Conflict, trauma and mental health: how psychological services in Northern Ireland address the needs of victims and survivors: introductions and recommendations (Report 1)

This report is one in a suite of four studies commissioned by the Commission relating to the needs of, and services provided for, victims and survivors. The studies were undertaken over a three-year period which included the Covid-19 pandemic and were thus greatly restricted in terms of field work and access to participants. The researchers engaged with victims and survivors who have accessed trauma counselling, psychotherapy and other supportive interventions. The researchers also engaged with psychological therapists and mental health managers in the statutory sector and with voluntary sector and community-based organisations that provide services for victims, survivors and their families. The report maps out and evaluates current practice and service provision and generates proposals on the optimal way to organise mental health services for victims and survivors in the primary, community and statutory systems. The Commission is grateful to all those who have contributed to the research process not least because of the sensitivities and reflections these considerations require.

A key focus of this study is the unique opportunity to conduct a clinical review of existing psychological therapy outcome data collected in specialist statutory trauma services and by service providers within the victims’ sector. The report showcases effective practice across sectors including the formation of key patient datasets, and analyses outcome data for service users accessing psychological treatment. From the clinical analysis of psychological therapy outcome data, stakeholder engagement and an extensive review of trauma-related literature, the report presents a series of findings and recommendations that require serious consideration by service commissioners and providers, practitioners and policy makers.

Recommendations from the research include the development and regional implementation of a standardised outcome framework with validated disorder-specific session by session measures across statutory sector provision for victims and survivors, and the strengthening and streamlining of bi-directional referral pathways from non-statutory services to more specialised statutory mental health trauma teams. Other recommendations include an increased understanding and greater adherence to evidence-based practice, and the need for more consultant psychiatry input into psychological trauma services, especially for more complex trauma presentations. The report also identifies a number of areas for improvement including the need for enhanced IT recognition systems and the standardised coding of patients with Troubles / conflict related issues across the health system.

In treating victims' needs as societal needs, we build on a solid foundation towards a future that offers peace, prosperity and growth for all who live here.