A community mental health team in Northern Ireland: new referrals as a result of civil disorder

Abstract

AbstractObjective: Northern Ireland has suffered from civil unrest since 1969. During this time both the nature of violence and the nature of psychiatric services have changed. Considerable variation in incidence figures for psychological consequence of civil unrest exists in the international literature (1). The purpose of our study was to ascertain the workload for a new community mental health team which had accrued solely as a result of civil unrest and the possible implication for the local service. Method: The new patient referrals to a Community Mental Health Team November 1990-91 which were solely and directly consequent on civil disorder were identified. The litigant population was excluded from study. We checked how many still remained in treatment in November 1992 and used Fisher's Exact Test to identify factors associated with still being in treatment at two years. Results: We found that 8.2% of the new referrals satisfied the criteria and 30% remained in treatment at two years. Satisfying criteria for post traumatic stress disorder was not significantly associated with still being in treatment. Remaining in treatment at two years was associated with having received or not received stress management advice in those satisfying post traumatic stress disorder criteria. Conclusion: Civil unrest substantially increased the Community Mental Health Team workload in the first year of existence.