A new mental health course, based in DCU, brings together carers, service users and service providers in bid to revolutionise services, writes Sylvia Thompson
AN INNOVATIVE mental health course which brings together service users, carers and health professionals has the potential to revolutionise the mental health services in Ireland, according to its course co-ordinator.
Based in Dublin City University (DCU), the nine-month course, co-ordinated by DCU lecturer Liam MacGabhann, aims to improve the treatment and care of people with mental health problems through a new model of care. The course, which has just signed off its first batch of students, involves teams of three (a service user, carer and health professional) working together to improve services.
"Members of the Health Service Executive approached DCU to see if it was possible to develop an educational programme that could be transferred into the mental health services to change them," explains MacGabhann who lectures in mental health practice at the School of Nursing at DCU.
The new model of care brings together friends and families of the service user, the service users themselves and the service provider as equals to discuss meaningful ways to help the person with mental health problems recover and lead a fulfilling life.
The idea of people with mental health problems and their carers working as active partners in the planning and delivery of mental health services is a strong component of the 2006 mental health policy document, A Vision for Change.
"This part of A Vision for Changehadn't been implemented in a meaningful way because there were no models to use," says MacGabhann.
"Service users were beginning to be represented on national bodies but this course has created an environment in which people bring different perspectives into a learning situation and become leaders themselves which has quite a significant impact," he says.
"When the lived experiences of both the service users and the carers are given some meaning in an approach to mental health services, this changes the relationship with the professional. The professional can give up the risk mentality when he/she sees the service user as a responsible person and when the carer is included as well, there are more opportunities for social ways of providing mental health services," he says.
"It's much more likely that a common solution found through shared decision-making will be suitable for everyone," he adds.
The participants on the first course came from mental health services in Dublin, Donegal, Mayo and Cork. As part of the course, each team (a service user, carer and health professional) had to work together on a service improvement project in their area. Each team has a mentor who continues to work with them to implement their project.
Colette Nolan, a former service user, was one of the participants. "I was very daunted by the course in the beginning because it was years since I was in school but when I realised that I was capable of doing the academic and the project work, it was very empowering," she says.
"The real challenge was combining the three different perspectives. I thought I was open minded but I realised that I too have a narrow view of services. I expected professionals to fix problems people had," she says. "Our project was to set up carer and service user councils and to train people to become involved in all aspects of mental health services," says Nolan, who also works in peer advocacy through the Irish Advocacy Network.
Cathy Buttimer is a carer from west Cork who did the course. "In our area, we're working on a needs-based project which will involve the tripartite approach. What I realised during the course was that carers need much more information about services and there also needs to be an out-of-hours helpline that people can call when they are at their lowest points."
Donal Coleman, clinical nurse manager in the Mayo mental health services, says that for him, the course was "a valuable and unique experience".
"You can be very defensive initially but then you see the points of view of the service users and carers. What was most important for me was not to take the lead but to encourage others to have an equal share in the project. It's important that people have their voices heard."
Thresea Browne, a carer and former service user from Donegal, sums up what such an approach can achieve. "Working in collaboration with the person who is ill and his/her carers is what has been missing in the mental health services. I've spoken to nurses who admit that what's routine for them, can be very frightening for the person coming into hospital.
"And especially so in the mental health services because there is still a stigma," she says.
Browne continues, "everyone has been working in isolation: service providers were frustrated and service users were intimated by the services. If this model goes ahead, it should make things easier for everyone but it will take a change in mindset, not money."
And, now as the second group of participants begin the Cooperative Learning course at DCU, MacGabhann is hoping for a snowball effect. "Small improvements can lead to larger changes. And so can a number of projects working within the same philosophy of genuine partnership," he says.