The Fixated Threat Assessment Centre (FTAC) is a UK police/mental health unit, whose function is to manage the risk to public figures from stalkers and individuals who are fixated on high profile public figures or prominent protected sites. It was formed in 2006 in acknowledgement that perpetrators of attacks and other unwanted incidents overwhelmingly suffered from psychosis, and could often be identified in advance of any incidents from precursor behavioural signs. Preventive treatment could then be applied, for the protection of the relevant public figures as well as the families and neighbours of the sufferer. It is jointly managed by the Home Office, the Department of Health and Metropolitan Police Service
The rationale for a joint police/mental health unit was the finding that the main danger of death or serious injury to politicians in Western Europe came from attacks by people suffering from a mental health illness, who had given warnings of what they might do in the form of inappropriate, harassing or threatening communications or approaches towards the politicians in question. [1] A similar picture was found in a study of historical attacks on the British royal family. [2] A separate detailed study of recent inappropriate communications and approaches to members of the royal family found that 83% of the individuals concerned were suffering from psychosis. [3]
Similar findings have come from the United States, where forensic psychiatrist Park Dietz has written: “Every instance of an attack on a public figure by a lone stranger in the United States for which adequate information has been made publicly available has been the work of a mentally disordered person who issued one or more pre-attack signals in the form of inappropriate letters, visits or statements...." [4] The role of FTAC in the UK is to detect such signals, to evaluate the risks involved and to intervene to reduce them. Such intervention often entails the obtaining of treatment and care for the fixated individual from psychiatric and social services and general practitioners in their town of residence.
The word ‘fixated’ in the name of the unit indicates that the main motivational drives behind the stalking of public figures are pathologically intense fixations on individuals or causes, these being obsessive pre-occupations pursued to an abnormally intense degree. [5] In the case of those pursuing the Royal Family, these fixations divide between beliefs that the individual was a member of the family or married to a member of the family; that the royal personage was involved in plots to persecute them; and that the Royal Family were culpable for failing to redress a particular grievance, often delusional, with which the individual was angrily obsessed.
FTAC was set up in 2006, jointly managed by the Home Office, the Department of Health and Metropolitan Police Service. [6] It is staffed by eleven police officers, four full-time senior forensic nurses, a full-time senior social worker and a number of senior forensic psychiatrists and psychologists from the Barnet, Enfield and Haringey Mental Health NHS Trust and the Oxleas NHS Foundation Trust. FTAC receives around 1,000 referrals a year of people who have engaged in threatening or harassing communications towards politicians or the Royal Family. [7] Around half are assessed as being of low risk after initial enquiries. The remainder are investigated by FTAC staff. They may then be referred to local health services for further assessment and potential involuntary commitment. In some cases, they may be detained by police under the section 136 powers of the Mental Health Act 1983 prior to referral.
Although run by London's Metropolitan Police Service, FTAC is responsible for dealing nationally with the stalking or harassment of public figures by lone individuals. According to its founder, David James, it attempts not only to provide protection for the subjects of obsessive attention, but also to help people with obsessions who have mental illnesses that might otherwise have gone undiagnosed or untreated. The basis of the approach arises from the fact that the majority of the fixated are driven by delusional beliefs based in potentially treatable mental disorders. Treating those with evident mental illness will have an important effect in reducing the level of risk to public figures, whilst at the same time improving the health and welfare of the individuals concerned. [5] The strap-line on FTAC's stationery is 'Preventing Harm and Facilitating Care'. [8] [9]
According to a statement made in June 2007 by the then Minister of State at the Home Office, Tony McNulty,
FTAC does not detain people in psychiatric hospitals. When it encounters an individual in need of mental health care it alerts their general practitioners and psychiatrists, who then provide appropriate help under existing legislation. FTAC may make use of police powers under section 136 of the Mental Health Act 1983 to take a person who appears to be suffering from mental disorder, and in immediate need of care or control, to a place of safety. When people are removed to hospital under section 136, they are examined by a registered medical practitioner and interviewed by an approved social worker, not associated with FTAC, in order to make any necessary arrangements for their treatment or care. [10]
In a parliamentary reply made in June 2009, the then Minister of State for Security, Counter-Terrorism, Crime and Policing, David Hanson said: "Since 2006, when FTAC began operation, 246 people have been detained under the Mental Health Act following a referral from FTAC and a subsequent decision by local health services. No individual has received a custodial sentence as a result of FTAC involvement." [11]
He also stated that during that same period, 27 people had been conveyed to a "place of safety" by FTAC staff under section 136 of the Mental Health Act 1983. [11]
FTAC published the details of its interventions in its first 100 cases in The Journal of Forensic Psychiatry & Psychology in 2010. Eighty-six per cent of those assessed by FTAC were diagnosed as suffering from psychotic illness; 57% of the sample group were subsequently admitted to hospital, and 26% treated in the community. In 80% of cases, the risk level was reduced to low by FTAC intervention, the remainder of cases remaining under continued FTAC management [9]
