The Needs of Individuals and Their Families Injured As a Result of the Troubles in Northern Ireland
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The needs of individuals and their families injured as a result of the Troubles in Northern Ireland Marie Breen-Smyth Professor of International Politics University of Surrey In association with Northern Visions Commissioned by WAVE Trauma Centre Funded by the Office of the First and Deputy First Minister through the Community Relations Council May 2012 1 “People who suffer from injuries are made to look like beggars if we need help. Doctors and government say it’s our past and we have to move on. This is our present.” Respondent in survey Before you know kindness as the deepest thing inside, you must know sorrow As the other deepest thing. You must wake up with sorrow. You must speak it till your voice catches the thread of all sorrows and you see the size of the cloth. Then it is only kindness that makes sense anymore, only kindness that ties your shoes and sends you out into the day to mail letters and purchase bread, only kindness that raises its head from the crowd of the world to say it is I you have been looking for, and then goes with you every where like a shadow or a friend. Naomi Shihab Nye “This project has received support from the Strategic Support Fund for Groups Working with Victims and Survivors of the Troubles, which is administered by the Northern Ireland Community Relations Council ( NICRC) on behalf of the Office of the First Minister and Deputy First Minister. NICRC promotes a pluralist society characterised by equity, respect for diversity and interdependence. The views expressed do not necessarily reflect those of the Community Relations Council.” 2 Contents Foreword ................................................................................................................................................. 6 Executive summary- Short Form ............................................................................................................. 7 Full Executive Summary and Recommendations .................................................................................. 17 Overview of the study ........................................................................................................................... 27 Introduction .......................................................................................................................................... 45 Literature Review and Review of existing research .............................................................................. 49 The framework: wellbeing as a central concept ................................................................................... 74 Research methods and ethics ............................................................................................................... 82 The size of the population of injured people ........................................................................................ 93 The Survey ........................................................................................................................................... 105 The interviews with injured people .................................................................................................... 148 The interviews with carers .................................................................................................................. 189 The interviews with professionals ...................................................................................................... 196 The archive and film ............................................................................................................................ 218 Conclusions and further research ....................................................................................................... 219 References .......................................................................................................................................... 221 Appendices .......................................................................................................................................... 228 Advisory committee ............................................................................................................................ 228 Ethical approvals ................................................................................................................................. 229 Interview Schedule - injured people ................................................................................................... 232 Participant information sheets ........................................................................................................... 237 Consent Protocols ............................................................................................................................... 243 QUESTIONNAIRE ................................................................................................................................. 248 3 List of tables Table 1: Injured Sample: Date of injury by cause of injury 87 Table 2: Religion and gender of injured sample 88 Table 3: Age of injured person by gender 89 Table 4: Status by gender 89 Table 5: Injuring agent by gender of injured person 90 Table 6: Geographical location of residence of injured person by gender 90 Table 7: Extent of injury 91 Table 8: CVSNI Summary of Previous Research 93 Table 9: Experience of the Troubles: NI Omnibus Survey 94 Table 10: NI-SEC-05: Persons injured due to the security situation in NI (only), 1969 to 2003 94 Table 11: NISALD Survey Question A14 – sight 97 Table 12: NISALD Survey Question B16 – hearing 97 Table 13: Age of Injured and non-injured Respondents 100 Table 14: Gender of injured and non injured groups 101 Table 15: Religion of injured and non-injured groups 102 Table 16: Gender of sample 107 Table 17: Religion of sample 108 Table 18: Ratio of Civilian to Local Security Forces; Balance of responses compared with COTTS deaths ratios and RUC injury ratios 109 Table 19: Age 109 Table 20: Year of injury compared with distribution of deaths 110 Table 21: Age at injury 111 Table 22: Geographical location of residence 112 Table 23: Location where injury occurred 112 Table 24: Relationship status 113 Table 25: Responsibility for injury 114 Table 26: Nature of injury 114 4 Table 27: Other injuries (a) 115 Table 28: Other injuries (b) 115 Table 29: Impaired physical function 116 Table 30: Other physical impairments 117 Table 31: Physical recovery since injury 120 Table 32: How is your physical health now? 123 Table 33: Impact of injury 124 Table 34: Experience of initial acute hospital treatment 127 Table 35: Years since initial acute hospital treatment 128 Table 36: Frequency of hospital attendance 128 Table 37: Purpose of hospital attendance 129 Table 38: Experience of GP and District Nurse 130 Table 39: Current experience of hospital or clinic 130 Table 40: How do you manage your pain? (a) 131 Table 41: How do you manage your pain? (b) 131 Table 42: Who helped you in the aftermath? (a) 132 Table 43: Who helped you in the aftermath? (b) 132 Table 44: Source of later support 133 Table 45: Who is your main carer? 134 Table 46: PDS score 136 Table 47: PDS scores by age 137 Table 48: PDS scores by gender 137 Table 49: Occupation at time of injury 138 Table 50: Ability to work since injury 140 Table 51: Ability to work since injury 141 Table 52: Quality of legal advice about compensation 141 Table 53: Length of time to settle compensation case in or out of court 142 5 Foreword Reflecting on the challenges faced in my previous role as Chair of a Statutory Committee for The Employment of Disabled People, during the Disability Discrimination Act consultation period, along with my fellow injured group members at WAVE Trauma Centre; we were all truly delighted when our long search to secure funding for a unique research study to explore the needs of the injured and their families was eventually granted. We are therefore indebted to the Community Relations Council and the Office of the First Minister and Deputy First Minister (OFMDFM) for supporting this much-needed study. Given the vision for the study and to ensure its robustness a twin track approach was adopted. The University of Surrey made the successful tender and was commissioned to carry out the research to deal with the intellectual aspect of the study. The research was also informed by an Advisory Committee made up of key stakeholders such as the seriously injured, the WAVE Injured group, various Victims Group representatives, the Commission for Victims and Survivors NI, OFMDFM, CRC, health and social care providers, WAVE Board members and employees See Appendix 1 for full list. The University of Surrey have been generous in their commitment to the study and we are grateful that their principal investigator, Professor Marie-Breen-Smyth was already conversant with the subject material, due to her earlier work on the Cost of The Troubles Study. Northern Visions documented the story of the study. It is also important to mention Damien McNally, WAVE’s Management Board Chair who worked tirelessly and unselfishly to ensure the objectives of the study were met. The study is needs focused and its primary purpose is to inform and advise Government, policymakers and legislators about current need and future provision. Whilst acknowledging that the ultimate loss was experienced by those families who suffered bereavement, many of the seriously injured during our years of conflict felt that their needs were overlooked both in the past and now in more recent times as society makes