South Belfast Research Articles

Community Perspectives to Inform Substance Use Prevention Practice

Abstract Problem The Market is a highly cohesive working-class community in South Belfast. Queen's Communities and Place (QCAP) has partnered with the Market as an anchor community to co-develop research to generate actionable data to alleviate public health challenges. Both the Market Development Association (MDA) and QCAP's research findings identified substance use (SU) as a key issue and delivered Northern Ireland's first peer naloxone training in December 2022. However, a long-term strategy aligned with residents’ vision is necessary. Methods The MDA and QCAP co-hosted an event in February 2023 asking attendees 4 questions to guide small group discussion: •What is the current situation with SU in the Market? •Why do these problems exist? •What are service gaps? •What should the MDA and QCAP do to help? QCAP staff conducted a qualitative analysis of the discussion notes and presented the results to the MDA to guide intervention development. Results Residents had nuanced knowledge of SU in the area and feelings of both powerlessness against larger forces and optimism for change if given the necessary resources. The analysis revealed 3 key themes: the breadth of the issue in the community; a lack of supportive services; and a need for demographically tailored SU education. Lessons QCAP and the MDA have a better understanding of area's concerns about SU and hopes for addressing it. Short and long-term actions are planned: •Event series for parents covering drugs circulating, signs of SU, and overdose intervention steps. •Materials added to the existing “community indicators dashboard” publicised through QR codes posted at key locations. •Programming for youth co-developed with the area's new youth forum. •Seeking funding for a “health navigator” based in the community to connect residents with services they need. •Building connections with local GPs using a local champion model to reduce provider burden. Key messages • Communities have strong understanding of their public health challenges and can effectively guide the development of intervention strategies. • It is feasible to derive meaningful and informative feedback to direct public health action through shared power in research and community-engagement.

Queen’s Communities and Place: towards the alignment of higher education place-based strategy with local need

Serving as a key delivery mechanism for Queen’s University Belfast’s (UK) strategic commitment to social and civic responsibility and economic prosperity, Queen’s Communities and Place is a research initiative based on engagement and partnership between communities, policy makers and academics. Combining academic expertise and experiential knowledge from the community, Queen’s Communities and Place uses a ‘place-based’ approach to co-create new solutions to address persistent physical, economic and social challenges, as well as to strengthen the engagement between Queen’s University and its surrounding communities. Queen’s Communities and Place launched in November 2021 with our anchor partner in the Market community in inner south Belfast. We are also working collaboratively with projects and communities in the north, west and east of Belfast across a range of sectors and academic disciplines. We have sought to challenge existing frameworks, with evidence-led, data-driven approaches to build interventions and practices together to identify what might work better here for communities to thrive. Capturing three perspectives – academic, community and local government – this co-written reflective article details the experience of establishing a working partnership with our pilot community, and provides some examples of how our approach is working to address the challenges on the ground to date.

Operation Achille Report proves RUC colluded with loyalists in 1990s South Belfast murders

Operation Achille Report proves RUC colluded with loyalists in 1990s South Belfast murders

When it matters most: a trauma-informed, outdoor learning programme to support children’s wellbeing during COVID-19 and beyond

This paper presents a unique school-based programme that harnesses the benefits of both trauma-informed practice (TIP) and outdoor environments to support children’s social and emotional wellbeing throughout the pandemic and beyond. In the opening sections of the paper, we discuss the extant literature and conceptual underpinning of TIP and outdoor learning, and highlight why both are needed, particularly in the context of Covid-19. We then chart the design of a six-week outdoor trauma-informed programme, devised to support children’s emotional regulation and overall sense of wellbeing. The programme activities are aligned to the Northern Ireland curriculum, and are tailored to make use of the outdoor spaces available in the first author’s place of work – a primary school in South Belfast. We conclude the paper by highlighting the importance of trauma-informed curriculum and pedagogical innovations and note future directions for trauma-informed schools. Whilst there are many generic guidelines on trauma-informed care in schools, this paper makes a distinct contribution to the field; firstly by demonstrating how teachers can use their craft – teaching – as a component of TIP; and secondly by infusing trauma-informed principles within outdoor learning environments.

