Clinical Services Addressing Violent Extremism: The Quebec Model

ABSTRACT

The association of ideologically motivated violence with mental health disorders raises spe-cific challenges for security agencies and clinical services. The aim of this paper is todescribe the clientele of a specialized intervention program based in Montreal, Quebec, interms of type of violent ideology and clinical presentation. We conducted a retrospectivechart review of 156 individuals referred for violent extremism who received clinical servicesbetween 2016 and 2021. Univariate statistics were used to present a description of clientsociodemographic and clinical characteristics. Roughly a third of clients referred for violentextremism presented non-ideologically based violence (32.6%), followed by 31.4% affiliatedwith far-right extremist ideology and over a quarter (25.6%) holding extremist views on gen-der. Over a third of these individuals had a stress-related (35.7%) and/or mood and anxietydisorder (36.9%), followed by 28% with an autism spectrum disorder diagnosis. The majorityhad some previous contact with mental health services. A significant number of clients dis-playing extremist discourses and/or actions needed psychiatric services but often failed toreceive them because of the reluctance of clinicians to work with individuals perceived ashigh risk; in addition, individuals may be reluctant to engage in services perceived to bepart of a socio-political system they reject. Specialized services are important as a means toprovide mental health care to this group and also to develop knowledge and best practicesfor working with this clientele and provide consultation to mainstream mental health serviceproviders.

KEYWORDS

Violent extremism; clinicalservices; mental health care;specialized intervention