REPORT: Conference RESILIENCE AND RECOVERY

On 6th and 7th October 2022, the CARe Network brought people from many countries together for a conference themed RESILIENCE AND RECOVERY. The conference took place in the beautiful city of Split, Croatia, and was hosted by the NGO’s Susret and Feniks. It was a very lively and interactive meeting, sharing knowledge, experiences and feelings.

The first day we focused on how we can transform and enrich mental health care in general. The second day was dedicated to the challenges connected to the Ukraine crisis.

Anka Slonjšak, the Croatian Ombudsman for people with disabilities, expressed at the opening of the conference how important it is to work together on social inclusion and to ensure the rights of people with a disability.

Supporting recovery of people with mental health issues should go hand in hand with creating a society where everyone feels welcome and can contribute with his or her talents. In different sessions we shared the latest developments in mental health care and how we can make personal and social recovery support stronger.

Alie Weerman, professor of mental health & society at Windesheim University, deepened the concept of experiential knowledge, illustrating this with impressive examples from her own life. Developing experiential knowledge out of personal experiences contributes not only to personal recovery but also to peer support, advocacy and the enrichment of professional practices.

Zdenek Císař, Michal Kašpar (Czech Republic), Zsuzsa Kondor (Hungary) and Dirk den Hollander (Netherlands) conducted workshops demonstrating the principles and power of self-help and peer support.

Dagmar Narusson from Tartu University, Estonia, introduced the principles of Open Dialogue, which connect very well with working in a relational and experiential way, bringing a micro network of a person with a certain need, family members and professionals together on an equal basis. Sharing experiences, feelings, needs and creating mutual support is a powerful way towards recovery.

Recovery does not happen in mental health care institutions, but in communities in the real world.

Building community connections was introduced by Jean Pierre Wilken (Utrecht University Netherlands & Tartu University Estonia). Dagmar Narusson showed how participatory research can reveal on the one hand the views of clients, family members and care workers on community participation and on the other hand the views of facilities in the community, like libraries, museums and businesses. Bringing perspectives together and building bridges will increase the possibilities for people with mental health issues for social inclusion. Aster Tooma, representing the largest mental health care provider in Estonia, demonstrated how they have been working on deinstitutionalisation with impressive results over the past decade, reducing the number of institutions and creating a great variety of living and support arrangements. The next step however is to connect much more to local communities.

The first day was concluded by a GAGA dance session leaded by Nataša Novotná, Czech dancer, choreographer and lecturer. She showed that discovering and strengthening the body adds to flexibility, strength, stamina, and skills.

The whole day showed that contributions to recovery can be made in many different ways: by self-help, peer support, open dialogue, experiential knowledge, art-based and bodily forms of expression.

On the second day of the conference, we concentrated on the new challenges connected with the war in Ukraine, exploring how to find hope for people who experienced loss and trauma.

Keynote speaker Nino Makhashvili (from Global Initiative on Psychiatry in Georgia) gave a thorough overview of different aspects of trauma and how people may cope. She described the content of Trauma-informed Mental Health Care and Trauma-informed services & systems. In the second part of her presentation, she described the consequences of the annexation of the Crimea in 2014 by Russia and the recent invasion. Studies show a high burden of key mental disorders of PTSD, depression and anxiety among Internally Displaced Persons, particularly women. Mental disorders reduced strongly functioning. Almost 61 - 75% were not receiving the care they need. After the first war studies showed many unaddressed/untreated mental health problems and trauma related conditions. Ukraine has not a properly developed care infrastructure and care systems to meet treatment demand. There is a need for trauma informed public mental health policies & strategies. The current war worsened the situation considerably, with an on-going exposure to traumatic events, which may lead to cumulative trauma. The whole society is affected and vulnerable.

More than 7 million refugees have been recorded in Europe alone (UNHCR) and 7.1 million people have been internally displaced, representing one-third of the pre-war Ukrainian population. Despite the ongoing war, the generally unsafe situation and the increasing lack of resources, already 2.5 million persons returned to Ukraine. Towns and cities are systematically razed to the ground; schools and hospitals are bombed and destroyed, among them psychiatric hospitals and social care homes.

In the last part of her presentation, Makhashvili described the impressive efforts a number of organisations are making to support resilience One of the initiatives is the Ukrainian-language Samopomich program. It provides a multi-faceted platform to help Ukraine deal with the psychological consequences of the war. It includes a website with a wide variety of resources, that are further transmitted via social media helplines. Other activities involve consultation for first line respondents who are directly confronted with the traumatic experiences caused by the war.

Makhashvili’s keynote was followed by testimonies from different countries affected by the war, starting with two psychiatrists from Zaporizhzhia, Galyna Guk and Mykola Khomitskiy, being with us while their city was being bombed. They talked about the huge impact of the war, and the great needs for mental health care support. At the same time, they expressed the hope that better services could be build after the war, including the elements of recovery supportive care as discussed during the first day, like support groups and community reintegration activities.

Lilit Baghdasaryan and Narine Khachatryan (Head of the Recovery College in Armenia / director of the MA program in Personality and Counselling psychology).shared the developments in Armenia. Psychologists Gulzhan Amageldinova, Begaiym Borbieva and Aigul Alikanova talked about the situation in in Kazakhstan and Kyrgyzstan. It was impressive to notice that despite limited resources, in all countries responses have been found to deal with the mental distress of both refugees fleeing into the country as well the re-traumatization of the events among the population. Multidisciplinary teams were formed and training programmes were developed.

Dolores Britvić, head of Department for Social Psychiatry in Croatia told us about how in her country after the Balkan war, regional psychotrauma centers were established for war veterans and other persons seeking assistance suffering from PTSD. The programme consisted of three group modalities: socio-therapeutic, psycho-educative and trauma-focused groups. Research shows that the programme was successful, but also emphasized the importance of social support in the recovery process of severely traumatized persons.

The second keynote of the day was delivered by Leendert de Bell (professor at Utrecht University of Applied Sciences / Netherlands). He shared his knowledge about refugees, entrepreneurship and return migration. He described the struggle of many refugees to integrate in the host country, especially to get a meaningful job. This is often due to language and cultural barriers. He mentioned several examples of programmes that are developed to get a better access to the labour market, but also programmes that facilitate the preparation to return to the home country when the circumstances allow this.

The last part of the conference was dedicated to work in different sessions on how the CARe Network can add to the efforts already made in different countries. It was obvious that the recovery knowledge that is present in the network is valuable for strengthening mental health services in the near future. We will continue to work on this, in close collaboration with local, national and supraregional organisations.

This conference was a great occasion to share recent developments in recovery supportive care, to express our solidarity with the people of Ukraine, to strengthen connections, and to share knowledge that can help to deal with the immense trauma caused by war.