World Mental Health Day 2018

Adolescence and the early years of adulthood are a time of life when many changes occur, for example changing schools, leaving home, and starting university or a new job.

For many, these are exciting times. They can also be times of stress and apprehension however. In some cases, if not recognized and managed, these feelings can lead to mental illness. The expanding use of online technologies, while undoubtedly bringing many benefits, can also bring additional pressures, as connectivity to virtual networks at any time of the day and night grows.

Half of all mental illness begins by the age of 14, but most cases go undetected and untreated.Many adolescents are also living in areas affected by humanitarian emergencies such as conflicts, natural disasters and epidemics. Young people living in situations such as these are particularly vulnerable to mental distress and illness.

Half of all mental illness begins by the age of 14, but most cases go undetected and untreated. In terms of the burden of the disease among adolescents, depression is the third leading cause.

> Read entire article World Mental Health Day 2018 | World Health Organization

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Finally some data about the mental health-terrorism link

If there is one thing that frustrates me most it is the tendency of a lot of people, well-intentioned or otherwise, to make sweeping statements about terrorism – what it is, what causes it, etc.- without doing the minimum amount of real research to back up their claims.

I am sure you have read much of the same material I have: terrorism is caused by alienation; terrorism is linked to discrimination; terrorism thrives in poor socio-economic areas; and so on and so forth. Empty phrases much of the time.

Thank God I am not like that!

This is due to a kind of protective mechanism: we cannot fathom how what we see as a ‘normal’ human being could become a suicide bomber so we ascribe abnormality, in the form of mental illness, to the perpetrator.Another common trope is that terrorists usually suffer from mental illness or, if not a disease per se, at least some kind of mental condition.

This seems to be something that many are more than happy to accept, whether or not there is any empirical data to support the belief. I surmise that this is due to a kind of protective mechanism: we cannot fathom how what we see as a ‘normal’ human being could become a suicide bomber so we ascribe abnormality, in the form of mental illness, to the perpetrator.

That way we can compartmentalize the culprit and separate whatever he (or she) believed in from an ideological angle from what we ‘normal’ ones do. Phew! Thank God I am not like that!

The problem is that we simply do not have a tonne of information to underscore this conviction. Part of the challenge is that it is really tough (!) to interview or do psychiatric testing on successful suicide attackers and even those that do survive their acts are often imprisoned and that too is an obstacle. In other cases the literature is inconsistent.

Back to the paper

I want to focus today on one paper recently published in The Journal of Personality Assessment by a friend of mine, Paul Gill of University College London and his former graduate student Emily Corner, now a lecturer in Canberra (as well as two people I don’t know – Ronald Schouten and Frank Farnham). But before I do that, allow me a rant. I find it unconscionable that journals and reviews charge exorbitant fees to read articles submitted by scholars.

These costs, I am sure, make it almost inevitable that most people will never be aware of this research. This is doubly unacceptable since many of these researchers receive public funding. I for one would like to see more general, cost-free access. There, rant over. Back to the paper.

Mental disorder prevalence across terrorist actors and the general population

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Gill et al try to put what we know and what we don’t about the link between mental illness and what they call ‘grievance-fueled targeted violence’ (of which terrorism is a subset). Here is the abstract:

This article aims to move away from intuitive appeals that link mental disorder with violence such as terrorism, mass murder, and other targeted violence. The article synthesizes the existing evidence base regarding the relationship between mental disorders and personality traits and (a) attitudinal affinities with violent causes, and (b) a number of violent behaviors (including mass murder and terrorism). The evidence base is mixed and the research focus changed across time: from simple and unempirical assertions of causation to an almost complete rejection of their presence to a finer grained and disaggregated understanding. Empirical research examining mental disorder in crime and violence highlights that the commission of such events is a complex synthesis of psychopathology, personal circumstance, and environment. The article concludes with several suggestions regarding future research and practice.

My takeaway from the article is something I have been saying for decades: terrorism is complicated.

Here is another excerpt from the paper that says much the same thing: ”The presence of symptoms of a mental disorder will only ever be one (NB emphasis added) of many factors in an individual’s movement toward radicalization, planning a terrorist attack, and following an attack. In many cases, psychological problems might be present, but completely unrelated.” And, the last paragraph:

Finally, despite the nascent empirical research showing the prevalence of mental disorders within terrorist samples, it is worth noting that such individuals typically remain a minority in most samples. This attests to the limitations of expecting mental health professionals to identify individuals at risk of carrying out mass violence. In many cases, psychologists might have little to contribute in those circumstances in which potential perpetrators display no psychological disturbance and continue to act rationally.

Finally!

This is an important contribution to a field that has been to date poorly served and begins to put real numbers to assertions.I want to commended Gill et al for this work (and not just because Paul is a friend). This is an important contribution to a field that has been to date poorly served and begins to put real numbers to assertions. I have always felt that the connection between mental illness and terrorism was not as many were asserting. Then again, my views are based on what I saw as an analyst at CSIS but I have precisely zero background in psychology or psychiatry.

