This part of the meeting is to discuss mental health issues with GROW. I welcome Mr. Mike Watts, national programme co-ordinator; Mr. Jim McSweeney, national chairperson; Ms Ruth Barror, national executive officer; and Ms Michelle Kerrigan, financial controller.
Before the presentations begin, I wish to draw the attention of witnesses to the fact that members of the committee have absolute privilege but that privilege does not apply to witnesses appearing before the committee.
On behalf of my colleagues, I thank the committee for affording us the opportunity to present GROW's work and to show how effective it can be. We hope to make a good case for having as many GROW groups as possible throughout Ireland. Without further ado, I will hand over to Mr. Mike Watts, who will make a presentation on our behalf. We will be delighted to take questions afterwards.
Perhaps the best way to illustrate how GROW works is to relate how I became involved in the organisation. I was a typical young man of the kind one hears so much about today. I was alienated and involved in alcohol, isolation and despair. I had massive levels of anxiety, which sometimes went into terror. At times I would hear voices and would often misinterpret sounds so that noises in the street were very threatening. I could see absolutely no hope for the future. Eventually, I decided to look for help. I was given a label of pathological shyness, which I really enjoy today, and an ongoing prescription for librium. The first experience of help was not a happy one because I was asked whether I would mind if students sat in on the interview. I said I did not mind, but I did.
The turning point for me was meeting my wife Fran, a brilliant and beautiful young woman. She came from a highly dysfunctional family and had distressing experiences herself and was very much at risk of mental breakdown. We bought a small farm in County Clare and were going to create the perfect lifestyle. Everything was going to be fine. We had our dreams but they were shattered when Fran broke down after the birth of our first child. The breakdown was psychotic, dramatic and really terrifying. I had a huge sense of revulsion and was told that she needed to be transferred to Our Lady's Hospital in Ennis. I refused and discharged Fran and Tom, and brought them home. I had the most terrifying night of my life. She did not know where she was. She sat up in bed and just screamed. She banged her head on the wall and began to pull her hair out. Next day I had to sign her into Our Lady's Hospital. It was a huge relief because the idea one has of an old mental hospital and the reality of the people in there are very different. That started a journey into despair again, with three years of frequent admissions and layers of medication. It was most frustrating that there was absolutely no direction on how we could help ourselves. Another real enigma was the fact that because Fran was so obviously sicker than I was, I was promoted to well and was treated as a carer. Over the years, Fran was diagnosed as having post-puerperal depression, schizo-affective disorder and manic depression. She was repeatedly committed, quite often by me, which put a huge strain on the relationship. At her most unruly, she spent long periods in locked wards in seclusion and had many rounds of ECT.
In 1976, we stumbled across GROW, which was a real turning point. GROW operates through a two-hour weekly meeting. The meeting is highly structured and geared towards motivating each person to do something about his or her mental health problems. Fran and I got very different tasks and were given relevant parts of the GROW programme, which is a psychology of mental health, to help us complete those tasks. Probably most importantly, we just got huge doses of encouragement to try and find a way out of mental illness.
At the time, GROW was pretty small. There were about 30 groups in the whole country. We had no staff, no offices, and everything was done by volunteers. At this time, we received annual support from GROW in Australia and our work began to spread. We got a grant from the Sacred Heart Missionaries in 1979, which allowed us to employ a first field worker. This was followed by the Southern Health Board, through Mr. Paudie Collins, and then the South Eastern and Midland health boards. Now all the health boards support us. We continued to expand and in parallel tried to develop management and organisational structures, but in the late 1990s we hit a wall. It became obvious we had to restructure and expand our management structures. At that point we joined IBEC. We were the largest organisation in the voluntary sector in the field of mental health and we had done it all with very little expert help outside GROW's membership. We were being steadily bombarded for more groups, both by professionals and service-users.
In 2002, we put together a bold and imaginative expansion plan, the success of which depended quite a lot on increased funding. While we had minimal increased funding, the plan has been a success. We have gone from 90 to 150 groups. We now have a national training team and a highly successful course in leadership for GROW members that has been evaluated by UCC with a grant from the Health Research Board. It is unusual for non-medical organisations to receive such a grant. We also have a company handbook including safety procedures, staff guidelines and disciplinary procedures, which puts us at the vanguard of the voluntary sector. We have a thriving website which attracts queries from all over Ireland and the world. We have a brand new image thanks to voluntary help from McConnells advertising. We have had a series of radio advertisements through BUPA Ireland. We have opened an information line and have established highly successful groups in the Central Mental Hospital and in Arbour Hill. I will speak a bit more about those later.
