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This article provides an overview of the literature on the impact of ‘the Troubles’ on mental health in Northern 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 (Northern 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 Northern 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 important to integrate these efforts. The relative under‐development of mental health services, the comprehensive Bamford Review (2005; 2006) and the positive approach of the Public Health Agency mean that, even in the current economic climate, there are great opportunities 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.

Mounting evidence of a crisis in mental health care for young people has underlined the need for early and better recognition of mental health difficulties in children. Recent policy suggests that schools and teachers must play a pivotal role in smoother pathways to care. This will necessitate enhanced working relationships between schools and child and adolescent mental health services (CAMHS). However, there is little understanding as to how teachers and mental health professionals currently relate to one another or what difficulties undermine ‘joined up’ care. In this study we examine current systems of collaboration between schools and child and adolescent mental health services, paying particular attention to relationships between schoolteachers and mental health professionals. Data was collected using semi‐structured, in‐depth interviews. Our findings indicate deep‐seated barriers to good collaboration. Moreover, teachers experience significant frustration through feeling excluded from the mental health care management of children despite being affected professionally by such decisions taken, the delays to intervention and poor communication between agencies. Interprofessional trust and mutual suspicion emerged from these interviews as an over‐arching factor. The implications arising from expectations for greater inter‐agency collaboration are discussed.