A COMMUNITY MENTAL-HEALTH TEAM IN NORTHERN-IRELAND - NEW REFERRALS ASA RESULT OF CIVIL DISORDER

Objective: Northern Ireland has suffered from civil unrest since 1969. During this time both the nature of violence and the nature of psychi atric services have changed. Considerable variation in incidence figur es for psychological consequence of civil unrest exists in the interna tional literature (1). The purpose of our study was to ascertain the w orkload for a new community mental health team which had accrued solel y as a result of civil unrest and the possible implication for the loc al service. Method: The new patient referrals to a Community Mental He alth Team November 1990-91 which were solely and directly consequent o n civil disorder were identified. The litigant population was excluded from study. We checked how many still remained in treatment in Novemb er 1992 and used Fisher's Exact Test to identify factors associated wi th still being in treatment at two years. Results: We found that 8.2% of the new referrals satisfied the criteria and 30% remained in treatm ent at two years. Satisfying criteria for post traumatic stress disord er was not significantly associated with still being in treatment. Rem aining in treatment at two years was associated with having received o r not received stress management advice in those satisfying post traum atic stress disorder criteria. Conclusion: Civil unrest substantially increased the Community Mental Health Team workload in the first year of existence.