We are developing a programme specifically aimed at young people. We also have a very successful project in St. Loman's in Mullingar aimed at long-term institutionalised people.
Our leaders are taking part in committees and coalitions of all kinds. For example, I am a member of the Mental Health Commission as a service-user representative. During my time on the Mental Health Commission, I was chairman of the committee which put together the discussion document on the recovery model. We also made submissions to a Vision for Change. We see ourselves very much at the frontline of the recovery movement. However, we have a saying, "You alone can do it but you cannot do it alone". That is true for GROW as an organisation.
We are still inundated with requests for new groups. We have the potential to expand. Our current plan is for 300 groups but we have the potential to expand to any number of groups. For example, we have seven groups in Limerick city, because we have the resources, but we only have 14 groups in Dublin, despite its larger population.
We are in huge demand in regard to the training of professionals in the recovery model. We provide a two-hour workshop for Trinity school of nursing. We were asked to put together a chapter for a text book on the recovery model and there are questions in the degree course on those presentations. We received requests from St. Vincent's in Fairview, through Dr. Angela Mohan, for a workshop for multidisciplinary teams; from St. John of God, through Dr.O'Callaghan, for a workshop for trainee psychiatrists; from the Ardee school of nursing, through Patricia Finlay, for a workshop on the recovery model; from the University of Limerick for a workshop for occupational therapists; and from the Irish College of General Practitioners for a workshop on mutual help.
Our work in prisons is far beyond our resources. Arbour Hill is crying out for a second group. We have just received a very small grant to develop three groups in Mountjoy over the next two years. We are being asked for groups in Limerick Prison, Portlaoise Prison, Loughan House and Castlerea Prison. Dr. Harry Kennedy, professor of forensic psychiatry and clinical director of the Central Mental Hospital, has agreed to explore ways we can build in an evaluation of the effects of GROW in prisons.
Dr. Angela Mohan wants to set up a special group for young people with a diagnosis of schizophrenia living in long-term care. She will provide professionals to be trained and to be part of the group. We have an invitation from Tony Bates, the newly appointed director of the Forum for Youth, to co-operate on some of our existing projects.
A question always asked is whether GROW works and where the evidence is. Apart from the many testimonies of people telling their stories and saying they have recovered, GROW is the most well-researched organisation in mental health in the world. Members have a diagram in their packs on a study done by Professor Julian Rappaport in Illinois. It took people as they came into GROW and traced back how many days they had spent in hospital prior to coming to GROW and then followed them for 32 months after they joined GROW. It matched up the people who joined GROW with other people through hospital records — people who had similar diagnoses and personal profiles. It compared the two sets of people. If members look at the graph, they will see the people in GROW spent 72% fewer days in hospital. That was just one finding. The other findings were that they needed less medication, fewer consultant hours, were more likely to be in employment and had better support networks. Interestingly, they were more likely to co-operate with their doctors. One of the big fears among professionals is that GROW interferes but research shows it does not.
GROW has been shown to work best with people with a history of institutionalisation and high levels of psychoticism, so we are most helpful to the people who are most expensive to the system. This research, which took place in the 1980s and 1990s, has just been confirmed in another study done by Professor Pat Corrigan in 2003. He identified GROW and mutual help as vital to any mental health system. ProfessorRappaport concluded that no mental health system can provide for people with mental health difficulties and what it must do is find niches in the community where people can be at home, start to become involved again and get back to full mental health.
I will conclude by telling the committee how GROW helped Fran and me to recover. It did so through its weekly meetings. The weekly meeting encourages one to make a recovery plan. I make a plea to this committee to ban the expression "care plan" because it is an insidious phrase, especially if one is young. It is as if one will be put into an institution and looked after for the rest of one's life. One needs a recovery plan which empowers one, shoves one out into the community and makes one find the help one needs.
