people discuss the need for mental health care in countering violent extremism.
Lone-wolf terrorists, as well as mass shooters, have shown rates of mental illness that are higher than the general population (Law Hum. Behav. 2015;39:23-34). For the most part, however, it is widely agreed that involvement in terrorism cannot be explained by an individual’s mental health diagnosis. Nonetheless, emerging knowledge from our research and the field experiences of many others point toward psychosocial struggles as central to the process of adopting violent extremist attitudes and behaviors.
Stories abounded at the summit about young people struggling with poverty, trauma, identity, and/or family issues, and how that made them vulnerable to recruitment into violent extremist organizations.
How might mental health professionals offer an antidote to this adversity and disaffection?
One role for mental health professionals identified by summit participants is direct intervention with individuals believed to be at risk for violent extremism. Law enforcement and community members are now successfully identifying these individuals earlier, before they have committed a criminal offense. Some of these individuals are being offered mental health treatment to get them off the path to criminal actions.
This approach follows the United Kingdom’s Channel, which is a multiagency program aimed at providing support to persons at risk for being drawn into radicalization, with mental health professionals playing key roles in assessment and support.
Here in the United States, the Safe Spaces Initiative developed by the Muslim Public Affairs Council includes a critical inquiry team with a psychiatrist or psychologist who works with the team to assess and care for persons already showing signs of radicalization to violence. As interventions such as these are deployed to counter violent extremism, mental health professionals need to be involved not only in providing these services but in answering key questions: How do you define the focus of treatment? How do you measure success? What approaches are most successful and for whom?
Another role that summit participants identified for mental health professionals is in designing and implementing prevention strategies. Our research among Somali Americans in Minneapolis-St. Paul identified multilevel risk factors but also protective resources that could mitigate against those risks but need strengthening. Building resilience to radicalization and recruitment involves strengthening community, family, and individual protective resources. Efforts to build resilience can draw upon prevention science that has been used to address public health, mental health, and behavioral problems through building comprehensive models that address modifiable multilevel risk factors and protective resources.
Getting mental health, communities, and law enforcement to work together is an ambitious challenge. Some precedent has been set for innovative law enforcement/mental health collaborations in the United States, such as the Yale Child Study Center’s Child Development–Community Policing Program. However, bringing collaborative models to scale – and to bear on the urgent problem of violent radicalization – will require that we, as a nation, invest in developing, implementing, and evaluating new collaborative models.
Although there is much hope at the promise of the mental health professions bringing needed expertise to the problem of violent extremism, the prospect of integrating mental health into countering violent extremism (CVE) raises many questions. At what points in the path toward radicalization to violence is mental health intervention indicated and helpful? How should individuals in need of mental health treatment be identified? What types of mental health interventions would be most effective for preventing radicalization to violence? What obligations do mental health providers have to share information with law enforcement vs. maintaining confidentiality with their clients? What kinds of training and capacity building would be necessary for both mental health professionals and law enforcement practitioners to work together effectively?
The U.S. Department of Homeland Security (DHS) has taken steps to further develop the role of mental health in CVE. In January 2015, our team began to work toward answers to these questions through a new project funded by the Science and Technology Directorate of the DHS through the University of Maryland’s START Consortium. The aim of the project is to better understand how to integrate mental health professionals, along with education professionals, into CVE.
Through our work, we will conduct a systematic literature review on mental health, education, and CVE and convene a targeted workshop with CVE, law enforcement, mental health, and education professionals, including representatives from the three CVE “pilot cities” of Los Angeles, Minneapolis-St. Paul, and Boston. The team will produce targeted cross-training modules for law enforcement, mental health, and education practitioners. These materials will be designed to be of practical use in the three pilot cities and will address the purpose of collaboration, promising program models, the degree of communication expected/possible, and potential conflicts of interest and associated steps for resolving them.
Vice President Biden was right. Incorporating mental health into CVE holds significant potential in enhancing prevention and intervention capacities. To do so effectively, however, requires a better understanding of how, when, and to what purpose assets and contingencies from mental health can be brought to bear on the challenges of countering violent extremism.