Symbolic landscapes: Exploring what markings, murals and memorials reflect about interculturism on Belfast’s Ormeau Road

This article explores what the symbolic landscapes in an area of Belfast reflect about the development of interculturism in the post-conflict city. It builds on previous research, focusing on the particular characteristics of South Belfast’s Ormeau Road, containing communities defined as ‘Protestant/Unionist/Loyalist’, ‘Catholic/Nationalist/Republican’ and ‘Mixed’. Secondary statistical data, montages of visual images, photo-elicitation and interview data are integrated to present an in-depth perspective on the current development of pluralism and interculturism in this one part of Northern Ireland. While the findings support the orthodox narrative about oppositional and contested identity in Northern Ireland, it is also concluded that many other meanings are silenced, hiding levels of unaddressed complexity.

Desegregation and Place Restructuring in the New Belfast

A sustained reduction in unemployment, economic growth and house price increase have reflected Belfast’s post-conflict renaissance just as readily as the global recession has exposed the fragility of construction-led growth. Rates of segregation had stabilised and new consumption spaces and élite developments further reflected the city’s engagement with globalisation and economic liberalisation. This paper explores the spatial impact of these processes, not least as gentrification has created new layers of residential segregation in a city already preoccupied with high rates of ethno-religious territoriality. A case study of south Belfast connects these shifts to the production of new mixed-religion neighbourhoods. These have the capacity to reduce the relevance of traditional binary identities, but at the same time reproduce new forms of segregation centred on tenure and class. The paper concludes by highlighting the implications for policy and practice, not least as the recession opens new spaces to present alternatives to the market logic.

How caseload analysis led to the modernization of the DN service

As we move into a new century and care moves out of hospital and into the community, there is a drive to seek new models for providing nursing care to patients in their homes. Following a Caseload Analysis report, the District Nursing Modernization Project was launched in April 2004, aimed to redesign the structure and delivery of the district nursing services in South and East Belfast. The service was totally re-engineered within the existing budget and workforce. Nursing careers changed as new supporting services were developed and new job opportunities became available within the service. The structure of the services was designed on the basis of caseload analysis gathered over a number of years. Evaluation of the project indicated that the project aim and objectives had been achieved. Caseload Analysis was instrumental in establishing the need to modernize district nursing services and how this should be carried out.

Fair play: creating a better learning climate for social work students in social care settings

This paper describes a pilot study and subsequent evaluation undertaken by the author which arose from his experiences as a practice teacher working with a student in a day care facility. The catalyst for the study arose from one student's comments about the confusion he and others on the placement site experienced regarding his role as a social work student in a setting where there was no defined social work role. It led to a study of students' views in a range of settings across South & East Belfast Trust, some of which may be deemed to be ‘social work settings’, i.e. with a defined social work role, while others may be considered ‘social care settings’, i.e. with no defined social work role. The aim of the study and subsequent evaluation was to consider problematic issues which arose for students in social care settings and how the quality of learning opportunities for them could be improved.

“We need to talk”: a study of working relationships between field social workers and fostering link social workers in Northern Ireland

Foster care in the United Kingdom and Northern Ireland has been in crisis throughout the past decade. This is most clearly demonstrated in the shortage of placements for children. The difficulty in recruiting new carers has taken a new significance for most agencies that struggle with more referrals than placements. As it becomes more difficult to recruit new carers, it becomes essential to retain existing carers. This research has focused on the working relationships between field workers and link workers and the role these relationships play in supporting carers. Previous research by the author (Sheldon, 2002) has indicated that carers wish to be treated with respect and as partners in a process of caring for children. It follows, therefore, that when social workers fail to work in this way carers become dissatisfied and this may lead to them ceasing to foster. The study was carried out via a postal questionnaire to all 80 field and link social workers within South and East Belfast Health and Social Services Trust, and this was followed by a series of 13 face‐to‐face interviews, nine with field workers and four with link workers. The results of the research have indicated a mixed picture of practice within the Trust. Foster carers are unanimously held in high regard by social workers and the task they fulfil is highly valued. There are many examples of successful working practices between field and link workers, but there are also examples of little or no communication. Many field workers have little idea of the problems facing fostering at the moment and this can be frustrating for their link work colleagues. New social workers have little or no preparation for working with carers and there is confusion as to the nature of the working relationship with them.

Developing an accessibility appraisal model for the external environments of housing estates

Based on research carried out on a mature estate in South Belfast, Northern Ireland, this paper investigates the obstacles to accessibility in order to produce an appraisal model for external accessibility. The study included a review of best practice, a preliminary access appraisal and resident and service provider consultation. Residents were surveyed on a number of issues including location, roads and pavements, transportation, level change, wayfinding, safety and security, and public areas. It was discovered that obstacles relating to wayfinding and traffic management created the greatest problems for residents. The resultant model will enable housing providers and managers to identify specific areas of inaccessibility and the feasibility of improving them as well as allowing comparisons between estates. It is intended to provide all agencies involved in housing with a basis for collaboration in the enhancement of accessibility.

