Show caption The report found that two-thirds of NHS referrals to Prevent came from mental health trusts. Photograph: Dominic Lipinski/PA Prevent strategy Report finds some NHS mental health trusts screen all patients for radicalisation Study by Warwick University also found patients referred to Prevent programme for watching Arabic TV or going to Mecca Diane Taylor Mon 19 Mar 2018 09.19 GMT Share on Facebook

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Four NHS mental health trusts are subjecting patients to blanket screening for radicalisation, with some referred to the Prevent programme for watching Arabic TV or going on pilgrimage to Mecca, a new report has revealed.

The Warwick University study surveyed 329 NHS staff on Prevent anti-radicalisation measures in the health service. With the UK the only country in the world to incorporate the duty to report signs of radicalisation into its healthcare system, NHS trusts are obliged to train staff to report patients or staff they suspect of being radicalised to safeguarding teams.

But according to study authors Charlotte Heath-Kelly and Erzsébet Strausz, less than half of the staff surveyed believe that Prevent belongs in the NHS or that it is intended as a safeguarding measure.

“There is evidence to suggest that the mentally ill are being inappropriately stigmatised as terrorism risks,” the report, called Counter-Terrorism in the NHS, states.

Heath-Kelly and Strausz sent freedom of information requests to all 54 NHS mental health trusts in England. Of the 49 that replied, four said that they assessed every patient for signs of radicalisation, while the others reported that they conducted radicalisation risk assessments on patients they had specific concerns about.

70% of NHS staff surveyed said they would be likely or very likely to raise a Prevent query on the basis of someone owning anarchist or Islamic philosophy books.

The staff surveyed also revealed a number of disturbing examples of what led to people being referred to Prevent by NHS staff, including:



A healthcare professional visiting a family at home who saw the child watching an Arabic TV channel with Arabic reading materials lying around.



An Asian man who was travelling to Saudi Arabia for the hajj.



A man who went to an accident and emergency department with burned hands, did did not provide an explanation for how he came by the burns, and was subsequently referred to police on suspicion of experimenting with bomb-making.



The report, which says that in Prevent priority areas Home Office officials are embedded in the NHS, will add to concerns over the use of the programme. It has already faced controversy as a method of identifying people who may have become radicalised and is distrusted by some communities.

After the Manchester Arena terror attack in May 2017, NHS staff were asked to encourage anyone they saw who had been at the arena to phone the police terrorism hotline. They were told that if patients refused, then the NHS staff could call the terror hotline and give police information after the patient had gone.



Each NHS trust receives a daily counter-terrorism briefing from the Home Office. “It is unclear why the NHS would require daily briefings on international terrorism for its work,” the report states.

The Home Office also provides NHS staff with advice on how to counter negative media stories about the Prevent programme.

The report takes issue with the definition of Prevent in the NHS as a safeguarding measure, saying that safeguarding has shifted from a welfare-oriented to a security-oriented endeavour.

According to the NHS website, the Prevent programme is “designed to safeguard people in a similar way to safeguarding processes to protect people from gang activity, drug abuse, and physical and sexual abuse”, adding that radicalisation is seen as a type of harm or abuse.

But there are concerns that the definition is hazily applied and operating in a legal grey area. Heath-Kelly expressed particular alarm about the instruction from police to refer any cases NHS staff have concerns about, even if those concerns turn out to be unfounded. “This is a surveillance rationale, not a safeguarding rationale,” she said.

The role of NHS mental health trusts in making Prevent referrals is key. According to Sir Bruce Keogh, NHS England’s former national medical director, two-thirds of NHS Prevent referrals come from mental health trusts. Since last November, the government has produced separate Prevent guidance for NHS mental health trusts.

One forensic psychiatrist interviewed for the study said: “It’s going to be a bit Mickey Mouse … as I say, I’m ashamed, it’s totally unscientific and it’s going to be based on opinion, so it’s a bit crap really, but it’s just trying to get at what’s going on.”



The report urges the four NHS trusts who investigate all patients for signs of radicalisation to stop doing so.

Two-thirds of the NHS staff surveyed said they were not confident that they could distinguish someone who had been radicalised from someone who had an interest in Middle Eastern politics. Although the NHS philosophy is “no decision about me without me”, consent is rarely obtained before a Prevent referral is made, the report finds.

Heath-Kelly said: “Historically this kind of thing has existed in non-democratic societies and we know the history of where that leads. It becomes deeply concerning when you look at the real world of how it works for people being asked to do something they are not trained to do and identify people who might in the future become dangerous. There is deeply problematic mission creep here.”

The security minister Ben Wallace said Prevent aimed to safeguard and support individuals vulnerable to all forms of radicalisation.

“Prevent is no more a surveillance scheme than the safeguarding schemes that have always been in place for healthcare workers to report signs of domestic or sexual abuse,” he said. “We all have a duty to protect vulnerable people from being groomed by those who seek to exploit them for the purposes of sexual, criminal or extremist exploitation.”



He said rules for health workers on patient confidentiality were the same in all areas of safeguarding, including referrals made over potential radicalisation.

