The current handbook is designed as a research- and theory-informed aid for clinical forensic practitioners working with individuals who present with extremism risk/vulnerability and mental illness. It was authored by Dr Zainab Al-Attar, University of Central Lancashire, United Kingdom and produced by the Radicalisation Awareness Network: Health & Social Care subgroup.

There is no empirical evidence to suggest that terrorism is predominantly committed by mentally ill individuals, and where mental illness is present, it may not be relevant to risk. Wherever it has some relevance, it may not be causal, and if it is partly causal, it is likely to interact with a range of political, social, environmental, situational and biological factors at any given time. Therefore, the current handbook does not seek to explain terrorism through mental illness but instead provides guidance on which aspects of mental illness may be considered and how, whenever an individual exhibits both mental illness and terrorist offending or extremist behaviours. It is designed to assist practitioners to unpack the complex impact of mental illness and test hypotheses on its possible role in an individual’s extremism vulnerability and risk.

This handbook is not meant to be used as a risk assessment methodology, nor does it seek to offer a quantitative measure of risk and vulnerability. It also does not seek to offer a position on the medico-legal implications of mental health contributors to extremism vulnerability/risk. Its sole purpose is to aid in qualitative assessments, formulation and intervention planning and it is designed to be used as an adjunct to the appropriate, existent riskassessment methodologies, intervention and therapeutic approaches, and mental health and counter-extremism frameworks and processes.

It is important that the work that mental health practitioners undertake with extremists does not operate in isolation and all efforts should be made to operate within a multidisciplinary framework. Such frameworks may involve security and law enforcement agencies as well as social and mental health services. Given that extremist behaviour may be covert or overt and contextualised by both operational and psychological factors, 4 Extremism, radicalisation & mental health: Handbook for Practitioners Introduction to the Handbook the clinical forensic practitioner provides one piece in a broader jigsaw of expertise, assessment, intervention and decision-making. It is important where possible that the operational and clinical experts inform each other’s insights. Clear lines of communication and information-sharing between professionals and agencies are important. Each country, state, organisation and professional group will have its own protocols on multi-disciplinary working and information-sharing and this handbook should only be used to inform practice within the confines of such existent protocols.

The structure of this handbook is as follows: It will firstly present an introduction to key concepts on which extremism risk/vulnerability formulation builds. Secondly, the handbook will provide a section on each of a number of mental illnesses or clinical diagnoses, with a consideration of how the symptoms may be relevant to extremism risk/ vulnerability and what approaches could mitigate such risk/vulnerability. Finally, it will provide a reading list, which may be of assistance to practitioners wanting to develop or refresh their knowledge of relevant theory and clinical practice.

Access the full Handbook

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