I have made
the following notes based on my understanding of the Agreement document,
and the concerns it raises in relation to victims. It has been read
avidly by those we work with, and generally the response has been
favourable. Therefore I think it is important, given that the Victims
commission is mentioned in the Agreement, that any undertakings in
the Agreement are seen to be delivered on.
The second stimulus
to the following remarks is a consciousness that we as an organisation
have been performing some of the functions outlined below, particularly
those in relation to providing information and non-financial resources
to local groups, and those of providing information on international
approaches. We, however, will go out of business at the end of thjs
year, when the funding for this project finishes. In my view, this
work is valuable, particularly in supporting and bringing together
those working in this field, and in encouraging local communities
to begin to audit the effect of the Troubles on them, as a precursor
to developing local initiatives. It is important that this work should
be continued by someone.
1. Crucial role of Victims Commission: Whilst the inclusion
of victims in the agreement document of 17 April, 1998 is welcome,
it refers and relies on the work of the Victims Commission to provide
the substance of the response to the situation of victims. This means
that any findings or measures recommended by the Victims Commission
will be linked to the agreement, and the ethos of the agreement.
2. International
expertise: The agreement makes particular mention of areas worst
affected by the troubles, and the need to support community based
initiatives in such areas, which should not only be financially supported,
but should also be resourced with expertise based on "international
best practice" established in other societies coming out of violence.
This will involve locating such international expertise, and making
it accessible to local communities, in accordance with community development
practice.
3. Deconstructing
silence and denial: Many of the established voluntary and statutory
organisations operating in this field have not addressed the issue
of victims of the Troubles, and may have some difficulty in doing
so, due to the long-standing culture of silence and denial that has
surrounded these issues. Such organisations should be supported, through
training, organisational development and other initiatives, to begin
to formulate organisational policies and goals around meeting the
needs of those who have suffered in the Troubles.
4. Allocation
of resources: The agreement also makes mention of "services that
are supportive and sensitive to the needs of victims... channelled
through both statutory and community based voluntary organisations
facilitating locally based self-help and support networks. This will
require the allocation of sufficient resources, including statutory
funding as necessary, to meet the needs of victims and to provide
for community based support programmes." It will be important that
those responsible for resource allocation have a sound understanding
of the field and are able to evaluate proposals from a broad perspective.
It is to be recommended that those with personal experience of bereavement
or injury are involved in these processes. It is also crucial that
some objective method of evaluating need is adopted, so that resources
can be directed at the communities and groups that have suffered most,
not merely at those who are good at obtaining resources. Support should
also be provided to communities in order to assist them to access
resources where the level of need is high, but where the community
infrastructure does not exist to obtain resources.
5. The need
for a dedicated Trauma Centre: As we mentioned in our earlier
meeting, the needs of victims are diverse, with a small number requiring
skilled psychotherapeutic treatment of conditions such as Post Traumatic
Stress Disorder and the aftermath of torture. We have found that even
though the numbers requiring scale of this need are limited, the situation
of people is often totally disabling, and the need is not likely to
disappear for at least a generation. Visitors to Northern Ireland
are shocked that there is not a professional Trauma Centre already
established, and in our experience, there is a skills deficit in the
professions in recognising and treating such Troubles related conditions.
Furthermore, some professionals appear to think that no special skills
or knowledge is required for treating, for example, victims of torture.
Local practice has been to rely heavily on medication, which is not
in accordance with the state of knowledge in the field. Given that
there are, in our estimation, several hundred people at least who
suffer severe symptoms as a result of failed assassination attempts,
witnessing brutality and so on, we would argue in favour of establishing
a specialist service. This should be located outside of the normal
mental health services perhaps housed within an independent body,
in order to avoid stigmatisation and local professional politics.
In such an initiative, local professional people coming fresh to the
problem can be trained according to international best practice, and
sent if necessary to Helsinki or Cape Town to gain the requisite skills
and expertise. In my view, such an initiative should glean what it
can from international experience in the field, and the appointment
of advisors from international sites of excellence, who can act as
sources of advice and support would be an invaluable resource.
6. Services
for young people: Furthermore, there is a shortage of NHS facilities
in mental health in general, with a doubling since 1992 of children
and young people held in adult psychiatric wards in Northern Ireland.
There are a total of 6 residential psychiatric beds for young people
in Northern Ireland.
Children
and Adolescents in Adult In-Patient Psychiatric Facilities in Northern
Ireland
Source of baseline
data for each year: Mental Health Inpatient System: Department of Health:
increases calculated by author.
Young people,
particularly young males as a priority: Given that the agreement
document specifically prioritises young people, and given that our
research shows that young people, particularly young (Catholic) males
are at the highest risk from death in the Troubles, it is important
that the support services and provision to young people are urgently
reviewed. The major children's charities should be galvanised in this
work, to lend it credibility and independence in the communities worst
affected. In such communities, both Catholic and Protestant there
is widespread disaffection from government agencies, and I fear for
the effectiveness of any new initiative from that source. Services
to children and young people are currently woefully inadequate, and
require urgent review.
