Forensic psychiatry, to most, is the exercise of deconstructing tragedy and the tragic. Yet the practice itself reveals urgency well beyond the jails, hospitals, and modest rooms where tales of misery pour forth. The lessons of my professional experience in Guantanamo Bay bear an important challenge to our nation and to people of all faiths -- if we dare to look at those locked up.
Under heavy political pressure, the United States has reconsidered the basis of confinement and has released hundreds of detainees from Guantanamo in recent years. Sensitivity to America's image among human rights organizations propelled compliant optimism by the American government that many detainees would no longer be a belligerence risk if restored to freedom.
Relying upon the detainee's own self-advocacy in interviews, America has transferred many to other countries for transitional custody or outright release. But the near-catastrophe of Umar Abdulmutallab's Christmas 2009 airline underwear bombing attempt and the defiant Guantanamo alumni leadership who directed him have raised warnings to the world to rethink risk assessment and risk prevention.
Against the backdrop of these competing forces, the United States Department of Defense asked me as a veteran of highly sensitive forensic psychiatric assessments to appraise the risk of one such Guantanamo detainee, Omar Khadr. Mr. Khadr, by his own statements in 2002 and most recently in October 2010, admitted to throwing a grenade that killed Sfc. Christopher Speer as he inspected the scene of a recently completed battle. Khadr was 15 at the time that he killed Speer.
When I interviewed Khadr last June in my capacity as a forensic psychiatrist, he was an English-speaking, socially agile 23-year-old with the kind of easy smile that so similarly warms those who encounter the Dalai Lama and Bin Laden alike. Anticipating his eventual release, the military commission asked me to go beyond the natural tendency of advocates and adversaries to see what they want to see in Omar the man.
Forensic psychiatry is no stranger to risk assessment. Since the United States Supreme Court decision in Estelle vs. Smith (1981) established the enduring role of psychiatry expertise in death penalty cases, psychiatry and psychology have significantly refined risk assessment. Forced to endow its approaches with the rigor of scientific method, psychiatry has deconstructed our clinical presumptions. The very question itself has matured to niches of particular context. Future dangerousness of violence in the community involves a different approach from assessing risk of violence in maximum security; those approaches differ from assessing risk of sex offense, of non-violent criminality, of domestic violence, stalking, even future contact offense in a child pornography consumer. Assessing future risk of dangerous Jihadist activity necessarily recognizes that an approach may borrow from clinical understandings about criminal and violent recidivism, but has to stay true to context (actual ideological violence or otherwise facilitating violence) in order to gain relevance.
Validity in risk assessment invariably draws from statistics and actuarial approaches. The statistics on released Guantanamo detainees who return to active battle are a source of consternation to those invested in the notion that only a few detainees could pose future harm. As recently as 2008, the recidivism rate was reported at 6 percent. That figure has climbed steadily and sharply upward, and a recent updated report from the Director of National Intelligence now asserts that 25 percent of released Guantanamo detainees have recidivated -- and over half of these combatants (83) are actually at large. What the U.S. government does not disclose is that their figures are a significant underestimation, for many reasons.
1) Government figures include those who remain in foreign jails and therefore have no opportunity to recidivate.
2) Released detainees often change their names, identity papers and countries and therefore cannot be accounted for.
3) The infrastructure to which many detainees are released is not equipped to monitor the nature of their activities as would parole officers and other features of Western societies. It is far easier to operate off the grid and therefore seemingly uninvolved in violent Jihadism.
4) Those who are more senior, such as the leaders of al-Qaeda of the Arabian Peninsula (AQAP), can be far more destructive by inspiring others than actually engaging in armed hostilities (as they did when younger).
Forensic psychiatry does not only concern itself with risk assessment, but also the appraisal of how to reduce risk as well. In that regard, some Muslim countries such as Saudi Arabia and Yemen, mindful of the anti-government agenda of their own Jihadists, developed what have come to be known as "deradicalization" programs.
Multidisciplinary initiatives, primarily emphasizing religious intervention, engage the misguided into a re-education about the Koran's message being one of non-violence rather than the apocalyptic nihilism of Islamist favor. If inmates' families repudiate Jihadism and take responsibility for their evolution, if the inmate has no serious violence history, the combination of reeducation in a peaceful strain of Islam with social and vocational reintegration and pro-social outlets for inflamed passion (such as marriage) has been more successful.
