Mental Health Community Support Services (MHCSS) are organisations that provide group programs as well as individual support workers. Many MHCSS employ peer support workers who are people with experiences of being diagnosed with ‘mental illness‘, and / or of being carers. They assist people with lived experience of severe mental health problems through peer support and specific interventions to improve people’s health and wellbeing. Particular areas of support include improving coping strategies, supporting a healthy lifestyle, and supporting people’s efforts towards personal recovery. Personal recovery has become a major focus of MHCSS, which aims to support people to set goals for the future, identify their strengths and improve social connections and participation in the community (see Personal recovery).
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Benefits of attending a group
One-to-one support
Practical help
Getting more involved
Benefits of attending a group
Many people spoke about the benefits they experienced from attending support groups or having a support worker. For Vanessa, isolation, stigma and loss of skills were the biggest problems she faced. She appreciated having somewhere to go on a regular basis. She said that it was important to get ‘out of your house’. Sarah described how attending a group recovery program helped with her feelings of loneliness and ‘things like not being understood’. Susana thought groups should provide more support with vocational training and education because so many people diagnosed with schizophrenia, psychosis, and / or bipolar disorder are unemployed.
Luana found going to a mental health support group really helpful. She enjoyed meeting others at the group and getting visits from her caseworker.
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Okay, so definitely I feel like going to a mental health support group has been really good because I’ve been able to meet people who are quite well and are managing their illness. So in a way, you know, they’ve sort of been a bit of an inspiration for me. So it has been nice to meet people who have mental health issues who you know, still interact and have friends and you know are studying or working.
So that’s been a really good support and also the one-on-one support I have received through the [mental health organisation]. That really helped when I came straight out of hospital. The way they set you up with a caseworker who will come and visit you and listen to you and give suggestions and keep you motivated and keep you thinking positive thoughts.
One-to-one support
Many people spoke about the benefits of accessing one-on-one support from a support worker. Support workers can come from a range of professions, including social workers, counsellors and occupational therapists, and also include peer support workers who are experts through their own lived experience. Support workers are focused on recovery and rehabilitation. The relationship between support workers and clients are often less formal and more based on practical support than what is offered by clinical service providers.
Taylor said her support worker was great and talked to her ‘on the same level’. She comes to Taylor’s house or takes her out for a coffee if she doesn’t want to go out.
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Well I actually go to, like they call it a ladies’ group. They have ladies’ groups and we go on outings. So it gives me an opportunity to meet people. She actually comes to my house and I have a therapy session with her at my house. So, because I don’t really like going out too much, she knows that and she’ll come to my house for me and we have a chat. Sometimes she takes me out for coffee and we have a chat. I just think it’s a different way of doing things. It’s more, with psychiatrists and psychologists I think it’s like more medical. This is more kind of on the same level as you. So yeah a bit more understanding I think, yeah.
Anna’s support workers are ‘fantastic’ and allow her to have her say about her support plan. She thinks senior medical staff should listen to more to them.
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I have had community services involved, and they have been absolutely fantastic and extremely supportive. And yes they do allow me to, you know, work on a care plan. And they do allow me to have a say in how I would like to be treated and what I feel I need. And you know that is absolutely brilliant.
And yeah, I would like to say that the community organisations that I have been in touch with, they deserve a really good rap. But unfortunately they don’t make the decisions when it comes to clinical stuff. So…
Could you talk a bit about how they’ve done that? How they’ve given you that support?
It’s a case of really sitting down and talking with me, rather than to me, about where I see my life going, how I feel I need to be supported, what resources they can use to make that happen, to have constant contact, to be appreciated, regardless of what phase I am in my illness. So whether I’m doing well, whether I’m manic, whether I’m in a depressive episode, it’s still being spoken to with respect and there’s a lot of dignity there.
And it’s the total, it’s a polar opposite to what I’ve experienced in the clinical side, put it that way. But unfortunately they’re not the decision makers at the end of the day. They can only recommend, and often their recommendations fall on deaf ears because senior medical staff still very much have the view that they are you know, the be all and end all, whatever that saying is, and they’re the ones with the clout.
So even though you know, I’ve had the support during what do they call them? The board hearings, review board hearings, and I’ve been supported in that context, at the end of the day it really matters what the psychiatrist says, not what the community organisation says. And I find that you know until they actually work as a partnership and they can do the same thing, then it’s going to make it really hard for me to actually find my place again.
Although getting out the house was important for some, for others, the fact that support workers could also come to their home was seen as an advantage.
Allen thought having someone visit you at home was better than going to an office.
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But generally speaking, the therapeutic engagement has been helpful. But it’s more helpful when I’m stressed. And it would also be more helpful in my home environment than a psychologist’s or a psychiatrist’s office.
Like I mean, my organisation that I work for offers home-based outreach support but I think that too few people are really eligible for this sort of support. And really, a lot of my problems that I have relate to my relationship to my home environment. And where I do most of my business and my community life. And this is where I think you’ve got to get the treatment where the site of illness is. Not in someone’s office where you never are other than when you are there. So I think getting the site of treatment in the patient’s most preferred place is essential.