7. Family
support and therapy: Specialist family therapy services will also
be important in providing support for families who have not been able
to cope with, for example, the impact of bereavement. We have evidence
of parents being unable to fulfil their parental responsibilities
because of the impact of a death or trauma on them.
8. Rebuilding
the social fabric of communities: Much of the thinking about victims
of the Troubles has focussed on individuals and families. However,
whole communities and communities of interest have been damaged, the
culture of violence has been established in such communities and the
social fabric seriously damaged. If there is to be a lasting peace,
the work of rebuilding that social fabric in such communities is of
crucial importance. This has been a challenge faced by many societies
coming out of violence, and again, we should learn from the experience
elsewhere.
9. Training
for mental health and general practitioners: Some of the resources
allocated should, in my view, be used to provide better and further
training for mental health and general practitioners in recognising,
referring on and treating the mental health sequelae to the Troubles.
What is urgently required is a competent service to which they can
refer on, and this point was dealt with above in relation to the establishment
of a Trauma centre.
10. Training
for new and existing professionals: In other professions, such
as social work, teaching and nursing, professional bodies should be
provided with effective incentives to initiate the inclusion of new
training at basic, post-qualifying and in-service levels. This new
training would ensure that people practising in these professionals
are equipped to recognise and deal appropriately with the effect of
the Troubles on people they come into contact with.
11. Resources
to support self-help and social support initiatives: Many of those
who have suffered require social support and self-help opportunities.
Contrary to what might be supposed, the establishment of social support
networks and facilitation of self-help initiatives is skilful and
work, which requires a sound knowledge base in human services. Specifically,
workers in this field must be able to build the capacity in local
communities and support local initiatives with expertise, information
and access to a wider network. People who have been victims of the
Troubles, in our experience, often do not have the personal resources
to manage and operate organisations without the support of paid workers
who can carry the day to day responsibilities on their behalf.
12. Democratising
services & accountability: It is crucial that such initiatives
remain genuinely in the control of users, since the "professionalising"
of services may well provide cuedos for professionals, but it further
stigmatises and disempowers people. What is called for is a new professionalism
that makes itself genuinely accountable to its patients and clients
in a way many of the professional services in Northern Ireland have
not done until now.
13. Employment
of former victims: Where possible local people and those who have
personal experience of surviving loss in the Troubles are employed
in such schemes, and in any new initiatives for those affected by
the Troubles.
14. Establishment
of an independent body of "experts" with personal experience of loss/injury:
Consideration should be given to a permanent independent body or commission
that would advise, support and promote work with victims of the Troubles.
Such a body should be multi-disciplinary and accountable to (or composed
of) a Board of people who have personal experience of loss and injury
in the Troubles. Its remit could be to influence existing services
to gear themselves towards Troubles-related needs, and to advise and
provide resources for local communities who wish to establish local
self-help and other services.
15. Trust
and acceptablity of new services: In the light of recent developments
and the response to the Victims Commission, thought must be given
to the participation and accessibility of any new arrangements to
both of the main traditions in Northern Ireland. It should be remembered
that those bereaved and injured by security forces are often understandably
mistrustful of state provision, and often reluctant to participate
in, for example the consultative exercise on the Victims Commission,
or to use state services. It is part of the healing process that provision
should take these fears into account and provide services that are
acceptable to the people who need them.
16. Public
awareness: In the course of our research, we have concluded that
there are two worlds in Northern Ireland. The first world is the mainstream
one, where the impact of the Troubles is limited to news broadcasts
and occasional fear, inconvenience or upset. The other world is that
inhabited by those who have been severely affected by the Troubles,
where everything is significant in relation to the Troubles, every
street has memories or dangers, anniversaries bring it all back. Most
people do not know about this second world. Yet an appreciation of
how much people have suffered is an important motivator for people
in the task of building a peaceful society. Educational programmes,
that are not sensationalist, or focussed on one incident or group
of people should be established so that public understanding of victims'
medium and long term experience is increased.
17. Truth
and justice: For some people who have lost family members, there
are strong feelings of injustice in cases where there are unresolved
justice issues, missing bodies, unanswered questions. For these people,
resolution or healing is often impossible in the absence of knowing
more about the circumstances of what happened to their loved ones.
The Victims Commission must address the situation of these people,
by some formal public means, so that their quest for more information
and public acknowledgement of what happened is satisfied as best it
can be. We recognise that this is a difficult area in the context
of a wider agreement involving prisoners and parties with links to
paramilitaries. However, the situation of these people could be put
to those parties, with a view to coming up with an agreed mechanism
by which the situation of victims' families could be realistically
addressed.
I hope these remarks are helpful.
Marie Smyth
Project Director
The Cost of The Troubles Study
22 April, 1998.
The
Cost of the Troubles Study