In protection terms, FTAC’s activities are said to benefit the families of the fixated individuals and the general public as much as the public figures that they are hounding. This is because those close to the fixated are more regularly exposed to their irrational and threatening behaviour than the public figures they target. [12] This finding is similar to that made in the USA by Dietz and Martell in a report prepared for the National Institute of Justice:
The persons most at risk of violence from the individual mentally ill person who pursues public figures are not the public figures or those that protect them – assuming they have the necessary security arrangements - but rather the private citizens who are the family members and neighbours of the mentally disordered subject. [13]
The setting up of FTAC was the main recommendation of the report of Fixated Research Group (FRG) which undertook a major research project on behalf of the Home Office between 2003 and 2006. This looked at inappropriate communications and approaches to members of the Royal Family, and systematically examined 8,000 files held by SO14, the royalty protection division of the Metropolitan Police Service’s Protection Command. The Fixated Research Group was composed of forensic psychiatrists and psychologists from the UK, Australia and the USA, who are experts in the field of stalking. They included Paul Mullen and Michele Pathé from Australia, co-authors of ‘Stalkers and their Victims’, [14] and J. Reid Meloy from San Diego, editor of The Psychology of Stalking. [15] The series of research papers published by the group in peer-reviewed scientific journals forms the evidence base for the Fixated Threat Assessment Centre.
The researchers at FTAC contend that the joint police-NHS model has other possible applications within the UK, such as in police responses to stalking of ordinary people and in homicide prevention. In their view, a logical further development would be the modification of the role of NHS police-liaison psychiatric nurses, so that they become embedded in police responses at borough or county level in order to perform an enabling role, to the benefit of individual patients and of public protection. [9]
A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is also characterized by a clinically significant disturbance in an individual's cognition, emotional regulation, or behavior, often in a social context. Such disturbances may occur as single episodes, may be persistent, or may be relapsing–remitting. There are many different types of mental disorders, with signs and symptoms that vary widely between specific disorders. A mental disorder is one aspect of mental health.
Pathological jealousy, also known as morbid jealousy, Othello syndrome, or delusional jealousy, is a psychological disorder in which a person is preoccupied with the thought that their spouse or romantic partner is being unfaithful without having any real or legitimate proof, along with socially unacceptable or abnormal behaviour related to these thoughts. The most common cited forms of psychopathology in morbid jealousy are delusions and obsessions. It is considered a subtype of delusional disorder.
Forensic psychology is the application of scientific knowledge and methods to help answer legal questions arising in criminal, civil, contractual, or other judicial proceedings. Forensic psychology includes research on various psychology-law topics, such as jury selection, reducing systemic racism in criminal law; eyewitness testimony, evaluating competency to stand trial; or assessing military veterans for service-connected disability compensation. The American Psychological Association's Specialty Guidelines for Forensic Psychologists reference several psychology subdisciplines, such as social, clinical, experimental, counseling, and neuropsychology.
Criminal psychology, also referred to as criminological psychology, is the study of the views, thoughts, intentions, actions and reactions of criminals and suspects. It is a subfield of criminology and applied psychology.
Forensic psychiatry is a subspeciality of psychiatry and is related to criminology. It encompasses the interface between law and psychiatry. According to the American Academy of Psychiatry and the Law, it is defined as "a subspecialty of psychiatry in which scientific and clinical expertise is applied in legal contexts involving civil, criminal, correctional, regulatory, or legislative matters, and in specialized clinical consultations in areas such as risk assessment or employment." A forensic psychiatrist provides services – such as determination of competency to stand trial – to a court of law to facilitate the adjudicative process and provide treatment, such as medications and psychotherapy, to criminals.
Park Elliot Dietz is a forensic psychiatrist who has consulted or testified in many of the highest-profile US criminal cases, including those of spousal killer Betty Broderick, mass murderer Jared Lee Loughner, and serial killers Joel Rifkin, Arthur Shawcross, Jeffrey Dahmer, Ted Kaczynski, Richard Kuklinski, the D.C. sniper attacks, and William Bonin.
The Mental Health Act 1983 is an Act of the Parliament of the United Kingdom. It covers the reception, care and treatment of mentally disordered people, the management of their property and other related matters, forming part of the mental health law for the people in England and Wales. In particular, it provides the legislation by which people diagnosed with a mental disorder can be detained in a hospital or police custody and have their disorder assessed or treated against their wishes, informally known as "sectioning". Its use is reviewed and regulated by the Care Quality Commission. The Act was significantly amended by the Mental Health Act 2007. A white paper proposing changes to the act was published in 2021 following an independent review of the act by Simon Wessely. It was confirmed on 17 July 2024 that a new mental health act would be legislated for in the forthcoming session of Parliament.
