Category Archives: Blog

Hearing Voices & Working in Mental Health Services

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by Eoin Toomey

I work as a Dance, Voice, Movement Facilitator with the Mental Health Service in the county where I live, in Northwest Ireland. I have been in this role for just under 15 years. I am a Voice-hearer and a Survivor of the Psychiatric System. I was an inpatient for five months in the mid-90’s, after beginning to experience many voices and visions post-university.

I have had 15 years guidance of what I would call a visionary Occupational Therapy Manager, who brought me into the healthcare services. I had been volunteering for a Voice-hearers Support Group, and she took me on board as a music therapy facilitator. She had lectured in OT at a University in London, had been influenced by Laingian Practitioners (see R.D.Laing), and by the Person-Centred approach of Carl Rogers, probably the most influential Psychologist from N America in the 20th century.I undertook some in-service training in Facilitation, though most of my learning was on the job. One thing my Boss & Supervisor would say is ‘no us and them’. I have worked in the acute psychiatric hospital, in Day Centres (now Day Services post-COVID) and in Supervised Residential Units; in most, if not all Mental Health Facilities in the county.

I have found that there was some resistance, over the years, to a psychiatric survivor working in mental health services, but that generally there is congruence in working together, and now I am almost universally accepted by other staff within the system. Of course, part of the supervisors/ boss’ role is to protect practice by (a) covering my back (b) ensuring due process with regards to the safety & well being of the Men and Women who are in the hospitals and (c) ensuring that I get paid. Of course an effective supervision process does much more than this.

I have worked for the most part with men and women who were the last inpatients of the older ‘Institutional’ system. I have got to know these people, who are my peers, well. I always take notes on each group and relate any issues arising to my supervisor. Of course we lose people, due to mortality, and the older age cohort, and this, obviously is part of the process also. I find that, as a user/survivor I am naturally congruent with the Men and Women. We are basically a singing group, where members choose the material we use. We also engage ‘check-in’s and some gentle exercises. We keep a time-boundary. Learning about boundaries or limits is essential to good practice. Pre-COVID, we organised an annual Christmas concert in the county cultural centre. This was always a sizeable event, with 30-40 people onstage, and cooperation between nursing, allied healthcare workers (OT’s, Social Workers, Psychologists and Peer Support Workers) on all aspects of the event, including being part of the backing band and organising the transport and food. We worked all year in preparation for this concert, and often the auditorium was packed to capacity. COVID, and mortality has ended these ‘Community Christmas Concerts.

The DVM is also part of Nurses training. I often have student nurses sitting in on groups. DVM and other music ‘therapy’ is recognised by medicine as conducive to good health. We know anecdotally that our dvm groups greatly help with the mood on wards and are very popular with the men and women of the service. We perceive that much more therapeutic programmes are needed in hospitals. Part of our ethos is to attempt to alleviate institutionalisation.
As I experience mostly episodic bouts of voices, these days and episodes usually occur periodically in the afternoon and evening, my own mental health phenomena do not affect my work.

Meet our Newest HVNI Board Member

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Hello, my name is Bruno Nicolai. For approximately 20 years I’ve worked in various roles in the community, supporting people to come together to identify their needs and take collective action to solve problems, and supporting individuals to overcome adversity in order to live the life they wish to live. I’m a qualified psychotherapist, I’m employed as a Mental Health Recovery Support Worker at Shine, I co-facilitate the Douglas/Cork City Hearing Voices Group, and in the past I’ve co-produced Hearing Voices Training for all staff within my organisation.

I received multiple psychiatric diagnoses as a teenager; each seemingly worse and less hopeful than the last. Back then, I only mentioned my voice-hearing experiences once or twice to psychiatrists. I learned very quickly that if I said yes to the questions they asked, there’d be a good chance I’d receive another diagnosis, a recommendation of some time in hospital, and a prescription for additional or stronger medication, without me being asked anything about the content or context of my experiences.

By my early 20s, my mental health had improved and voice hearing dissipated. There are innumerable reasons this positive change occurred, but in brief, my recovery began when I found a community of peers and professionals whom I felt truly saw, heard, valued, and respected me, which I internalised. From that point onward, there was no stopping me.

Though my most distressing years occurred in my late teens, I can trace the origins of my poor mental health to a succession of precarious and shaming life-experiences beginning in infanthood, each piggybacking on the next until it became too much. Viewing it through the Power Threat Meaning Framework lens, my distress was completely understandable. I liken my recovery to the paradoxical theory of change; the more I discovered and accepted about my authentic self, the more I changed and the happier I became.

Over the past two decades, my passion for mental health recovery has led me along several different paths, to where I am today. I have seen the recovery movement re-defined and re-interpreted into various forms; at times like a square peg hammered into round hole, and though well intentioned, some of these interpretations seem to maintain the traditional pathologising paradigm, while others move away from it. As my involvement with the Hearing Voices movement increases, I find myself curious to learn about the diversity that lies within it.

As you can imagine, for me, joining the Hearing Voices Network Ireland board is very exciting. Without a doubt, I’ve big shoes to fill, as I replace my board predecessor and wonderful Shine Team Leader, Tian Herbert. I’m very much looking forward to getting stuck-in, supporting, promoting, and expanding the reach of HVNI’s amazing work, and hopefully getting the opportunity to meet lots of you along the way.