To ask the Minister of Health to detail the trauma-informed psychological therapy services currently commissioned by his Department that provide treatment for complex post-traumatic stress disorder in line with National Institute for Health and Care Excellence guidance.

My Department has a formal link with the National Institute for Health and Care Excellence (NICE) under which NICE Clinical Guidelines are reviewed locally for their legal and policy applicability here. Where found to be applicable, they are endorsed for implementation within Health and Social Care (HSC) organisations.

DoH Circular HSC (SQSD) 13/22 sets out process for endorsement, implementation, monitoring and assurance of Clinical Guidelines in Northern Ireland. As there is no dedicated funding source to support the implementation of NICE Clinical Guidelines in Northern Ireland, any resources required are considered against other competing priorities. Nevertheless, HSC organisations are expected to implement guidance as far as possible within existing resources.

NICE have published a range of guidance relevant to mental health. There are a significant number of recommendations contained within each NICE guideline and the extent of implementation varies across Trusts.

In line with NICE guideline NG116, which covers both PTSD and CPTSD, individuals with post-traumatic stress disorder will typically be offered, after full assessment and as indicated, an appropriate psychological therapy, most often trauma-focused cognitive behaviour therapy or EMDR (eye movement desensitisation and reprocessing therapy).

If Complex Post Traumatic Stress Disorder (C-PTSD) has resulted from a Troubles/conflict-related trauma care may be provided by the Regional Trauma Network (the RTN). The RTN brings together services provided by both the statutory (through the Health and Social Care Trusts) and community and voluntary sector organisations. (funded through the Victims and Survivors Service).

Most Adult service users seen by Psychologists will have complex trauma presentations in their personal experiences, even if it isn’t the initial reason for referral. Within Adult Psychological Therapy Services, service users often have a background of traumatic childhood experiences or of traumatic experiences in adulthood, such as domestic violence/sexual violence). Psychologists working within Early Intervention & Rehab services and within Inpatient MH services will also support service users with complex trauma presentations.

It should also be noted that complex trauma can present outside Mental Health services. This can include Clinical Health Psychology Services (in relation to trauma related to healthcare diagnosis or experiences; Maternity Psychological Services (in relation to experience of birth trauma or a delayed impact of childhood traumatic experiences) and Neuropsychology Services (where understanding a diagnosis of Functional Neurological Disorder can include the impact of historical traumatic events). Psychologists working within all these areas have expertise and training in working with complex trauma as a presenting challenge.

Complex trauma can also be present for children and young people. Psychologists working across all childrens services have expertise and training in working with trauma as a presenting challenge including in CAMHS and particularly within the world of Looked after & Adopted children and ‘edge of care’ families. Each Trust has a single consultant post funded by Regional Trauma Network who works with colleagues across the Trust and within 3rd sector organisations in supporting children and families with Trauma of the Troubles and wider trauma presentations via training, consultation and on occasions co-working alongside Trust colleagues.

All staff delivering psychological therapy for C-PTSD would be expected to do so in a trauma informed manner and following National Institute for Health and Care Excellence guidance.