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.