Ciaran Mulholland: the Psychiatrist's Manifesto

Abstract

Set up in 2017 as a fitting legacy for the 3700 killed and 55 000 injured in the conflict, it aims to provide a world-leading mental health service, across a network of voluntary and statutory sectors, for victims of all forms of trauma in Northern Ireland. Mulholland says the causes are complex: socioeconomic deprivation is strongly associated with mental illness; there is a long legacy of underfunding of mental health services (half the proportion of health funding compared to England); there is a tribal political structure, leading to impasses in policy decision-making; and the psychological ripples of the Northern Ireland civil war continue to reverberate 23 years after it ended. There is a burgeoning evidence base that early intervention can improve outcomes for young people with psychotic illness and even prevent transition from at-risk mental states in some cases. According to data collected between 2004 and 2008, 8.8% of the population met criteria for post-traumatic stress disorder (PTSD) at some point in their lifetimes (higher even than in other, more intense conflict