Living With the Trauma of the 'Troubles'

Author(s): Social Services Inspectorate
Document Type: Report
Year: 1998
Title of Publication: Publication Title
Publisher: Department of Health and Social Services
Place of Publication: Belfast
Subject Area(s): Community, Health, Social Service
Client Group(s) : Victims

Abbreviations: SSI - Social Services Inspectorate, DHSS - Department of Health and Social Services, NI - Northern Ireland

Background to the Research

  • In 1995, the SSI was asked by the DHSS to lead a developmental project to examine and promote the development of services to meet the social and psychological needs of individuals affected by the conflict.
  • The main objectives were to:
    • Identify the referral arrangements.
    • Explore the arrangements for publicity, policy implementation and practice.
    • Identify and promote good practice.
    • Identify gaps in provision.
    • Develop a basic set of standards for work in this area.
    • Provide a report making recommendations as necessary.
  • It was considered that the report could form the basis of a charter for those affected by the conflict and that it could be used to raise general awareness of the problem.

Research Approach

  • A lay assessor was appointed to assist the project leader.
  • The SSI developed a draft project brief.
  • A reference group of representatives of relevant organisations was established.
  • A workshop was set up to allow for comment on the proposed project.
  • Written responses were invited from professional organisations.
  • Local community groups were invited to express their views.
  • Questionnaires were distributed to key target groups involved in the provision of relevant services.
  • Survey responses were analysed and interpreted.
  • Follow up interviews were held with certain respondents.
  • A draft report was prepared and reference group consulted again.
  • A final report was prepared for publication and dissemination.

Main Findings

Referrals

  • GP's often play a key role, as they are frequently the first point of contact.
  • The voluntary and community sectors offer useful support. Crisis support teams have been developed by social services in some parts of NI.
  • Many people referred with addiction problems blame their condition on events related to the conflict.
  • Health and social services have not tailored their response to deal with those most affected.
  • Self support groups were seen to provide valuable help.
  • Some services are unfortunately located in non neutral areas.
  • There are concerns about confidentiality.
  • Only the most seriously affected should be referred to the mental health services as these are perceived to carry a stigma.
  • Access to the psychology services is considered inadequate. A co-ordinated response involving all the relevant bodies is required.
  • The crisis support teams should be developed province wide. The location of services needs to be carefully considered.
  • The manpower requirements of the psychology service should be examined to improve its effectiveness.

Publicity, Policy Implementation and Practice

  • There is a general lack of information and awareness about available and existing services. Some form of register/directory of services should be available.
  • Support services should offer a 'continuum of care,' graded to provide appropriate levels of service as required. Training should be available for those working within this continuum and provided on the principles of anti-sectarian practice.
  • There are many concerns about counselling, such as accreditation, supervision, co-ordination, quality and effectiveness.
  • Many organisations have difficulty in accessing sufficient funding.
  • The overall demand for help is increasing and those affected are mainly located in North and west Belfast and Londonderry.

Gaps and Shortfalls in Provision

  • Better co-ordination and speed is required. More efficient co-ordination between existing service providers is desirable.
  • Child and adolescent psychiatric services are under resourced.
  • Long waiting lists are the norm for those requiring psychological support.
  • There are a number of worrying issues regarding compensation payouts and the associated legal process.
  • Some community and voluntary groups expressed a lack of trust in social services.
  • There was considerable support for the provision of a 24-hour confidential helpline.

Identifying and Promoting Good Practice

  • The core features identified are:
    • Improved availability of information.
    • The need for practical help.
    • Timely intervention when required.
    • Sharing information with children as they can be severely affected following trauma.
    • Training of those providing help.
    • Better networking and liaison between agencies.
    • Avoiding the creation of dependency in those affected.
    • Recognising that symptoms may recur.
    • Developing a role for volunteers with listening skills.
  • It was acknowledged that:
    • Local services have incorporated many of these features in their own practice and that self help groups have been vigorous and effective in many areas.
    • Proficient voluntary organisations supervise and regularly support their counsellors.
    • The Institute for Counselling and Personal Development has organised useful courses to improve volunteer's confidence in helping individuals.
    • Some respected voluntary organisations have felt the need to look beyond NI in order to fulfil their training requirements.

A Proposed Set of Basic Standards for Work With Individuals Affected by the Conflict

  • Services should be accessible and freely available when and where required.
  • Affected individuals should be treated with respect and dignity.
  • Services must respect the client's right to privacy.
  • There should be ready access to information on the range of services available.
  • Helpers must be trained, supervised and supported adequately.
  • Those providing counselling should be trained, supervised and supported to the standards set by the appropriate accredited body.
  • Those helping should know the limits of their service and understand the range of services available from other sources.
  • The network of service providers should maintain good lines of communication with one another to ensure satisfactory liaison.
  • Service providers should aim to restore the client's independence and should avoid creating dependency.
  • Those providing help should recognise that symptoms may recur or manifest themselves long after the event.

 

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