I am presenting this poster at the 39th International Conference of Australian Mental Health Nurses,

Pan Pacific Hotel, Perth, Australia

October 2013

…you can follow along on Twitter at #ACMHN2013

A CONVERSATION TO BUILD MENTAL HEALTH RURAL RECOVERY IN A CHURCH SETTING: A STORY ABOUT A PATCHWORK QUILT, A YOUNG PERSON & A MENTAL HEALTH NURSE 

Rhonda L. Wilson, RN BNSc MNurs(Hons) PhD candidate, School of Health, University of New England, Armidale NSW Australia

Twitter @RhondaWilsonMHN

Email rhonda.wilson@une.edu.au

Introduction Mental health nurses in collaboration with churches can contribute positively to the mental health of communities.

This project shows how mental health nurses who already established in their dual roles as church member & mental health nurse, can contribute in a unique way to the mental health of individuals within their usual church setting. Social capital within churches can be harnessed to promote mental health helping within smaller groups & to reduce the stigma & isolation often experienced by people and families with mental health problems.

While a young woman was in hospital receiving acute mental health treatment over a period of weeks, a group of 16 church people produced a patch work quilt to give to the young member of their church who had experienced an acute episode of mental distress. The project was jointly led by a mental health nurse & an expert patchwork quilt maker. This collaboration capitalized on the skills within the small group, & combined them in such a way as to develop a unique avenue of support to the young woman quilt recipient. Church community members were enthusiastically engaged with the quilt making process because it offered them an opportunity to come together & learn more about mental illness while expressing their concern & care towards the young woman experiencing the episode of mental health distress. The quilt recipient was able to be engaged in the community without the adverse impacts of stigma or awkwardness. Together, this promoted acceptance in both directions and enhanced mental health recovery potential and shared community.

Goals.

1. Provide a safe recovery environment for the young woman & to prepare the church community as a safe, stigma-free & supportive place to assist recovery.
2. Convey care, comfort & support
3. Raise mental health awareness about mental ill-health amongst church community members.

Nursing Social Capital

Nurses promote health, well-being & recovery.

Nurses are health & well-being social capital in their professional & community roles.

An expression of health & well-being social capital occurs within a church community setting.

Nurses are health capital in rural churches for people with mental health problem 

Prevalence of mental health problems is higher in rural communities

Rural communities have fewer formal mental health services.

Project Implementation 

Two people, a mental health nurse & a quilt maker planned the project together.

•Fabric resources were donated by interested people, & the project participants were invited by word-of-mouth to group sewing sessions.•A snowballing of interest ensued as more people (including non-sewers) became involved.•At the first session, the mental health nurse led a short discussion about mental health awareness & a guided group conversation about the topic followed.•The quilt maker led a short workshop about the techniques that would be used to develop the quilt.•An eight-week time frame to complete the project was selected.•A theme was chosen which would resonate with the recipient & reconnect her to some personal successes she had achieved in the recent past, volunteering in Africa & Greece.

Post Project Survey Results

Ethics was obtained & an evaluation survey of project participants (n15) conducted using an anonymous online survey tool (survey monkey) to understand if the project had met its original goals.

Selected participant comments which reflect their experiences & aspirations about the project:

•a quilt is a physical reminder that she is loved & valued.

•It allows the recipient to not have to deal with many well meaning (but awkward) visitors. It is a visual & tactile reminder at the lowest of times (yet) offers physical comfort, & these are important aspects of the gift. The sense of unity that the quilt displays (many people working on it, but all put together) may also offer some comfort and remind the recipient of the power of community and their position within that, no matter her mental health.

•Inspiration to press on with her life dreams.

•Whenever she has & holds on to the quilt that she will not feel alone.

•Strong sense of working together. Sense that people were ‘doing something’ to contribute to a solution.

•The opportunity to express love by doing something tangible. Plus I like quilting!

•I wanted to help, but didn’t know how.

•How helpless I felt & how little I really know about mental health even though my own brother suicided many years ago.

•It is a medical condition no different to a broken bone-that it needs care & needs to repair with time.

•We all have down times – they are a part of life.

•That it is good to talk about it – not push it under the carpet like it doesn’t exist.

•The sense of the shared ‘journey’, the collective expression of love and care.

•A beautiful, beautiful idea 🙂 wonderful bonding…

Discussion. What was learnt about mental health and quilting:

Project members were able to come together in such a way as to generate a recovery environment & to promote a public conversation about mental health matters in a supportive environment. They were able to transfer their internal motivation of helping, towards active practical helping, & to participate in a public conversation about mental health. These aspects are very important in the reduction of stigma about mental health problems & to help in the development of resilience & recovery in community groups and amongst individuals.

The shared journey of learning about mental health, being prepared to talk about mental health, & of contributing to a quality activity together, helped group members in their personal spiritual & mental health development & awareness.

Initially there was a shared awkwardness about mental health but conversations about mental health issues became easier over time, setting the scene for a warm, welcoming recovery environment for the quilt recipient to return to. A group environment developed where members were sufficiently brave to step beyond their personal comfort zones & learn new skills, either about mental health conversation, or about quilting. Both were equally confronting for some members.

The quilt recipient was presented with the quilt in a usual church service & after the mental health nurse had assessed the emotional safety of doing so with the quilt recipient. The quilt recipient was extremely appreciative of this moment & it opened the conversation about mental health & recovery more widely amongst the broader church community who were then able to contribute to the overall safe, warm recovery space amongst people who cared for her.

Conclusion

A brief project was envisaged as a local response to a mental health crisis for a member of small rural church. The unique social capital within the church community was utilized to assist the recovery of one person following a mental health crisis, & to create a stronger public conversation about mental health issues thereby reducing stigma. The partnership of a mental health nurse & an expert quilter, & their leadership of a small group were key elements in developing the project.

The outcomes of the project have been extremely positive & have yielded a professionally constructed quilt as a tangible mental health recovery resource, & developed a stronger affinity for caring for people with mental health problems within a small group. The project had its origins as an act of kindness & compassion but, by utilizing the social capital strategically, developed into a positive experience for the quilt recipient, quilt group members, & the broader local church.

This project demonstrates how the quilt concept was developed, and what can be achieved by a small group of people who are prepared to harness their collective skills towards improving grass roots community mental health on a small scale.