Dr. Weine is professor of psychiatry at the University of Illinois at Chicago. Dr. Ellis is assistant professor of psychology in the department of psychiatry at Boston Children’s Hospital/Harvard Medical School.
At the recent White House Summit on Countering Violent Extremism, Vice President Joe Biden called for mobilizing “mental health resources” to stop people from becoming violent extremists. This followed President Obama’s call for solutions that lie in empowering communities. At the summit, I (SMW) heard many participants who are working with at-risk young people discuss the need for mental health care in countering violent extremism.
Lone-wolf terrorists, as well as mass shooters, have shown rates of mental illness that are higher than the general population (Law Hum. Behav. 2015;39:23-34). For the most part, however, it is widely agreed that involvement in terrorism cannot be explained by an individual’s mental health diagnosis. Nonetheless, emerging knowledge from our research and the field experiences of many others point toward psychosocial struggles as central to the process of adopting violent extremist attitudes and behaviors.
Stories abounded at the summit about young people struggling with poverty, trauma, identity, and/or family issues, and how that made them vulnerable to recruitment into violent extremist organizations.
How might mental health professionals offer an antidote to this adversity and disaffection?
One role for mental health professionals identified by summit participants is direct intervention with individuals believed to be at risk for violent extremism. Law enforcement and community members are now successfully identifying these individuals earlier, before they have committed a criminal offense. Some of these individuals are being offered mental health treatment to get them off the path to criminal actions.
This approach follows the United Kingdom’s Channel, which is a multiagency program aimed at providing support to persons at risk for being drawn into radicalization, with mental health professionals playing key roles in assessment and support.
Here in the United States, the Safe Spaces Initiative developed by the Muslim Public Affairs Council includes a critical inquiry team with a psychiatrist or psychologist who works with the team to assess and care for persons already showing signs of radicalization to violence. As interventions such as these are deployed to counter violent extremism, mental health professionals need to be involved not only in providing these services but in answering key questions: How do you define the focus of treatment? How do you measure success? What approaches are most successful and for whom?
Another role that summit participants identified for mental health professionals is in designing and implementing prevention strategies. Our research among Somali Americans in Minneapolis-St. Paul identified multilevel risk factors but also protective resources that could mitigate against those risks but need strengthening. Building resilience to radicalization and recruitment involves strengthening community, family, and individual protective resources. Efforts to build resilience can draw upon prevention science that has been used to address public health, mental health, and behavioral problems through building comprehensive models that address modifiable multilevel risk factors and protective resources.
Getting mental health, communities, and law enforcement to work together is an ambitious challenge. Some precedent has been set for innovative law enforcement/mental health collaborations in the United States, such as the Yale Child Study Center’s Child Development–Community Policing Program. However, bringing collaborative models to scale – and to bear on the urgent problem of violent radicalization – will require that we, as a nation, invest in developing, implementing, and evaluating new collaborative models.
Although there is much hope at the promise of the mental health professions bringing needed expertise to the problem of violent extremism, the prospect of integrating mental health into countering violent extremism (CVE) raises many questions. At what points in the path toward radicalization to violence is mental health intervention indicated and helpful? How should individuals in need of mental health treatment be identified? What types of mental health interventions would be most effective for preventing radicalization to violence? What obligations do mental health providers have to share information with law enforcement vs. maintaining confidentiality with their clients? What kinds of training and capacity building would be necessary for both mental health professionals and law enforcement practitioners to work together effectively?
The U.S. Department of Homeland Security (DHS) has taken steps to further develop the role of mental health in CVE. In January 2015, our team began to work toward answers to these questions through a new project funded by the Science and Technology Directorate of the DHS through the University of Maryland’s START Consortium. The aim of the project is to better understand how to integrate mental health professionals, along with education professionals, into CVE.