The premise is a sensible one; Jihadism is a phenomenon of religious ideology and inspiration, not a mental illness. The pious Imam is more potent than would be any psychotherapist or antipsychotic medication. Even more powerful are those programs whose deradicalization Imams come from a life in terrorism, and can attest to how terror practitioners will know no paradise. Of those programs, the deradicalization that enjoys the greatest success is not surprisingly the most regulated program: that of Singapore.
Unfortunately, closer study reveals that in Saudi Arabia, for example, those in Interior Minister Prince Nayef's ballyhooed deradicalization programs are redirected only to avoid attacking the kingdom itself. This not-in-my-neighborhood band-aid is partly to blame for Saudi Jihadists moving to the greater flexibility they exploit in neighboring Yemen, while training their sights on airliners and Chicago synagogues alike.
A current appraisal of deradicalization programs therefore appreciates their potential relevance. At the same time, the structure and composition of the program can render the work useless or worse yet, disingenuous. Proposals for Omar Khadr's future illustrate this latter point well. It was Khadr's own attorneys who specifically proposed deradicalization for Khadr in February 2009 featuring Toronto-based Imam Zafar Bangash in the role of steward for Khadr's reintegration into society post-release.
But steward into what? Imam Bangash has a legacy of incendiary anti-West rhetoric, including his 2002 characterization of Canada as a "fully paid-up member of the Anglo-Saxon mafia responsible for most of the recorded genocides in the world," and his assertion in Canada's National Post that the United States establishment wanted 9/11 to happen to pursue oil exploration initiatives in Afghanistan.
Deradicalization like this is no different from keeping Omar Khadr marinated in the extremist climate of the Guantanamo camps. There, American servicemen eager to promote the impression that freedom of religion is respected, stand idly by as Jihadists dominate and feed off each other to achieve a more concentrated degree of radicalism than one would find anywhere outside an Awlaki-run mosque.
The Saudi Prince Nayef, appraising the risk of released Guantanamo detainees from a different vantage point from ours, noted that ex-Gitmo detainees "infected" Saudi deradicalization programs and contributed to elevating the recidivism of those who had never been to Cuba.
Regrettably, tiny Singapore has far outpaced the world in implementing meaningful deradicalization. Attempts in Britain have collapsed under the force of charming and aggressive Jihadists who menace moderate Imams into submission and retreat. Jails and prisons of Europe are now dominated not just by Muslim presence, but extremist thinking. In American as well as Canadian facilities, tens of thousands of inmates are converting to Islam every year.
Yielding to the notion that they are respecting religion, corrections officials have failed to make a committed effort to staff prisons with devout, forceful but peaceful-minded Muslim imams. As a result, the more charismatic, Machiavellian, and aggressive leaders within North American corrections facilities dominate and influence vulnerable and often alienated Muslim prisoners. These influences remain after prisoners are released and have been implicated in American terror attacks by American-born ex-cons.
Many argue that the ripening of destructive fantasy in Guantanamo happens because of Guantanamo, and being detained. My experience in Guantanamo -- more humane and easier living than any maximum security facility I visit around the United States on a regular basis -- and my study of corrections in Europe and America teaches me that radicalization in Guantanamo is no different from the phenomenon in corrections systems of even the greatest of America's critics -- including the Arab world.
Violent Jihadism is the byproduct of psychopaths who seek apocalypse and shroud themselves in the Koran, media naivete that cloaks them in intrigue, academia propagandists who provide terror leaders with intellectualized legitimacy, and Jihadism's ability to exploit freedoms to redirect America and Canada from confronting it ideologically. The forensic psychiatric lesson of Guantanamo, and Omar Khadr's eventual hero's return to his highly radicalized family and the Canadian terror fundraising infrastructure his father built as an al-Qaeda financier, is that the hearts and minds we have to win are in our prisons today and our streets tomorrow.
If our government does not actively deradicalize with the message that Islam must seek equality rather than theocracy, tomorrow's prisoners – be they in Gitmo or in any other prison in America -- will continue to amiably soak in hate and find comrades-in-arms who buy into that now-dominant message of Islamist supremacy and entitlement to violence.
Dr. Michael Welner is Chairman of The Forensic Panel and an ABC News Consultant. He has been the principal forensic psychiatrist in some of the most complex cases of recent years, including Andrea Yates' child-killing, Elizabeth Smart's kidnapper, wrestler David Benoit's psychological autopsy, and the testamentary fitness of Hong Kong billionaire Nina Wang. Dr. Welner is also coordinating landmark research of an evidence-driven measure to assess the worst of crimes, which invites direct participation of the general public at www.depravityscale.org.