Promoting mental health in Northern Ireland: addressing division, inequality and stigma

This article provides an overview of the literature on the impact of ‘the Troubles’ on mental health in Nor thern Ireland. It identifies three main phases of professional and policy response from concerns about the effects of the violence in the early 1970s, through many years of collective denial and neglect, until acknowledgment, following the Good Friday Agreement in 1998 (Nor thern Ireland Office, 1998), of high levels of trauma and unmet need. The issues of inequality and stigma are also considered and it is argued that peace is necessary but insufficient for promoting mental health. The development of mental health services in Nor thern Ireland and the relatively recent focus on promoting mental health are also outlined and examined. It is suggested that attempts to address the needs arising as a result of ‘the Troubles’ and more general mental health promotion strategies have, to some extent, developed in parallel and that it may be impor tant to integrate these effor ts. The relative under-development of mental health services, the comprehensive Bamford Review of Mental Health and Learning Disability (2005; 2006) and the positive approach of the Public Health Agency mean that, even in the current economic climate, there are great oppor tunities for progress. Routine screening, in primary care and mental health services for trauma, including Troubles-related trauma, is recommended to identify and address these issues on an individual level. It is also argued, however, that more substantial political change is needed to effectively address societal division, inequality and stigma to the benefit of all.

Market Economies with an Endogenous Social Division of Labour

This paper considers a general equilibrium theory of a competitive market economy with an endogenous social division of labour. The theory is founded on the notion of a “consumer- producer”, who consumes as well as produces commodities. In this approach, the emergence of a meaningful social division of labour is guided by the property of increasing returns to specialisation and the process of trade among fully specialised individuals. All decisions of individual consumer-producers are based on a set of perfectly competitive market prices of the commodities in the economy.
We show that a perfectly competitive price mechanism supports a dichotomy of production and consumption at the level of the individual consumer-producer. In this context we show existence of competitive equilibria and characterise these equilibria under increasing returns to specialisation: Under certain well-described conditions, markets are equilibrated through adjustment of the social division of labour; therefore prices are fully determined by the supply side of the economy.