Through our work, we will conduct a systematic literature review on mental health, education, and CVE and convene a targeted workshop with CVE, law enforcement, mental health, and education professionals, including representatives from the three CVE “pilot cities” of Los Angeles, Minneapolis-St. Paul, and Boston. The team will produce targeted cross-training modules for law enforcement, mental health, and education practitioners. These materials will be designed to be of practical use in the three pilot cities and will address the purpose of collaboration, promising program models, the degree of communication expected/possible, and potential conflicts of interest and associated steps for resolving them.
Vice President Biden was right. Incorporating mental health into CVE holds significant potential in enhancing prevention and intervention capacities. To do so effectively, however, requires a better understanding of how, when, and to what purpose assets and contingencies from mental health can be brought to bear on the challenges of countering violent extremism.
Dr. Weine is professor of psychiatry at the University of Illinois at Chicago. Dr. Ellis is assistant professor of psychology in the department of psychiatry at Boston Children’s Hospital/Harvard Medical School.
At the recent White House Summit on Countering Violent Extremism, Vice President Joe Biden called for mobilizing “mental health resources” to stop people from becoming violent extremists. This followed President Obama’s call for solutions that lie in empowering communities. At the summit, I (SMW) heard many participants who are working with at-risk young people discuss the need for mental health care in countering violent extremism.
Lone-wolf terrorists, as well as mass shooters, have shown rates of mental illness that are higher than the general population (Law Hum. Behav. 2015;39:23-34). For the most part, however, it is widely agreed that involvement in terrorism cannot be explained by an individual’s mental health diagnosis. Nonetheless, emerging knowledge from our research and the field experiences of many others point toward psychosocial struggles as central to the process of adopting violent extremist attitudes and behaviors.
Stories abounded at the summit about young people struggling with poverty, trauma, identity, and/or family issues, and how that made them vulnerable to recruitment into violent extremist organizations.
How might mental health professionals offer an antidote to this adversity and disaffection?
One role for mental health professionals identified by summit participants is direct intervention with individuals believed to be at risk for violent extremism. Law enforcement and community members are now successfully identifying these individuals earlier, before they have committed a criminal offense. Some of these individuals are being offered mental health treatment to get them off the path to criminal actions.
This approach follows the United Kingdom’s Channel, which is a multiagency program aimed at providing support to persons at risk for being drawn into radicalization, with mental health professionals playing key roles in assessment and support.
Here in the United States, the Safe Spaces Initiative developed by the Muslim Public Affairs Council includes a critical inquiry team with a psychiatrist or psychologist who works with the team to assess and care for persons already showing signs of radicalization to violence. As interventions such as these are deployed to counter violent extremism, mental health professionals need to be involved not only in providing these services but in answering key questions: How do you define the focus of treatment? How do you measure success? What approaches are most successful and for whom?
Another role that summit participants identified for mental health professionals is in designing and implementing prevention strategies. Our research among Somali Americans in Minneapolis-St. Paul identified multilevel risk factors but also protective resources that could mitigate against those risks but need strengthening. Building resilience to radicalization and recruitment involves strengthening community, family, and individual protective resources. Efforts to build resilience can draw upon prevention science that has been used to address public health, mental health, and behavioral problems through building comprehensive models that address modifiable multilevel risk factors and protective resources.
Getting mental health, communities, and law enforcement to work together is an ambitious challenge. Some precedent has been set for innovative law enforcement/mental health collaborations in the United States, such as the Yale Child Study Center’s Child Development–Community Policing Program. However, bringing collaborative models to scale – and to bear on the urgent problem of violent radicalization – will require that we, as a nation, invest in developing, implementing, and evaluating new collaborative models.
Although there is much hope at the promise of the mental health professions bringing needed expertise to the problem of violent extremism, the prospect of integrating mental health into countering violent extremism (CVE) raises many questions. At what points in the path toward radicalization to violence is mental health intervention indicated and helpful? How should individuals in need of mental health treatment be identified? What types of mental health interventions would be most effective for preventing radicalization to violence? What obligations do mental health providers have to share information with law enforcement vs. maintaining confidentiality with their clients? What kinds of training and capacity building would be necessary for both mental health professionals and law enforcement practitioners to work together effectively?
