Mental health professionals play an important role in violence prevention in communities across Illinois. Social workers, family therapists, forensic psychologists, and psychiatrists work in community clinics, schools, public and private hospitals, and in private practices to help both victims of violence and those who are at a higher risk of engaging in violence. But can mental health professionals use their expertise as part of a public health approach to preventing ideologically inspired targeted violence?
Mental health, legal, and law enforcement professionals explored this question during a half-day workshop last month at UIC. Planned by the Illinois Criminal Justice Information Authority’s Targeted Violence Prevention Program, the University of Illinois College of Medicine/Department of Psychiatry, and the Illinois Department of Human Services/Division of Mental Health, workshop attendees exchanged ideas and asked questions with a shared goal of preventing violence in our communities.
While at-risk individuals can be identified early and outside of the criminal justice system to help prevent violence, families often are left wondering where to turn to for help. Community-led efforts to prevent ideologically inspired targeted violence require access to therapeutic, non-punitive, and confidential resources to ameliorate the issues that create an increased risk of violence without stigmatizing the people in need.
But upon inquiry by one of the presenters, a psychologist and FBI investigator, we learned that while mental health professionals agreed they would work with individuals at risk for harming themselves, they are hesitant about working with a person at risk for harming others with violence that might be deemed terrorism.
What drives this hesitancy? After all, when looking at prevention early on the risk factors and protective factors related to violence are not very different in most cases. The mental health professionals and law enforcement in attendance seemed to agree that upstream the issues may be similar. The ideologies that promote violence often come later and are rarely the primary cause of violence. One attendee said the hesitation was not fear of the patient but a fear of the expectations from law enforcement.
The presenters from the FBI and from the U.S. Department of Homeland Security each noted that their expectations of providers vis-à-vis confidentiality between a mental health provider and her patient were no different in cases involving suspected domestic or homegrown terrorism, and certain premeditated violent hate crimes on the one hand and other forms of violence on the other hand.
Department of Homeland Security Civil Rights and Civil Liberties attorney Kareem Shora, provided several examples of Americans who engaged in acts of ideologically inspired targeted violence, including Wade Michael Page, a white supremacist who killed murdered six innocents at a Sikh Temple in Wisconsin, Dylann Roof, the white supremacist responsible for the murder of nine churchgoers in South Carolina, and Omar Mateen, who proclaimed allegiance to ISIS moments before killings 49 at a an Orlando night club. Mr. Shora noted that in each of these cases there may have been opportunities for family and friends to engage these individuals and get them help.
UIC Psychiatry Professor Stevan Weine, M.D., and Dr. Sharon Coleman, deputy director of the IDHS Department of Mental Health, discussed the risk factors, protective factors, and warning signs used by mental health professionals to assess an individual’s risk for violence and determine which services or assistance may reduce risks and bolster protective factors. Dr. Weine focused on using a “threat assessment” approach commonly used by mental health professionals in various settings. Dr. Coleman noted that mental health professionals working in violence prevention have risk assessment skills that can be used to assess individuals whom family or friends feel may be in some kind of crisis. Dr. Coleman also noted that looking at ideology may entail looking at an individual’s unique beliefs on the legitimacy or necessity of violence.
The workshop closed with a discussion on the legal and ethical obligations of mental health professionals. Attorney Scott Hammer, who has handled more psychiatric malpractice cases and events than any other attorney in Chicago, focused on the legal obligations of confidentiality and the “duty to warn” obligations in Illinois. Dr. James Marley, associate professor at Loyola University of Chicago School of Social Work, addressed ethical obligations of mental health professionals.
ICJIA’s Targeted Violence Prevention Program is engaging with more mental health professionals to better understand whether and how mental health professionals can expand their violence prevention work to include prevention and early intervention related to ideologically inspired targeted violence.
Ideologically inspired targeted violence, whether it is a pre-meditated violent hate crime, domestic terrorism, or terrorism connected to a foreign terrorist organization, must be addressed in violence prevention efforts alongside those addressing domestic, sexual, gang and other types of violence. While ideologically inspired violence is rare, the impact is far-reaching – this type of violence is intended to frighten and divide us.
We cannot allow our commitment to prevention to be degraded by practices or strategies that stereotype, stigmatize, and profile whole communities. Renowned terrorism researcher Dr. Robert Pape described this not as a problem for one particular community but as a national problem for all Americans to address. The Illinois Criminal Justice Information Authority and its Targeted Violence Prevention Program are committed to pursuing whole-of-society solutions to all forms of ideologically inspired targeted violence while safeguarding individual civil liberties.