Omagh: the bomb that launched the government's CBT programme

Ten years ago last week, a bomb went off in a parked Vauxhall car on Market Street in Omagh, a market town with a population of 22,000 in County Tyrone, Northern Ireland. It killed 29 people, as well as two unborn babies, and injured many others.

In the immediate aftermath of the bombing, the Sperrin Lakeland Trust, which has a hospital on Market Street in Omagh, asked the Maudsley Hospital in London, which is one of the leading centres in the world for treating post-traumatic stress disorder, to send help. It did, flying in a team of psychologists headed by perhaps the leading psychologist in the UK, professor David Clark.

Over the next few weeks, Clark and his team treated hundreds of the traumatised citizens of Omagh using cognitive behavioural therapy (CBT), a form of therapy developed in the US in the 1950s and 60s.

One shop worker said he needed months of counselling after helping a woman in the street. Richard Walker, quoted by the BBC, said: "There was a woman lying with her clothes nearly half blown off her with her leg broken and her knees all broken. It was a terrible sight. I went for over two months of counselling once a week and it really helped. They got me to make a tape of what happened and play it over and over to get it out of your system."

Not everyone responded to treatment. Some, ten years later, are still in treatment. Some wounds don't heal. But Clark says a significant proportion of those treated did respond well, and their mental suffering decreased and stayed diminished over time.

The UK government was understandably impressed by the evidence Clark amassed. He told me, at a CBT conference at the Maudsley Hospital last year, 'It was our work, and the evidence from it, in Omagh that really impressed the government that CBT worked'.

As a result, the government started to listen seriously to Lord Layard's calls for a national mental health service, mainly staffed by CBT therapists, to treat the one in six British citizens who will suffer from depression or chronic anxiety at some point in their lives. In 2006, the government passed the Improving Access to Psychological Therapies (IAPT) programme, which says the government will spend £173mn a year by 2010 on training new therapists, mainly in CBT.

The government hasn't spent that money yet, and maybe it won't be around long enough to do so. I sincerely hope the next government will continue with this plan, which seems to me one of the most important government initiatives in the last few years.

Omagh, meanwhile, is now home to one of the most advanced centres in the world for the treatment of PSTD and for helping communities cope with catastrophe - the Northern Ireland Centre for Trauma and Transformation.

CBT, PTSDJules EvansComment