Troubles-linked trauma in North untreated for decades, report finds

New diagnostic categories of complex post-traumatic stress disorder (CPTSD) and prolonged grief disorder (PGD) should be considered when assessing the mental health needs of Troubles’ victims and survivors, a report has found.

The Queen’s University Belfast research aimed to provide a scientific review of trauma services across the North, 25 years after the landmark Belfast Agreement ended the Troubles.

It found that more psychological services were required.

The study, which included interviews with victims and survivors, found that half of participants exhibited symptoms of “re-experiencing, avoidance, hypervigilance and relationship difficulties which would indicate PTSD symptoms”.

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In some cases, treatment hadn’t been received for 20 years.

A limited availability of services in the early phase of the Troubles as well as the “associated stigma and shame” of seeking help when trauma was “rarely talked about” led to delays.

Researchers recommend “the need for specialist services to help with more complex presentations of trauma”.

They also call for more “targeted interventions” to deal with prolonged grief disorder, which differs from “normal” grief and leads to a “persistent yearning or missing the deceased, or pre-occupation with the circumstance of the death and difficulty engaging with new social or other activities due to the loss”.

“It is important to accurately assess the mental health needs of victims and survivors of the Troubles and in particular consider new diagnostic categories of complex post-traumatic stress disorder (CPTSD) and prolonged grief disorder (PGD) in order to provide interventions and treatments that have a strong evidence base,” according to the authors.

Dr Michael Duffy from the school of social sciences, education and social work at Queen’s led the study with colleagues from across the university as well as Ulster University, the Belfast Health and Social Care Trust and Trinity College Dublin.

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Dr Duffy said there were few greater issues than the continuing trauma caused by decades of conflict.

“Twenty five years after the Good Friday [Belfast] Agreement, we still see scars of conflict both in those that experienced it and in intergenerational trauma passed on to children and young people in the most affected communities.

“These studies analysed outcome data relating to mental health needs of victims and survivors of the Troubles from services across health and social care trusts and the community and voluntary sector in Northern Ireland, and the Border regions in the Republic of Ireland in order to make recommendations for future service provision.”

Researchers also recommended “greater consistency” of psychological services. At the time of the research, only two health trusts had a dedicated Troubles-related trauma service.

Entitled “Conflict, Trauma and Mental Health – How Psychological Services in Northern Ireland Address the Needs of Victims and Survivors”, the report was produced for the Commission for Victims and Survivors and funded through the EU’s Peace IV Programme.