July 14, 2004
Terry Ryan, President
Children of Ireland
P. O. Box 13241
Tallahassee, FL, USA 32317
We wanted to write to you and respond to Richard Black’s recent letter outlining the response of the Trust to our recent visit to Northern Ireland to provide assistance about the high rates of youth suicide. We would start by acknowledging our appreciation for his comprehensive and clearly presented response, with a thorough and very helpful explanation of programs and services. We are once again impressed with the commitment and strong intentions by Richard and the Trust to address the issue of youth suicide and the development of strategies to remediate this problem. However, some lingering questions and concerns remain that we would like to share with you. They are as follows:
1. Richard’s letter provides a comprehensive list of programs and initiatives (PIPS, Community Counseling Project, Health Action Zone, Child and Adolescent Mental Health Services, and the Trauma Resource Center). Although the programs described sound like excellent services it is noteworthy that only one of these programs (PIPS) is described as dealing directly with youth suicide. The others are described as addressing youth and trauma (Community Counseling Project); mentoring, peer education, and overall mental health and wellbeing through an interagency multi-sectoral partnerships (Health Action Zone), developing new models of child and adolescent mental health services (Child and Adolescent Mental Health Services); and trauma (the new Trauma Resource Center). Our concern with not directly addressing the problem of youth suicide as clearly defined components of these other programs is that the incidents of completed youth suicides will continue to be at high rates in the years to come.
2. In the letter from Richard there is a clear outline of the Trust’s responsibility in relation to the intra and intersectarian conflict. The letter clearly states that the “Our primary responsibility is to deliver treatment, care and support to address health and wellbeing need within our catchment population. The conflict is an important part of the context in which we have to deliver services and we address those issues through a range of community development approaches in each community and across communities. This includes interagency initiatives to support displaced families, support for interface projects and involvement with the development of the Community Empowerment Partnerships in North Belfast which were recommended in the Dunlop Report which followed the Holy Cross School dispute. The Trust is active in all these initiatives but it is not our remit to lead on the resolution of the conflict which as you appreciate is fundamentally located in the political realm….We as a Health and social services Trust look primarily to other Government supported agencies such as the Community Relations Council to take on some of the work you refer to.”
Although we would fully concur with Richard Black that there are a number of social issues that contextualize the problem of youth suicide, we would see the Trust assuming a somewhat different role in addressing this multi-faceted problem. Very helpfully, Richard pointed out the work of the Community Relations Council and the extensive work they are doing related to the conflict. Noteworthy on their website, where their work is described, there is no mention of youth suicide prevention. This is appropriate, since youth suicide prevention is not within the purview of their mission and goals. Thus an organization such as the Community Relations Council would not have mental health or social services as an area of expertise. Rather the Trust would be the fully recognized group of experts in this area.
Still the question remains about how do intra and intersectarian interventions, which provide the complex social and environmental context for youth suicide and other related issues that Richard mentions (e.g., family relationships, unemployment, lack of hope, and poor self-esteem) target issues of great concern such as youth suicide. We remain strongly convinced based on our meetings and observations in Northern Ireland, extensive international work around the world, and significant work in the area of trauma, that the facilitation of cross-community communications between (inter) and within (intra) sectarian groups where there are high levels of conflict, must be instituted in manner that focuses on youth suicide. In fact in his letter, Richard mentions lists the Community Counselling Project and the new Trauma Resource Centre as programs that will address youth suicide, supporting the notion that conflict, trauma, and suicide are interrelated.
To adequately address this multifaceted problem different types of interventions than those that are customarily used in peace building and conflict resolution interventions, which do not typically address associated mental health problems and healing. Rather, it would necessitate experts in mental health/social services to take the lead, in collaboration with already established organizations such as the Community Relations Council, to promote new and different interventions that emphasize mental health/social services issues. We would suggest that the Trust could take the lead in this, working cooperatively with other agencies, but taking the lead in the areas of mental health and social services, given the established expertise of highly qualified staff.
An example of how a program addressing sectarian conflict might look different is described below. We might imagine a series of meetings that engages communities in a process could take place both within and then between sectarian communities. A starting point could be within respective sectarian communities with community leaders to discuss concerns and strategies to address youth suicide, with the premise being that one of the contributing factors to this problem is the ongoing intra and intercommunity conflicts, with an aim to reduce youth suicide. A second step in this process could be to bring together respective leaders from each sectarian community who participated in the first set of meetings, again to discuss youth suicide prevention. Focusing on the problem of youth suicide by respective community groups may help build towards better cooperation in addressing this commonly shared tragic issue facing each community. In these meetings the realities of youth suicide could be explored including the struggles and impact on families and the community. We realize that this type of emotionally charged content is oftentimes not discussed in conflictual situations, yet believe it may be a key to deeper levels of healing and future cooperation. It should be mentioned that to facilitate these community meetings which would incorporate healing, pain, anger, compromise, change, and cooperation, would require highly skilled group facilitators that may have skills that go beyond conflict mediators. We thus urge the Trust to reconsider its position in relationship to youth suicide, and consider taking a lead with the other agencies in Northern Ireland in addressing the sectarian conflict when and where it relates to mental health issues such as the reduction of youth suicide. Bob and I would be glad to assist in the planning and implementation of a project of this nature through The Children of Ireland as neutral parties (this would be a key factor in facilitating such meetings). In addition there are numerous other colleagues from around the world who have similar expertise and would be willing to contribute to this effort.
3. In accordance with the May 17th recommendations that Bob Conyne and I sent to the Trust, Richard’s response spoke about a strong commitment to prevention. This issue was of great concern to a number of community agencies and Trust personnel. We are hopeful that this commitment will translate into changes in funding priorities, since prevention must be reflected in programming and service delivery to make an impact on suicide prevention.
4. It is highly commendable that steps have been taken to reform social work training. The revamping of university training in social work may be able to provide a good start in doing the same with counselling. It is highly recommended a process is initiated to reexamine regional and national counselling training content, licensure, and course delivery, and its relevance to trauma and conflict in Northern Ireland. Once again, Bob and I would be very willing to assist in this regard as neutral parties.
In summary, we continue to be impressed with the strong commitment and comprehensive levels of programming by the Trust. Simultaneously we are concerned that the lack of a greater system-wide direct programmatic focus on the prevention of youth suicide and the decision to defer intra-sectarian and inter-sectarian conflict interventions to other agencies with regards to mental health and youth suicide may prove to be problematic and obscure the tremendous efforts made in other areas of mental health and social services work. In turn, there is a concern that this decision by the Trust will not appreciably decrease youth suicide rates, but rather perpetuate a continuation of the high rates that we are now witnessing in parts of Northern Ireland and Belfast.
We again, thank you for support and dedication to this important issue and would be glad to clarify any questions that you might have with regards to this letter.
Dr. Fred Bemak and Dr. Bob Conyne