This is why I am excited that this kind of analysis is – finally! – being carried out. There are still challenges, however, mostly tied to data collection (all the stuff I had access to at CSIS remains out of the public sphere for example). Nevertheless I remain optimistic that we will now begin to see work along these lines.

I remain skeptical that there is a causational relationship between psychopathy and terrorism but I am open to changing my mind.

To Gill et al and others – please keep doing this. It is much appreciated!

The difference between mental illness and radicalisation

When we come across a phenomenon that is new and strange to us we often struggle to gain an understanding. What we are seeing or hearing is beyond our realm of experience and hence our ‘comfort zone’, and we don’t have a readily available framework to make sense of it. As a result we have a tendency to do one of two things:
  1. Throw up our hands and say ‘I don’t get it and I won’t get it’, or
  2. Use what is familiar to us and cram the new event into that box
  3. (I suppose there should be 3, Learn what is really going on)

I think that 2 is what happens often when we are faced with cases of violent radicalisation. A really good example of this is what is transpiring in a Toronto courtroom these days in the matter of R. vs. Rehab Dughmosh. To bring you up to speed on this proceeding, Ms. Dughmosh attacked staff at a Canadian Tire back in June with a golf club and a knife and claims that she is with Islamic State. Since her arrest and incarceration pending trial she has refused to leave her cell or cooperate at all with the judicial process and refuses to be represented by a lawyer.

Some are questioning whether her rejection of a normal court appearance may indicate an underlying mental health problem (see the National Post’s Christie Blatchford’s excellent report on the latest shenanigans of Ms. Dughmosh here). After all many would say that her words are just ‘crazy talk’ (no offence intended towards the mentally ill – this is a common phrase).

Rehab Dughmosh, pictured in a previous court appearance, said in court Wednesday, “I will always be a supporter of the Islamic State.”

Radicalization or mental illness?

My fear is that we see radicalization and ‘bizarre’ statements as nothing more than mental illnessMs. Dughmosh may indeed be mentally ill – I am not a psychiatrist nor a psychologist so this is well beyond my expertise. But, based on the few words she has said so far I do know one thing for certain: she is heavily radicalized and her behavior is 100% consistent with Islamist extremist ideology. Whether or not there are additional mental health issues is incidental as far as I am concerned (although I clearly recognize that these would have a significant effect on whether or not she stands trial).

My fear, though, is that we see radicalization and ‘bizarre’ statements as nothing more than mental illness and in this we would be very, very wrong.

According to what we know, Ms. Dughmosh traveled to Turkey to join IS but was ‘intercepted’ and sent back to Canada.

That in and of itself suggests that she had made a choice to hook up with a listed terrorist entity (interestingly she has been charged with terrorist offences in addition to assault and other crimes, showing that the Crown sees enough to make a case under the terrorism provisions of the Canadian Criminal Code).

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An Arab interpreter, Justice of the Peace Alice Napier, Rehab Dughmosh and Crown attorney Candice Suter at College Park court.
Terrorists opt for what is not only superior in their minds but they also cast aspersion on what democracy stands forThere are other things that make me certain that she is indeed radicalized and not necessarily mentally ill. She has refused to recognise the jurisdiction of the court and said “I do not worship what you worship”. This may strike some as merely an obvious religious statement: she is Muslim and most of the people in court are probably not (in fact she calls them ‘kuffar‘ – infidels). But there is much more than that going on here. Ms. Dughmosh is telling us that she does think that our laws and our system of governance apply to her. That is why she has denounced ‘any law that is not Allah’s’.

Islamist extremists reject civil law and democracy for a simple reason: they violate what they believe in. To an extremist the only real law is that which is found in the Quran and is hence divine. Everything we do, from elections to the drafting of legislation, is human-based and hence inferior. Terrorists opt for what is not only superior in their minds but they also cast aspersion on what democracy stands for.

Classic sign of radicalization

Actually, this visceral hatred for our way of doing things is a classic sign of radicalization and Ms. Dughmosh is demonstrating it in spades.

This case recalls that of Chiheb Esseghaier, the convicted terrorist in the 2013 VIA Rail plot. He made very similar outbursts during his trial. There are those that are trying to overturn his sentence as they are convinced he is schizophrenic. It will be interesting to see where this goes.

In the end though, Mr. Esseghaier was heavily radicalized. So is Ms. Dughmosh at first blush. There may be some underlying psychopathology but that must not eliminate the fact that both individuals embraced a hateful, violent ideology and sought to kill on that basis. It is not that Ms. Dughmosh ‘does not understand’ the court process: she understands it very well and rejects it as beneath her.

We must not reduce radicalization to mental illness from the outset. The two may co-exist but they are VERY different psychological phenomena. We ignore that at our peril.