Tag Archives: services

Hearing Voices & Working in Mental Health Services

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.