Practitioners' perspectives on the challenges of dealing with the interaction between mental illness and violent extremism in Countering Violent Extremism (CVE)

While mental health frameworks are increasingly accepted in Countering Violent Extremism (CVE) policies, little is known about practitioners' experiences when individuals are mentally ill. This paper discusses how mental health clinicians review interactions between psychopathology and violent extremism, and which challenges Dutch practitioners face in decision-making processes around including severely mentally ill people in CVE individual case management approaches. Inclusion means that people are identified as (potential) violent extremists, which justifies CVE interventions on top of regular mental health care. Semi-structured interviews were conducted with 12 international mental health clinicians and 13 Dutch CVE practitioners. Data was analysed with qualitative thematic analysis. Results show that professionals usually view the risk of extremist violence, and not psychopathology, as the decisive factor for inclusion, unless (forensic) mental health clinicians advise otherwise. Nevertheless, some practitioners can experience challenges around making dichotomous choices about including mentally ill persons. Some expressed concerns about illegitimately labelling certain people as 'radicalised' when they suffer from severe mental illnesses (e.g. psychosis). CVE cases with mental illnesses are, however, characterised by heterogeneity, non-dichotomy and missing information. False negatives and false positives concerning uptake in pre-emptive CVE policies can have detrimental individual and societal effects. Future research suggestions are provided.