Winning hearts, healing minds

SUCCESS STORIES:Joan Hamilton planned Slí Eile, a residential centre for people discharged from psychiatric hospitals, as a beacon of hope for a neglected group. But not
everyone liked her idea

JOAN HAMILTON’S heart stopped. She had just returned home from fetching some groceries when she saw a group of people outside her house near the village of Dromina in north Co Cork.

Armed with placards like “get out and stay out” and chanting slogans, the protesters were voicing opposition to a residence being planned in the area for people recently discharged from psychiatric hospitals. They feared it would have security implications for the locality.

“I literally got weak at the knees when I saw it,” says Hamilton, the founder of the Slí Eile housing association. “I just couldn’t believe it. This is a small community. People all know each other. And here were people outside my door calling for it to be shut down. It was one of my lowest points, I think.”

The protests didn’t end there. Several evenings a week over the course of several months the protesters would arrive outside the site of the planned facility in a newly-built housing estate on the outskirts of Charleville, Co Cork.

Her car was surrounded by picketers on one occasion. On another occasion, one of the home’s would-be residents was followed into the town by some protesters, one of whom walked backwards in front of the resident wielding a large placard. One of her sons ended up in hospital as a result of stress.

“I just wouldn’t have believed it. It was a real education. Some people would sit behind me at mass, then fly back to the house and we’d have to walk the gauntlet.”

Five years later and everything has changed. The centre, now situated in an ordinary home in Charleville, Co Cork, has firmly established itself as part of the community. And it has become a beacon of hope for people who believe there is a better way than the current psychiatric system to recover from mental illness.

Slí Eile is a supported residence for up to six former psychiatric hospital patients at any one time. It’s a homely atmosphere where residents learn to gain control of their lives in an accepting and supportive environment.

Its aims are simple: help residents to believe in their own potential, develop the skills to manage their mental illness and, in time, create a transition to a more independent form of living. All the residents play a role in running the house, such as cooking, cleaning and household budgets, as well as running a bakery which sells bread and scones to local shops.

There have been remarkable successes over the past five years, with residents – who once seemed destined to languish in the psychiatric services – progressing to living on their own in social housing. “We are not caring for people here, but we care about them,” says Hamilton. “It’s supported living, so it’s a stepping stone to something more permanent.”

The organisation is now seeking to expand, in order to cater for more residents who are on a waiting list to move into the centre. It is hoped that Slí Eile can move to a working farm – based loosely along the lines of Hopewell Farm, a therapeutic farm in Ohio – which could cater for up to 16 residents.

Donations, as well as State funding, have been vitally important. But perhaps the most gratifying source of funding has been from the community itself.

The community in Charleville has rallied around Slí Eile, helping out in fundraising initiatives, while secondary school students from the local school have volunteered their time at the centre.

“All in all, this has been very positive,” says Hamilton. “Once we moved in here, and people understood what it was all about, they got it. And the school kids have been wondering what all the fuss was about. So, it’s also tackling the stigma in society around mental health.”

The search for an alternative model of recovery came from Hamilton’s experience of the lack of support available for her daughter when she became mentally ill.

Joan had come to Ireland via Jersey. She had met her husband Jerry – a Corkman and carpenter – over there and was married at the age of 17. By the age of 22, she had four kids.

“Talk about innocent!” she jokes.

The couple moved to Ireland in the late 1960s with their children – they had six in all – believing it would be a better environment for them. After seeing a thatched cottage for sale outside Charleville, they bought it and moved in.

“This was the Ireland of the late 1960s and it was like going back in time. I think people thought we were exotic – I must have been one of the first women around here to wear trousers and Jerry had long hair.”

They were, as Joan says, living in “happy-happy land” until they began to grow worried about their daughter Geraldine. She was 14 and was becoming increasingly withdrawn and introverted.

The advice from medics was that she might have a mental health problem. As a last resort, she was admitted to a psychiatric hospital for the first time at the age of 16.

But instead of helping, she went downhill fast. The only meaningful option made available was drugs, with little or no attempt to address her underlying condition, says her mother.

“She was in a locked ward with more than 20 other patients. If she didn’t comply with their instructions, she was put in an isolation unit. At one point she was being given four strong sleeping tablets every day.

“I just felt despair and hopelessness. After visiting her, I’d be crying by the time I got to the car because I was leaving her there. So, what do you do? Walk away? Stop visiting?”

As Hamilton saw it, the system itself seemed to have given up on her daughter and others like her. “There was little or no sign of a recovery ethos. They assumed a person would never work again. And it all seemed so punitive. There was no recognition that because you might have been a bright, intelligent person in the past, that you might become that again.”

Determined to find an alternative, Hamilton made contact with five other families who were facing similar circumstances and helped establish the Cork Advocacy Network. At their first meeting – organised around the subject of alternatives to the mainstream psychiatric services– they expected 60 or 70 people to turn up. Their jaws dropped when some 700 people attended.

“It was harrowing, hearing the stories of misery: sons, daughters, sisters, wives. I really didn’t know things were that bad.” The Slí Eile housing association flowed from this hunger for change. The aim was to create a supported living environment where people would be supported in everyday skills: shopping, cooking or just getting up in the morning. It would also link into health services like counselling.

There were plenty of obstacles along the way. Planning was a problem, as were protests. Hamilton had to step back from the project for a while when she was diagnosed with cancer, but she went on to make a full recovery.

The perseverance paid off. Over the past five years, Slí Eile has helped lots of people with mental health problems to regain control of their lives and begin to fulfill their potential.

“This isn’t rocket science,” says Hamilton. “It’s what people want. It gives people a sense of structure and purpose, a reason to get up in the morning, in an atmosphere where they feel safe and accepted. It’s all about making choices.”

Not only is the model effective, but it’s relatively cheap as well. A typical bed in a psychiatric hospital costs in excess of €100,000. However, a bed in Slí Eile costs an estimated €38,000. If Slí Eile meets its aim of moving to a larger farm-type setting, the cost would fall to just €20,000 per bed.

Hamilton is keen to stress that there others who play a crucial role in running the organisation, including staff, volunteers and mentors in the area of fund-raising and care. But possibly the best advocates for what Slí Eile is all about are the residents themselves.

Sitting at lunchtime on the day I visit, the residents – all women, aged between their mid-20s and mid-50s – speak eloquently and warmly about how they are slowly but surely turning their lives around.

“I’ve been stuck in the revolving doors of the psychiatric system for years, but this feels different,” says Marie, a Dublin woman who has been living here for the past three months.

“For the first time in years, it feels like I’m making progress. I feel settled and I’m focused on my goals. It’s not all sweetness and light. We have our moments, but I feel we all have a special bond here. We look out for one another.”

Tammy, 26, has been living here for four months. She’s been in and out of psychiatric hospitals since the age of 13. Last week, she had a “messy day” and walked out, only to come back that evening wondering at what she had done.

“I tend to give up things. I only ever worked once, and that was in McDonalds for two weeks. . . I realised that day that this is the place to get well. You can’t just give up – you’ve to pick yourself up and make progress on your own, with the support of everyone else.”

Joan’s daughter, Geraldine, is also making great strides, taking responsibility for making the dinner, cooking, cleaning, as well as playing a central role in the Slí Eile bakery.

Ciara, 42, seems to speak for all the women when she says she is grateful to have another chance to rebuild her life. “I know this might sound sugary sweet, but it’s changing around our lives. At the end of the day, though, it’s up to each of us. We’re trying to be patient, consistent and do what we need to do. It takes time, but we’ll get there.”

Series continues in tomorrow's Life & Culture. Read the series online at irishtimes.com/indepth/success-stories