Practical help
People received different kinds of help from groups and support workers. Brian had practical support like replacing his fridge when it broke down while Susana went on a few group holiday programmes. Niall said ‘probably the best thing [he] did’ was attend an anxiety support group and a hearing voices support group. With the support of a service he had been with for 10 years he had also started doing creative writing, and had almost finished a book of poetry when we spoke to him.
David found the ‘collaborative recovery model’ used by his outreach service helped him to think about his goals. Working on things that are meaningful to him has helped build his self-esteem.
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So yes, psychotherapy has been helpful in terms of understanding my feelings and even understanding my motivations. But practically I sought out, my psychiatrist introduced me to a community mental health service that I got a referral to and I was still in quite a state of crisis at the time. And unfortunately they had quite a long waiting list in terms of getting on to the outreach services. So it took about a year before I was able to be, I guess, taken up into their case load.
They had someone who came to my home and would talk to me about trying to, like I’d identified leaving the home as one of my goals and trying to get back out and reconnect with friends. And she would help me try and achieve those goals but really it wasn’t until [mental health organisation] that bought out the, you know, [mental health organisation] or whatever it was called. And they came in with the collaborative recovery model and trying to get consumers or clients to identify their own goals, identify strengths and values and that’s been really practical help for me, trying to build my self-esteem and build my self-confidence. Work on things that are important to me – so it’s got to be meaningful to me otherwise I’ve got no reason to put my energy into it at all.
But making it relevant to me and making it meaningful to me makes me feel like I am actually leading a full existence. I’ve got a reason to get out of bed in the morning. I’ve got things that I’m contributing to and I feel like I’m making a valuable contribution. You know, I’m even thinking about returning to work, hopefully in the mental health field.
Gurvinder said his support worker really helped him organise his time and helped him through ‘some tough times’.
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It sounds like you’re very happy with your [mental health organisation] worker?
Yeah, yeah we get along well.
What’s that like setting your goals and talking about what you want to do? How do those conversations go?
Good. We, we have a very good rapport, me and my [mental health organisation] worker. Like say I want to do something like I wanted to set up a study plan. Like that’s what I really wanted to do. She would go, “All right. Let’s put a, let’s do a goal workshop round it”. And she would tell me, “Oh okay, how many hours do you want to study?” I said, “You know, two hours in the morning, three at night”. Like she helps me organise everything and listens to what I, like I had court in the past year. And she helped me, really listened, listened to what I was saying and helped me through some tough times when I thought I was facing jail.
So you know, things like that she really, she supports you and, and gives you advice on how to handle things and how to handle the situation that you’re in and stuff like that. Yeah.
Getting more involved
Quite a few people we spoke to were very involved in the community with some doing volunteer work and others employed as peer support workers. They described how good it felt to be helping others in similar circumstances. Chris said he facilitates a group where people get together and connect with others and ‘basically get away from their four walls… their isolation’. He said the members were very grateful so ‘it’s good’. Evan spoke about running art therapy workshops. He said the people who attended ‘couldn’t thank [him] enough’. Maria has been doing mental health advocacy since 2004 and trained to do a course for people diagnosed with severe mental health problems on recovery. She has also served on the management board of a mental health organisation, which was enjoyable because of the ‘education and resources’ she was able to provide for others. Carlo is an ambassador for one mental health advocacy group and a volunteer for another. He thinks that sharing knowledge is important.
Helping a mental health organisation has improved
David’s self-confidence and self-esteem. Eventually he wants to do peer support work for them.
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I get called up and asked to sit on interview panels or I’m a couple of committees at [mental health organisation]. I feel like I’m making a valuable contribution. You know, I feel like people are seeking my services because I’m offering something valuable, whether it’s just my experience or my prior work skills, it’s given me so much more self-confidence, self-esteem.
Things that I hadn’t experienced for years because I’d totally devalued myself when I crashed. I just, I’d lost my personal, romantic relationships, so I thought I had nothing to offer anyone personally and then I lost my job and I’ve had nothing to offer anyone professionally. So what use was my life? I had nothing professional or personal to offer anyone, in my mind at least. I mean it wasn’t necessarily the truth but that’s how I felt. Yeah so I feel like I’m living a more meaningful existence now.
I’ve been supported by [mental health organisation] for about three years or so. And I want to work for [mental health organisation] eventually and I can’t do that while I’m engaged as sort of as, while they’re engaged with support. So I’ve got to prepare myself for a time when they won’t be there as a support. So I’m trying to structure my life in a way that I get used to not having that support yet still function.
And are they involved in your decision making about that? Do they know that that’s what you’re thinking?
Absolutely, absolutely. I mean very encouraging, very supportive, it’s definitely been something we’ve discussed in terms of how to make it so that it’s not a painful exit or a, you know, a short, sharp, “Okay, you’re going to be working for us, so we can’t support you anymore, goodbye”. You know, it’s possibly not even going to come up in the next six months but it’s going to be a long process of working out how to be more independent and self-reliant and less reliant on the support so that it doesn’t have a large, negative impact on me when I disengage.
