A tick­ing time bomb

Men­tal health ex­perts trained in threat assess­ment may help thwart ter­ror­ist at­tacks

Baltimore Sun - - COMMENTARY - By Ste­van Weine Dr. Ste­van Weine is a re­searcher with the Univer­sity of Mary­land’s Na­tional Con­sor­tium for the Study of Ter­ror­ism and a pro­fes­sor of psy­chi­a­try at the Univer­sity of Illi­nois at Chicago. His email is smweine@uic.edu.

The fa­ther of Ah­mad Khan Ra­hami, the sus­pect of re­cent bomb­ings in New York and New Jer­sey, told re­porters that in 2014 he was wor­ried about his son and took his con­cerns to the FBI. They in­ves­ti­gated, the fa­ther said, and told him his son was fine.

“He’s OK,” they said. “He’s clean, he’s not a ter­ror­ist.’”

No one ever linked the young man to a men­tal health pro­fes­sional trained in threat assess­ment who could bet­ter de­ter­mine whether he was on a dan­ger­ous path — one that could re­sult in mass vi­o­lence — and whether treat­ment could be of­fered to get him off that path.

Emo­tional and fam­ily in­sta­bil­ity of­ten play a role in ter­ror­ist at­tacks, along with mis­guided ide­ol­ogy. That sug­gests we can’t rely only on tra­di­tional law en­force­ment ap­proaches to pre­vent them but must also in­cor­po­rate the skills of men­tal health pro­fes­sion­als. Law en­force­ment officials widely ac­knowl­edge this, yet we still have no na­tional or local pro­grams to make the nec­es­sary links re­gard­ing ide­o­log­i­cal ter­ror­ism. The clos­est we come is in some school districts where ex­perts are trained to spot the po­ten­tial for school vi­o­lence and pre­vent it.

Us­ing this model, I helped de­sign and lead a table­top ex­er­cise this sum­mer in part­ner­ship with the U.S. Depart­ment of Home­land Security’s Of­fice for Com­mu­nity Part­ner­ships and the Los Angeles County Depart­ment of Men­tal Health.

At the cen­ter of the con­fer­ence room sat an ac­tor and men­tal health pro­fes­sion­als from the Los Angeles County Depart­ment of Men­tal Health’s school vi­o­lence pre­ven- tion pro­gram. In the au­di­ence were local men­tal health pro­fes­sion­als, com­mu­ni­ty­based ser­vice providers, local ac­tivists, law en­force­ment and fed­eral officials.

We de­vised two mock cases of per­sons pos­si­bly on their way to an at­tack. One char­ac­ter was a col­lege stu­dent mo­ti­vated by white su­prem­a­cists and an­other was a dis­grun­tled em­ployee in­spired by ISIL, also known as ISIS. In each case, there was an op­por­tu­nity to change the course of events; words had been spo­ken in a class­room or a work­place that trig­gered con­cern.

We in­vited the men­tal health pro­fes­sion­als to as­sess whether they were a threat or not and then to talk with a team of other com­mu­nity-based providers to de­cide what to do next. The pro­fes­sion­als had to do what they do ev­ery day with threat­ened vi­o­lence in schools. But in this in­stance, they were faced with new chal­lenges re­lated to ide­o­log­i­cally mo­ti­vated vi­o­lence.

The char­ac­ters were very con­vinc­ing, and the sit­u­a­tions they dra­ma­tized were in­ten­tion­ally am­bigu­ous. The men­tal health pro­fes­sion­als did many things well. They lis­tened com­pas­sion­ately and asked prob­ing ques­tions. The teams came to rea­son­able con­clu­sions about the po­ten­tial for vi­o­lence, and they knew when and how to co­op­er­ate with law en­force­ment.

Those who at­tended the table­top saw at first hand how men­tal health pro­fes­sion­als could play a role in vi­o­lence pre­ven­tion. They saw a trained men­tal health pro­fes­sional con­duct­ing an in­ter­view in a way that was non-threat­en­ing and non-stig­ma­tiz­ing, but ef­fec­tive in un­der­stand­ing the per­son’s in­ten­tions and ca­pa­bil­i­ties for vi­o­lence. The table­top con­vinced all present that get­ting men­tal health pro­fes­sion­als in­volved af­ter con­cerns are ex­pressed, by build­ing on the best prac­tices of school vi­o­lence pre­ven­tion, may be an ef­fec­tive way to seize op­por­tu­ni­ties now be­ing missed and to pre­vent the next ter­ror­ist at­tacks.

We also found there was room for im­prove­ment in the men­tal health pro­fes­sion­als’ ap­proach. They didn’t know enough about ide­o­log­i­cally mo­ti­vated vi­o­lence to rec­og­nize how com­mit­ted the ac­tors were to tak­ing vi­o­lent ac­tion. They also had no es­tab­lished re­la­tions with ser­vice providers to re­fer these clients back to their home com­mu­ni­ties. They weren’t sure how to best in­form or in­volve com­mu­nity lead­ers, ei­ther, es­pe­cially those who may have deep sus­pi­cions about both men­tal health pro­fes­sion­als and law en­force­ment.

The table­top made it clear what kinds of fur­ther train­ing and ca­pac­ity build­ing need to be ar­ranged for suc­cess­ful vi­o­lence pre­ven­tion pro­grams with men­tal health pro­fes­sion­als. But to be sure a lot more than a table­top needs to be done.

With $10 mil­lion of new grants from the U.S. Depart­ment of Home­land Security soon to be awarded, some com­mu­ni­ties should be able to bring men­tal health pro­fes­sion­als into their pub­lic safety ef­forts, giv­ing those in need from un­der­served com­mu­ni­ties greater ac­cess to ser­vices. But more re­sources will be needed given the scale of the prob­lem — and the stakes.

While the at­tacks Mr. Ra­hami is ac­cused of com­mit­ting were not fa­tal, the next one may be.

AN­DRES KUDACKI/AP

FBI agents in­ves­ti­gate the scene of an ex­plo­sion last month in Man­hat­tan’s Chelsea neigh­bor­hood. Ah­mad Khan Ra­hami, a U.S. cit­i­zen born in Afghanistan, has been charged by fed­eral officials with plant­ing bombs in New York and New Jer­sey.

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