The U.S. Department of Homeland Security (DHS) has taken steps to further develop the role of mental health in CVE. In January 2015, our team began to work toward answers to these questions through a new project funded by the Science and Technology Directorate of the DHS through the University of Maryland’s START Consortium. The aim of the project is to better understand how to integrate mental health professionals, along with education professionals, into CVE.
Through our work, we will conduct a systematic literature review on mental health, education, and CVE and convene a targeted workshop with CVE, law enforcement, mental health, and education professionals, including representatives from the three CVE “pilot cities” of Los Angeles, Minneapolis-St. Paul, and Boston. The team will produce targeted cross-training modules for law enforcement, mental health, and education practitioners. These materials will be designed to be of practical use in the three pilot cities and will address the purpose of collaboration, promising program models, the degree of communication expected/possible, and potential conflicts of interest and associated steps for resolving them.
Vice President Biden was right. Incorporating mental health into CVE holds significant potential in enhancing prevention and intervention capacities. To do so effectively, however, requires a better understanding of how, when, and to what purpose assets and contingencies from mental health can be brought to bear on the challenges of countering violent extremism.
Dr. Weine is professor of psychiatry at the University of Illinois at Chicago. Dr. Ellis is assistant professor of psychology in the department of psychiatry at Boston Children’s Hospital/Harvard Medical School.
Protecting adolescents from radicalization, recruitment
Why do young people go to war zones – especially if their parents brought them to the United States for a new start? To stop adolescents from being lured to places such as Syria, Iraq, or Somalia, we need answers to that question.
One answer we hear from Somali Americans is, “We are the generation that was supposed to fix Somalia.” They were not presented with good options for doing so in a peaceful way, however, and this has made it relatively easy for terrorist organizations to exploit their passion. In 2007 and 2008, at least 17 Somali American adolescent boys and young men living in Minneapolis–St. Paul secretly left their homes and flew to Somalia to join militant extremist training camps run by Al Shabaab (Dynamics of Asymmetric Conflict 2009;2:181-200).
To better understand why this happened and how it can be prevented, we conducted a research study of Somali Americans funded by the U.S. Department of Homeland Security. We interviewed 57 people in Minneapolis–St. Paul who were either Somali American males aged 16-30 years, Somali American parents or adult family members, or service providers who worked within that community.
Multiple risks found
What we found is that no single risk factor explains violent radicalization. Instead, a combination of multiple risks at the individual, family, community, and societal levels are implicated.
To explain how to address these risks, we built a model called Diminishing Opportunities for Violent Extremism, or DOVE. This model shows that building community resilience to violent extremism depends on sustaining and strengthening (or in some cases initiating) protective resources through collaborations between family and youth, community, and government.
According to the DOVE model, these protective resources should focus on three risk levels:
• Diminishing youth’s unaccountable times and unobserved spaces (the times when adolescents and young adults are not answerable to parents or other adults and are in spaces where they are out of the sight of adults).
• Diminishing the perceived social legitimacy of violent extremism (perceptions of the appropriateness and necessity of violent extremist ideology and actions).
• Diminishing contact with recruiters or associates (adolescents and young adults interacting directly with either recruiters or companions who facilitate their increased involvement in violent extremism).
The U.S. government, state and local law enforcement, and local communities have been trying to organize prevention activities to address these and other risks. In Pres. Barack Obama’s Sept. 24, 2014, address to the United Nations, he stated: “There is no military solution to the problem of misguided individuals seeking to join terrorist organizations.” He supported a strategy called countering violent extremism, or CVE. This strategy is concerned with preventing violent ideologies from taking hold of people in the first place, and intervening and dissuading people from crossing the line toward actual violence.