I had to tackle the discomfort of shyness. I found creative writing classes, music classes, art classes, going back to third level study — I did a degree in psychology and a masters in family therapy — and Toastmasters very helpful. My wife found working with a Traveller group in Ennis, the ICA, a back-to-work course through FÁS, languages and the church also very helpful. We both fully recovered in the sense that we do not see a consultant or take any medication, and Fran was on lithium for 15 years.
GROW also made us realise that it is not just a matter of overcoming illness. One must learn about mental health and this is where the system falls down. The system is expert on mental health but almost totally ignorant about it. I made a presentation to the National Economic and Social Forum a couple of weeks ago which was attended by Maureen Gaffney. She said it was only at the end of the 1990s that psychology woke up to the idea of the psychology of mental health but that there is wonderful work being done.
A very important detail is that GROW is free to everybody who comes. This is unbelievably important, as mental illness so often goes hand in hand with poverty and unemployment. GROW is extremely good value to the Government to run. Rappaport's research would suggest huge savings and Michele Kerrigan has done some work on the figures. They extrapolate the savings to the State based on Rappaport's research and they are very conservative. GROW is a low-profile organisation. It is called Ireland's best-kept secret, even though it is the largest organisation, and that is because we put all our effort into the groups and the work we do. I thank members for their attention. We will try to answer any questions.
I welcome the delegation from GROW. I have known of this organisation for approximately 15 years. I have attended some of its conferences and have done some work with it. I have enormous regard for it and will not ask questions on how it operates because I know very well how it functions and what is does. I have admired it for many years.
One of the biggest problems I see, having looked at mental illness, mental health or mental well-being, is the difficulty overcoming the stigma surrounding the area. It protects the system from dealing with it. How will we get those who suffer from a mental illness or those who have recovered from one to talk and demand that services be improved or that adequate services be provided? I do not want to become political, but €25 million was provided for mental health in yesterday's budget. It was one of the smallest allocations for a very important public health issue. Some €25 million was provided last year to develop mental health services.
Some 22 years ago we were told about multidisciplinary and community-based psychiatric teams. It is as if it was invented last January with A Vision for Change. It is so frustrating to know that recommendation is over 22 years old, or perhaps even more, because there was a report in the 1960s which referred to it. It is being peddled to us that A Vision for Change in January produced this. Prior to that, we were told we were waiting for a report from this expert group even though an expert report entitled Planning for the Future was made 22 years ago, with 50% of its content reflected in a Vision for Change. Will this change? We have been given commitments. Planning for the Future was accepted as Government policy and every Government over the past 22 years stated that it was Government policy. Now A Vision for Change is accepted as Government policy. Nothing will happen until the political system is challenged by the electorate to do something about it.
The reason it is not challenged is that if a person or a member of his or her family is suffering from a mental illness, he or she does not want to reveal it and expose the person. We will be challenged next year about waiting lists, MRSI, and accident and emergency departments, but we will not be challenged about four years waiting for a child to get a psychiatric assessment. The matter of psychiatric assessments will not be brought up with us.
Any campaign or work that can be done to de-stigmatise all that area would be worthwhile because the level of suffering endured in this State or any other — one in five persons — is so enormous, silent and frustrating. GROW is at the coalface in the understanding of all of this. What is GROW's reaction to that near silence?
The "Prime Time Investigates" programme was not a surprise. It was a surprise to too many people, but it was not a surprise to anybody who had any understanding of what has been happening with children because we know those families exist in every parish throughout the country. There is some such person in every townland.
What will make the breakthrough? Will there be a breakthrough when we get multidisciplinary teams, adequate numbers of psychotherapists, occupational therapists, family therapists and psychiatric nurses in our communities, as well as the promised 20-bed units for child and adolescent psychiatric inpatients? One day we are told that they will be provided at the end of next year and the following day we are told that they will be provided in 2008. If one applied for planning permission today, we all know those places would not be available in 2008.
I ask GROW for a response. We hear discussions about a certain psychiatric illness not being an illness at all, and that is highly dangerous. We know of people who felt that way and went off their treatment, and we went to their funerals after suicide. It is dangerous that such discussion goes on and that one does not hear realistic understanding.