The Threat Management Unit (TMU) is the threat management unit of the Los Angeles Police Department (LAPD), tasked with investigating harassment and stalking, especially against celebrities and officials. The TMU was formed in 1990 after the murder of actress Rebecca Lucile Schaeffer. Over the years the TMU has been visited and emulated by law enforcement agencies and security companies across the United States and the world.
Suicidal ideation, or suicidal thoughts, is the thought process of having ideas, or ruminations about the possibility of completing suicide. It is not a diagnosis but is a symptom of some mental disorders, use of certain psychoactive drugs, and can also occur in response to adverse life circumstances without the presence of a mental disorder.
Suicide risk assessment is a process of estimating the likelihood for a person to attempt or die by suicide. The goal of a thorough risk assessment is to learn about the circumstances of an individual person with regard to suicide, including warning signs, risk factors, and protective factors. Risk for suicide is re-evaluated throughout the course of care to assess the patient's response to personal situational changes and clinical interventions. Accurate and defensible risk assessment requires a clinician to integrate a clinical judgment with the latest evidence-based practice, although accurate prediction of low base rate events, such as suicide, is inherently difficult and prone to false positives.
Forensic social work is the application of social work to questions and issues relating to the law and legal systems. It is a type of social work that involves the application of social work principles and practices in legal, criminal, and civil contexts. It is a specialized branch of social work that focuses on the intersection of law and mental health. Forensic social work is an important part of the criminal justice system and provides an important link between mental health and the legal system.
Homicidal ideation is a common medical term for thoughts about homicide. There is a range of homicidal thoughts which spans from vague ideas of revenge to detailed and fully formulated plans without the act itself. Most people who have homicidal ideation do not commit homicide. 50–91% of people surveyed on university grounds in various places in the United States admit to having had a homicidal fantasy. Homicidal ideation is common, accounting for 10–17% of patient presentations to psychiatric facilities in the United States.
A psychiatric assessment, or psychological screening, is the process of gathering information about a person within a psychiatric service, with the purpose of making a diagnosis. The assessment is usually the first stage of a treatment process, but psychiatric assessments may also be used for various legal purposes. The assessment includes social and biographical information, direct observations, and data from specific psychological tests. It is typically carried out by a psychiatrist, but it can be a multi-disciplinary process involving nurses, psychologists, occupational therapist, social workers, and licensed professional counselors.
Stalking is unwanted and/or repeated surveillance or contact by an individual or group toward another person. Stalking behaviors are interrelated to harassment and intimidation and may include following the victim in person or monitoring them. The term stalking is used with some differing definitions in psychiatry and psychology, as well as in some legal jurisdictions as a term for a criminal offense.
In United States civilian law enforcement, a Threat Management Unit is a police department team that provides criminal and behavioral analysis and risk assessments in an attempt to review, and ultimately mitigate, the potential for violence with an emphasis on prevention. Threat Management Units identify risk factors, patterns of escalation, and construct an environment that inhibits or prevents violence. The services provided cover a wide range of topics, including, but not limited to terrorism, school violence, sexual crimes, stalking, cyber crimes, domestic violence, arson, sabotage, communicated threats, insider threats and pre-attack behavior. Research in this area of law enforcement is known as Threat Safety Science.
The following outline is provided as an overview of and topical guide to psychiatry:
Barnet, Enfield and Haringey Mental Health NHS Trust (BEH) is a large provider of integrated mental health and community health services in North London, providing services across Barnet, Enfield, and Haringey. The trust currently employs around 3,000 staff and serves a population of just over a million. The annual income in 2017-18 was c. £210 million.
Involuntary commitment or civil commitment is a legal process through which an individual who is deemed by a qualified agent to have symptoms of severe mental disorder is detained in a psychiatric hospital (inpatient) where they can be treated involuntarily.
Urban Metcalf was a clothes salesman and asylum patient who was arrested for allegedly attempting to assassinate King George III. Metcalf went in and out of various asylums for his entire adult life before eventually being permanently committed to York asylum in 1822. Metcalf reportedly believed that he was King, based on a 'delusional genealogy', and repeatedly tried to enter royal palaces.
Disaster psychiatry is a field of psychiatry which focuses on responding to natural disasters, climate change, school shootings, large accidents, public health emergencies, and their associated community-wide disruptions and mental health implications. All disasters, regardless of exact type, are characterized by disruption: disruption of family and community support structures, threats to personal safety, and an overwhelming of available support resources. Disaster psychiatry is a crucial component of disaster preparedness, aiming to mitigate both immediate and prolonged psychiatric challenges. Its primary objective is to diminish acute symptoms and long-term psychiatric morbidity by minimizing exposure to stressors, offering education to normalize responses to trauma, and identifying individuals vulnerable to future psychiatric illness.