[Attitudes of Healthcare Professionals to Extremism and Treatment Options]. / Einstellung von Fachkräften aus den Heilberufen zum Thema Extremismus und zu Behandlungsoptionen.

OBJECTIVE: In view of the cruelty of acts of terrorism and violent extremism, it is often inconceivable what the underlying motives are. Analyzes of the attacks in Ansbach (2016), Halle (2019) and Hanau (2020) showed a picture of different psychological conspicuities among the perpetrators, which highlights the need to involve health care professionals in the prevention of extremism. Against this background, the treatment of people with extremist attitudes appears to be crucial in order to prevent negative consequences for those affected, but also for society. METHODS: Within the framework of an anonymous online survey, physicians and psychological psychotherapists were asked about previous experiences, attitudes and wishes regarding the treatment of patients with extremist attitudes. Furthermore, data on their own work was collected. RESULTS: A total of 364 physicians (18%), psychological psychotherapists (72%) and participants with other job descriptions (10%) took part in the study. Only one fifth state that they felt well trained in the subject. About half of the respondents would offer a place in therapy (if they could decide on the patients themselves), likewise about half have already dealt with the topic of extremism and the majority see a need to deal with the topic more in the future and indicate a need for further training. The analyses show that physicians have so far dealt with the topic somewhat more than those with psychological psychotherapeutic training, and professionals in private practive are more likely to see a connection between extremism and psychiatric illnesses than professionals in hospitals, but would be less willing to offer patients with extremist attitudes a place in therapy. DISCUSSION: Physicians and psychotherapists need further training on extremisms and should be better prepared fo the challenges of treating patients in this context. CONCLUSION: In order to increase the chances of providing adequate care for mentally ill people with extremist attitutdes, health professionals should be better prepared for the topic in the future, for example through further training or opportunities for cooperation.

[Experiences of dangerous situations in psychiatry and psychotherapy involving patients with extremist attitudes]. / Erfahrungen mit Gefährdungssituationen in Psychiatrie und Psychotherapie bei Patienten mit extremistischer Einstellung.

BACKGROUND AND OBJECTIVES: Dangerous situations in connection with the treatment of persons with suspected extremist attitudes have become increasingly relevant. A survey of physicians and psychotherapists is intended to provide information about concrete dangerous situations among these patients. MATERIALS AND METHODS: By means of an anonymous online survey, which comprised 16 main questions and up to 95 additional questions, a total of 364 health professionals were asked about the general situation and about patients, as well as relatives with suspected extremist attitudes. RESULTS: In all, 17.5% of the participants were physicians, 72.1% psychotherapists. 47.7% work exclusively in a hospital, 34.2% in a private practice. A total of 57.7% of the participants have already treated patients with suspected extremist attitudes (46.7% treated relatives); 27.6% were confronted with situations of self-endangerment (30.1% in the case of relatives), 49.5% with situations of danger to others (18.3% in the case of relatives), in which they often did not feel safe. Altogether, 20.3% of the professionals informed security authorities, and not quite half found this contact to be comparatively unhelpful/not at all helpful (45.5% among relatives). The majority of the participants had no contact to other agencies, such as specialized counselling centres for deradicalization. Physicians experienced the situations of endangerment more often than non-medical psychotherapists. A comparison between professionals from hospitals and private practices shows no significant differences. DISCUSSION: The study was able to show that extremism and the associated dangerous situations are an important topic in the treatment of patients and that physicians and non-medical psychotherapists should be well prepared. Networking with extremism prevention agencies and good cooperation with security authorities would be important and desirable for the future.