Traumatic experiences have afflicted the lives of more than 210,000 people in Northern Ireland, says David Bolton, a 61-year-old retired social worker and senior manager in the health service in Northern Ireland. Bolton has spent most of his life dealing with victims of the Troubles.
He fears that if politicians don’t properly address this problem, the mental sufferings of the Troubles’ generation will pass on to further generations.
Billy McConville, who died last month, was the son of Jean McConville, who was abducted, murdered and secretly buried by the IRA in 1972. That experience massively shaped his troubled life as did the abuse he suffered in the care homes he and his nine siblings ended up in after their mother’s murder.
Bolton says it will take “big politics” to deal with the issue of mental health in the North. “The implications of not taking action are that you are left with a legacy of long-term mental health problems which then run the risk of becoming trans-generational.”
There is a huge responsibility to tackle this issue, says Bolton. “When you get people with long-term chronic mental health problems that are linked directly to the experience of violence that the narrative they then share with others – with their children, with others within their community – is likely to amplify senses of grievance and injustice rather than try to resolve them. The prospect is you sow the seeds for future violence.”
He says the reverse can also be true in that there are people who will “turn their faces steadily against violence”.
Born in Dublin but raised near Enniskillen since the age of six, Bolton has written a book called Conflict, Peace and Mental Health which draws on his expertise in the area of trauma and the Northern conflict.
He was centrally involved in helping survivors in the aftermath of the 1987 IRA Enniskillen and 1998 Real IRA Omagh bombings and these also feature heavily in the book. He was a founding director of the Northern Ireland Centre for Trauma and Transformation. His book cites a range of detailed studies he and other groups and individuals have conducted into the affects of the conflict.
Post-traumatic stress disorder
From the mid-1960s to 2006, more than 3,700 people died in the violence. While detailed records were not kept, it is estimated that another 50,000 were maimed and injured.
Quoting research, Bolton says that about 500,000 of the North’s population of about 1.8 million have been “affected by the Troubles”.
A 2008 survey that looked specifically at the mental health impact of the Troubles estimated that there are at least 34,000 people in Northern Ireland enduring post-traumatic stress disorder (PTSD). And, he adds, that does not take into account people who suffer from Troubles-related complicated grief, depression, stress and other anxiety disorders and those who consequently developed a dependency on alcohol or street and prescription drugs.
He believes it is reasonable to say that some 200,000 people have been “bereaved” in the conflict.
It seems a high figure but he challenges that assumption with a story about his French teacher, Eva Martin, when he was a student in Fivemiletown in Co Tyrone. A member of the Ulster Defence Regiment, she was killed in an IRA rocket and gun attack in Clogher, Co Tyrone in 1974. Aged 28 she was the first woman member of the British army or RUC to die in the Troubles.
“Her death was devastating on her colleagues, to her fellow teachers, to the various classes in the school. To this day I can be deeply moved by the memory of that event,” says Bolton.
His point is that it is not just parents, brothers and sisters and extended families of the victims who have deep-felt emotions about loss of life, but members of the wider community as well – and if you take cases like Omagh and Enniskillen, entire communities.
Bolton says most people, including those who have directly witnessed the years of violence, suffered no, or minimal, long-term mental health disorders. Many, in fact, responded with high levels of resilience. But, he adds, there is “robust international comparable data” to suggest that about 213,000 adults have experienced mental health difficulties related to the Troubles.
Citing another study he says that Northern Ireland had the highest levels of PTSD among a number of countries that experienced conflict, including Israel, South Africa and the Lebanon.
What prompted Bolton to write the book was the conflict in Syria and, before that, in Iraq. He hopes it will be of use to counsellors and psychiatrists and psychotherapists and anyone trying to deal with the traumatic impact of conflict.
After the Islamic State attack in Manchester in May in which 23 people were killed including the suicide bomber, Manchester University Press sent early copies of Bolton's book to local mental health professionals and religious and community leaders. A copy also was sent to the mayor of London Sadiq Khan after the terrorist attacks in the city.
Bolton is emphatic that there are still thousands of people in Northern Ireland who, like Billy McConville, need help and support. Referring to another study he says that on average it takes 22 years for people experiencing Troubles-related anxiety or trauma disorders to come forward. “It is never too late to ask for help and there are good services in place.”
‘Your victims or my victims’
One of the great hurdles is the inability of politicians to establish structures and mechanisms to deal with the past and to help victims and survivors. “That certainly has been a problem: how difficult it is for politicians particularly in a civil conflict context to try and reach agreement over issues about whether they are ‘your victims or my victims’, or ‘your dead or my dead’. It takes big politics to try and over-arch these things.”
A large block is what constitutes a victim. The frequently cited example is the 1993 IRA Shankill bombing in which 10 people were killed including bomber Thomas Begley. Was Begley as much a victim as those he killed?
The families and most others would say no but many Republicans argue that Begley was caught up in a “war” not of his own making, notwithstanding that he chose to join the IRA, and therefore an equal victim.
The practical impact of that conundrum is that issues such as decent pensions for people injured in the conflict cannot be resolved because of the political disagreement.
Bolton says he does not want to take any “cheap shots” at politicians because these are difficult societal puzzles. “I don’t know the answer. Perhaps all we can do is take incremental steps and make progress where progress can be made.”
In the meantime, more action is needed to assist those suffering mental health issues as a result of the violence. “We do need a conversation about what does it take for this society to be at peace with itself and what do we mean when we talk about recovery and healing and peace of mind.”
There are practical measures that can assist those suffering trauma or anxiety or stress. “We need a gearing up of services to strategically address the chronic and long-term impact of the Troubles.”
Victims of the peace
The key argument he makes is that the violence may be over but its impact is not. “In Ireland, whilst the dead of our civil conflicts are held sacred by one side or another (seldom by all) the suffering survivors run the risk of being abandoned because we cannot politically agree on how they ought to be helped,” he says.
He writes of how the “surviving victims of the conflict become also victims of the peace”, abandoned in a “no-man’s land between the past and the emerging future with nowhere to go back to yet feeling unable to go forward”.
Bolton says while addressing the problem is a constant struggle, he has not lost hope. “You could get down and sometimes you think we never learn. The ability to be cruel to each other seems endless and appalling at times. But that is more than counter-balanced by the goodness and kindness of people.”
He recalls how a woman approached him in the aftermath of the carnage of the Omagh bombing which claimed the lives of 29 people, including a woman pregnant with twin girls.
“Beauty from ashes,” she told him, quoting the Book of Isaiah and the line about “providing for those who grieve in Zion – to bestow on them a crown of beauty instead of ashes”.
This was most fitting, Bolton says. “It is a constant battle of darkness and light but good can come as well. Beauty from ashes – that is a powerful touchstone for me.”
Conflict, Peace and Mental Health: Addressing the Consequences of Conflict and Trauma in Northern Ireland is written by David Bolton.