The DOVE model supports the basic claim of CVE that government can’t do it alone, and it is going to require changes in communities. Meaningful preventive responses to radicalization must originate from within communities. One promising example is the Safe Spaces Initiative, a community-led preventive intervention developed by the Muslim Public Affairs Council. Safe Spaces leaves it up to communities to intervene with young people who might be getting involved with radicalization but have not yet entered into criminal space. It calls for communities to form Critical Inquiry Teams that include the participation of mental health professionals.
Role of mental health professionals
Incorporating mental health into CVE holds significant potential for enhancing both intervention and prevention capabilities with adolescents and young adults. In the United Kingdom, a national strategy called Prevent includes Channel, a multiagency program aimed at providing support to people at risk of being drawn into radicalization. One key component of Channel is for mental health professionals to be involved in assessment and support, but in order for mental health, law enforcement, and communities to be able to work together on radicalization and recruitment in the United States, we are going to have to invest in developing, implementing, and evaluating new collaborative models.
The threat of recruitment and radicalization has heightened significantly with the rise of ISIS (Islamic State of Iraq and Syria). ISIS uses propaganda videos and social media messages to appeal to a range of audiences, including would-be violent avengers, humanitarians, immigrants and refugees, and converts – males and females. Hundreds of U.S. foreign fighters reportedly have gone to ISIS. U.S. law enforcement agencies are concerned that more Americans will join ISIS, and that those foreign fighters who have joined and traveled abroad might pose security threats here at home.
To compete with ISIS to prevent more young people from going to Syria and Iraq, implementing CVE programs and policies is a national priority. This could be an opportunity for psychiatry and other mental health professionals to contribute to national and local response strategies.
One new initiative is a project recently begun by our team that is funded by the Science and Technology Directorate of the Homeland Security Dept. as part of a broader research portfolio on CVE conducted by the START Consortium, which aims to better understand how to integrate mental health professionals into countering violent extremism. This project presents an opportunity for psychiatrists and other mental health professionals to contribute to national and local response strategies to radicalization and recruitment.
Dr. Weine is professor of psychiatry at the University of Illinois at Chicago. He will address the issue of radicalization and recruitment to violence among Muslim-American teens at the upcoming joint meeting between the American Society for Adolescent Psychiatry (ASAP) and the Internal Society for Adolescent Psychiatry March 26-29 in New York. The meeting, which is themed “The Art and Science of Adolescent Psychiatry and Psychotherapy,” also will include resumption of ASAP’s Certification Examination in Adolescent Psychiatry.
Why do young people go to war zones – especially if their parents brought them to the United States for a new start? To stop adolescents from being lured to places such as Syria, Iraq, or Somalia, we need answers to that question.
One answer we hear from Somali Americans is, “We are the generation that was supposed to fix Somalia.” They were not presented with good options for doing so in a peaceful way, however, and this has made it relatively easy for terrorist organizations to exploit their passion. In 2007 and 2008, at least 17 Somali American adolescent boys and young men living in Minneapolis–St. Paul secretly left their homes and flew to Somalia to join militant extremist training camps run by Al Shabaab (Dynamics of Asymmetric Conflict 2009;2:181-200).
To better understand why this happened and how it can be prevented, we conducted a research study of Somali Americans funded by the U.S. Department of Homeland Security. We interviewed 57 people in Minneapolis–St. Paul who were either Somali American males aged 16-30 years, Somali American parents or adult family members, or service providers who worked within that community.
Multiple risks found
What we found is that no single risk factor explains violent radicalization. Instead, a combination of multiple risks at the individual, family, community, and societal levels are implicated.
To explain how to address these risks, we built a model called Diminishing Opportunities for Violent Extremism, or DOVE. This model shows that building community resilience to violent extremism depends on sustaining and strengthening (or in some cases initiating) protective resources through collaborations between family and youth, community, and government.
According to the DOVE model, these protective resources should focus on three risk levels:
• Diminishing youth’s unaccountable times and unobserved spaces (the times when adolescents and young adults are not answerable to parents or other adults and are in spaces where they are out of the sight of adults).
• Diminishing the perceived social legitimacy of violent extremism (perceptions of the appropriateness and necessity of violent extremist ideology and actions).
