Mental health issues and psychopathologies have been looked at as potential explanations for violent extremist radicalization for a long time and caused significant debates among academic experts. While psychological or psychopathological determinants for entering extremist environmentscan mostly be discarded based on the available evidence (except certain personality traits and mental health issues of lone actors), this discourse has rarely focused on the mental health impacts, for example, through factors such as substance abuse and toxic stress, as the consequences of radicalization processes, membership in violent extremist milieus and for deradicalization as well as disengagement for children and adolescents. This article provides a theoretical assessment regarding the available evidence from multiple academic disciplines on mental health problems and associated issues such as substance misuse in young people who have been exposed to violent extremist ideologies or who underwent a violent radicalization process. It discusses the implications for intervention specialists and potential ways to address and manage the risks resulting from these multiple and complex issues. It is argued that the psychological mechanisms involved in violent radicalization have traumatic (i.e. toxic stress) and therapeutic components. Therefore, a trauma psychological perspective on this issue is warranted.