Frank Farnham

Barnet, Enfield and Haringey Mental Health NHS Trust · North London Forensic Service

Increasingly, studies compare risk and protective factors for involvement in violent and nonviolent terrorist behaviors. This exploratory study investigates whether this distinction is sufficient, or whether it should be disaggregated further into more granular terrorist roles and behaviors. Using data on 404 referrals to a UK countering violent ex...

Purpose This paper aims to present issues of deterrence related to stalking. Design/methodology/approach The authors have combined recent mixed method research findings and existing general deterrence literature with their practitioner experiences of working with this population, to provide a novel viewpoint paper intending to influence advancemen...

The adoption of the term grievance-fuelled violence reflects the fact that similarities exist between those committing violent acts in the context of grievance in different settings, so potentially allowing the application of insights gained in the study of one group to be applied to others. Given the low base rate of violence against public figure...

The problem of assessing risk in cases of concerning communications to companies has been subject to little systematic study. This article examines a series of sixty-two such cases referred by companies to Theseus, a threat assessment group. It looked at factors associated with two proxies for risk—approach in previous problematic communicators and...

Lone-actor terrorists are more likely than group-based terrorists to have mental health problems. When an alleged terrorist is arrested and prosecuted, there are a number of ways that their mental health can become pertinent: behavioral issues in the jail, competency to stand trial concerns, a plea of not guilty by reason of insanity, sentence miti...

Best practice in threat assessment requires the use of standardised, evidence-based tools to assist in case formulation. Considerable numbers of such tools have been developed for use in risk assessment in criminal justice, mental health and community settings: instruments have been published for the threat assessment of cases in specific areas, su...

Fixated individuals pose a significant threat to public figures. Previous research compares individuals labeled ‘approachers’ to those labeled ‘communicators.’ Typically, such studies compare a number of risk factors among the two groups to identify significant differences. This has impactful implications for the threat assessment and management of...

Attempts to address the threat of harm posed by perpetrators of child sexual abuse (CSA) have rightly increased in recent years, with well-known efforts such as operation NOTARISE resulting in 750 arrests; however, the cost of such operations is also high. Operation NOTARISE resulted in 24 suicides; the estimated economic and social cost of which h...

Objective An emerging body of research indicates that child sex abuse (CSA) offenders are at high risk of suicide when their offenses come to light and that those accused of accessing indecent images of children (IIOC) are at particular risk. Methods We conducted a systematic review and narrative synthesis on suicide rates and risk factors in this...

The relationship between violent radicalization and poor mental health is complex and multilayered. We use the principles of equifinality and multifinality to demonstrate this complexity. In terms of equifinality, we draw upon the existing evidence base to demonstrate that the end outcome of violent radicalization has many paths into it. Some indiv...

Concerning approaches and communications to the Royal Family and other British public figures are relatively numerous. This paper examines over 2000 such cases logged over a three-year period in the United Kingdom. Using police and health data, the paper conducts a series of bivariate and multivariate analyses to demonstrate the predictors of what...

Overview of the approach adopted by the National Stalking Clinic in assessment and intervention with those who engage in stalking behaviour.

The Fixated Threat Assessment Centre (FTAC) manages the risk posed to public figures by fixated individuals by paying attention to their correspondence and approaches and liaising with the mental health and criminal justice agencies responsible for their management. This paper offers a narrative reflection on the clinical experience of this unusual...

This article aims to move away from intuitive appeals that link mental disorder with violence such as terrorism, mass murder, and other targeted violence. The article synthesizes the existing evidence base regarding the relationship between mental disorders and personality traits and (a) attitudinal affinities with violent causes, and (b) a number...

Prominent figures are frequently subjected to unwanted and intrusive attentions. Such stalking behaviour is often driven by psychotic illness, angrily blaming the public figure for delusional persecution (resentful motivation), or based on erotomanic delusions (intimacy seeking motivation), for example. This behaviour can cause psychological harm t...

This report is a summary of the research conducted as part of the work of the Suicide Prevention Group from 2015 to 2017. The report outlines a systematic review of the known published literature on risk factors of suicide in CSE and IIOC offenders and qualitative research conducted across three groups (law enforcement officers, Lucy Faithfull Foun...

A survey concerning intrusive/aggressive behaviours towards MPs was administered at Westminster, and in Queensland, New Zealand and Norway. Follow-up interviews were conducted with a sample at Westminster. This paper examines the experiences and associations of the 239 Westminster responders, of whom 81% had experienced intrusive/aggressive behavio...

Politicians suffer intrusive and aggressive behaviours from members of the public, often lone actors fixated on personal grievances. Few explorations of intrusive behaviours towards politicians have been published; their results are not directly comparable. We surveyed intrusive/aggressive behaviours towards UK members of parliament (MPs); our surv...

Seventy per cent of general practitioners (GPs) were found in an earlier study to have been subject to aggressive/intrusive behaviours by patients, with nearly 20% stalked and 20% harassed. Using the same sample, an exploration was undertaken of patterns of behaviour, patient characteristics, including mental illness and motivation, GP characterist...

