THE MENTAL HEALTH CONSEQUENCES OF THE TROUBLES:
AN INTERNATIONAL CONFERENCE
A PROPOSAL
[Draft I, March 28, 2001]
Charles R. Figley, Ph.D.
Florida State University

Executive Summary

Mission: Prepare for the end of the Troubles to save lives and increase prosperity for everyone.



            Northern Ireland has entered the recovery phase of the Troubles. Most informed experts agree that the period following peace begins with a period of "relief, confusion, silence, disbelief, and little concern about the negative fall out.”  Yet, the national anxiety level gradually climbs and induces a variety of social problems which range from greater smoking, increased crime rate and general lawlessness, to elevations of family violence and violence in general. The subsequent periods are unique to the context. However, the situations most always get worse before they get better.  It is time for reflection on the Troubles during Northern Ireland’s recovery phase. This conference proposes to assemble a collection of the world's experts on the peace-induced period of transition so that Northern Ireland can learn from the world, and the world can learn from Northern Ireland. The conference also assembles experts from Northern Ireland to explain the context and specify what would be needed to carry out post-Troubles stress management. . Of greatest importance are those within the government who are responsible for the health and well-being of the nation of Northern Ireland: the National Health Service (NHS), the Faith Community, the volunteer community, and the professional community. Plans are already under way to become aware of and effectively cope with and plan for the increased need for experts in assessing, treating, and managing acute and chronic stress from the Troubles and its consequences.   The five-point purpose of the conference includes:

1. Brief the world community about the Troubles and its consequences
2. Offer observations and consultation to Northern Ireland.
3. Bring attention to needs of the most severely affected.
4. Publish conference results so that others may learn.
5. Educate the world about the shift in Northern Ireland.

This proposal includes the five-point purpose (above), describes the 5-day conference, the structure and content of the conference, and describes the products emerging from the conference, and the tasks and resources required to reach the mission:

Purpose of the Conference

The purpose of this conference is five-fold. First, it provides an opportunity for the world community of experts to be adequately briefed on the special and complex circumstances of Northern Ireland’s context. As a result, their observations and consultations will be more useful both to helping the people of Northern Ireland and adding to the scholarly and professional corpus of knowledge.

Second, the conference provides a forum for the world community to offer observations and consultations to their Northern Ireland colleagues who will be responsible for designing and carrying out a post-Troubles stress management plan. As a result, the world community will be more invested in the outcome in Northern Ireland and offer continuing attention and assistance. Moreover, the world community will be in a better position to interpret the unique contributions during the post-Troubles period in the form of research results, contributions to theory, clinical innovation, assessment and others useful achievements that will lead to preparing the communities of Northern Ireland to serve the people's needs and contribute to world peace.

Third, the conference brings useful attention to the social, psychological, and health needs of those most severely affected by the 30 plus years of the Troubles. Consistent with the experiences following periods of civil war, the initial years of peace are, ironically, a period of crisis requiring significant adjustments on the part of everyone at some level. It is a time when old ways appropriate for adapting to domestic violence and bloodshed are discarded and replaced by ways of peace, reconciliation, and forgiveness. Unfortunately, this period is also one characterized by acts of revenge, vindictiveness, and efforts to resist giving up the power income available during war years. It is also a period of remembering and hope. It is a time when victims of the Troubles come forward to tell their stories.

Fourth, the conference is an opportunity for gathering up the contributions it stimulates and to disseminate them in various media. Papers prepared for the WAVE Conference will be published in the 3rd issue of the current volume of the journal, Traumatology. There will be a special issue of that same journal in 2002 devoted to understanding the challenges in Northern Ireland in helping the traumatized. The conference proceedings will provide an excellent draft for a book. However, others not participating in the conference should be included if their contributions are consistent with the purpose of the conference. This book will serve as a useful resource for professionals and policy makers responsible for the welfare of the people of Northern Ireland during this critical post-Troubles period. In addition to the book, there will be an audio and video production available. In addition to serving Northern Ireland, these products will be useful to the world community by making a contribution to the corpus of knowledge about similar communities affected by domestic unrest similar to the Troubles.

Fifth, the conference is an opportunity for the citizens of the world, through its various news media, to be alerted to the shift in Northern Ireland, and to be aware that it is safe to visit and invest. Moreover, the world community will be informed by not only the costs of the Troubles but also its lessons; by innovation and strength of the people of Northern Ireland to transcend the pain of the past and build a nation ever stronger because of it.