I do not want to raise any controversy about waiting lists, but we have known about them in the psychiatric area for years and then when it is exposed, it is almost rubbished. I do not know how the people who have children on those waiting lists feel about all this discussion going on around the area.
That is why Professor JulianRappaport concluded that the success or failure of efforts on community care would depend less on mental health professionals' ability to create supportive environments or teach skills, and more on the ability to find and encourage naturally occurring niches.
Deputy Neville mentioned all the money that is put aside and all the multidisciplinary teams, which are great, but the voluntary sector does not even figure and is not even mentioned. There is no extra allocation earmarked for GROW or the other players in the voluntary sector, and the danger is it will be put into a pool and we will be told to share it among ourselves in little bits, which is a recipe for disaster.
What a person who has had a breakdown needs is people whom he or she is at home with. One needs little steps and encouragement to get re-involved in society so that one can get better.
On the question of coming off medication, GROW is careful to insist that people stay on their medication and follow their doctor's instructions and if a person is at a stage where he or she is really better, that he or she negotiates with his or her doctor to come off the medication.
Often it is difficult to get through that psychiatric illness can be cured.
Absolutely.
Some feel that if they seek help, that it is a life sentence and a labelling——
Often it is.
——which it is not.
According to the statistics, 72% of admissions are re-admissions. One gets stuck in the system because it is a mental illness system.
Early intervention is extremely important and it is not happening either where waiting lists create denial. Many young people, especially young boys, will not accept that they have a problem.
Absolutely.
If they accepted that and sought help at an early stage, they would have a 90% chance of a cure.
The wonderful aspect about GROW is that it is anonymous, one is not registered, and one's details are not taken. It is a considerable step for somebody to go to GROW, but once he or she takes that step, there is a complete programme which helps him or her to come through to recover and then empowers him or her to speak openly of the breakdown being his or her badge of honour.
I have a final question. Do psychiatrists advise people to go to GROW?
Some do.
A great many do. Many, like the ones I mentioned, Dr. Angela Mohan and Dr. O'Callaghan, and the local psychiatrists in Kilkenny, such as Dr. Louis Calvert, are asking us to demonstrate to the patients in admission wards how GROW works, and we have orientation groups in many of the hospitals.
That is a positive development, but I encounter some psychiatrists who almost see GROW as an interference.
They do. However, research showed that people coming to GROW are more likely to follow their doctors' instructions. That was Irish research done by Dr. Liz Dunne through UCC. We undertook a profile of all GROW members in which 1,000 questionnaires were sent out and more than 300 were returned, and that was one of the conclusions. Another interesting conclusion was that the membership of GROW is almost 50% male and 50% female. GROW reaches men and there are many young men in the groups.
I wish to be associated with the welcome extended to the group. I am especially delighted to welcome its members. I am sorry I had to follow most of GROW's presentation on the monitor in my office because of a little problem in my constituency, but I did follow it.
I am interested in the list from GROW. I noted the group has me down as representing Fianna Fáil in Dublin South-West, which has a population of 78,601 and one GROW group. Not to be flippant, that figure concerns me because only 64,000 of them are on the register of electors.
I listened carefully to Mr. Watts. He referred to the fact that GROW to some extent keeps a low profile. As someone who lives in Tallaght and represents the area, I had not heard much about GROW, but that has all changed. They have listed the one new GROW group. Without patronising that GROW group, I want to state that I have met it over recent weeks. Its members are all women, but I am sure there will be members who are male. Ms Rita Power, Ms Marian MacKay and Ms Mary Quinn are now operating in Fettercairn Community Centre. That is a tremendous boost for the area.
The Chairman will recall Fettercairn arose a number of times at these sessions, where I made the point that this community of approximately 6,000, most in local authority housing, does not have a general practitioner service. I have raised this at the committee and with the Minister for Health and Children. It is significant that we are able to state this morning that the GROW in my constituency has been established in this parish. That is a tremendous boost for the area. Without patronising it, I compliment those concerned because it is a really positive sign, spearheaded by GROW, that this community is deserving of these kinds of services.
I realise Mr. Watts made the point that GROW is a low-profile organisation and I hope I do not get it into trouble by saying that it got positive publicity last week in the Tallaght Echo. It is good that GROW is reaching out and saying to people in a community which does not have its own GP services that it is there if they want to talk. That is good in the context of the point Deputy Neville made.