We work in a national mental health diversion service; this gives us a good overview of a range of mental health services across the country. We are writing to draw attention to a new development in a range of adult mental health services around the country (we have had experience of this in several separate geographical areas throughout the UK) -...

Health service workers are at increased risk of being stalked. General practitioners (GPs) have the most contact with patients, but there have been no detailed studies of the stalking of GPs. This paper reports a methodologically rigorous survey of stalking, harassment and aggressive/intrusive behaviours amongst a sample of GPs in the UK. A questio...

Study of risk factors for violence to prominent people is difficult because of low base rates. This study of harassers of the royal family examined factors suggested in the literature as proxies for violence--breaching security barriers, achieving proximity, approach with a weapon, and approach with homicidal ideation. A stratified sample of differ...

  Detailed comparison of factors associated with abnormal approach to the prominent and with escalation from communication to approach has not hitherto been undertaken. This partially reflects the failure of individual studies to adopt compatible terminologies. This study involves a careful dissection of six public figure studies, three involving U...

Abnormal approach and escalation from communication to physical intrusion are central concerns in managing risk to prominent people. This study was a retrospective analysis of police files of those who have shown abnormal attentions toward the British Royal Family. Approach (n = 222), compared with communication only (n = 53), was significantly ass...

The main risk of death or serious harm to public figures in western countries comes not from terrorists or criminals, but from the activities of lone individuals with intense pathological fixations, the majority of whom are mentally disordered. We report preliminary efficacy data from the Fixated Threat Assessment Centre (FTAC), the first joint pol...

In stalking research, the risk domain of persistence concerns the likelihood that intrusive behaviours will continue towards the same target. This is a major source of anxiety to victims, and is of practical importance in the allocation of expensive protective resources. This study examines the associations of persistence in two different samples:...

A significant number of mentally ill defendants pass through the courts, where clinicians advise upon their ability to fairly stand trial. This is codified in the assessment of ‘fitness to plead’. In England and Wales, the narrow ‘Pritchard’ criteria that determine fitness date from 1836. The authors undertook a piece of qualitative research with t...

Public figures are at increased risk of attracting unwanted attention in the form of intrusions, stalking and, occasionally, attack. Whereas the potential threat to the British Royal Family from terrorists and organized groups is clearly defined, there is a dearth of knowledge about that from individual harassers and stalkers. This paper reports fi...

This paper considers the problem created by those who harbour unusually intense fixations on public figures. It examines the nature of such pathological fixations and how they differ from the wide range of normal concerns which lead people to communicate with, and even occasionally harass, politicians and other prominent persons. In those harbourin...

Fitness to plead is a fundamental legal concept. Its determination in England and Wales rests on professional interpretation of the ‘Pritchard’ criteria (1836). In the United States, the determination of the analogous concept of competence to stand trial rests on professional interpretation of the ‘Dusky’ criteria (1960). Numerous assessment instru...

The role of psychotic disorders in attacks on British Royalty is examined. In the 23 attacks, there was evidence of psychotic illness at the time in 11 (48%) cases, with evidence of mental disorder in 4 additional ones. These data almost certainly underestimate the contribution of major mental disorder, as psychiatric evaluations were not available...

The only systematic studies of attacks on public figures come from the USA. These studies de-emphasize the role of mental illness and suggest threats are of no predictive value. This study re-examines these questions through a study of attacks on European politicians. All non-terrorist attacks on elected politicians in Western Europe between 1990 a...

This study examined recognition of and attitudes towards abnormal, persistent, unwanted attention, or stalking, in two professional groups closely involved in assisting the victims of this behaviour, i.e. police officers and general practitioners (GPs), in four European countries (Belgium, n = 185; UK, n = 118; Netherlands, n = 113; Italy, n = 100)...

This study examined recognition of and attitudes towards abnormal, persistent, unwanted attention, or stalking, in two professional groups closely involved in assisting the victims of this behaviour, i.e. police officers and general practitioners (GPs), in four European countries (Belgium, n = 185; UK, n = 118; Netherlands, n = 113; Italy, n = 100)...

The authors review extant research on threats, approaches, attacks, and assassinations of public figures in the United States. Despite the limited number of studies, data exist concerning: 1) threatening letters and approaches to celebrities; 2) attacks and assassinations of public figures, usually the President of the United States; 3) threats and...

Studies of violence in stalking have treated interpersonal violence as a homogeneous phenomenon. This study was conducted to ascertain whether the associations of serious violence in stalking are the same as those of general violence in stalking. Of 85 stalkers referred to a forensic service, those who had committed acts of serious violence (homici...

50 stalkers were assessed before their trials. Serious violence was significantly associated with previous sexual intimacy between stalker and victim; such stalkers were significantly less likely than those who stalked strangers to have psychotic illness.

The mental health service needs of all North London patients in medium (N = 97) and maximum security (N = 79) were assessed. Patients and key nurses were interviewed using validated measures and, for patients in maximum security, the respective responsible medical officers (RMOs) also completed a standard enquiry form. Multi-disciplinary panels fro...