February 2014 - January 2015
“A city in which one man suffers less is a better city.”
Luigi Di Liegro, 1987
Rome’s Social Plan for 2011-2015 showed that there are over 30,000 adults aged 16-75 with mental health-related issues currently cared for by ASL’s (local public health authorities) Mental Health Department.
In the entire region of Lazio there are 84,000 patients recovered in mental health institutions. Nonetheless, mental healthcare staff barely covers 70% of the positions required to meet demand and ensure proper psychiatric services. Mental health centers have actually been cutting down on staff progressively, as data published in March 2013 shows.
This has mostly affected the areas of psychotherapy and prevention. In the face of the growing demand for diagnosis and psychotherapy, a waiting period of at least 30 days is required to arrange a psychological visit at the public mental health centers in Rome; and this is in the speediest of cases.
Fondazione Federico Ozanam – Vincenzo De Paoli conducted a survey in 2008 on the living conditions of people suffering from mental distress in the city of Rome. The survey showed that 18% live alone, 70% with their families and 12% in other housing arrangements.
According to the researchers, family care appears to be regarded as the ideal solution for the mentally ill. Research shows, however, that a considerable number of these patients (34%) live with a sense of loneliness and hardship when it comes to social insertion.
It is also relevant to say that 25% of the mentally ill living with their families do not receive effective support due to the severity of the situation they face. In these cases, as per Rome’s Social Plan, the role of care facilities and volunteers is crucial. Unfortunately, most of the times many of the families concerned are not even aware that other options exist.
This project is part of the initiatives Fondazione di Liegro launched in the field of mental health in 2005.
The intervention consists in (1) activities that will provide citizens and relatives with tools to better understand the problem of psychic distress and in (2) launching of listening, guidance, support and accompaniment services for the mentally ill.
Fondazione Di Liegro’s methodology is based on the premise that aiding others means helping them to take care of themselves. Under this perspective, “to care for” means to recognize a person’s limitations and resources in relation to their context and to help them find the person beyond the illness.
The project’s ultimate goal is to improve the psychological and social well-being of both persons with mental illnesses and their families.
The project is structured around four axis:
Fondazione Internazionale Don Luigi Di Liegro
ASL Rome Mental Health Department
I – Providing volunteers and families with the skills to better care for their relatives who suffer from mental illnesses
1. Training Course for family members and volunteers
The annual training, information and awareness course targets volunteers, family members and citizens who wish to learn more about mental health. The course introduces participants to the foundation’s person-centered methodology, focused on listening and identifying the patients’ skills beyond the difficulties they are experiencing.
The course’s objectives are:
The course comprises a combination of lessons and seminars, role-playing exercises, discussions and placements for volunteers in mental health facilities. It is taught by psychiatrists, university lecturers, heads of the ASL Rome Mental Health Department and representatives from different family associations.
Upon completing the course, those volunteers who are interested in working with us will go on to an orientation interview. Those selected will then be proposed activities to take part in. Some volunteers will be chosen for placement in local mental health facilities and some will help in the art therapy workshops.
Family members who finish the training course can go on to the self-help groups.
2. Placement in local mental health services
Agreements and conventions have been made with local health authorities and hospitals in Rome that allow our trained volunteers to aid their healthcare staff.
Specific activities are defined in conjunction with the health institutions to fit particular programs.
Our volunteers support the local healthcare structures with organizing art therapy workshops and other activities. Our person-centered methodology ensures that volunteers establish a relationship with the patients.
The support activities carried out are characterized by the volunteers’ ability to enhance therapeutic pathways by connecting mental health professionals and family members. This makes it possible for patients to access resources that are external to both the healthcare facility and the family.
Volunteers are supervised by a psychologist through monthly meetings. In these meetings they can share their rational and emotional experiences.
3. Self-help groups for family members
Family self-help groups are a service provided exclusively to the patients’ relatives. The groups are coordinated by the participants and include a moderator and a volunteer. Supervisions take place on a monthly basis and are carried out by psychologists and psychiatrists.
These groups were created to offer support to the families, helping them break away from their loneliness and form a network of solidarity. Through sharing their experiences, family members can rediscover personal resources which have been overwhelmed by their relative’s mental illness, reinforcing the family environment.
II – Improving the living conditions and well-being of the mentally ill
1. Art therapy workshops
Social rehabilitation cannot be achieved only through counseling and medication. This is why patients are inserted in art therapy workshops, where they engage in activities designed to unlock their internal resources and potentials.
The art therapy workshops, which include theater, photography and music therapy, provide structured community activities and serve as a way to prevent and heal emotional distress and isolation.
Art helps persons in mental distress express themselves and their emotions in different ways, hence promoting participation and social inclusion.
2. Guidance service and social support
Listening and support are given those contacting Fondazionde di Liegro with problems linked to mental health and social marginalization. People are offered relevant information, orientation and support, being directed to more appropriate institutions according to their needs and requests.
3. ICF implementation
One of the project’s goals is to measure the impact implemented activities have on the persons being accompanied. This impact is assessed using WHO’s Classification of Functioning, Disability and Health (ICF).
We use ICF methodology in our activities as an instrument for observing, evaluating and certifying the successful completion of the work programs. Using ICF we can assess the participation and involvement of patients in activities and thus, most importantly, their impact.
The survey for measuring functionality levels through ICF represents a particularly innovative initiative in the field. ICF seeks to determine positive and negative changes in patients’ behavior during the time they are accompanied. ICF establishes a common framework which allows for all conditions of dysfunction to be compared using their impact on an individual’s functionality as a measure.
Training Course for family members and volunteers
The training course started on 6 May and counts 100 participants.
A list of available activities was proposed to last year’s training course participants during individual interviews. Each of the 85 volunteers picked the activities they felt most interested in helping us with. The activities included support in mental healthcare services, guidance services and social support, volunteering within the foundation, self-help groups, theater workshop, photography workshop and sailing workshop.
Guidance services and social support
The services database management system is our main tool for providing patients with guidance. All information regarding services in the public has been collected and we are currently working on identifying those offered by the private social sector. We have individuated 2,800 registered organizations in the Albi Regionali del Terzo Settore (ARTeS) (regional registers of the third sector of the region of Lazio), including associations, cooperatives and voluntary organizations.
The guidance services and social support are to be managed by volunteers. The 10 volunteers who showed interest in this activity were given the opportunity to collaborate in setting up the information management system.
Self-help groups for family members
The foundation has organized two self-help groups and a third one is expected to be organized soon. The “San Giuseppe” group, with 12 participants, meets every two weeks. The “Ostiense” group, with 10 participants, meets on a weekly basis.
Art Therapy Workshops
An ICF training course for foundation workers and volunteers is currently in progress. The group has produced an indicator checklist for classifying the functionality levels of patients participating in the project’s activities. ICF-related procedures shall be implemented at the end of the training course.