Simple explanations are usually wrong – mental health is not the only relevant factor when assessing the threat of terrorism

News reports of terrorist attacks often note that the perpetrator suffered from mental health problems. This is especially so for attacks or attempted attacks by lone individuals. Clinical Director Allan Seppänen nevertheless finds that mental illness is not a significant explanation for terrorist activity.

Allan Seppänen, Clinical Director at HUS.

Popular reports of terrorist attacks or attempted attacks often seek to discuss the mental health of the perpetrators. If a perpetrator has sought treatment for mental health problems, then this is often viewed as the reason for the violent act. Forensic psychiatrist Allan Seppänen nevertheless insists that the explanation is seldom so simple. Seppänen is a Consultant Forensic Psychiatrist and Clinical Director at Helsinki and Uusimaa Hospital District (HUS).

"Psychiatric illness is not a significant explanatory factor for terrorist acts overall. News coverage of mental health problems can simplify and medicalise events without having to consider socio-political, cultural and religious dimensions that may be uncomfortable and awkward for commentators and society at large."

Severe mental health problems usually prevent coordinated activities with other people, though even a person with paranoid schizophrenia has the potential to act independently for an extended period.

"I would expect such a person to be excluded from a close-knit group fairly quickly. We might cautiously begin by assuming that there would be more mental health problems among lone operators than among those acting in a group."

There are problems in bundling mental health problems together when we consider their significance in the context of terrorist attacks. Seppänen points out that no mental health disorder is directly related to terrorist violence.

"Some mental disorders increase the likelihood of violence in general, while others reduce that likelihood. For example, depression deactivates individuals and typically reduces their likelihood of committing a violent offence. Severe psychotic illnesses slightly increase the tendency to commit acts of violence, especially when combined with a substance abuse problem."

Supo continually updates its list of individuals who are counter-terrorism targets. The list of CT targets is a counter-terrorism tool that guides intelligence gathering and threat prevention. It is essential to identify potential attackers in advance. Knowledge of possible mental health problems is one factor that raises concerns precisely because certain disorders can increase the potential for violence. Mental health nevertheless always remains only one factor in the overall assessment.

Sometimes mental health problems reduce the threat of terrorism. Seppänen has seen situations in which patients have created online identities that are entirely detached from their true identities and functional capacities.

The same phenomenon is known to Supo. People who present themselves aggressively and make threats online may, for example, prove to be very limited in their personal life management and functional capacities, and to pose no real threat.

Mere words do not make an action terrorism

Seppänen finds that mental health problems do not predispose individuals to radicalisation, which instead has more complex causes. Certain psychiatric disorders, on the other hand, involve thinking patterns that may resemble radicalisation to the layman, even though they are a completely different phenomenon from the perspective of a psychiatrist.

"Rather many psychotic illnesses involve religious delusions and the same type of dogmatic religious rhetoric that we are accustomed to hearing in the discourse of radicalised individuals. The thinking of these individuals is nevertheless wholly controlled by the contribution of the illness to the mindset, and it cannot be manipulated by such instruments as propaganda."

News coverage of mental health problems can simplify and medicalise events.

Counter-terrorism operations at Supo have similarly noted that mere words do not yet make an action terrorism. The ideology may be superficial and its authenticity hard to assess. A court of law ultimately decides the matter on the basis of all available evidence in the most difficult situations. A psychiatric examination is arranged if necessary when assessing the criminal responsibility of perpetrators.

The most devastating terrorist attacks do not arise from a passing whim or delusions. They are often preceded by years of systematic planning. Complex strike plans involve a large number of people with various functions. The planners of attacks in particular, but also the perpetrators, tend to have a very strong ideological conviction, which they believe justifies the use of extreme violence.

Is any psychological trait associated with radical activity? Both Supo terrorism analysts and Seppänen are dubious that any such link exists.

"There are so many kinds of radicalisation. Terrorist groups are highly disparate, and involve so many types of role that they are inevitably very heterogeneous."

Instead, there is often a background in experiences of isolation, humiliation, and lack of ability. Seppänen finds that radicalisation can be prevented by the same means that otherwise support social and mental well-being. He considers it important for people to be encouraged to integrate into their own environment and educate themselves.

Even though mental health problems are not a significant explanation for terrorism, Seppänen remains keen to highlight the risks associated with difficult access to care.

"The plain fact is that mental health services have been run down too far. This always carries a risk of untreated psychiatric problems that may also manifest as violence."