Support and promotion of mental health through peer support groups
To mark this year’s WMHD, the Mental Health Innovation Network is running a month long series (#WMHD2015 Blog Series) highlighting dignity in four areas of global mental health where dignity is most often compromised and/or redeemed. This week’s subtheme is “Peer Support Groups”.
Share this blog on social media using the hashtag #WMHD2015 and our Twitter handle (@mhinnovation), and join the conversation by commenting below.
It is estimated that 450 million people around the world are suffering from mental illness. There is also a huge amount of misconceptions, myths and stigma about mental illness and about people coping with it, globally. Thus, affected families are mostly avoided or distanced by majority of the community. This usually means, that the primary responsibility to take initiative, break barriers of isolation and ensure inclusiveness, rests with the peers, namely, the caregivers and other people with mental illness.
Provision of a friendly environment
Persons with mental illness and their caregiver family members meet periodically in separate groups. Frequency and timing of the meeting is predetermined, usually once in a week or once a fortnight. Since these groups are specifically formed for people who are otherwise neglected by society, it is necessary to follow some self-imposed rules or code of conduct is necessary. This includes a non-hierarchical structure, encouraging sharing openly within the group but with strict confidentiality, individual freedom to speak or not, and a non-judgemental attitude towards other group members. In Pune, India, we have support groups at four locations for the caregivers and at one place for people with mental illness.
Most of the people with mental illness when joining the group, start by expressing great relief that ‘they are not alone’. They vent their pent up feelings. In their groups, they share disturbing events they’ve experienced, behaviour of other people and their own mistakes. The non-judgemental atmosphere and the promise of confidentiality of the shared information promotes less anxiety which leads to an ease of sharing. Successes, however small, are endorsed and people with mental illness are encouraged to work for recovery. Steps taken by each member towards positive mental health inspire others to replicate them, leading to mutual learning and appreciation.
Group facilitation through peer support workers
Experienced individuals in the group, who have empathy, experience and information about mental illness, facilitate these groups successfully. They listen patiently, encourage every effort made to get well and help participants to cope with various aspects of life generally affected by mental illness in the family. Orientation for volunteering as group facilitators is conducted as also refresher programmes from time to time.
Self-help groups as a road to wider recovery
Support groups, subtly develop a new value system for its members as they receive respect from each other and nurture a feeling of dignity. Over a time they gain enough confidence to mingle, interact with people and also to cope up with adverse remarks. Cognitive, behavioural and medical recovery is important but attitudinal and functional recovery is equally important. Support groups can be seen as harbinger of wider recovery and a step forward to include people with mental illness in broader society.
Due to stigma, fear and ignorance these multi-dimensional advantages of support group, however, are not tapped in most of the societies. Efforts to form support groups are being made in different countries, yet such efforts remain restricted to just a few pockets of urban society usually. Barriers of stigma are too strong for support group to grow into a movement.
Considering the acute shortage of resources, adequate holistic treatment for all is an illusory goal in the immediate future. Peer support groups which enhance dignity of the individuals and facilitate recovery, and are low-cost and address the shortage of resources in some ways, should be considered as an important and viable addition to mental health services.
In most of the countries where support groups exist, most are struggling to extend help and deliver appropriate services to people with mental illness and their caregivers. Unfortunately, response from governments, professionals, private sectors and non-profit organizations is lukewarm. A lot is said about importance of informal care, in terms of its frequency and cost effectiveness, but little is done in action. It is true that support group has to be run by peers and for peers, however, support group needs a conducive social atmosphere for germination and growth.
Schizophrenia Awareness Association (SAA), is a Pune based organisation which works to spread awareness, establish peer support groups and provide rehabilitation facilities for persons with mental illness. Support groups, which create awareness, promote recovery and reduces stigma, has continued to be SAA’s main plank since the onset. We can genuinely claim that the following tenet of Recovery International, a mental health self-help organization, continues to inspire and promote mental health in our organisation:
"We don’t wait to get well to do things. We do things to get well and grow."
Image courtesy of Valentina Iemmi. Copyright © 2015 Valentina Iemmi. All rights reserved