The recently launched report, which includes a series of reviews and studies, was produced for the Commission for Victims and Survivors (CVSNI) and funded through the EU’s Peace IV Programme.

The project was led by Institute Fellow (Legacy) Dr Michael Duffy, Senior Lecturer in the  School of Social Sciences, Education and Social Work at Queen’s, working with a multi-disciplinary team of colleagues from across the University, Ulster University, the Belfast Health and Social Care Trust and Trinity College Dublin.

Speaking about the report Dr Duffy said: “In this country, there are few greater issues than the continuing trauma caused by the ‘the Troubles’. 25 years after the Good Friday 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 are part of a series of reports commissioned by CVSNI, relating to the needs of and services provided for victims and survivors, and provide a scientific review of trauma services.

“The 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.”

The report recommendations included:

• 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.
• A research-based rationale should be developed for the provision of all therapies and  interventions.  This also applies to complementary therapies, which may be provided  either as part of a mental well-being service or to augment more mainstream therapeutic interventions for conditions such as PTSD, for example, in the treatment of comorbid chronic/persistent pain.
• The data from all agencies suggests that a proportion of service users are presenting with more complex trauma presentations. Consultant Psychiatry input into psychological trauma services, especially in the statutory services, may be necessary given the potential role for medication in this area.
• There is a need for greater consistency of psychological service provision for victims and survivors across the region. For example, at the time of this study, only two Health and Social Care Trusts had a dedicated Troubles related trauma service. A more standardised regional approach and partnership between the statutory and voluntary sector is important. In this respect, the recent development of the Regional Trauma Network is a positive step.
• Trauma-focused training and education should be available for suitable staff in both statutory and non-statutory organisations providing psychological services and more specialist training for those working above step care level 3 i.e., specialist trauma qualifications. Therapists should preferably be accredited by the relevant professional body.
• A research/outcomes culture should be encouraged across all sectors including cross border studies. Specific research projects should be considered to understand and  improve interventions for PGD and CPTSD. 

The report draws on a range of evidence sources, including literature reviews, analysis of outcome data, and interviews with victims and survivors in relation to their personal experience of services. 

Commissioner for Victims and Survivors, Ian Jeffers, explained why the research was undertaken: “An important reason for conducting this study was to gain a deeper understanding of the important role that trauma-focused psychological therapies can play in addressing the complex mental health needs of victims and survivors and their families.

“It is an under-researched issue, despite Northern Ireland having some of the highest levels of conflict-related mental health disorders globally, including Troubles-related PTSD. This trauma is not necessarily historic, with continuing paramilitary violence and the UK Government’s legacy legislation exacting a considerable psychological burden on many individuals and their families across our society.

“Studies like this, with the voices and experiences of victims and survivors central to it, is key to ensuring that research findings have real-life impact. This particular project can help inform the ongoing development of the new Regional Trauma Network (RTN) and in effectively responding to the continuing transgenerational impact of the Troubles legacy on our population’s mental health.”

The full report is available here: https://www.cvsni.org/wp-content/uploads/2023/07/FINAL-Trauma-Services-Report.pdf