In addition, the GROW group in Fettercairn is trying to embrace the entire region. I just want to be positive. I am not always so parochial at these meetings but I am proud of what happens in Tallaght, and what GROW is trying to achieve, certainly in my community, should be welcomed by us.
Often we point out the importance of these meetings. On a Dáil sitting day such as this, as our visitors can see, there is always a great deal of pressure on politicians to be here, there and everywhere, but I believe these meetings are especially important because they give groups an opportunity to share information, exchange views and make the case for their own services. In addition, they can also make the case in respect of the services they provide. I often make the point that everybody is competing in respect of the health budget. It is important to understand that the groups which come before us have competing interests and everyone is seeking a slice of the cake. In that context, it is vital that we hear the different views in order that we can understand those interests.
I welcome what our guests are doing. I also welcome the service they provide in my parish in Tallaght. I will provide them with as much help as possible. I am impressed that they chose a particular area that I have highlighted on many occasions, in the context of health delivery, as being neglected. In my view, they have struck a blow in that regard.
I thank our guests for attending and for making such an excellent presentation. I am aware of their work. I am interested in they way in which they want to encourage developments within prisons because this could prove extremely useful. The group receives referrals from psychiatrists but I wonder whether most of its members are self-referred. Does it refuse to take any people? Are there some individuals who are impossible to take on? For example, does the group deal with those who have alcohol problems or who are dependent on drugs?
If one thought too much about the lack of investment in mental health, one would become very depressed. As far as I can see, our guests have not indicated the sum of money they are seeking to undertake their expansion. It would be useful if Ms Michelle Kerrigan could provide us with information in that regard.
I will take the questions in order. The Senator inquired about referrals. A total of 23% of our referrals come from GROW members, 20% come from friends, psychiatrists are responsible for 6.5% of referrals, GPs are responsible for 2%, other professionals are responsible for 10% and 22% come about as a result of advertisements. The conclusion is that the spectrum relating to referrals is extremely broad.
The Senator also inquired as to whether we take on everybody who is referred to us and Mr. Watts will answer her question in that regard.
We do take everyone. One of the dilemmas in respect of working in prisons is whether to work with sex offenders. We are working on an addition to our policy on confidentiality. However, we take on anyone who is referred to us. We work very well in tandem with people who have addiction problems. In Australia and America we have GROW residentials and a mix of people with addiction-type problems and those serious mental health difficulties works well. People with addiction problems tend to have more readily accessible leadership qualities and as soon as they stop drinking or taking drugs, they are more likely to articulate what is happening to them and make faster progress. Those with serious, long-term mental health difficulties challenge the rest of us to keep trying to improve the quality of our lives.
At present, we have funding of €1.1 million and we have 150 groups throughout the country. We have in place a development plan that will take us up to 2011. To implement this plan, we will need an injection of €1.4 million — which would bring our total funding up to €2.5 million — by 2011. We are not asking for this money to be provided in a lump sum, since the development plan operates on a phased basis. We employ two people to manage our field workers. At present, they are split on a North-South basis and this makes for a heavy workload. We are seeking another two managers to manage the remainder of the staff in conjunction with the HSE structure, as currently presented to us. Building on that, we wish to employ more field workers in the various HSE areas in order that we might bring the number of our groups up to approximately 300 by 2011. At that stage, we envisage that we will be dealing with approximately 3,000 people.
At present, we deal with 1,300 people. The cost of hospitalising that number of people in 2005 would have been over €17 million. The cost for GROW to deal with them was €1.1 million. It could be stated that we provide value for money. We are empowering people and this is leading to fewer readmissions to hospitals. We wish to issue a special plea to the Government to examine our development plan and assist us with it over the next five years.
The figure of €2.5 million is a pittance. In light of the costs relating to hospitalising people, providing us with €2.5 million would lead to a saving of €14 million. In my view, the service provided is almost too cheap. We see what we propose as a great way of developing into the future.
I welcome the delegation. I apologise for my late arrival, but I was obliged to be in the Dáil. I read the group's submission, which is extremely interesting.