Using commercially available technology to assist in the delivery of person-centred health and social care.

Videoconferencing (via ISDN at 128 kbit/s) was used between a service provider, the South and East Belfast Health and Social Services Trust, and clients at home. The equipment was used successfully by various health-care workers and was sufficient for the clinical requirements of professional staff. Our experience demonstrated that there are clinical benefits of telecare. The users perceived that the technology added to the quality of their lives. Clients reported feeling less isolated, more secure at home and more in control. The Trust is currently commissioning purpose-built accommodation for adults with cognitive impairment. The residents will be people who are on the verge of requiring institutional care. Presence sensors, appliance and door contacts will allow lifestyle patterns to be monitored. The system will notify the service provider's staff of variations from the norm for each resident.

'A Word in Your Ear': A Study of Foster Carers' Attitudes to Recommending Fostering to Others

Foster care has been in crisis throughout the last decade. This is most clearly demonstrated in the shortage of placements for children and young people. The difficulty in recruiting new carers has taken a new significance for most agencies that constantly struggle with more referrals than available placements. Foster carers are a valuable resource for children who cannot live at home and agencies must be conscious of 'caring for the carers' to ensure they continue to provide this service. Aware that research indicates that most carers come into fostering via word of mouth, the author set out to look at this issue throughout the current foster carers within the South and East Belfast Health and Social Services Trust. Previous research the author had undertaken relating to ceased carers indicated the majority would not recommend fostering. The author was concerned that if these results were representative of present carers, the Trust might experience future recruitment difficulties. The study was carried out via a postal questionnaire to all carers asking whether they would recommend fostering and this was followed by a series of 10 face-to-face interviews. Five of the interviewees indicated they would recommend fostering and five would not. The results of the questionnaires indicated that approximately 80% of carers would recommend fostering, whilst 19% would not. The interviews highlighted both the positives and negatives within fostering at the present time. There was an almost unanimous acceptance that fostering has become more difficult in recent years and there were many suggestions as to how these problems could be alleviated. Given that the majority of carers within the Trust would recommend fostering, an opportunity exists to harness this goodwill and it may well provide the basis of an ongoing recruitment policy to enable the agency to at least maintain the present number of placements it provides.

Creating safety for trauma survivors: What can therapists do?

This paper serves as a reminder to those working clinically in the field of trauma, of the necessity for therapists to adequately include issues of safety within the therapeutic process. Addressing these issues is an integral part of the therapy and not simply a practical prerequisite or a parallel process. Validation of this thesis is drawn from trauma literature and an account of safety issues relating to the therapeutic setting and processes is given. Case examples illustrate the type of issues that might usefully be addressed within the therapeutic context to increase individual and family safety for clients as they continue to live within their local communities. This paper draws on recent work undertaken at the Family Trauma Centre. Based in South Belfast, this Centre is in its second year of operation. It has a primary remit to provide clinical treatment for children and their families suffering from the traumatic effects of 'the Troubles' in Northern Ireland. The community context for this work has been one of continuous low-grade conflict in the midst of a 'Peace' process.

Where do patients with cancer die in Belfast?

Most patients with cancer prefer to die at home but the majority die in institutions. To determine place of death for patients with cancer in Belfast, to examine changes over time and identify factors associated with place of death. A survey of deaths registered in Belfast over a six-month period for 1977, 1987 and 1997 identified patients dying from cancer. Epidemiological data included age, gender, malignancy, social class, marital status, area of residence and place of death. Home deaths fell from 35% in 1977 to 28% in 1997. Hospital deaths fell from 50% in 1977 to 40% in 1987 rising to 42% in 1997. Hospice deaths rose from 13% in 1977 to 25% in 1987 falling to 23% in 1997. There was an association between place of death and age, marital status, type of cancer and area of residence, but not with social class or gender. The majority of people fail to achieve a home death. Resources need to be targeted to those most at risk of an institutional death; females, the elderly, the unmarried, those with haematological malignancies and residents of South Belfast.

