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Confronting the Mental Health Realities of Successful Exit from VFRE

By Life After Hate.

Who are those who are looking to exit violent far right extremism (VFRE)? Just as the definition of VFRE has adapted and expanded over the years, so, too, have the needs of those looking to leave VFRE changed. Over the last decade it has become clear that direct-service work combatting violent extremism is the most effective way to help establish a safer and more resilient nation.

That direct service is enormously labor intensive, with many Exiting Individuals requiring 12-18 months of services, or more, to truly separate. Through the support of licensed professionals and “formers” who serve as peer mentors, individuals can identify what they need to do to leave hate and violence and contribute to society without violence.

To help Exiting Individuals accomplish this, Life After Hate, the first nonprofit in the United States dedicated to helping individuals disengage from violent far-right hate groups and hateful online spaces, sought to identify the mental health and risk factors associated with the typical “profile” on an individual seeking to exit VFRE.

About This Analysis

A leader in the violence intervention community Life After Hate (LAH) recently completed a chart review of those individuals who self-identified as currently or previously involved in violent far right extremism and who sought services from LAH’s ExitUSA™ program from January 2020 through August 2022. These individuals completed intake questionnaires and biopsychosocial intake interviews, including questions about mental health and risk indicators.

Self-Report Mental Health and Risk Indicators

Based on this analysis, Life After Hate determined:

  • 88% of Exiting Individuals endorsed experiencing at least one mental health symptom or risk factor such as suicidal ideation, violence ideation, depressed mood, anxiety, panic, major shifts in mood, angry outbursts, or low self-esteem. Anxiety (66%) and depressed mood (60%) were most common, followed by major shifts in mood (34%) and angry outbursts (32%). Forty-five percent of Exiting Individuals reported low self-esteem.

  • Nearly 50% of Exiting Individuals reported some form of risk at intake, with 42% reporting suicidal ideation and 28% reporting violence ideation or intent within the past 30 days from intake. (It is important to note that this reflects the individuals who were willing to disclose suicidal and violence ideation in intake paperwork or in the first meeting with case managers, it does not reflect the total number of individuals who later disclosed suicidal or violence ideation after establishing rapport with staff.)

  • When asked, 42% of Exiting Individuals reported feeling alone and 35% reported feeling helpless. Individuals who were actively involved in violent far right extremist groups and those who had recently disengaged were most likely to report feeling alone and helpless, while those who had been disengaged for multiple years were less likely to endorse these feelings.


When it comes to population factors, this data may not reflect the population of individuals who are or have been involved in violent far right extremism as the individuals seen in ExitUSA™ at Life After Hate are self-referred. There may be differences in mandated populations; however, programs should be prepared to screen, assess, and competently respond to mental health and risk factors.

With regard to risk and threat, programs that work with members of VFRE must seek to do no harm and to help vulnerable populations. To that end, programs must have staff who are trained to screen, assess, and respond to suicide and violence ideation or intent, as well as other forms of risk to individuals who are exiting violent extremism.

Mental health is a key consideration, and programs who seek to support self-referred individuals who are or have been involved in violent far right extremism should be prepared to assess for and respond to mental health needs. This reinforces the need for a multidisciplinary team with licensed behavioral health providers who are trained to recognize, screen, and respond to mental health needs. Though mental health symptoms or disorders may not be the reason the individual became involved or remained in violent far right extremism, they may be barriers to disengagement and reintegration.

Loneliness and helplessness are major factors, and programs working with Exiting Individuals should address issues of loneliness and social isolation. Direct social support, such as peer mentoring, or through services that promote the development of healthy social support networks such as education or skills training to develop interpersonal skills may be helpful. Likewise, programs should empower and support socially responsible self-determination in Exiting Individuals through future-oriented planning, goal setting, and services to address barriers to achieving personal goals.

These realities demonstrate the challenges that organizations like LAH face at the start of each exit case and highlights the need for the changes we are currently adopting in the services we are providing. The individuals coming to LAH are grappling with serious issues. For years, there is much that providers like LAH believed, based on anecdotal evidence. Now, there is clear data directly from those individuals who are involved in and exiting violent far right extremism to support those assumptions.

Next Steps

The need for programming for Exiting Individuals will only continue to grow, both as more see the need to exit the violent far right and as others see that exiting is possible and re-engaging with society in a positive, meaningful way can be achieved. To meet these demands – particularly the mental health needs of Exiting Individuals – programming must focus on five key components. This would include: 1) risk and threat assessment; 2) case management; 3) skills training; 4) social support; and 5) mental health services.

Done effectively, and with purpose and proper preparation, such programming can be enormously successful in addressing the growing risks of VFRE and providing the support that Exiting Individuals need to both begin the process and successfully completing it. Without that purpose and preparation, such programming can be damaging to both the individual, to the Exit process in general, and potentially to society resulting in a step backward for the field.

Knowing this, and reflecting on the profile that this most recent data set provides, Life After Hate has five recommendations:

  • Licensed mental health professionals and social workers must be part of the Exit process and must be trained both in how to identify and address risks such as suicidal ideation, self-harm, , and violence ideation.

  • Exit programs must work closely with trained mental health professionals who can provide the specific care and interventions required to address any relevant mental health needs.   

  • Programs working with Exiting Individuals must have clear ethical standards, professional roles, codes of conduct that both abide by all state and federal laws, including confidentiality standards and mandated reporting laws.

  • The community must work together to identify and expand mental health services available to those seeking to exit VFRE.

  • Exiting individuals should be made aware of the time investment the process takes, with programs being honest about the time required and the complex issues that must be addressed for successful exit.

About Life After Hate

Life After Hate is committed to combating violent extremism to establish a safer, more resilient nation. The words and actions spewed by VFRE are only growing in both number and impact in this nation. The only way to send VFRE into retreat is to help individuals identify what they need to leave hate and violence behind. More directly, we need to reduce the magnitude of VFRE and make it more difficult for new members to be recruited.

To accomplish our mission, Life After Hate offers a portfolio of resources, including our direct services program, ExitUSA™, and a range of complementary education and community engagement initiatives designed to amplify the work and findings of ExitUSA™.

Life After Hate is built on five core values:

  • Compassion, the basis for promoting individual and societal prosperity without violence;

  • Empathy, listening with open minds and hearts to create an environment that supports change and healing;

  • Integrity, emphasizing the ethical standards, responsible leadership, and continuous improvement necessary to do right by the communities we serve;

  • Redemption, supporting honest efforts to renew one’s life; and

  • Accountability, a lifelong commitment to action that adds good to the world while taking responsibility for previous pain one has caused.


Budge, S.W. and Riccards, P.R. (2022). Confronting the Mental Health Realities of Successful Exit from VFRE. Life After Hate. For more information on Life After Hate, its programs, or its research, please contact


The article was first published by LIFE AFTER HATE. With kind permission of the LIFE AFTER HATE 

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