Opinion: dealing with Northern Ireland's high rates of mental illness requires dealing with perceived differences between groups

By Siobhan O’Neill and Claire CampbellUlster University

It is well recognised that Northern Ireland has high rates of mental illness. Many of these conditions are connected to the traumatic events that high proportions of the population were exposed to during the years of violence known as the Troubles. Whilst the majority of the population experience good mental health, there remains a significant minority for whom trauma exposure has led to severe and enduring mental illness.

Moves are underway to address this and the provision of psychological treatments is expanding. Attention has now turned to the next generation and how we can address the transgenerational impact. Evidence shows that having a parent with depression is associated with a higher risk of mental illness. There are biological, and epigenetic factors that appear to result in parental trauma and mental illness altering genes that impact on the risk of mental illness in offspring.

But it is important that we focus on the mechanisms of transmission which are modifiable. Mental illness and trauma can impact on a caregiver’s ability to promote the child’s emotional and physical response to perceived stress, and capacity for self-regulation. These processes are the basis of resilience to stress and effective coping. They enhance the person’s capacity to form relationships and function in a world of competitiveness and uncertainly.

"The Northern Ireland portrayed in Derry Girls continues to exist to some extent"

Unfortunately trauma exposure and mental illness often go hand in hand with poverty, neglect and adversity. This provides a particularly toxic mix and the result is the existence of population subgroups in Northern Ireland with adversities and trauma exposure leading to a 15-fold risk of suicidal behaviour. The growing acknowledgement of the role of childhood adversity, and the need for trauma informed practice in schools and early years settings, is to be welcomed.

There is also a drive to address the continuing sectarianism that continues to inhibit peacebuilding. Empathy, our ability to appreciate that others have different, and equally valid, perspectives, is promoted through attachment behaviour in childhood, whereby caregivers train children to identify and regulate their emotions. The same behaviours can be compromised when a caregiver has untreated mental illness or trauma exposure.

93% of young people are educated separately in Northern Ireland and and perceived "differences" are consolidated at an early age

In a context of deprivation, high rates of mental illness, educational underachievement, and unemployment, coupled with sectarianism and paramilitarism, the impact on empathy could result in poor cognitive complexity, with individuals being more prone to viewing the word as groups of people who are more different than similar. In Northern Ireland, 93% of young people are educated separately and therefore the perceived "differences" are consolidated at an early age with the "other" group identifiable in terms of uniform and school.

The Northern Ireland portrayed in Channel 4's Derry Girls continues to exist to some extent. Protestants watch different TV channels, they looked different and they "kept toasters in cupboards". There were more differences than similarities, so it is no wonder that we have difficulty achieving a peace that allows both "sides" to live together free from fear of the "other". 

From RTÉ Radio 1's Ray D'Arcy Show, an interview with Derry Girls' writer and creator Lisa McGee

Social psychology has proposed three approaches to fast track improvements in intergroup relations: increase the contact between the groups, focus on the common qualities that we all share and teach integrative complexity. Integration and increased social contact with people from different social groups can be beneficial in dispelling myths about a group, and often improves the relationship between groups. However, when contact is negative and not freely chosen it can lead to more negative attitudes about the other group. Despite this, research suggests that contact is generally more positive than negative and has positive effects.

The real barrier to this approach in Northern Ireland is the enduring community divisions in employment, residence and education. There is also evidence that when contact works and improves views of members of another group, it can have the unintended consequence of making people less likely to work to change any unfair conditions or treatment that their own group faces. A second approach to improving group relationships is to highlight the things group members have in common ("we’re all human"). While this may seem intuitive, it does not always work. For example, research suggests that adapting a Northern Irish (rather than a Protestant or Catholic) identity may serve a means for a person to represent themselves as tolerant and inclusive without changing their political attitudes or supporting inclusion in a meaningful way.

Perhaps now is the time to examine the benefits of this approach for young people in Northern Ireland

Integrative Complexity offers a promising alternative. It is a thinking style characterised by a willingness to consider a range of competing ideas as valid and legitimate. This approach has the benefit of enhancing the skills we need in order to work with people we disagree with, whilst not requiring anyone to change their views. 

Importantly, the approach does not seek to weaken a person’s investment in their social group, which we know is protective against mental and physical illness. Nor is the success of this approach reliant upon plentiful or positive interactions with members of the other group. Increased integrative complexity should equip individuals with the skills to more effective advocate for themselves and their group and to develop critical thinking skills that are beneficial beyond improving intergroup relations. This approach has been successful in improving intergroup relations in several contexts and perhaps now is the time to examine the benefits for young people in Northern Ireland. 

Professor Siobhan O'Neill is Professor of Mental Health Sciences at Ulster UniversityDr Claire Campbell is a lecturer in Social Psychology at the School of Psychology at Ulster University.

The views expressed here are those of the author and do not represent or reflect the views of RTÉ