When our mental health takes a dip, it can be very hard to find or access the supports needed to help navigate this dark time in our lives. Many people who don’t have an official mental health diagnosis, but experience bouts of anxiety or low mood, are reluctant to present for clinical interventions, yet are unaware of non-clinical supports available in the community.
One successful model of a community mental health support service is the Galway Community Café, the first of its kind in Ireland when it opened in 2021. It offers a free, out-of-hours mental health service that is led by people with lived experience of mental health challenges. Based in the Mr Waffle café across the road from University Hospital Galway’s Emergency Department, it is ideally located to help support those in crisis.
Mental distress
In the three years since the Galway opening, community cafés have been launched in Cork, Dublin, Sligo and Waterford. The services are supported by Crisis Resolution Teams made up of multi- disciplinary professionals including psychiatrists, psychologists, occupational therapists, and nurses as part of the HSE’s Mental Health Policy for Everyone Implementation Plan 2022-2024.
Maria McGoldrick, is area lead of Mental Health Engagement and Recovery with HSE West Community Healthcare. She is also the project manager of Galway Community Café.
“The seed for the Galway Community Café was first sown eight years ago when we were holding our public mental health forum meetings in Mr Waffle on Newcastle Road. One of those in attendance, Thom Stewart was upset at the level of suicides in the Galway area and felt something more needed to be done,” she explains.
“He had heard of a model in the UK which offered an alternative service to people in mental distress whose only option was to go to A&E, where there is quite often a negative experience.
“A hospital emergency department is not the place for someone in crisis, it’s chaotic. If you’re already chaotic coming in, that environment adds to your trauma. A lot of people leave before they’re seen by doctors. Sadly, here in Galway this can lead people to end up in the river.”
Maria says the support of the café owner was instrumental in the service getting off the ground.
“Kevin Nugent is an incredible man who hosted our forum meetings in the café and decided to donate the building to the HSE in the evenings for the community café. Some of the forum members who are service users developed a proposal for an alternative service to A&E in a non-clinical setting to support people in crisis, based on the UK model. We applied for funding through Atlantic Philanthropies and it was successful and the service that operates today is a partnership between the HSE and Mental Health Ireland.”
The café is open from Thursday to Sunday, 6.30pm to 11.30pm and bookings can be made online, over the phone, or by walking in off the street.
Customers avail of a café menu, where they can sit down with a peer connector to discuss their mental health and get advice and support on how to cope with the challenges they face.
“It’s very different from a clinical setting, the people we welcome are customers just like in any other café,” says Maria.
“Our peer connectors are people with lived experience of mental health challenges and the process of recovery. They are there to support the customer through their experience and to highlight and share what worked for them when they were in despair.
Connections
“One of the things our customers say is the best part of the café is the fact that there’s no one there who can take away their liberties. There’s no clinician so they feel comfortable enough to open up and say what is happening for them, safe in the knowledge they are retaining control over their decisions.
“We would never make somebody go somewhere they don’t want to be unless they were a serious risk to themselves or the public. Where someone is very unwell or they’re at the point of self-harm or worse, then we will have to act and it’s more about encouraging the person to attend a clinician. We ask if they will come over to the hospital with us and our peer connectors can accompany people to A&E and sit with them until they are triaged. They will try to encourage the person to bring someone to stop them leaving, because that is often the biggest problem.
“We haven’t lost a customer in the four years we’ve been open and that’s in the region of over 2,000 people.”
An evaluation of the service by the HSE in June of this year revealed the number of appointments as the café has almost tripled from 586 in 2021 to 1,424 in 2023.
The café offers face to face supports to people throughout Galway city and county. Those living in rural areas and those who don’t have access to public transport, or those who have mobility issues and cannot travel to the cafe, can avail of support via phone and video calls.
Safe space
“We weren’t going to do phone support because were anxious as the risks are slightly higher when the support is offered over the phone,” says Maria.
“But Covid left us with no other option. We’ve found that so many people who can’t physically come to us, have nothing to support them. Our phone support has become vital to them. We would have customers in rural areas with minimal access to transport but we’ve been able to connect them with things happening in their communities which helps them get out of the house.
“The majority of our customers, both in person and on the phone, are people maintaining their mental health and wellbeing and just needing that connection with someone. We encourage people who have the capacity to come into us when they can.”
Maria says the café is a safe space for anyone with mental health issues, and urges those who needed support to reach out.
“It’s not a case that you should feel you can only come to us when you’re in crisis. One customer told us he didn’t want to take up a spot, but it’s not about that. I found it really sad because this gentleman had come in in a bad way and he said he had wanted to come in earlier but he didn’t want to take a spot from someone who really needed it.
Isolation
“If you feel in any way that you need support, you want to talk to someone because you are struggling, come to the café. It’s better to maintain your margin of mental health wellbeing than to leave it and find yourself in a terrible state or needing Garda intervention or worse.”
Maria says the rise in isolation, across all age groups, is impacting heavily on people’s mental health.
“Connections are so important and the isolation out there is phenomenal. That is something nearly every customer who comes in would express, regardless of age or where they live,” she cautions.
“Loneliness and feeling isolated is massive, it is one of the things that seems to be impacting people a lot.
“Many people with mental health issues wouldn’t be comfortable going to a pub because of the noise or the distractions so they have nowhere to go socially, especially in Ireland, which is so pub-centric.
“A lot of our customers wouldn’t drink alcohol as they wouldn’t feel safe in those environments so we have a social Saturday where people can come in, hang out, meet other people, start connecting. We have creative workshops, hearing the voices of peer support groups, games night, book club. It’s an opportunity for people to connect with other people in a nice, safe, free environment.”
More community cafés are being rolled out across the country as part of the HSE’s national model to increase access to mental health supports. The Galway café has recently been approved for funding to implement a Crisis Resolution Team to provide clinical support.
“Our customers have begged us to open all week but that is just not going to happen at this period of time. We still don’t have an evening service from Monday to Thursday, but the ambition would be that the Crisis Resolution Team will fill that gap,” says Maria.
“A lot of people see mental health as a weakness but actually I’ve always found it’s a sign of a person who is highly intelligent, that has become overstimulated by society and life and they just can’t cope with that stimulation any more.
“Something brought you to that point and if you reflect on it to work out what that is, what you can do to minimise it the next time, the less impact it will have on your mental health.
“We are just happy that we inspired the Government to develop and implement our model across the country.”
If you or someone you know have struggled with any of the themes in this story, support is available at:
Aware: Information, support and peer groups for people experiencing anxiety, mild to moderate depression, bipolar disorder and mood-related conditions. Freephone 1800 80 48 48, 10am to 10pm; www.aware.ie
Make the Moove: Make the Moove is a mental health initiative supported by FBD which started in North Tipperary Macra in 2018 to help combat and raise awareness around suicides in the farming community. Since 2018, Make the Moove has grown, offering subsided counselling, awareness talks, training and more recently a Crisis Response Team (CRT). Check out makethemoove@macra.ie or call 0860840442
Pieta: Free individual counselling, therapy and support for people who self-harm or are thinking about suicide and people who have been bereaved by suicide. Freephone 1800 247 247, any time; pieta.ie
Samaritans: Services are available 24 hours a day. Freephone 116 123, any time; samaritans.ie
Text About It: A free, 24/7 service. Free-text HELLO to 50808 for an anonymous chat with a trained volunteer, any time; textaboutit.ie
HUGG: Email support@hugg.ie or call 01 513 4048 (monitored answering machine)
Galway Community Café offers a free, out-of-hours mental health service that is led by people with lived experience of mental health challenges.