I have no expertise in this area and I bow to the superior knowledge of my colleague, who has dealt with the issue for many years. The difficulty for many public representatives is that, like ordinary people, they do not fully understand this issue. As a result, we are afraid of it. Many of my colleagues may have had the experience of people with serious mental problems who have not taken their medication knocking on their doors, either very early in the morning or late at night. This has happened to me on at least three occasions and my wife and children were quite scared by the individuals who arrived at our door. What often happens is that one just wants the problem to go away because it is difficult to deal with somebody in such circumstances.
A number of statistics were provided. The first of these is that there is a 90% chance of a cure being found. However, it was also stated that there is a 70% rate of recidivism. There appears to be a major disparity——
There is a 90% cure rate if early intervention is made. However, there is no early intervention.
If such a huge success rate can be achieved, why do people become caught up in this never-ending cycle? One of my questions has probably already been answered, but I would like our guests to comment further on the actual savings that can be made. Ms Barror stated that for every €2.5 million invested, €14 million can be saved.
Is it possible to describe what constitutes mental health? Is it equilibrium? What is the effect of alcohol on mental health? I feel strongly about the role alcohol plays in Ireland in respect of mental illness. In the opinion of our guests, how should we address that issue?
I might be in a position to comment on that matter. I am a volunteer and I work full-time for GROW in a voluntary capacity. I became burnt out as a result of the job at which I worked at quite an early age, relatively speaking. I was suffering from depression and did not realise that this was the case. Alcohol and depression go hand in hand because one drinks more to relieve depression. It is the wrong thing to do because alcohol is a mood-changing drug and if there is a psychiatric imbalance in one's system, a mood-changing drug will have a detrimental effect. Illicit drugs and alcohol have much the same impact. If the sale and distribution of alcohol in Ireland could be curtailed, mental hospitals would empty in a short time. Dr. Loftus in the west has been saying this for a lifetime.
People suffering from addiction have approached us. They go through the programme, following which they can cope with themselves and keep away from drink, as I have. I have not touched a drink for years, since I became involved with GROW and learned the error of my ways. It was a little late because I was forced to take early retirement and so on. Alcohol and illicit drugs are a problem. People with a psychiatric illness who dabble with these mood-changing drugs will be set off. GROW can score by entering partnerships with all the medical professionals and others in the field. While we represent the user, we are not regarded as a partner in the recovery process.
The broad consensus among professionals is that there is no cure for mental illness, which is an absolute farce. We have proved repeatedly that people can lead normal lives, earn a living and take their rightful place in society. When one discusses this with the professionals in the field, they ask what we mean by being cured. Our view of being cured is where a person can take his or her rightful place in society, earn a living, look after a family and do the same things as everybody else. All we seek in the long term is to be regarded as a partner in the recovery process of mental illness but we find this an uphill task because while we receive referrals on a large scale from various sources, they are the pioneers in the field. The average psychiatrist does not want to know our organisation. I frequently visit the mental hospital in Limerick and it is frightening to see groups of mental patients huddled together with nobody talking to them. The so-called carers are stuck in offices filling out nebulous reports which will do nothing for anyone, instead of talking to the patients and encouraging them to do things for themselves. That is where we come in and we can do it for half nothing. Two general practitioners participating in the medical card scheme receive more money from the system than GROW annually. We operate in eight areas and provide an invaluable service. I make an impassioned plea to the committee regarding the little additional funding we require because it would be more than a good investment for the community at large.
GROW has an alcohol policy, under which we arrange live-in community weekend breaks. Ours is a structured organisation. We do not allow people to become sexually involved and GROW weekend breaks are totally alcohol-free. People are told beforehand and all the participants, without exception, are amazed they can enjoy themselves more without alcohol. One has never seen the dancing that takes place at a GROW social because it is safe, good fun.
Mr. McSweeney's definition of "recovery" is lovely but we have a page entitled "How do you know you have recovered?" This is how the programme works. It refers to the psychology of mental health and is based on the notion that people have needs. GROW enables them to meet three needs: the need to be able to hold one's head up high and say "I am somebody"; the need to be able to be secure with other people, whether they are threatening or non-threatening, and to be able to be with them; and the need to have a goal or sense of purpose in one's life. The latter need is often threatened.
