Programme: Newton International Fellowship
Name of PI: Tarek Younis
Title of project: The impact of anti-radicalisation policies on British Muslims and NHS healthcare professionals
Start and end dates: 2016 – 2018
Award amount: £98,997.02
Institution: University College London
About the project
There is a tendency to reduce racism as instances of individual discrimination. In a move to go beyond “bad apples”, this research turns the lens back on policy which institutionalises racialised logics within healthcare. The War on Terror is unique in that the threat of terrorism is commonly associated with Muslims in public logic. In turn, the Prevent policy is exceptional insofar as the UK is the only country in the global north which has made it a public duty for healthcare staff to identify and report patients they suspect may be vulnerable to radicalisation—future terrorists. The Prevent policy thus introduces a novel and unique window into exploring how racialised policies are introduced, experienced and practiced in healthcare settings, especially for Muslims.
There were several key findings. First, Prevent’s attempt to “colourblind” its counter-radicalisation training—by not focusing on Muslims—does not address the racist associations between Muslimness and threat. Rather, it merely makes it more difficult to charge Prevent with racism. Second, NHS staff felt awkward and uncomfortable in Prevent training. Especially among Muslim staff, there is a fear of speaking out against counterterrorism, as it operates on a moral boundary of “good vs evil.” The “good” position then is for staff to accept that Prevent is necessary and good, even if they believe it may be harmful to patients. This raises the question of the increasing roles of NHS staff, and the ethical conundrums they face in providing healthcare for patients while navigating top-down policy structures like Prevent.
By turning the lens on policy, this research looks at how the political climate is infused within healthcare settings, institutionalising and legitimising racialised logics in the process. The issue of racism then is not only between people—like patients and staff—but rather the very healthcare setting becomes racialised through security policies like Prevent. Thus, as some Muslim patients admitted during the fieldwork, one is cognisant of the possibility of a racist Prevent referral simply by entering the NHS, before interacting with staff. At the same time, staff are conscious of the Prevent duty around Muslim patients, though they may dislike the policy. This speaks to the complexity of introducing policies like Prevent in healthcare, whose racist impact cannot simply be deduced by counting the number of “Muslim” referrals.
The impact is more complicated than explicit experiences of discrimination. Rather, we see how the Prevent policy—as it securitises space—infiltrates every facet of the clinical interaction, to racist consequences. Muslim staff and patients are worried their statements may be misconstrued and self-censor as a result. A GP was reluctant to engage in certain conversations, like home-schooling, for fear of being held responsible for not following policy. And patients are concerned with seeking therapy in the NHS, out of fear certain ideas (e.g. on foreign policy) will trigger a security “trip wire” (the exact words the police use in speaking of Prevent in the NHS).
Impacts and value
The academic impact of this project is derived from understanding how liberal racism operates through colour-blindness. Prevent, along other policies in healthcare like Hostile Environment, are not (explicitly) directed at certain groups. At the same time, notions of threat, violence and belonginess are racialised in the public imaginary. This project provokes discussions of racism in healthcare outside of overt incidences of discrimination and contributes to the growing theme that healthcare is not an “apolitical” space. Rather, it is the permeability between public and healthcare logics which allows for racist associations, then legitimised by policies like Prevent. This work has been shared on international platforms, to outline the dangers of “colour-blindness” in healthcare and to think critically of institutionalising counter-terrorism in public bodies.
Younis’ research claims that colourblind policies on racialised social conflicts (like counterterrorism) are ineffective, counter-productive and subject to human rights concerns. Rather, the racist association between threat and Muslimness must first be taken as a given, as is known in research. This has not been taken up by policy-makers, who continue to promote colourblind strategies in issues of violence, threat and immigration.
This project has helped developed greater public awareness on counter-violent extremism strategies, liberal racism and Islamophobia in various countries across the Global North, including the UK, Canada and Denmark.
Benefits of the award
“The British Academy award has benefitted my professional development in many ways. Not least, it set the building blocks for my current post—senior lectureship at Middlesex University—where I teach and research on the importance of politics and racism in psychology.”
One of the main outputs of this British Academy award, an article in the Sociology of Health and Illness, received the Mildred Blaxter New Writer’s Prize. This facilitated Younis joining the journal’s editorial board, which has been an immensely enlightening experience. The award also facilitated establishing enduring ties with numerous scholars and organisations, who share an ethos of social justice and anti-racism in healthcare.
The award has also helped Younis develop ties and projects with various institutions. For example, he collaborated in a special issue on Race, Mental Health and State Violence for the journal of Race and Class, run by the Institute of Race Relations. He has also collaborated and worked on off-shoot projects of security and health with various NGOs. For example, he was a co-writer on MedAct’s report on Vulnerability Support Hubs, detailing Prevent’s expansion into mental health. He has also translated this research into clinical practice, considering the impact of security policies on “safe spaces” with HealingJusticeLondon.
Otherwise, the project set the foundations for two more successful seed funding projects, Racial Capitalism and Security (with Canadian researchers) and Deobfuscating Surveillance (also with Canadian researchers), each £5000, awarded in January 2021. These projects continue to expand upon the intersection of security, surveillance and race.
“Tarek’s work on Prevent in the NHS has been crucial in understanding how Islamophobia enters the NHS through 'security' policies. It also sheds a necessary light on the ethical dilemmas NHS staff face on a daily basis, trying to manage the increasingly policing-oriented roles they are given, while focusing on their patient’s wellbeing. The British Academy’s support of Tarek has facilitated a much needed conversation on race and security in healthcare, and we are hoping to see more such work in the future.” - MedAct, NGO mobilising health workers to challenge the social, political and economic conditions which damage health and deepen health inequalities