Mental health assessments are being conducted in the presence of police in little-known hubs that embed nurses and psychologists with counter-terrorism units, raising “serious ethical concerns”, a medical charity has said.
The so-called “vulnerability support hubs” have become a permanent feature of the UK counter-terrorism apparatus since they were introduced to trial a national “vulnerability support service” in 2016 and are now established in three regions – the north, Midlands and south.
Thousands of individuals suspected of potential extremism, most of whom have been referred to the government’s counter-terrorism programme Prevent, have been assessed by the hubs, which see consultant psychiatrists, consultant psychologists and mental health nurses work alongside counter-terror police.
A major study by the charity Medact has concluded that the focus of the project is for the benefit of counter-terrorism policing rather than the patients, which puts the embedded mental health professionals at risk of compromising medical ethics.
The hubs should be scrapped, said Medact, which researches and campaigns on the social, political and economic factors that affect health inequalities.
The charity said it uncovered details of the operations in unpublished evaluations of the project pilot. As well as discovering that police officers had sat in on mental health assessments, Medact said it had found that those referred to the hubs were detained under the Mental Health Act in cases where police appear to be applying pressure on health professionals.
In one case study in the report, the charity said, police escalated concerns about a patient in order to “secure admission and prevent discharge” on the basis of “unacceptable unknown” information.
Other case studies also show that medical professionals are encouraged to monitor patient medication regime compliance on the basis of concerns such as “acting in an odd manner” or being a “convert to Islam”, Medact said.
The report raises concerns that the hubs encourage health workers to act beyond their remit, with practices including collaborating with police to assign “combined” mental health and counter-terrorism risk gradings to the people referred.
Thousands of individuals have been referred to the programme, a large proportion being young people including teenagers and children as young as six, the report added.
The report’s findings show that a Muslim is at least 23 times more likely to be referred to a mental health vulnerability support hub for “Islamism” than a white British individual is for “far-right extremism”.
Police are currently rolling the vulnerability support service out nationwide via Project Cicero.
NHS Trusts tied in with the project included Birmingham and Solihull NHS Foundation Trust, Barnet, Enfield and Haringey NHS Trust, Greater Manchester Mental Health Foundation Trust and the Lancashire and South Cumbria NHS Foundation Trust – but overall control of the hubs lies with counter-terrorism units.
The reported aim of the original pilot was “to improve the understanding of both police and health professionals of the associations between mental health conditions and vulnerability to radicalisation” and “to assess the value of mental health professionals working alongside counter-terrorism police officers … in relation to the management of individuals referred to the police with known or suspected mental disorders who may be vulnerable to radicalisation and extremism”.
The pilot project – which cost nearly £800,000 in its first year – was jointly funded by counter-terrorism police, the NHS and the Home Office.
A government spokesperson said: “Healthcare practitioners recognise Prevent as part of their safeguarding duties and with over 300,000 patient contacts every day, the NHS has an important role to play in preventing vulnerable people from being drawn into terrorism.
“A key part of Prevent is to enable frontline staff to recognise and safeguard individuals at risk from all types of radicalisation, referring them to pathways for appropriate support … tailored to an individual’s needs.
“Mental health conditions may contribute to a person’s wider vulnerabilities, though the relationship between mental health and radicalisation is complex.”
Chief superintendent Nik Adams, counter-terrorism policing’s Prevent coordinator, said: “There is nothing ‘secretive’ about our vulnerability support service and if people are interested in learning more about our vital work to divert people with mental ill health away from the criminal justice system and towards the clinical support they need, they can find more information on the Prevent page of our website.
“The sad reality is that terrorist groups are producing vast quantities of propaganda that is carefully designed to influence a small but significant number of individuals – experiencing often unique combinations of poor mental health, behavioural disorders and other complex needs – who then appear more susceptible to manipulation by extremist groups.”