Islamophobia: Why Prevent is a barrier to HIV prevention
by Natasha Dhumma
The Prevent duty is part of the Government’s counter-terrorism strategy, aiming to prevent the radicalisation of individuals towards extremism. The Counter Terrorism and Security Act 2015 requires public bodies including the NHS and local authorities to report people considered at risk of radicalisation as part of their safeguarding duties. This safeguarding function is highly contested however, with concerns its rationale is more akin to surveillance whereby individuals are viewed as potential criminals rather than those with care and support needs.
Despite recent efforts to cast its net wider, 44 per cent of referrals under Prevent relate to “Islamist extremism”. A disproportionate number of these referrals were escalated for further intervention by the Home Office compared with other types of extremism (such as the far-right). It is clear therefore that Prevent unfairly targets Muslims.
The UK is the only country in the world where a duty to report signs of radicalisation is expected of a healthcare system. Research from France, where health professionals are comparably uninvolved in counter-extremism measures, shows that 1 in 5 Muslims surveyed felt counter-terrorism policy made them more careful about what they say to doctors and nurses. Although it is not yet possible to quantify its impact in the UK, it follows that Prevent’s effect would be significantly greater.
Endangering patient-doctor relationships
It is crucial doctors and patients can foster open and trusting relationships. But fears around being considered a terrorism risk will result in patients self-censorship and ultimately those in need of support will be kept from seeking it out. This is particularly true for mental health where patients can be all too easily stigmatised as vulnerable to radicalisation. Indeed, two-thirds of NHS referrals to Prevent come from Mental Health Trusts.
Reem Abu-Hayyeh is Peace and Security Campaigner at global public health charity Medact that has been researching the issue and agrees: “Initial findings of our forthcoming report on the Prevent duty in health services point to Prevent disrupting the therapeutic relationship between the clinician and patient, particularly when mental health issues are involved. This disproportionately affects people from BAME backgrounds, including children and young people."
Data from Public Health England (PHE) shows that Muslims living with HIV reported poorer wellbeing such as sleep loss and feeling unhappy or depressed, 21 per cent said they were losing sleep over worry rather more than usual compared with 18 per cent for all respondents. Muslims were also more likely to have been diagnosed with a number of mental health conditions, such as bipolar disorder and personality disorder, highlighting that a strong patient-health worker relationship is all the more important to reduce such disparities*.
As highlighted in our earlier blog looking at the wider experiences of Muslims’ living with HIV reluctance to access treatment has serious consequences for public health. Eliminating HIV relies on testing and early intervention. If individuals disengage from these institutions and settings through fear of being labelled a suspect, and if the wider socio-economic context in which health professionals work encourages them to view patients through the prism of radicalisation, there is a real risk that effective HIV prevention will be compromised across society.
*Data collected from the Positive Voices survey run by Public Health England, NAT and Positive Voices in 2017 (unpublished). See https://changingperceptions.co.uk/ for more information.
Read the first part of this blog here.
Natasha Dhumma is Head of Policy and Campaigns at NAT (National AIDS Trust).