`The sickness runs in my family," says Joseph, currently a third-year university student at Trinity College, Dublin. "I had a brother who topped himself 10 years ago and another who died of natural causes in the end, but he had also tried to do himself in. I don't think for any of us it had anything to do with confusion about gender roles," he says wryly.
Joseph started an arts degree in 1992 and from the start found the experience overwhelming. "I felt as if I was being engulfed. I wasn't sure how to take people . . . they were all from such different backgrounds from me - different accents - much more affluent." He began to feel the pressure was too much too bear and went to the college psychologist for help. "I expect that because there were people in my family who had been in and out of psychiatric services, it sort of acclimatised me to the system and that was good, but in another way it was bad - it was habit-forming. In becoming ill I was just following suit - I was the next one on the list to go off their trolley." For this student "going off his trolley" meant an eight-week voluntary stay in hospital. "I remember a totally depressing atmosphere - I was one of the living dead. I was alive, but just barely. I also felt safe. Contradictory feelings, really."
Out of hospital and out of college, Joseph seemed destined to become just another statistic with very few options - one of the many people, mostly young men aged 18-25, who experience mental health difficulties and never fully regain their sense of self or their place in their communities. However, through a referral from his psychiatrist, Joseph was introduced to the Camus Project.
Funded as a pilot scheme under the EU Horizon programme in partnership with the Polio Fellowship of Ireland, it is named after the author whose novels deal with issues of profound alienation. The Camus Project was established in January 1996 and is open to people over 16 who have had their first admission to a psychiatric hospital during the previous two years. It is a flexible four-month programme designed to help participants re-evaluate their lives and their experiences; to learn about mental health and how to care for themselves better; and to gain a greater sense of control in the determination of their own lives. Participants sometimes stay for more than one programme.
The feeling of loss of control and the lack of ability to determine her future spurred one former participant's attempt to take her own life two years previously: "It was a culmination of a lot of things," says 24-year-old Jane. "I was treated very poorly in my job. I had very low self-esteem. How I felt inside took over. I felt like a piece of dirt - really negative. I began to feel that there were dark forces conspiring against me. I realised I was really losing it when I saw a guy on the bus with a beard and dark hair and I thought he was Satan and that he was laughing at me. It was then I decided that I would kill myself. I decided I would jump off the top of the building where I worked. The next day, I went straight from the lift, down the corridor and out the window. I couldn't jump. I was so disgusted. I couldn't even kill myself."
After that experience Jane's delusions escalated rapidly and a few days later she was admitted to hospital. She was there for four months. A small notice in a newspaper led her to be one of the first to avail of the project. "For me, Camus is about bridging the gap to being a whole person again," says Jane, adding that she now feels more sure of herself than ever before.
The Camus programme co-ordinator, psychologist Deirdre de Burca, says mental health professionals have only recently realised just how critical early intervention is - before someone becomes totally engulfed by the experience of having had mental health difficulties. "At the time of their first admission to psychiatric hospitals, people are quite open as to what has happened to them and the Camus project makes the best use of this advantage. Mental health problems are not something that people necessarily have to live with for the rest of their lives. We believe it is part of the human experience and the whole process of living. It doesn't make them any different from other people. They can and do learn from it and gain a sense of control over it."
According to de Burca, for many people their jobs or study choices may have been a source of stress leading up to their illness. "We focus on people's strengths and abilities and help them organise research visits to companies and individuals in whose work area they are interested."
One of the most attractive and successful aspects of the programme is that it is based in the Taney Hall Community Centre in Dublin, a very pleasant, informal venue which, according to de Burca, is "non-medical and nonstigmatising". Describing the process of integration into the centre as "seamless", she points out that the programme is, in fact, very enjoyable. Alice, who completed the programme just before Christmas, agrees. "All the creative stuff - like arts and drumming - is wonderful. To be able to make a bloody great big noise in the group while still remaining an individual - its brilliant. Camus is so uplifting - seeing what other people can do, seeing each other come out of ourselves and change so much. It is a real privilege."
For Alice, like the others, one of the most important aspects of the project has been access to weekly counselling sessions outside the course which were paid for by Camus. "Up until now I have done lots of counselling which I have always paid for myself and it has always been a struggle - wondering how much more I can afford to have. I think it is fantastic the course can provide so much support and in such a respectful way."
"A lot of people on the programme have gone back to third-level education and that is really gratifying to see," says de Burca.
"For someone to have had a very serious breakdown, and in the space of four to eight months to move from a point where they have been utterly devastated by their experience, to a position where they have regained enough confidence in themselves and coping skills to resume their studies - it's great."
A minority of participants remain unoccupied at the end of the programme. Colette O'Connor, Camus's facilitator, explains. "I am disappointed if I can see that a person hasn't reached their full potential. But if they are reaching their goals, moving forward, becoming more themselves, I am pleased. It is about having choices. That is what we offer."
"I am really glad I have had the experience of breakdown," Jane says. "Before it I really did believe that it was the car, the job, the boyfriend that was important. Now I know that what is important is that I like myself."
(Apart from the employees in this project, the names of all those in this article have been changed)
The Camus Project has recently completed its pilot phase. It is now negotiating with the National Rehabilitation Board to continue under the ESF. The project is also pursuing corporate sponsorship. For more information contact Deirdre de Burca at 01-2301682.