• Diminishing contact with recruiters or associates (adolescents and young adults interacting directly with either recruiters or companions who facilitate their increased involvement in violent extremism).
The U.S. government, state and local law enforcement, and local communities have been trying to organize prevention activities to address these and other risks. In Pres. Barack Obama’s Sept. 24, 2014, address to the United Nations, he stated: “There is no military solution to the problem of misguided individuals seeking to join terrorist organizations.” He supported a strategy called countering violent extremism, or CVE. This strategy is concerned with preventing violent ideologies from taking hold of people in the first place, and intervening and dissuading people from crossing the line toward actual violence.
The DOVE model supports the basic claim of CVE that government can’t do it alone, and it is going to require changes in communities. Meaningful preventive responses to radicalization must originate from within communities. One promising example is the Safe Spaces Initiative, a community-led preventive intervention developed by the Muslim Public Affairs Council. Safe Spaces leaves it up to communities to intervene with young people who might be getting involved with radicalization but have not yet entered into criminal space. It calls for communities to form Critical Inquiry Teams that include the participation of mental health professionals.
Role of mental health professionals
Incorporating mental health into CVE holds significant potential for enhancing both intervention and prevention capabilities with adolescents and young adults. In the United Kingdom, a national strategy called Prevent includes Channel, a multiagency program aimed at providing support to people at risk of being drawn into radicalization. One key component of Channel is for mental health professionals to be involved in assessment and support, but in order for mental health, law enforcement, and communities to be able to work together on radicalization and recruitment in the United States, we are going to have to invest in developing, implementing, and evaluating new collaborative models.
The threat of recruitment and radicalization has heightened significantly with the rise of ISIS (Islamic State of Iraq and Syria). ISIS uses propaganda videos and social media messages to appeal to a range of audiences, including would-be violent avengers, humanitarians, immigrants and refugees, and converts – males and females. Hundreds of U.S. foreign fighters reportedly have gone to ISIS. U.S. law enforcement agencies are concerned that more Americans will join ISIS, and that those foreign fighters who have joined and traveled abroad might pose security threats here at home.
To compete with ISIS to prevent more young people from going to Syria and Iraq, implementing CVE programs and policies is a national priority. This could be an opportunity for psychiatry and other mental health professionals to contribute to national and local response strategies.
One new initiative is a project recently begun by our team that is funded by the Science and Technology Directorate of the Homeland Security Dept. as part of a broader research portfolio on CVE conducted by the START Consortium, which aims to better understand how to integrate mental health professionals into countering violent extremism. This project presents an opportunity for psychiatrists and other mental health professionals to contribute to national and local response strategies to radicalization and recruitment.
Dr. Weine is professor of psychiatry at the University of Illinois at Chicago. He will address the issue of radicalization and recruitment to violence among Muslim-American teens at the upcoming joint meeting between the American Society for Adolescent Psychiatry (ASAP) and the Internal Society for Adolescent Psychiatry March 26-29 in New York. The meeting, which is themed “The Art and Science of Adolescent Psychiatry and Psychotherapy,” also will include resumption of ASAP’s Certification Examination in Adolescent Psychiatry.
Why do young people go to war zones – especially if their parents brought them to the United States for a new start? To stop adolescents from being lured to places such as Syria, Iraq, or Somalia, we need answers to that question.
One answer we hear from Somali Americans is, “We are the generation that was supposed to fix Somalia.” They were not presented with good options for doing so in a peaceful way, however, and this has made it relatively easy for terrorist organizations to exploit their passion. In 2007 and 2008, at least 17 Somali American adolescent boys and young men living in Minneapolis–St. Paul secretly left their homes and flew to Somalia to join militant extremist training camps run by Al Shabaab (Dynamics of Asymmetric Conflict 2009;2:181-200).
To better understand why this happened and how it can be prevented, we conducted a research study of Somali Americans funded by the U.S. Department of Homeland Security. We interviewed 57 people in Minneapolis–St. Paul who were either Somali American males aged 16-30 years, Somali American parents or adult family members, or service providers who worked within that community.
