Hurlow et al1 contradict the assertion that severe mental illness does not have a significant role ‘overall in the area of terrorism’. The authors state that there is evidence for mental illness in cases of lone-actor terrorism, suggesting that these cases are more likely to come to the attention of psychiatrists.
I strongly disagree with the authors. Although there are several psychological factors contributing to radicalisation, experts in terrorism studies agree that those who commit acts of terrorism ‘are not mentally disturbed’.2
There is little consensus in the literature regarding the importance of mental illness in lone-actor terrorism. However, the evidence suggests that mental illness is not a key factor contributing to acts of violence in these cases.3 It is therefore erroneous to insinuate that psychiatrists have a role in identifying these individuals. It is also highly questionable whether a ‘future potential Breivik’ would – or could – be identified by psychiatrists. In the case of Breivik, the forensic psychiatric evaluation concluded that although he has narcissistic personality disorder, he was not affected by a serious mental disorder when committing the act of terrorism, nor at the time of the evaluation.
The role of individual preventive interventions is limited in preventing relapse in regular criminality4 and remains highly controversial with regards to terrorism.5 The question of terrorism and mental health is extremely relevant and important, and warrants further study. However, the evidence to date shows a weak correlation between mental disorders and terrorist acts.
- © 2017 The Royal College of Psychiatrists