Resident participation in the evaluation of external accessibility requirements in housing estates

Accessibility is now a major issue in the design and maintenance of housing estates. This paper considers the reasons why this issue has emerged and the main obstacles to accessibility encountered by housing estate residents. Focusing on a mature estate in South Belfast, Northern Ireland, investigates the obstacles to accessibility experienced by the residents in order to produce a hierarchy of impacts. Residents were surveyed on a number of issues including location, roads and pavements, transportation, level change, wayfinding, safety and security, and public areas. It was discovered that obstacles relating to wayfinding created the greatest problems for residents; however, attitudes towards accessibility varied according to the age of the respondent. The study concludes that accessibility should be introduced estate‐by‐estate dependent on a resident profile in order to maximise resources and advocates the adoption of a co‐ordinated interagency approach.

The development of specialist skills in the assessment, investigation and treatment of children and young people with disabilities who may have experienced abuse

Abstract This article outlines a study which took place in South & East Belfast in relation to work with children and young people with disabilities. It examines the incidence of abuse among these children and looks at the response from the professional network and concludes that there needs to be greater recognition of the phenomenon of abuse of disabled children, an increased level of co-operation between child protection and other specialists working with disabled children and increased opportunity for training.

Knowledge, attitudes and behaviour in relation to dental health of adults in Belfast, Northern Ireland

The aim was to investigate the knowledge, attitudes and behaviour related to dental health of adults living in two neighbouring areas in Belfast, Northern Ireland. 81 adults aged 30 yr or over from two neighbouring residential areas in South Belfast completed a structured interview. The responses of those who retained natural teeth were very different from those who were edentulous. Those in the higher socioeconomic status groups had clearer knowledge, more positive attitudes and more appropriate behaviour related to dental health than those in lower socioeconomic status groups. The differences between the residents of the two areas were less obvious than those noted between the different socioeconomic status groups. It was concluded that the results revealed misconceptions amongst adults in Northern Ireland regarding the causes of dental disease and how it might be prevented both in themselves and in their children.

The Impact of Private Residential and Nursing Care on Statutory Residential and Hospital Care of Elderly People in South Belfast

Dependency levels were compared in residents of private, voluntary and statutory residential homes, private nursing homes and patients in geriatric continuing-care wards in South Belfast. Dependency levels were least in private and voluntary residential homes, were similar in residential and private nursing homes, but were very much greater in the geriatric wards. Evidence of dementia was found in 23% of residents of voluntary homes, 35% of residents of private residential homes, 61% of residents of statutory residential homes, 54% of those in private nursing homes and 80% of patients in geriatric wards. Severe degrees of immobility and incontinence were commoner in nursing than in residential homes, but much commoner in geriatric wards. The number of private residential and nursing home places in the area studied has increased three- to five-fold since a previous survey in 1985. In this time, dependency levels, and frequencies of dementia, immobility and incontinence have increased in both statutory residential homes and geriatric continuing-care wards. It appears, therefore, that private residential and nursing homes take rather less dependent old people and that highly dependent old people are being concentrated in hospital.

Relaxation skills: Their use by social workers in a primary care setting

Abstract What follows is an account of an innovative piece of social work practice which might usefully be extended to other settings. This relaxation group was started in a large South Belfast Health Centre in 1984, for patients who were referred to the social workers with a variety of problems. The patients have benefitted from the support of the group, and the opportunity to learn skills which they can use in everyday life. The group has continued since 1984 and gone from strength to strength. It has been found useful by patients, social workers and other members of the primary care team. Similar groups are now run by the social workers in two other health centres in South Belfast. A formal consumer survey was carried out in 1985, and results of this are discussed, as are more recent comments from patients, doctor and social workers.

Disability and dependency in elderly people in residential and hospital care.

Physical dependency and mental impairment were assessed in 143 residents of residential accommodation for the elderly and 125 patients in geriatric continuing-care wards in South Belfast. Although dependency, immobility and incontinence were more common in the hospital patients, there was considerable overlap in the disability levels in the two types of care. There was evidence of dementia in 51% of the residents and 71% of the patients, while 29% of residents and 70% of patients were incontinent. Overall, less than 1% of the elderly population was in each of residential or geriatric hospital care but the proportion rose with age and was greater in older women. About 17% of elderly people in South Belfast with dementia were in residential or geriatric hospital care. The projected increase in the number of oldest people, particularly women, and the increased risk of dementia in this age group, means that the need for residential and continuing hospital care for the elderly will continue to increase.