The Deputy asked why there was a 72% readmission rate. It is a good question. A number of leaflets have been included with our pre-budget submission, one of which is entitled Going Home. People who use GROW say the worst moment is when they are discharged from the psychiatric unit and told to return within four weeks. Those who can attend a GROW unit in the meantime have contact with others who help them out but those who cannot find it difficult to cope when they return to their families from a psychiatric unit. GROW has an amazing part to play in this regard. The lack of community support accounts for a significant proportion of the readmission rate.
What percentage of persons defined as "recovered" are drug-free and what percentage are on medication?
I do not know but it is not that big an issue if, as Mr. McSweeney said, the person can hold down a job, enjoy himself or herself and have a sense of purpose. Many come off medication but some do not. It must be a personal choice; nobody has the right to advise anybody else. Some try early on but are hurt by it. They end up back in hospital and their treatments are negative. While they are well, they choose to stay on medication.
The reason I ask the question is that I have tabled parliamentary questions about general practitioners prescribing Valium and so on, which seems to happen a great deal.
Absolutely. It is unbelievable.
While I do not have the required expertise, is it good to prescribe that amount?
No, it is terrible.
A survey was conducted in the south west and 70% of general practitioners responded that they had not been adequately trained to prescribe for mentally ill patients but they had do it because there was nowhere to send them. If they could diagnose and adequately treat such patients using the requisite skills, 90% of persons who suffer from mental illness could be dealt with at that level.
Or they could refer patients to GROW.
Is that a good idea?
Our vision is to have GROW groups as available as general practitioners or pharmacists.
Dr. Ronan Fawsitt from Kilkenny is chairman of the Irish College of General Practitioners and totally in favour of GROW. Every second person who has come to us from Kilkenny has been referred by Dr. Fawsitt. A woman called Kitty from Doolin was on Valium for 30 years and, within two years of attending GROW, was completely off it. She is a most wonderful person. Her story and those of her husband and daughter are included in this volume.
Does Mr. Watts agree that, in general, Valium and other drugs are overprescribed?
Absolutely. My wife was on 18 tablets at one time.
Representatives of the Irish College of Psychiatrists appeared before the committee recently. Most psychiatrists have between 400 and 600 patients at any given time but a psychotherapist is not available for referrals 70% of the time.
But they have access to GROW, if only we could persuade them.
What can a psychiatrist do with 400 patients other than prescribe medication?
Perhaps 40 GROW groups could be established.
Members might think GROW is a support group but it goes further than this. One attends the group to receive support but it offers a definite recovery programme. It means that when one goes along for help, one is given the support but one must do something every week and be helped by the programme. That is how people move from being so dependent and so ill to being empowered to take their place in society.
What is the difference in approach between GROW and AWARE?
I could not speak for AWARE; I have never been to an AWARE meeting. GROW has a programme of recovery; we cannot speak for another organisation. Recovery Inc would be a very similar organisation to GROW in many aspects.
It is a very definite programme and the steady steps are taken from A to Z in the recovery plan. It is all about recovery as opposed to care.
A relative coming to a GROW group will not be permitted to talk about the person who is being labelled as having mental illness. Such relatives will be asked about the problems which the illness causes them and they will be asked to work on their own lives rather than becoming a carer for somebody else.
On the point about general practitioners, there is work to be done about educating GPs as to the services that are available, including those in the voluntary sector. GROW has some part to play in educating GPs and this is done. Other work which needs to be addressed by the HSE is that of informing GPs of the services that are available within the community so that perhaps instead of giving a prescription, they could make a referral. This work needs an injection of funding for it to be carried out.
The voluntary sector is dependent on people doing work for nothing, such as Mr. Jim Sweeney, who is a prime example. People who come to GROW go on to develop other groups once they have become well. This is the ideal progression and the reason it is so cost-effective. It is a user-led movement and is run mostly by people who do it for no fee and who love to do it. Minimum support is needed.
It is part of a person's recovery to help other people and this is the secret of it.
I thank the delegation for the presentation and I hope the committee can do something in return. There are clear benefits from GROW and the costs involved are quite minimal. The committee will make inquiries to see what can be done when the Minister for Health and Children and the HSE come to a meeting in January 2007.
