Why I am committed to this project - a personal view

Address by Mrs Catherine Gonzi, Malta, spouse of the Prime Minister of Malta, at the second meeting of the project on user empowerment in mental health, June 2009

Good afternoon,

I must share with you that I find it painful to acknowledge and also shameful to accept that in the twenty first century, when the World has progressed so much, there are still many persons suffering from mental health problems; persons who still lack knowledge about their illness, are shy to seek professional help and who keep their ailments secretive. The main reason for this, I believe, is the stigma attached to mental illness.

For more than thirty years I have known the pain and suffering which persons with mental health problems, their families and carers go through. My family and I experienced my brother’s mental illness at a time when the medical model of mental health was still predominant in Malta. I remember vividly the confusion, worry, stress, misunderstandings, negative consequences, relapses and repeated hospitalizations.

Only after my siblings and I carried out an extensive search for information did we begin to understand. And even then, we had to draw considerable effort from within ourselves to counter the burden of the illness and of stigma. The fact that we were a numerous family, and educated, helped us to face the circumstances and cope, somehow.

As a result of this experience, I now appreciate that the most effective way of overcoming these obstacles is for the user and family themselves to speak up about what they are going through. Yet, at the same time, how can we expect them to speak out when they feel absolutely drained with the situation that is surrounding them? How can they be helped to come forward, and to exert their energy in combating exterior barriers?

The beauty and strength of society lie in its variety, in the participation of all it members. We should not, however, be content only with social inclusion- we need to take it a step further. People need the space to actively contribute towards all that is relevant to them; they need the structures to engage in a process of social development that reflects the social work principle – ‘starting where the client is’. The opening up of decision-making powers to interested parties, allowing them increased control over their lives, and decreasing the level of control that others have over them – I find the objectives of this project commendable. The overriding benefit of users’ active participation is the ripple effect – they themselves will then become the message – a strong counter argument to prejudice and stigma, in practice. Having been a carers’ representative on the Maltese National Mental Health Commission for a number of years in the early 90s I strongly appreciate the role.

It is a relief that in some countries stakeholders have already come together to provide necessary tools and structures within their communities empowering users and carers to come forward, and to make themselves heard. I am sure that we will hear these as examples of good practice…

Empowerment to participate in whatever is relevant to oneself is fine … but, I dare say, I hope we will even manage to make it better. Let us aim high, even if we have to tread one step at a time – our ultimate objective should user participation across the board.

At this point in time such an objective may sound remote – we are still struggling with having users participate in what is directly relevant to them as users. However, I am sure that empowerment itself will take us down the right path. Users who are supported to venture out to participate in mental health related aspects could find it easier to participate in other areas in society. Structures that allow users’ increased presence in wider circles will contribute towards the dissipation of misconception, greater acceptance and more freedom for them to function. While being realistic about the challenges that we face, let us be ambitious.

The context within which this project is underway is encouraging enough to allow us to be so. International and pan-European entities are often primarily concerned with economic issues, which we all agree are central to development. However, there cannot be development without health, and there is no health without mental health. This joint project between two leading institutions augurs well for placing mental health issues higher on their agendas and firmly including them in their lists of deliverables. The high profile that these institutions represent will certainly go a long way in encouraging individual countries to follow suit.

Finally, I come to the real reason why I am here today. As a result of my personal experience, and more recently as a result of listening to many people sharing the plight of mental illness, it is my wish, and I also consider it as my duty, to advocate within my community and beyond for the empowerment of individuals experiencing mental ill health and their significant others.

So, it is indeed an honour and a pleasure for me to join you at this working meeting. I am very glad to accept the invitation to endorse this international project focusing upon empowering all people with mental health problems, their families and other carers.

I wish you much fruitful collaboration. May you come up with a strategy that does justice to mental health service users and contributes towards the improvement of our society. I stand committed to give you my continued support.