Multiple risks found
What we found is that no single risk factor explains violent radicalization. Instead, a combination of multiple risks at the individual, family, community, and societal levels are implicated.
To explain how to address these risks, we built a model called Diminishing Opportunities for Violent Extremism, or DOVE. This model shows that building community resilience to violent extremism depends on sustaining and strengthening (or in some cases initiating) protective resources through collaborations between family and youth, community, and government.
According to the DOVE model, these protective resources should focus on three risk levels:
• Diminishing youth’s unaccountable times and unobserved spaces (the times when adolescents and young adults are not answerable to parents or other adults and are in spaces where they are out of the sight of adults).
• Diminishing the perceived social legitimacy of violent extremism (perceptions of the appropriateness and necessity of violent extremist ideology and actions).
• Diminishing contact with recruiters or associates (adolescents and young adults interacting directly with either recruiters or companions who facilitate their increased involvement in violent extremism).
The U.S. government, state and local law enforcement, and local communities have been trying to organize prevention activities to address these and other risks. In Pres. Barack Obama’s Sept. 24, 2014, address to the United Nations, he stated: “There is no military solution to the problem of misguided individuals seeking to join terrorist organizations.” He supported a strategy called countering violent extremism, or CVE. This strategy is concerned with preventing violent ideologies from taking hold of people in the first place, and intervening and dissuading people from crossing the line toward actual violence.
The DOVE model supports the basic claim of CVE that government can’t do it alone, and it is going to require changes in communities. Meaningful preventive responses to radicalization must originate from within communities. One promising example is the Safe Spaces Initiative, a community-led preventive intervention developed by the Muslim Public Affairs Council. Safe Spaces leaves it up to communities to intervene with young people who might be getting involved with radicalization but have not yet entered into criminal space. It calls for communities to form Critical Inquiry Teams that include the participation of mental health professionals.
Role of mental health professionals
Incorporating mental health into CVE holds significant potential for enhancing both intervention and prevention capabilities with adolescents and young adults. In the United Kingdom, a national strategy called Prevent includes Channel, a multiagency program aimed at providing support to people at risk of being drawn into radicalization. One key component of Channel is for mental health professionals to be involved in assessment and support, but in order for mental health, law enforcement, and communities to be able to work together on radicalization and recruitment in the United States, we are going to have to invest in developing, implementing, and evaluating new collaborative models.
The threat of recruitment and radicalization has heightened significantly with the rise of ISIS (Islamic State of Iraq and Syria). ISIS uses propaganda videos and social media messages to appeal to a range of audiences, including would-be violent avengers, humanitarians, immigrants and refugees, and converts – males and females. Hundreds of U.S. foreign fighters reportedly have gone to ISIS. U.S. law enforcement agencies are concerned that more Americans will join ISIS, and that those foreign fighters who have joined and traveled abroad might pose security threats here at home.
To compete with ISIS to prevent more young people from going to Syria and Iraq, implementing CVE programs and policies is a national priority. This could be an opportunity for psychiatry and other mental health professionals to contribute to national and local response strategies.
One new initiative is a project recently begun by our team that is funded by the Science and Technology Directorate of the Homeland Security Dept. as part of a broader research portfolio on CVE conducted by the START Consortium, which aims to better understand how to integrate mental health professionals into countering violent extremism. This project presents an opportunity for psychiatrists and other mental health professionals to contribute to national and local response strategies to radicalization and recruitment.
Dr. Weine is professor of psychiatry at the University of Illinois at Chicago. He will address the issue of radicalization and recruitment to violence among Muslim-American teens at the upcoming joint meeting between the American Society for Adolescent Psychiatry (ASAP) and the Internal Society for Adolescent Psychiatry March 26-29 in New York. The meeting, which is themed “The Art and Science of Adolescent Psychiatry and Psychotherapy,” also will include resumption of ASAP’s Certification Examination in Adolescent Psychiatry.
