New counter-terror rules give GPs bizarre incentives to refer mental health patients as radicalization threat
been afoot to train every GP, nurse, dentist and X-ray technician to spot the “signs” of radicalization.
The government is now increasingly committed to using mental health practitioners to deal with Prevent cases and in November the Home Office launched a new e-learning package about radicalization for those working in the mental health sector. The NHS will now not only make Prevent referrals about patients – it will also receive Prevent cases and provide these people with mental health support.
Think carefully about what a standard referral to Prevent will mean under these new rules. A person requiring mental health support causes concern to someone, but rather than being referred directly to the NHS for help they are placed on the Prevent pathway. They then pass through all the stages of the Prevent referral path, including specialist police background checks, before their case is scrutinized by the local authority Channel panel. Only at that point does the team decide that the individual has a health need, rather than requiring de-radicalization.
Rather than provide adequate mental health care for all who need it, British society is more comfortable assuming that some vulnerable people are potential terrorists. Only when a specialist team declares that de-radicalization is not required does the potential for healthcare then reopen. This is a consequence of the Prevent duty itself. Since 2015, when reporting under the Prevent duty became mandatory, the number of people referred has rocketed. Where the system could once expect 500 or 1,000 referrals a year, it received 7,631 in 2015-16.
Once a person is referred to Channel they will be put in the charge of a Channel mentor who usually has experience of youth work or religious expertise. But it can take up to 18 months for the Home Office to approve a new mentor, and our conversations with some of them for our research suggest that there aren’t enough across the country to provide for 7,631 people per year. During this long approval process, existing mentors remain exceptionally busy. This goes someway to explain why mental health and social care services have been asked to step in and deal with Prevent referrals.
Bizarre incentives
If access to social care, healthcare and education steers someone away from extremism, then it is sensible to assume the removal of those services must increase vulnerability. But merging social care with counter-terrorism safeguarding also creates a bizarre incentive for GPs to make inappropriate referrals to Prevent, so that their patients can gain access to the housing, psychiatry and social care which patients are otherwise denied because of government cuts. During interviews for our study of Prevent in the NHS a GP expressly told us that:
One of my patients, single man, was made homeless. He had no chance whatsoever of getting housing. He was referred to Prevent because when he turned up at the housing center saying ‘I want to kill Muslims and Africans …’ So, he got referred straightaway to Prevent. He was housed in a couple of days. There are times where I’ve actually thought to myself, ‘you’ve got housing issues, maybe I should say you’re a danger to society, you’re at risk of radicalizing’.
When austerity removes the safety net people rely upon for mental health services and housing, social care professionals will find other ways of obtaining services for those in need – even if it involves stigmatizing them through the Prevent program. While Prevent has long been confused about the line between security risk and social care need, this dynamic has been made infinitely more problematic by economic austerity.
Charlotte Heath-Kelly is Associate Professor, Politics and International Studies, University of Warwick. Erzsebet Strausz is Assistant Professor, Department of Politics and International Studies, University of Warwick. This article is published courtesy of The Conversation (under Creative Commons-Attribution / No derivative).
