Re­cov­ery-ori­ented ap­proach to men­tal ill­ness is the gate­way to health

Peer-led project in Rath­mines of­fers ‘place to re­gain my­self and get a sense of hope’

The Irish Times - Tuesday - Health - - Mental Health - Sylvia Thomp­son

The colour­ful hand­crafted sign across the large front win­dow of a shop in the heart of Rath­mines, Dublin 6, is a clear shout-out that Gate­way is open to all. To­gether with Áras Fol­láin in Ne­nagh, Co Tip­per­ary, this men­tal health project is a pi­o­neer in the re­cov­ery-ori­ented ap­proach to men­tal ill­ness, where peo­ple with lived ex­pe­ri­ence be­come ad­vo­cates for oth­ers on their shared jour­ney to well­ness.

A group of 10 Gate­way mem­bers vol­un­teer to speak to The Ir­ish Times about why they come here. Richard Moloney has been a mem­ber of Gate­way for many years.

“I have a sense of be­long­ing here. It’s a holis­tic space be­cause it takes care of all the el­e­ments: there are prac­ti­cal cour­ses, cre­ative cour­ses and re­lax­ation and med­i­ta­tion classes. It’s a place to re­gain my­self and get a sense of hope and re­spon­si­bil­ity,” he says.

Cathy Ben­nett says the fact that every­one has had some kind of men­tal health dif­fi­culty is a pos­i­tive thing.

“I thought my work­ing life was over, but here I meet peo­ple who have sim­i­lar ex­pe­ri­ences to me and it will help me go back into the work­ing world again.

“I now feel that the neg­a­tive ex­pe­ri­ence of be­ing un­well might be of use to me mov­ing for­ward.”

We are sit­ting around a ta­ble in Gate­way’s front room. A pool ta­ble stands to the right of us. Be­yond that is a “lis­ten­ing space” where peo­ple can sit qui­etly. Then, there’s a com­puter hub where the news­let­ter is pub­lished and an­other large room for other ac­tiv­i­ties.

No ther­apy ses­sions

Project co-or­di­na­tor Fionn Fitz­patrick is keen to point out that there aren’t any ther­apy ses­sions, al­though many of the ac­tiv­i­ties can be ther­a­peu­tic.

“We also of­fer mem­bers the op­tion of go­ing for low-cost coun­selling through our part­ner­ship with My Mind [coun­selling ser­vice],” says Fitz­patrick.

Mary Quinn has been com­ing to Gate­way for about seven years. “I was scared when I first came. I was very quiet and shy – you wouldn’t think it now – but I still have my quiet days.

“I find it is a very safe place to be. I work on the news­let­ter and do the cre­ative writ­ing work­shops. Some­times I just sit on a chair or play games on the com­puter.”

Kevin O’Beirne is an­other long­stand­ing mem­ber of Gate­way. “I of­ten feel quite low here. I’d feel the same if I was in Ea­son’s. I don’t ex­pect to feel great on ev­ery visit. I don’t ex­pect peo­ple to make it alright. I might feel lousy one day and bet­ter an­other. I may get to the point when I need to leave for a while.”

Mau­reen Quinn has been com­ing to Gate­way for a year. “I feel you are ac­cepted as you are. It’s easy to feel re­laxed and com­fort­able. Gate­way has been a hugely valu­able sup­port to me. I’d be lost with­out it.

“I’m not work­ing at the mo­ment, and fa­cil­i­tat­ing craft ses­sions and be­ing in the singing group gives me a sense of pur­pose.”

Fitz­patrick says that be­cause Gate­way is a mem­ber-led or­gan­i­sa­tion, all the ac­tiv­i­ties are de­cided on year by year. “We also get in­for­ma­tion about com­mu­nity em­ploy­ment schemes and we pri­ori­tise Gate­way mem­bers and pro­vide train­ing for any po­si­tions that arise.”

Fillingavoid

An­other Gate­way mem­ber will talk on first-name ba­sis only. “Bat­tling fear is my big­gest prob­lem. With all the rhetoric about men­tal health, there is still nowhere for proper re­ha­bil­i­ta­tion. That’s frus­trat­ing for me, but Gate­way fills the void,” says Tom.

“I’ve had two break­downs and the fear of go­ing back into a psy­chi­atric hos­pi­tal is so great. I was a high achiever in busi­ness and I lost ev­ery­thing. It’s a very low place to come back from. Now, I’m ruth­less about my men­tal health.

“I’m ruth­less about stay­ing well. I walk, I come to Gate­way. I at­tend an­other men­tal health group called Re­cov­ery and I keep in touch with peo­ple who un­der­stand men­tal health dif­fi­cul­ties.”

His re­marks spark nods of agree­ment among the other mem­bers. Their ef­forts to stay well need ac­knowl­edge­ment in a so­ci­ety that still doesn’t fully recog­nise their strug­gles.

Fitz­patrick ar­gues that peo­ple with on­go­ing dis­tress­ing ex­pe­ri­ences and men­tal health chal­lenges still get min­imised or triv­i­alised in spite of bet­ter men­tal health aware­ness.

“Whether you see men­tal health prob­lems as an ill­ness or a re­sponse to in­equal­ity and dys­func­tion in so­ci­ety, peo­ple still need com­mu­nity spa­ces to re­cover their sense of iden­tity and so­cial con­tact and sup­port is a re­ally im­por­tant part of that.”

