Economic impact of PTSD in Northern Ireland

Northern Ireland has the world's highest recorded rates of Post Traumatic Stress Disorder (PTSD), ahead of war-hit regions such as Israel and Lebanon, at a yearly cost to the public purse of around £175 million, according to a major report by University of Ulster psychologists and Omagh-based trauma treatment experts. 

Their survey is part of the World Mental Health Survey Initiative, a series of standardised surveys in more than 30 countries, including nations with a recent history of civil conflict. The series covers a range of health issues and is based on World Health Organisation criteria.

The report states: "Northern Ireland has the highest level of 12-month and lifetime PTSD among all comparable studies undertaken across the world including other areas of conflict."

The Northern Ireland study shows that violence has been a distinctive cause of mental health problems for around 18,000 people, or 1 in 4 of the total PTSD category.

The researchers, taking 2008 as a sample year, estimated the combined direct and indirect costs of PTSD here to be £172.8 million.

Of that, the cost associated with PTSD linked to a conflict-related traumatic event was £46.7million

The joint study says costs will continue to soar here as people whose mental ill-health is linked to traumatic incidents grow older. It suggests that an expansion of trauma-focused therapies aimed at helping people to recover would have long-term benefits for the economy and the individuals involved.

The research is the work of the Bamford Centre for Mental Health and Wellbeing, which is based at the Magee campus of the University of Ulster, and the Northern Ireland Centre for Trauma and Transformation (NICTT).

The report, entitled 'The Economic Impact of Post Traumatic Stress Disorder in Northern Ireland' was launched at Parliament Buildings, Stormont today (Monday December 5). It was conducted with funding from the Lupina Foundation of Canada. The researchers say the cost estimates, based on 2008 prices, are likely to be 'conservative'.

The researchers undertook an analysis based on responses among 4,340 adults who were interviewed between2004 and 2008 for the Northern Ireland Study of Health and Stress, the largest epidemiological study of mental disorders ever conducted in Northern Ireland.

Finola Ferry, a research associate at the Bamford Centre, who is lead investigator in today's report, said: "This is the first ever economic cost-of-illness study to focus on PTSD. It reveals that PTSD and other disorders associated with trauma represent a significant public health burden here, with economic implications right across society that stretch far into the future. "

David Bolton, lead researcher with the NICTT, commented: "Many people with this devastating disorder have had it for a long time and have developed multiple problems as a result. International research shows that recovery from PTSD is unlikely if sufferers do not have access to trauma-focused treatment.

"There is obvious unmet need - and more attention should be given to people and communities with significant trauma related problems, including those needs arising from years of conflict. The report provides policy-makers with the most reliable available information upon which they will be able to base their choices for the future."

The report estimated the direct PTSD costs, arising from all types of traumatic experiences, at £33 million, based on 2008 prices. Direct costs included visits to family doctors and other health services and prescribed medication.

Indirect PTSD costs in 2008 were estimated at £139.8 million. Some 80% of that was due to lost work productivity associated with long term sickness absence

The study found that two-thirds of adults had experienced one or more traumatic events, which iscomparable with international rates.

It is estimated that nearly 40% of the population have had a conflict-related traumatic experience.

The research estimates that around 118,000 adults met the criteria for PTSD at some point in their lifetime, which is 8.8% of the population. About 68,000 adults met the criteria in the previous 12 months, which is 5.1% or close to 1 in 20 of the population.  Conflict-related events are a factor in 27% of those cases, or just over 1 in 4.

People with PTSD are also more likely to have a range of other mental health disorders and also a range of chronic physical conditions

Quoting separate research led by Professor Brendan Bunting from the University's Bamford Centre for Mental Health and Wellbeing, today's report points out that people with anxiety disorders such as PTSD wait on average 22 years before seeking help. Just over 1 in 3 people with PTSD said that they had received help that they considered "helpful or effective".

 The report also says that this combination of lengthy delays in treatment-seeking and the lack of access to effective treatments may help explain the substantial costs of productivity losses found in this report and, coupled with the elevated prevalence of PTSD among the adult population of Northern Ireland, point to substantial levels of unmet need in the community and the need for strategic services developments.

"With a lack of readily accessible and effective services and treatments capable of curing PTSD and related disorders as early as possible (rather than just controlling and managing symptoms), the costs of PTSD and associated disorders are recurring year on year on year and are mounting as PTSD becomes more chronic and as individuals develop associated.