The Plan

The conference is the centerpiece of a program of post-Troubles activities. Prior to the conference the National Health Service (NHS) will identify a set of advisory panels. These panels will represent the various communities affected by the Troubles and the professionals responsible for the delivery of health services. Among other things, the panels will recommend a set of guidelines for practitioners working with the traumatized in all professions and service providing contexts. These objectives include plans to anticipate and manage a significant increase in stress at the individual, familiar, community, and national levels. The plan will also include strategies to coordinate services with the volunteer community (e.g., the WAVE Trauma Centres), including the faith communities. The plans would be in first draft form by December 1 2001, well ahead of the proposed world conference.

The NHS panels would also work closely with the professional and academic communities in Northern Ireland to generate a list of questions that could be answered by conference participants. These questions, between 5-25, will form the central structure of the report that would emerge from the conference, in addition to the assembled papers.

The Conference

The Conference will be held following Good Friday in observation of the Good Friday Peace Accord that was signed in 1998, four years prior to the Conference. This will provided a useful symbolic significance. It emphasizes both the hope for peace and the end to the Troubles.

The Conference will be held over a five-day period. Day One, Orientation for Visitors, provides the background and contextual information necessary for guest professionals to fully appreciate the Troubles for those who survived this dangerous period in Northern Ireland. Experts on the history, politics, sociology, and health delivery system of Northern Ireland will provide the orientation. Plans call for sufficient opportunity for discussion, questions, and answers. This follows materials supplied to the conference participants who are guests of Northern Ireland well in advance of their participation. These materials can be accessed from the World Wide Web (www.Troubles-Conference.com).

Day Two, Setting the Agenda, provides an overview of the NHS Panel’s set of questions, the answers to which form the basis for the Post-Troubles Health Services (PTHS) Plan. In the morning, following statements of welcome from the City, organizing conference committee, and the sponsoring bodies, there will be the first in a series of keynote presentations.  In the afternoon, three keynotes will discuss efforts in similar contexts in the world (Chile, South Africa, and another selected country and the subsequent health and mental health consequences.

Day Three, Contributions from the World Community, provides a variety of venues for international experts to share their work and experiences most relevant to the agenda of the conference and the needs of Northern Ireland at this critical point in history. In the morning, experts on three locations (including South Africa and Chile) discuss their particular context of war, peace, and recovery at the national, community, family, and individual levels. In the afternoon, conference members would choose one of ten sub-sessions led by invited, international experts who will share their work and experiences most relevant to the agenda of the conference. The final session will be a conference-wide discussion lead by the conference convener. The focus of the discussion is the integration of the contributions of the last two days toward the purpose of the conference.

Day Four, Designing a Post-Troubles Program of Assistance, provides a forum for academics, practitioners, and policy makers of Northern Ireland to present their contributions. In the morning, a series of plenary sessions will address the following questions:
(1) How many people are emotionally and medically affected by the Troubles who would seek additional assistance from the National Health Service?
(2) What would be the nature of this assistance?
(3) What additional resources are needed to meet this anticipated demand?
(4) What would be the most fundamental elements in a post-Troubles Recovery plan?
(5) What would be the role of the international community in this plan?

In the afternoon, conference members would choose one of five sub-sessions led by the morning's feature speakers. Sessions would include designing programs for children, the frail and disabled, victims/survivors, the general public, and community-specific programs.

The final session will be a conference-wide discussion lead by the conference convener. The focus of the discussion is the integration of the contributions of the last two days toward the purpose of the conference.

Day Five, Strategies for Stress Management, provides an opportunity for conference attendees and presenters to learn about and practice the most effective methods of stress detection, reduction, and management. In the morning session, participants will learn about the most recent studies regarding the neurobiology of stress, particularly the negative health effects of chronic Post-traumatic stress disorder. Other sessions will discuss the research that supports most efficient methods for detecting and reducing distress. In the afternoon, conference members would choose one of ten sub-sessions that focus on one or more methods of stress detection, reduction, and management. The final session will be an opportunity for final observations by anyone who has attended the conference. This session will be continued in the evening with a final dinner in honor of conference participants and a final wish for success in designing and implementing a comprehensive post-Troubles recovery program.