Ir­ish­study

“It takes a com­mu­nity to sup­port a per­son in re­cov­ery,” said He­len McEn­tee, Min­is­ter for Men­tal Health and Older Peo­ple, at the launch of the first Ir­ish study into peer-led sup­port projects for peo­ple re­cov­er­ing from men­tal health dif­fi­cul­ties.

“To talk with oth­ers who have come through sim­i­lar dif­fi­cul­ties gives peo­ple hope and al­lows them to be happy in their own com­mu­ni­ties,” she said.

Her pres­ence and that of Anne O’Con­nor, the head of the HSE men­tal health di­vi­sion, at the pre­sen­ta­tion of re­search into the peer-led projects, Gate­way in Rath­mines and Áras Fol­láin in Ne­nagh, Co Tip­per­ary, was both a po­lit­i­cal and health ser­vices val­i­da­tion for the work th­ese com­mu­nity-based projects do.

“We can work with well-es­tab­lished and well-run projects such as th­ese. And we want to see more peer-led or­gan­i­sa­tions which pro­vide a safe place and a so­cial out­let,” says O’Con­nor, who spent a half-day in Gate­way to ob­serve the work there.

The six-month re­search by Trin­ity Col­lege Dublin (TCD) school of nurs­ing looked specif­i­cally at the im­pact of the peer-led men­tal health projects.

“Our re­search found that the vast ma­jor­ity of mem­bers of Gate­way and Áras Fol­láin are ex­tremely sat­is­fied with the ser­vices of­fered,” says Re­becca Mur­phy, a post­doc­toral re­searcher at TCD.

“Th­ese places of­fered a sanc­tu­ary, a so­cial and ed­u­ca­tional space which was un­der­pinned by be­ing peer-led.

“No one asked about their di­ag­no­sis or med­i­ca­tion, which made peo­ple feel very safe and un­pres­surised to speak if they didn’t want to.”

Peer­sup­port

Prof Agnes Higgins, lead re­searcher from the TCD school of nurs­ing, spoke about how peer sup­port has emerged from the Vi­sion for Change men­tal health pol­icy doc­u­ment (2006).

“Peer sup­port is non-hi­er­ar­chi­cal space to ex­plore is­sues in a safe con­text and bear com­pas­sion­ate wit­ness. It doesn’t as­sume a prob­lem ori­en­ta­tion. It nor­malises ex­pe­ri­ence and gives peo­ple courage and re­silience to move for­wards.”

The ser­vices of­fered at Gate­way in­clude arts and crafts work­shops, med­i­ta­tion and re­lax­ation, as well as meet-ups in lo­cal cafes in Rath­mines.

Fionn Fitz­patrick, Gate­way co-or­di­na­tor, says: “It’s based on equal­ity, par­tic­i­pa­tion and so­cial in­clu­sion. Many of us were ex­cluded and left with­out a voice – dis­tanced from so­cial, work­place and ed­u­ca­tion, our homes and hav­ing fam­i­lies.

“At Gate­way, we work on a level play­ing field, chal­leng­ing and chang­ing at­ti­tudes and liv­ing life to the fullest on our own terms.”

Mu­tual sup­port and friend­ship are at the core of all ac­tiv­i­ties. “We need the right to fail and the right to thrive and suc­ceed,” she says.

Áras Fol­láin hosts meet­ings from men­tal health sup­port or­gan­i­sa­tions such as Grow and Shine, as well as run­ning art and craft and well­be­ing work­shops.

Both Gate­way and Áras Fol­láin are funded on a year-by-year ba­sis by the HSE through its fund­ing to Men­tal Health Ire­land.

“Peo­ple tell us that it’s very dif­fer­ent to a day hos­pi­tal, which is about ill­ness. Here it’s about well­ness,” says Margo O’Don­nell-Roche, co-or­di­na­tor of Áras Fol­láin.

Sense of nur­tur­ing

Other peer-led men­tal health sup­port groups ex­ist through­out the coun­try. Orla Barry, the out­go­ing chief ex­ec­u­tive of Men­tal Health Ire­land, says peer-led projects give peo­ple a sense of nur­tur­ing.

“It’s like a feel­ing of be­ing home. It’s im­por­tant to note that th­ese projects are or­gan­i­cally driven. They emerge them­selves and de­velop in­cre­men­tally as they need to.”

How­ever, Mur­phy notes that the fund­ing model is prob­lem­atic.

“Both projects lack fi­nan­cial cer­tainty and some of their core work is di­verted to­wards fundrais­ing. And vol­un­teers who are di­verted to­ward fundrais­ing are more likely to with­draw.

“Peer-led ser­vices such as th­ese need to be seen as an in­te­gral part of qual­ity men­tal health ser­vices in our com­mu­ni­ties.”

Fol­low­ing the pub­li­ca­tion of this re­search, mem­bers of Gate­way and Áras Fol­láin are keen to build a net­work of sol­i­dar­ity with peer-led projects around Ire­land.

PHO­TO­GRAPH: ALAN BET­SON

Mem­bers of Gate­way men­tal health sup­port group in Rath­mines: from left, Mau­reen Quinn, Kevin O’Beirne, Mary Quinn, Fionn Fitz­patrick, Gate­way Co-or­di­na­tor, Maura Ferry, Cathy Ben­nett and Richard Moloney.

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